A court in Cambodia on Thursday sentenced an unlicensed medical practitioner to 25 years in prison after finding him responsible for causing a mass HIV infection in a village in Battambang province by reusing unsterilized syringes.
The Battambang Provincial Court found Yem Chhrem, 56, guilty of cruel behavior causing death, intentionally spreading HIV, and practicing medicine without a license while treating patients in Sangke district’s Roka commune between 1996 and 2014.
More than 270 villagers in Roka ranging in age from 3 to 82 have tested positive for HIV—the virus that causes AIDS—since late November 2014, and at least 11 Roka villagers are now believed to have died from the disease. In one extended family of 50 people, 16 were infected.
Yem Chhrem had faced life imprisonment for murder, but his charge was downgraded ahead of his five-day trial in October. He has maintained his innocence, saying the infections were not intentional and that he routinely sterilized syringes while treating patients.
In addition to the 25 years in prison, the court also ordered him to pay 2-12 million riel (U.S. $495-2,965) in compensation to each person affected by the outbreak, as well as 5 million riel (U.S. $1,235) to the state. He was barred for life from practicing medicine again.
After the verdict was announced, Yem Chhrem’s relatives vowed to appeal his sentence, speaking to reporters in front of the court building.
His wife Yorm Chenda called the punishment “too severe” and “unacceptable,” and said she would fight to get the court to reduce her husband’s sentence.
“My husband was not guilty of a crime so serious as to justify the court sentencing him to 25 years imprisonment,” she said.
Yem Chhrem’s lawyer, Em Sovann, said he found the final verdict “reasonable and acceptable,” but did not rule out the possibility of an appeal.
“I view this case as a success, but if my client wants to appeal, it is possible it will be continued,” he said.
Many Roka residents who were infected with HIV expressed frustration over the sentence, saying Yem Chhrem should have been imprisoned for life because their own futures had been cut short by the virus.
“I was infected with HIV and I am in much more distress than the doctor, so I am unable to forgive him,” said one victim, who spoke to RFA’s Khmer Service on condition of anonymity, fearing discrimination associated with HIV infection.
Following his arrest last December, Yem Chhrem was taken into protective custody, with authorities fearing he might be lynched by residents of Roka.
Leng Monineath, a doctor with local rights group Licadho who was present at Thursday’s sentencing, told RFA that authorities must investigate further to determine if other unlicensed medical practitioners in addition to Yem Chhrem were to blame for the HIV outbreak in Roka.
“Considering the size of the commune, I don’t believe that there weren’t any other clinics nearby that had treated [some of] those victims in Roka,” he said.
“I want relevant officials to look into the case more properly and more transparently to find justice for society and the nation.”
Lack of practitioners
In February, authorities in Battambang ordered nine unlicensed doctors to shut down their practices in the province, including six in Roka commune.
A month later, the Ministry of Health reinforced a ban on unlicensed health workers and clinics—which are commonly used in rural communities with poor access to the state’s healthcare system—and urged local authorities to implement it.
However, some villagers in remote areas of the country complain that obtaining medical treatment has become extremely difficult since the ban was reinforced in March, and nearly impossible if they encounter an emergency in the middle of the night.
According to the Ministry of Health, 5,757 private clinics became licensed in Cambodia between 2009 and 2014, and the ministry is working to approve additional facilities. It said that almost 4,000 illegal health-service providers were still operating in August.
Cambodia’s dearth of licensed medical practitioners stems from the bloody 1975-79 era of the Khmer Rouge regime, when physicians, lawyers, teachers, engineers, scientists and professional people in any field were murdered, together with their extended families.
According to the World Bank, in 2012 Cambodia had a mere 0.2 physicians for every 1,000 people, or nearly 3,000 in a nation with a population of just under 15 million at the time.
Cambodia had one of the most serious HIV epidemics in Asia during the mid-1990s, but has made significant strides against infection in recent years through an aggressive campaign to promote safe sex, according to UNAIDS.
New infections dropped by 67 percent, from 3,900 in 2005 to 1,300 in 2013, while more than two-thirds of the 75,000 people living with HIV are accessing antiretroviral therapy—the highest percentage of treatment access in the region, the U.N. agency said.
Reported by Hum Hour for RFA’s Khmer Service. Translated by Pagnawath Khun. Written in English by Joshua Lipes.