Journalist | Phnom Penh, Cambodia
A father waits outside the commune health centre for HIV tests results with his daughter. // Alex Consiglio
A father waits outside the commune health centre for HIV tests results with his daughter. // Alex Consiglio

By Alex Consiglio and Khy Sovuthy
The Cambodia Daily

ROKA COMMUNE, Battambang province – While police on Thursday searched the home of the unlicensed doctor suspected of spreading HIV to more than 100 people here, Prime Minister Hun Sen, speaking in Phnom Penh, said he had serious doubts about the accuracy of the equipment used in multiple rounds of testing.

Since the Roka commune health center in Sangke district began preliminary testing for the virus on December 8, about 110 people have been found to be infected with HIV, including 19 children. Five more were found to be carrying the virus Thursday morning, according to the center’s director.

But speaking to some 1,000 students and government officials at a graduation ceremony at the National Institute of Education, Mr. Hun Sen said he was all but certain that the spate of positive HIV results was due to faulty testing equipment, rather than an actual outbreak of the virus.

“So far, I 99 percent do not believe that it’s AIDS,” Mr. Hun Sen said. “If out of 800 people, 106 are infected, that’s the end of us.”

“Probably, if we were tested using those machines, half of us would be infected by AIDS. I still don’t believe it. I don’t believe it.”

Mr. Hun Sen said all available “technological resources” must be exhausted before coming to any conclusions.

“Is an 80-year-old person infected with AIDS? And are young children infected with AIDS too? So, we don’t need to make a quick conclusion. We must use all available technological resources,” he said.

“We don’t mean that we look down on our doctors and equipment, but it’s extremely hard to believe.”

Of the 90 villagers who had tested positive at the commune center as of Tuesday, 89 again came up positive when tested a second time at the provincial referral hospital on Wednesday, according to Mean Chhi Vun, director of the Health Ministry’s National Center for HIV/AIDS, Dermatology and STD (NCHADS).

Mr. Chhi Vun said health officials would continue to conduct tests to ensure the accuracy of the initial rounds.

“We do not yet have the real figures,” he said. “Those who tested positive still need more tests.”

Mr. Chhi Vun said blood samples taken from people who tested positive were on Thursday sent to the Pasteur Institute in Phnom Penh for additional testing.

Asked whether the 16 people who tested positive on Wednesday at the commune health center again tested positive at the provincial hospital Thursday, Im Chetra, director of operational health in Sangke district, said that he had been told to stop talking to the media.

“The legal persons won’t allow me to tell you anymore,” he said, before hanging up his phone.

Despite Mr. Hun Sen’s doubts about the unprecedented outbreak of HIV in Roka commune—with those testing positive ranging in age from 4 to 80—UNAIDS country representative Marie-Odile Emond said Thursday that results of the tests conducted in the commune can be trusted.

“They are quite reliable,” she said. “There’s a small risk of a false positive. That’s why you do a second test. The second test is considered confirmed.”

An investigation into the outbreak has so far centered on Yem Chrin, an unlicensed doctor who regularly treated many of the commune’s villagers with injections and intravenous drips.

Mr. Chrin was detained for questioning by provincial police on Wednesday and remained in their custody as of Thursday evening.

Led by Tith Bunna, deputy director of the Interior Ministry’s forensics department, provincial police searched Mr. Chrin’s home Thursday for evidence.

Dozens of empty vials, which previously contained saline, glucose and vitamin B12 shots, littered the yard around the house. Police also collected at least 20 needle tips as they inspected the remnants of a recent trash fire behind the building.

“Everything collected here today will be taken for forensic analysis,” said James McCabe, director of operations for the Child Protection Unit, a police unit supported by the Cambodian Children’s Fund that has been aiding the investigation.

“The reality is this will be an exhaustive inquiry because we need to determine where the source came from,” he said.

Mr. Hun Sen also addressed the accusations against Mr. Chrin in his speech Thursday.

“It has been said that a doctor caused the transmission. So what is the way transmission happens now?” he said. “It means that [the doctor] carries AIDS. So he injects medicine in himself first before he injects others. It’s impossible. It’s highly unlikely.”

“But can we ask a clear question?” the prime minister added. “Are all 106 people showing symptoms [of HIV] treated by him or what?”

Mr. Chhi Vun, the NCHADS director, said Wednesday that the commune health center is preparing a survey to help determine the source of the virus.

NCHADS has now been joined by the World Health Organization, U.S. Centers for Disease Control and Prevention, UNAIDS and Unicef to “carry out a full epidemiological investigation to determine the source” of the outbreak, according to a joint press release issued Thursday.

Along with provincial governor Chan Sophal, Health Minister Mam Bunheng also made a brief visit to Roka commune Thursday morning, but villagers who were hoping for answers and medicine were left disappointed.

Mr. Bunheng quickly toured the commune health center, tussling children’s hair and squeezing babies’ cheeks, and then delivered a speech to about 300 villagers waiting nearby.

The minister assured villagers that a team would arrive in the commune soon to study the outbreak, and then advised them on winter safety.

“Please, all the old people, make sure to wear winter jackets,” he said. “And be careful when warming up by a fire because sometimes children can get burned.”

Mr. Bunheng then distributed socks and sarongs to villagers before briefly speaking with reporters.

“We will give the information clearly once they know [the outbreak’s cause],” he said.

“I’m finished talking,” he added. “I’m afraid if I talk too much, I will say something wrong.”

Villager Sam Lorm, 80, who tested positive at the health center on Wednesday, was unhappy with Mr. Bunheng’s visit.

“This morning, both the health minister and the governor did not seem focused on the people who got HIV,” he said. “They are not paying attention.”

Mr. Lorm said he and others affected by the outbreak are poor and were hoping for delivery of anti-retroviral drugs.

NCHADS’ Mr. Chhi Vun, who also visited the commune Thursday, said such medicines are guaranteed free of charge at district and provincial hospitals, but officials did not dare bring it to the commune.

“We could not,” he said. “It would be like candy.”