無國界醫生 Médecins Sans Frontières
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Cambodia: The story of a HIV patient, Ekar Nap

25 Feb 20074 Read Time

Ekar Nap – 40 year old
Her son Lai Dee – 12 year old

Ekar Nap, mother of five, comes from the district of Kirivong, Cambodia, 50 km away from MSF's clinic in Takeo. A volunteer for MSF since April 2001, she has been working as a Patient Support Person. She receives mothers at the paediatric ward, helps taking HIV positive children's weight and size, and all the needed parameters.

She realised she was HIV positive in March 2004 when she got a blood test at a local NGO.

At the time I was really sick, I had become very thin and I had rashes all over my body. My skin was very itchy and my parents took me to have a blood test. I suspected I was HIV positive for a long time but I had never done the test because I was scared, and I knew I would be very depressed.

My husband used to go out every night and I knew he was seeing other people. I had many doubts about his status and I kept asking him to do a test but he didn't want to do it. He had genital warts and gonorrhoea, and I asked him to wear condoms with me, but he said he that he was being careful when he "went out" and condoms were for sex workers. We were married and he wouldn't wear a condom with me, he told me to stop asking him; there was nothing I could do.

In 2000, my husband became really sick. I kept asking the doctor if he had AIDS but the doctor said he had typhoid fever and enteritis, but it wasn't AIDS. I sold all our rice paddies and land to pay for his treatment. I strongly suspected he had AIDS and I felt that one of my children may have been infected too because he was more fragile than my other children and was born with blisters on his head. But the doctor just wouldn't say. My husband died and never told me anything until the end. In retrospect, I think he may have paid the doctor to keep his secret because there was still a lot of stigma with AIDS at the time.

I went to live with my parents who were farmers, and took care of the children and worked in the fields. I had become very poor. When my husband died my 15-year-old child felt like he had lost everything. He was really upset and he dropped out of school and went to Sihanouk to find a job and help support the family and me.

It took me 4 years after his death to do the test because I was so scared. In 2004, I became very sick. The HIV test was positive and the result gave me such a shock. I took my son with me to be tested and he was also positive. I cried so much and I felt so angry with my husband. A week later I took all of my children to be tested as well. I felt so desperate. I have only one daughter whom I love very much. I thought if she too was positive, I would kill myself. I really wanted to commit suicide. But she turned out to be HIV negative. I thought of my children and that gave me the strength to carry on.

Some people around me discriminated against me including from within my family. Some of my brothers and sisters would refuse to eat with me. When I would go to the Pagodas people were avoiding me. But my parents were supportive and they helped me financially. They sold rice, and many chickens and pigs to help me pay for the treatment of my opportunistic infections. I spent 10,000 riels for it through a local NGO and then I was referred to MSF. I would never have had the money to pay for my treatment, especially for ARVs. At that point I weighed 20 kg and my CD4 count was 47. I felt so suicidal and awful, but my son wasn't sick yet. MSF put my son and me on ARVs and I started feeling better. I gained 10 kg, that's when he started getting sick. He had fever, skin rashes, and missed school a lot.

Now he's much better. The discrimination is not that bad for him anymore. At school at the beginning the children suspected he was HIV positive and they didn't want to play with him. One day the teacher pulled his ear in the classroom asking why he was not attending properly, so I went to see him and told him the truth. His attitude was positive, and gave my son after school class for free sometimes to catch up.

I'm very worried for him, but he is a clever child. When he gets down I try to encourage him to study. He understands about his disease. I hope he can continue his education and get a job. We're not rich and AIDS can't be cured. This disease is fierce but I continue to take care of my children and we support each other.

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