Transcript High Risk Young Population

Advance Research Team
Kem Ley
Nhim Dalen
Boray Boralin
Umakant Singh
Definition and Type
Type of High Risk Young Population
1)
Workers
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2)
Entertainment Workers
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3)
4)
Migrant Workers
Factory Workers
Construction Workers
Restaurant workers
Domestic Workers
Sex Workers , Beer Promoters, Karaoke Girls
Men Who Have Sex With Men-MSM
Drug Users and Injection Drug Users-DU/IDU
Youth in hotspots
Others young population with unemployment
Country Context
General Population
13,395,682
Elderly
0ver 64
Adult Population
50-64-non
reproductive age
Adult Population
15-49Reproductive Age
Young Population
10-24-UN Definition
Children under 18-
UN Definition
General young population aged
between 10-24 is 35% or 4.7 millions or
youngest population in Southeast Asia
General children under 18 is 41% or
5.5 millions but OVC is 14% or
750,000
Statistics of High Risk young Population
High Risk Young Population
Female Entertainment Workers
(NCAHDS 2009, UNAIDS Country Profile)
34,193 (26,000 are Beer &
Karaoke Girls)
Men who have sex with men (MSM)
21,327 in 10 provinces
(FHI and KHANA) 2009
Drug Users(DU &IDU)-NCHADS 2007
15,000 (IDU 2000)
Garment Factory Workers of 262, MoC, 2010
319,383 (1.5 # per day)
Cambodian seasonal construction workers
40,000 (2.5$ per day)
Agence France Press 2009
Migrant Workers Thailand , CDRI 2009
180,000,
(Human Rights Watch report) Malaysia Up to 50,000 women
migrated to Malaysia
Around 1,687 workers travelled to South Korea in
2009, compared with 2,531 in 2008
Youth in Hotspots
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71% of female and 90% of male respondents report
drinking alcohol
3.5% of female and 15.2% of male respondents reported
ever using illicit drug (Yama, Yaba, Metham, Amphetha..)
Over 41% of male and 23% of female study participants
reported being sexually active. Or 83% of those male
paying sex with women in the past year.)
Sweethearts relationship (56% F, 66% M). Moreover,
condom use was alarmingly low (31% F, 58% M)
STI Symptoms (43% F, 30% M) did not seek STI treatment
12% of F participants who have had sex reported that they
become pregnant, among which 33% experienced induced
abortion.
Entertainment Workers
 Criminalization of vulnerable population
 Contradicting of Anti-human Trafficking and sexual exploitation Law,
Drug Control Law, Community Safety Policy
 Public health consequence and human rights violation
 High discrimination and stigmatization against entertainment workers
 All most all interventions are failed to reach entertainment
workers
 There is no DATA BASE SYSTEM to monitor the status of
entertainment workers and levels of enforcement of legal
frameworks application
 Building enabling environment for NGOs, Associations and
Unions for providing and supporting heath , social and legal
services to entertainment workers
Entertainment Workers-FEW
 NCHADS 2009, MoH, 34,193 women working as EW (45.1%
were aged between 20-24), 10% younger (15-19).
 Law on Antihuman trafficking and sexual exploitation enacted
in Feb 2008 leading the failed application of social issues
pogram and CU100% or CU 100% Policy/Prakas 066 or
brothel closure.
 BBEW decreased from 6,000 to 1,775 in 2009 VS NBB-EW
increased from 26,000 to 32418
 BSS, NCHADS, MoH , In both BB and NBB EW consistent
condom use with non paying sweethearts was much lower 52%
and 54% respectively.
 30% abortion in the last one year (PSI TRAC SURVEY)
 Most of them are drug users
Entertainment Workers-IDU/DUs
 NCHADS, MoH, 13,000, DU, 2, 000, IDU
 Majority of drug users are young population 80% are under
25 years old of age and 17% under 18 years.
 Mapping of over 3,000 street children found that 42% used
drug, with 14% reporting injection drugs.
