柬埔寨"艾滋村"的憤怒與悲傷

ROKA, Cambodia — Frail and depressed after her diagnosis, Chem Mao decided to take her life by climbing a mango tree in her backyard, fastening one end of a rope around a sturdy branch and the other around her neck, and jumping. As she shuffled weakly beside her cinder-block house toward her family’s small orchard she saw her grandchildren playing nearby and relented, collapsing into tears.

柬埔寨羅卡——在獲得診斷結果之後，姜茂(Chem Mao)身體虛弱，心灰意冷，決定在自家後院的芒果樹上自殺。她打算把繩子的一端系在一根牢固的樹叉上，另一端繞在自己脖子上，然後縱身跳下。姜茂拖着虛弱的身子，經過自家的煤渣磚房，前往後院的小果園。看到孫輩在附近玩耍，她心軟了，不禁哭了起來。

“I didn’t have enough strength to get up the tree,” she said. “Maybe I’ll try again another time.”

“我沒有那麼大的力氣爬上樹，”她說。“也許我改天會再試一次。”

Ms. Mao, 55, is among more than 200 villagers in this rice farming community in western Cambodia who tested positive for H.I.V. last month. The Cambodian authorities say that an unlicensed doctor who reused syringes and other medical equipment spread the infection.

在柬埔寨西部的這片稻米種植區，有200多名村民在上個月的艾滋病毒(HIV)檢測中結果呈陽性，55歲的姜茂就是其中之一。柬埔寨當局表示，這是一名無照醫生重複使用注射器等醫療器械所致。

Even in a country inured to hardship and suffering, the infection of such a large number of people within a radius of a few miles was shocking.

不過，在幾英里半徑的範圍內，就有如此多的人感染HIV，即便是在柬埔寨這樣多災多難的國家，也相當令人震驚。

The victims are everywhere — in the wooden stilt houses, in the paddies harvesting rice, in the gilded Buddhist temple at the entrance to the village, and in the playground of the yellow ocher primary school. The 82-year-old abbot of the temple was infected, as were 12 children who attend the primary school.

到處都是受害者——在木棚屋裏，在收割稻穀的田地裏，在村口鍍金的佛教寺廟裏，在小學的黃土操場上。廟裏82歲的老住持感染了，小學裏的12個孩子也未能倖免。

Grief seems to reach a crescendo in Roka as a visitor walks down the main dirt road: Five minutes from the temple is a cluster of houses where 16 members of an extended family were infected.

在羅卡，當你走在主幹道的土路上時，悲傷的感覺會步步加深：從寺廟走過五分鐘，你會看到一片房子，居住在那裏的一個大家族有16名成員感染了HIV。

What the victims appear to have in common is that they were treated by Yem Chrin, a village medical practitioner who was charged last month with aggravated murder, intentionally spreading H.I.V. and practicing without a medical license. He is in prison while awaiting trial in the nearby city of Battambang.

受害者似乎有一個共同點，那就是他們都接受過嚴漆(YEM Chrin)的治療。嚴漆是一名鄉村醫生，上個月被控重度謀殺、故意傳播HIV，以及無照行醫。目前他被關押在附近城市馬德望的看守所中，等待審判。

The provincial prosecutor, Nuon San, said in an interview that a number of people in the area had died from H.I.V. in the past and that the authorities were investigating whether Mr. Chrin may have been responsible. Officials quoted in the Cambodian news media said Mr. Chrin had admitted reusing needles and syringes.

該省檢察長農桑(Nuon San)在採訪中表示，這一地區之前已有一些人死於艾滋病，當局正在調查嚴漆是否應對此負有責任。柬埔寨新聞媒體援引官員的話報道，嚴漆承認自己重複使用針頭和注射器。

For two decades, Mr. Chrin made house calls to sick villagers here, one of seven unlicensed doctors in the community, officials said. He trained and practiced as a nurse in a refugee camp during the convulsive years after the fall of the Khmer Rouge in 1979, according to his daughter, Chrin Reaksa.

官員們稱，在過去二十年裏，嚴漆爲這裏的村民上門看病，是該地區七名無照醫生之一。根據他的女兒漆叻沙(Chrin Reaksa)的描述，紅色高棉政權1979年倒臺後的那些動盪年頭中，他在一所難民營接受了護理培訓，並在那裏服務。

When he moved to Roka, “more and more people asked him for help, so he started his medical practice,” Ms. Reaksa said in an interview. “The government never expressed any concerns about a license.”

搬到羅卡後，“越來越多的人向他求助，於是他開始獨立行醫，”漆叻沙在接受採訪時說。“政府從來沒有提出過行醫執照方面存在任何問題。”

Many villagers, even those infected, staunchly defend Mr. Chrin, describing him as a kind man who treated even those who could not pay.

很多村民，甚至包括感染上HIV的一些人，也在很堅定地爲嚴漆辯護。他們說他很善良，就連那些沒錢付費的人也會診治。

“Honestly I don’t think the doctor caused this,” said Chhay Yao, 76, the matriarch of the family in which 16 people were infected. “He was so clean. And he’s not a bad person. If we had money we gave it to him. If not he would always say, pay me later.”

“老實說，我覺得這不是醫生造成的，”76歲的蔡堯(Chhay Yao)說。她是16人被感染的那家人的女族長。“他非常講衛生，不是壞人。如果我們有錢，就給他。如果沒有，他總是說以後再給。”

He made house calls, and was happy to oblige villagers who preferred a drip or injection instead of pills.

他上門給村民看病。有些村民更願意打點滴或者進行肌肉注射，而不是吃藥，他也很樂意滿足他們的要求。

The villagers’ affection for the doctor does not blunt their pain and bewilderment over the mass infection. Prum Em, Ms. Yao’s 84-year-old husband, stares with blank incomprehension when asked about the infections, which struck across three generations.

