Meet Rithy: Grandmother and Outreach Worker at the Heart of Cambodia’s HIV Response

By The Global Fund

November 27^th, 2023

Ly Rithy is at home in the cheerful company of her granddaughters, 7-year-old Tiya and 12-year-old Srey Pin. Nestled away from the high-energy hum of the main avenues of the Toul Sangke neighborhood in Phnom Penh, Cambodia, Rithy’s home is found at the close of a quiet lane.

Rithy laughs easily alongside her granddaughters as she hangs up clean laundry on a line, her dark red hair smoothed back into a ponytail.

Tiya runs by in a flurry of giggles. Rithy smiles as Srey Pin rolls by on her bicycle.“I tell my granddaughters, that if they like to help people, to support their community, they can do the same work that I do,” she says.

Meet Rithy: Grandmother and Outreach Worker at the Heart of Cambodia’s HIV Response

Rithy is on a mission to end HIV in Cambodia. At 55, she has been supporting female sex workers access HIV prevention, treatment and care for over 20 years.

Five days a week, she distributes condoms, conducts dual HIV/syphilis rapid tests, provides information on HIV prevention, including on pre-exposure prophylaxis (PrEP), and brings women to clinics for further treatment and follow-up. For Rithy, her work to support female sex workers runs deep.

Her eyes darken as she recounts how, in 1997, she was trafficked into the sex trade. Lured from her home in Kampong Cham Province to Phnom Penh with promises of work, she was forced to service male clients with little to no pay. If she refused to work, she would face violence and other abuse.

“I do not want other young women to be put on sale like I was,” says Rithy.

In the early 1990s, decades of conflict came to an end in Cambodia. As industry began to grow so did sex work and human trafficking – often involving women and girls with few options to support themselves or their families.

Women who sell sex are often marginalized, face barriers in accessing healthcare and are particularly vulnerable to HIV.

Rithy experienced first-hand what it was like for female sex workers in the mid-1990s, when HIV infections were soaring.

“My first objective and purpose at the time was to encourage those girls to take HIV tests,” she says. “I wanted to prevent them from dying, from passing away and leaving their children behind.”

She has also witnessed and has been part of the huge steps forward in ensuring sex workers have access to health services today.

At the height of the HIV epidemic in Cambodia, HIV prevalence among female sex workers was close to 40%. Two decades later, UNAIDS estimates that figure has fallen to 4.9%.

At the heart of Cambodia’s progress is close and thoughtful collaboration between three players: the government, health service providers and civil society, including communities most affected by the disease.

“It’s been called ‘the triangle that moves the mountain,’” says Dr. Tia Phalla, Vice Chair of the National AIDS Authority. This unified group is in constant dialogue, working and leading together on a shared platform of trust and commitment. Each player listens to the other, with all involved having a voice and a spot at the table.

In 2022, Global Fund-supported HIV prevention programs reached close to 39,000 female sex workers in Cambodia.

Rithy begins her workday at a park near Wat Phnom, a temple that stands on the only hill in Phnom Penh. The park is a known spot for sex workers. Women call out warmly to Rithy – she knows over 500 sex workers in the community by name.

Rithy’s outreach goes far beyond offering practical tools to prevent HIV infection. She aims to build trust with everyone she meets, so that they know that they can come to her and Cambodian Women for Peace and Development, the organization through which she does her outreach work, if they need help.

This community-led approach achieves significant results: In 2022, antiretroviral therapy coverage among sex workers living with HIV was almost 83% – a stand-out among other countries in the region.

Later in the evening, Rithy joins a cohort of other outreach workers and field staff at Street 136, a vibrant and dizzying area filled with karaoke bars and other entertainment venues where sex workers conduct business. Rithy routinely gives out her personal phone number to the women she meets.

A mobile van idles discreetly near one of the bars. Rithy’s colleagues explain that the van can accommodate two people at a time, with a curtain neatly dividing the space in two. Inside the van, women can collect condoms and HIV self-tests, they can be tested for HIV and syphilis and get information – in-person, but also via Telegram and Facebook – about prevention of HIV and other sexually transmitted infections, family planning and PrEP.

The atmosphere is relaxed as Rithy and a few of her colleagues walk beyond the vicinity of the van to approach women sitting outside the different entertainment venues. They come to the area every month, so their presence is a friendly and well-known fixture in this buzzing environment.

The evening’s work concludes with the onset of sudden and bracing rainstorm, the water falling quick and fast over the city.

It’s time for Rithy to go back home. With her serenity and strength, she embodies someone who – as they say in Cambodia – works from the heart.

Footnotes

Written by Margo Mombrinie. Photos by Maika Elan (VII Photo). With many thanks to the National Centre for HIV/AIDS Dermatology and STD Control, the National AIDS Authority, KHANA, Cambodian Women for Peace and Development, Chhouk Sar Clinic, Toul Kork Health Center and Men’s Health Cambodia.