Cambodia: Giving Reproductive Health a Place in the Dharma

The revitalization of Buddhism in Cambodia provides multiple opportunities to support reproductive health and rights, including HIV prevention, in impoverished communities still struggling with the traumas of the recent past. This case study, along with that of Malawi, explores potential areas of action that could be undertaken by UNFPA and its partners through work with religious and traditional leaders.

After decades of war, Cambodia today is in the process of healing and spiritual renewal. Part of this involves the re-birth of Buddhism, which still constitutes an important aspect of daily life for the vast majority of the population.

This social transformation presents valuable opportunities to promote reproductive health and rights, including the prevention of HIV/AIDS. The epidemic has already assumed alarming proportions in the country. Buddhist nuns and monks, who are an integral part of Cambodian society, are contributing to efforts to defeat it. And they have the potential to become even more powerful allies, especially in reaching young women, who are too often the victims of sexual violence and trafficking.

Buddhist culture thrives in all of Cambodia's provinces. Traditionally, each village had a spiritual center—a wat, or temple—where as few as five and as many as 70 monks reside. Around the country today are more than 4,000 wats, some spreading over many hectares, with temples, living quarters and dozens of stupas, or conical memorials that hold the cremated ashes of generations. Almost 54,000 monks live in the wats, practising Buddhist teachings. About 80 per cent of them join the monkhood temporarily, for the shelter, protection and education—both Buddhist and vocational—that the wats provide.

The government-supported Buddhist training and education system is, in fact, an important entry point for UNFPA and its partners. Incorporating issues such as population and development, gender equity and equality, reproductive health and rights and HIV prevention in a new curricula could go a long way in ensuring that these messages reach the general population—especially the four out of five people who live in rural areas.

Monks and nuns occupy a high moral ground in Cambodia and their influence is pervasive. They have also taken an active part in the construction of medical centres and other social services in the community. The Supreme Patriarchs of the two Buddhist monastic orders have highlighted the importance of HIV/AIDS prevention in their sermons since the early 1990s and have exhorted their followers to lend assistance to communities fighting the epidemic.

A number of UN-supported efforts are bolstering the community response to HIV/AIDS and giving positive direction to other Buddhist countries in the region. For example, in collaboration with the European Union, UNFPA is coordinating an initiative that is targeting adolescents in Cambodia and HIV/AIDS, along with other issues related to reproductive health.

In the wake of a devastating war, the social structure of Cambodian society crumbled, leaving adolescents impoverished and vulnerable with little social support. There are, for instance, no real youth groups, aside from a few political organizations. Furthermore, the level of awareness regarding HIV/AIDS portends dire consequences. In a recent survey, 80 per cent of the Cambodian young people who responded believed that they could not contract HIV. The HIV prevalence rate for males and females aged 15-24 is 0.99 per cent and 2.50 per cent, respectively. Yet few of the ongoing programmes in reproductive health focus on the specific needs of adolescents.

The joint programme, funded by the European Commission and UNFPA, works with two international NGOs and their local counterparts to train nuns and monks to deal effectively with young people on the topic of HIV/AIDS; to launch HIV prevention campaigns through education in and outside the monastery; and to provide care and support for people living with HIV or AIDS and to youngsters who have been orphaned by the disease. The initiative is also helping to reduce the stigma associated with HIV/AIDS by emphasizing a compassionate Buddhist response.

WHAT COULD WORK

• Providing increased support to Buddhist nuns and monks could enhance the service role they increasingly seek in their communities, especially in the areas of public education and social development.

• Gender perspectives could be effectively integrated into Buddhist teachings, such as the Five Precepts (which urge all Cambodian Buddhists to be faithful to their husbands and wives and to refrain from sexual harassment, telling lies and cheating, drugs and alcohol, gambling and stealing). Additionally, by emphasizing the merits earned through non-violence, nuns and monks could play a role in preventing gender-based violence.

• Buddhist nuns could be involved in efforts to reach out to adolescent girls and women on issues related to reproductive health, trafficking, the commercial sex trade and HIV/AIDS. The role of nuns in the Buddhist sangha (monastic order) could also be strengthened.