村民對嚴漆的喜愛並沒有緩解這次集體感染帶給他們的痛苦和困惑。當被問及感染的事情時，蔡堯84歲的丈夫布隆恩(Prum Em)眼神空洞而不解。他家三代人中都有成員感染上HIV。

“I have done only good deeds my whole life,” he said. “It’s inconceivable that the family could have this much bad luck.”

“我平生只做善事，”他說。“這個家的運氣這麼差，真是不可思議。”

Family members say they are treated with suspicion when they travel outside the village, including one mother who was instructed to wash her hands with antibacterial gel when the clerks in a shop learned she was from Roka.

家裏人說，他們到村子外面走動的時候，別人會用懷疑的態度對待他們。比如，當商店店員得知一名婦女來自羅卡村的時候，就要求她用抗菌液洗手。

“People from other villages are not welcoming us anymore,” said Em Soeum, a member of the family. “They discriminate against everyone from the village, including H.I.V.-negative people.”

“其他村子的人不再歡迎我們了，”來自這個家族的恩順(EM Soeum)說。“他們歧視我們村的所有人，沒有HIV的人也不例外。”

The mass infection in Roka comes just as Cambodia has received accolades for its handling of H.I.V. In early December, around the time the infections were discovered, the United Nations praised Cambodia for reducing the number of new H.I.V. infections by 67 percent since 2005. Cambodia has an H.I.V. prevalence rate of around 0.7 percent, a third lower than that of neighboring Thailand, according to United Nations statistics.

羅卡的集體感染事件爆發的時候，正逢柬埔寨因爲應對HIV有方獲得讚譽之際。去年12月初，聯合國還讚揚了柬埔寨，因爲該國新的HIV感染人數比2005年減少了67%。羅卡的感染差不多就是那個時候被發現的。聯合國的統計數據顯示，柬埔寨的HIV感染率大約爲0.7%，比鄰國泰國低三分之一。

Roka is about five kilometers, or about three miles, from the nearest paved road and a 15-minute drive from Battambang, a hub of commerce in western Cambodia.

羅卡離最近的公路約5公里，距柬埔寨西部商業中心馬德望15分鐘車程。

Soeun Sophath, the deputy head of the government health clinic in the village, which is staffed with nurses, said the first sign that something was wrong here came in August, when a routine H.I.V. screening of a pregnant woman came back positive. It was the first positive result in the village since the screening program began two years ago, and health workers could not find an explanation for the infection. When another pregnant woman tested positive in November as well as an elderly man and his daughter-in-law, villagers panicked and stormed the health center to be tested. Dozens tested positive.

森索潘(Soeun Sophath)是羅卡村公辦衛生所的副主任，這個診所中配有護士。森索潘表示，情況不妙的第一個跡象出現在去年8月。當時，他們做常規的孕婦HIV篩查，發現有一例結果呈陽性。自從兩年前開始篩查以來，這是該村的首例陽性結果，醫護人員卻找不到感染的原因。11月時，又一名孕婦HIV檢測呈陽性，一個老人和他的兒媳婦也是如此，這下村民們慌了，紛紛趕到這家醫療中心進行檢測。結果數十人呈陽性。

“They were crying and crawling on the ground and hugging each other,” Ms. Sophath said. “I was crying, too. I was shocked.”

“他們哭着，在地上爬着，擁抱彼此，”森索潘說。“我也哭了。我很震驚。”

Prime Minister Hun Sen initially expressed disbelief that the tests were correct. “Right now, 99 percent, I don’t believe it’s AIDS,” he was quoted as saying in the Cambodian news media.

首相洪森(Hun Sen)最初表示不敢相信測試結果是正確的。“眼下，我99%不相信是艾滋病，”柬埔寨新聞媒體援引他的話報道。

A few days later, as the police and medical investigation and treatment teams sent from Phnom Penh blanketed the community, a court in Battambang charged Mr. Chrin.

然而幾天後，金邊派出的警察和醫療調查處理人員遍及整座村莊，馬德望的一家法院也對嚴漆提起了指控。

Not everyone in the village is forgiving of Mr. Chrin. Ms. Mao bursts into a tearful rage when asked about him.

村裏並不是每個人都原諒了嚴漆。當問到他時，姜茂氣得直掉眼淚。

“I want to chop him to pieces. I want to torture him,” she said. “I want to inject my blood into his family members so they know what it feels like.”

“我想把他砍成碎片。我想狠狠地折磨他，”她說。“我想把自己的血注射到他的家人身上，讓他們嚐嚐這是什麼滋味。”

Described by her neighbors as one of the most talented farmers in the village, Ms. Mao has been too weak to work lately. Her cucumber plants, neatly arrayed in rows, are dead. The bitter melons that she planted a few steps from her house have withered on the vine. A row of cornstalks are yellowed and stunted.

姜茂的鄰居說她做農活非常能幹，在村裏數一數二。但她最近身體變得太虛弱。她種的黃瓜苗整齊地排列成一行行，現在卻都死了。她種的苦瓜就在距離自家房子幾步之遙的地方，已經在藤蔓上枯萎。一排玉米也是莖葉泛黃，發育不良。

Ms. Mao said the H.I.V. medication, which she began taking this month, made her feel nauseated and weak.

姜茂說，這個月開始使用的HIV治療藥物讓她感到噁心乏力。

“I’ve always been able to take care of myself,” she said. “No one has ever helped me and I don’t want anyone’s help. I just want to be able to work again.”

“我一向都可以照顧好自己，”她說。“從來不需要人來幫我，我也不想要任何人的幫助。我只是希望能夠重新干農活。”