 35% of IDUs reporting sharing of needles and syringes at last
injection.
 More than half (53.3%) of IDU reported having sex after
using drugs in the past year.
 Criminalization of drug users (Drug Control Law)
 Lack of support for voluntary treatment and harm reduction
 Lack of enabling environment for implementers
 24.4% of IDU infected with HIV
Entertainment Workers-MSM
 KHANA and FHI, 2009, 21,327 in selected 10 provinces. But
number may underestimated
 Many MSM have sex with female partners
 2/3 (66%) of MSM excluded transgender reported having
sex with female partners in the past year.
 High discrimination against MSM (Stigma Index Study 2011
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Self-Stigma
Family
Community
Society
 Majority of MSM have no formal job-unemployment rate is
high
Entertainment Workers
Entertainment Workers
Entertainment Workers
Entertainment Workers
Entertainment Workers
Entertainment Workers
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Source: •
40000
35000
30000
25000
NBBEW
20000
31,191
15000
10000
5000
5,309
BBEW
•
13,723
6002
3,430
3,002
In 2007
In 2009
0
In 1997
NCHADS
2009
Sexual behavior w/SH
-17% currently have
more than one SH
-Avg. 1.5 SH per year
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Sexual behavior w/client
-52% SH was formerly a
client
-Avg. 2.15 client per week
-Avg. 22 sex acts with
-Avg. 3.4 sex acts with
client per month
SH per month
Large Number of Concurrent Sweetheart Relationships,
TRaC Survey, PSI 2009
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34, 193 EWs ( NCHADS)
14.7%, EW HIV Prevalence
18% of DFSW reported
unprotected sex with sweetheart
in the past month
31% of DFSW had an abortion
in the past 12 months
53% of DFSW reported STI
symptoms in the past year
% of IDFSW reported
unprotected sex with sweetheart
in the past 3 months( 24% of
BG s, 20% BP and 19% KK)
%of IDFSW had an abortion in
the past 12 months (17% BG,
30% BP, 25% KK)
Entertainment workers
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Source: CACHA, WNU , UNAIDS Action Research 2009
469 sex workers
were detained in
Phnom Penh in 2009,
up from 415 in 2008.
Nut Nang, MoSAVY,
said-Phnom Penh Post,
Jan 22, 2010. Many
factories were closed
and factory workers
lost their jobs, and
most of them did not
go back to their
hometown but instead
turned to EE to earn
money for their
families.
Increased STI rate among BB-EWs-NBB-EW
STI Rate among DSW and NBSW
81% 83% 80%
52%
34% 30%
38%
59%
53%
45%
33%
DSW
BMC 2008
BMC 2009
Source: Interpretation of Prakas 66,
PSI/UNAIDS, FHI, CBCA AND NAA
89%
NBSW
SRP 2008
SRP 2009
SHV 2008
SHV 2009
Data Management, PAO in BMC, SRP and SHV,
HIV prevalence rate among DSWs in 2006 and 2009
45.00%
41.05%
37.88%
40.00%
35.00%
30.70%
26.70%
30.00%
25.00%
20.40%
20.00%
15.00%
10.00%
5.00%
0.00%
DSW BMC ( Ssp, MBR, O3C)
DSW in Siem Reap Town
HSS 2006 PAO 2009
DSW in Sihanoukville
Situation of entertainment workers
Before 2008
Fear Police when carrying
condom
Connecting with EW
representative
2008-2009
Average income per month
10
9
8
7
6
5
4
3
2
1
0
Monthly Payment to police and
local authority
Arrest and detain owners and
EW
Future
Average expenditure per month
Participate on HIV education
session
Access to quality health services
Trust on HCP’s performance
Comparison the current situation and the past as well as future expectation
( 10 is the top and 1 is the lowest one)
Cambodian Workers
 Poor Data Base System to monitor the enforcement of
labor law and other legal frameworks
 There is no oversight committee and oversight plan
 There is no minimum wage policy-Very low wage for
garment factory workers, domestic workers and hotel
and restaurant workers
 Limited enforcement of Cambodia Labor Law
 Poor recruitment and training for workers
 Tremendous Labor Exploitation and violation
 Human Trafficking and Sexual Abuse are associated
 Corruption is common in Cambodia
Cambodian Workers-Factory Workers
Low Wage 61 US$
Violation of labor Law and poor
implantation of Labor Law
Poor Living Condition
Labor Exploitation
Very Low nutrition
Poor Hygiene and Sanitation
Overcrowded
Poor Medical Care and Education
Collapse
GDP per capita is 830 US$
(Draft of National Budget law
2012)
Minimum Wage should be 70
US$ in minimum with full
package of social protection
such as annual leave, sick
Leave, retired fund, bonus,
health insurance, accident
insurance, maternity leave, 3
dependents, temporary house
etc.
• Move from Factory Workers to
entertainment workers with high Risk
Situation-Trafficking, Sexual Abuse…
• Malnutrition population
• Risk in pregnancy- Mal-nutritional
Child
Cambodian Workers-Migrant Workers
There is oversight committee-DPs-CSOs-GOs and VGs
Labor Exploitation
Poor Management
Poor Training
Market Adaption
Professional Trainers
Letter of Agreement-Memorandum of Understanding
Poor Data Base System
Limited Law Enforcement
Poor Investigation and Emergency Response System
Lack of Participation from
CSO and Migrant Workers
Lack of Legal Frameworks
Poor recruitment Process
Legal Frameworks
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Ratified CEDAW
UN Declaration 1993
Law on SHTSE
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Law on drug Control
Law on DV
Prakas 66
Prakas 86
SP on EW, NAA
HIV SP, MoI
EW Core Group, NAA
SOP-EW, NCHADS
• NTWG-CoPCT, NCHADS
• P-CoPCT-ST
• P-CoPCT-CC
• MEKA
• PF
• PE
• EWs
Rational for recommendations
Self-Employment
Paid Employment
Enabling Environment
 Social Land Concession
 Minimum Wage Policy
 Law Enforcement
 Irrigation System building
 SME support
 Decriminalization of VG
 Livelihood Options-CSOs
 Loan with full package
 Corruption Eradication
 Family based
 M&E and Oversight Team  Leadership-Morality
Reference Centre,
 CSO Programmes
 Democracy and D&D
Community-Based
Labor Exploitation
Reference Centre
Formal Workers
Vocational Training
Human Rights
 Market Place for
Violation
farmers
Poverty
Entertainment
Workers
Labor Exploitation
Human Trafficking
Sex Works
Unemployment
Youth in Hotspots
Drug trafficking
Materialization
Recommendations
 Increased employment among young population
 Investment in irrigation
 Supporting SME
 Minimum Wage Policy formulation and enforcement
 M&E Systems, Tools and Data Base System for monitoring the status of
workers and enforcement labor law, exploitation, violation and application
of minimum wage policy
 Oversight committee and oversight Plan
 Decriminalization of vulnerable groups such as Sex Workers, Drug Users,
MSM and others
 Access to MFI with full package such as market and business training,
vocational traiining…
 Building enabling environment for NGOs, Associations, Unions and other
community-based groups for health, social and legal issues
References
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2009, KHANA and FHI, MSM size Estimation
2009, PSI TRAC Survey
2010, NCHADS, BSS, HSS
2010, NCHADS, DU/IDU size estimation
2010, PSI Prakas 66 assessment
2010, WNU, Entertainment Workers and Sex Worker Assessment
2009-2010, UNAIDS Cambodia Country Profile
2010, Ministry of Commerce
2010, ILO, Better Factories, Newsletter
2010, Agence France Press
2009, CDRI report
2010, Human Rights Watch Report
2008, RCG, MoP Cambodia Census
2009, RGC, MoP, Cambodia Socio Economic Survey