THE SCOPE FOR A UNV PROJECT

TO SUPPORT AND FACILITATE ONGOING PROCESSES OF GREATER INVOLVEMENT AND EFFECTIVENESS

OF BUDDHIST INSTITUTIONS

IN THE RESPONSE TOWARDS HIV/AIDS IN CAMBODIA

a pre-feasibility study

Roger Henke

Sou Ketya

Lath Poch

Lim Sidedine

Hean Sokhom

Centre for Advanced Study (CAS)

PO Box 2030, # 85, Road 141, Sangkat Veal Vong Khan 7 Makara, Phnom Penh, Cambodia
Tel. +855-23-214494

cas@forum.org.kh

Contents

1.Introduction

2.Activities undertaken

3.Lay out of the report

4.The commitment of the Buddhist hierarchy towards greater involvement of religious institutions

5.The interpretation of greater involvement of religious institutions of other important stakeholders

6.The UNICEF Cambodia Buddhist Leadership Initiative ‘Religious Response to AIDS’

7.Assessment of question marks identified in the proposal

8.A recommendation to UNV on how to proceed from here

9.Additional References

Annexes

1.Proposal for the pre-feasibility study

2.List of Key Informants

3.A tentative overview of all projects/non-governmental organizations relevant to the issue of social involvement of Buddhist religious institutions

Throughout this report we will make use of the acronym GIEBI for indicating “Greater Involvement and Effectiveness of Buddhist Institutions in the response towards HIV/AIDS in Cambodia”.
Introduction

On the basis of initial discussions with (former) UNV Cambodia program officer Roland Campen and UNV’s GIPA project coordinator Alex Marcelino about the importance of involving religious institutions in the Cambodian response towards HIV/AIDS and the possibilities for UNV to support ongoing and potential involvement, CAS was invited to produce a proposal outlining our ideas regarding possible ways to explore these possibilities.

As input for our proposal UNV provided us with its accumulated (grey) literature on the subject. As a first service[1] to UNV we produced a discussion document that – based on a preliminary analysis of the available material - proposes a pre-feasibility. This analysis already identifies several operational conditions that a UNV project addressing the greater involvement of religious institutions should fulfill:

qIt should operate within a national framework within which a volunteer approach to supporting and facilitating ongoing processes of religious involvement can be embedded (this framework is available);

qIt’s major focus should be on ways to create an enabling environment;

qIt should address both the policy level (national and provincial) and the local support level;

qIt should test and demonstrate the effectiveness of this modality for supporting coordination and partnership between (activities of) religious institutions and GOs and NGOs in the sector of HIV/AIDS as an example for such coordination and partnership regarding other social issues.

This discussion document also outlines a list of issues that one would need more (solid) information about in order to be able to formulate practical objectives and activities for a UNV support project.

The document therefore proposes a two-stage approach: a limited pre-feasibility study followed by a more substantial follow up in case the pre-feasibility would discover real scope for a UNV support project.

After a feedback round, that included the current UNV program officer Ruby Bañez, this document was finalized as a pre-feasibility proposal (see annex 1) and served as the basis for a small-scale consultancy project executed by CAS and reported upon in the following.

1.Activities undertaken

All activities listed in the proposal (see annex 1) were undertaken:

1.Interviews were conducted in Phnom Penh with the Patriarch of the Mohanikaya sect and the secretary to the Patriarch of the Dhamayutakanikaya sect, the director of the NAA and the Secretary of State of the Ministry of Cults and Religions. Because of the central importance of UNICEF’s support to the MoRC’s religious response program both in terms of the number of activities undertaken and in terms of the fact that any UNV activity will have to be in line with this program, two key informants were added: UNICEF’s project officer HIV/AIDS and the UNICEF paid consultant to the MoCR[2]. For the overview of relevant NGO activities (see below) three short interviews were conducted in Phnom Penh (see annex 2).

2.A site visit was conducted to a total of three Battambang-based NGO’s. All of them are pagoda-based and we conducted interviews with program staff involved, most of them monks, and collected written material.

3.A tentative list of relevant NGO activities was drawn up (see annex 3).

3.Lay out of the report

These activities are reported upon in this paper along the lines specified in the proposal, with one new issue added to the list. This means that we do not report upon each individual interview, nor do we deliver assessments of the project sites visited in Battambang. The information collected is analytically used to address two core issues for assessing the feasibility of a UNV intervention as specified in the proposal.

qThe commitment of the Buddhist hierarchy towards greater involvement of religious institutions

qThe interpretation of greater involvement of religious institutions of other important stakeholders

To these issues, the UNICEF interventions are added as an important context factor that any UNV intervention will have to align itself with:

qThe UNICEF Cambodia Buddhist Leadership Initiative ‘Religious Response to AIDS’

Before concluding with a recommendation to UNV on how to proceed from here, we assess the list of question marks that came out of our initial analysis of the available material.

4.The commitment of the Buddhist hierarchy towards greater involvement of religious institutions

All involved, i.e. both the lay and the religious individuals interviewed, confirmed that the commitment of the religious hierarchy at the various levels, but especially at the apex, is important. It was also confirmed that neither of the two Patriarchs object anymore to Buddhist institutions’ involvement in HIV/AIDS issues (two years ago this was not yet the case). The same seems true for chief monks at provincial and district levels.

However, according to what we were told by Samdech Tep Vong on the one hand and the secretary to Samdech Bour Kry on the other their interpretation of what kind of involvement is deemed appropriate seems to differ somewhat. Mohanikaya sees scope for moral education to prevent HIV infection, for material support to HIV/AIDS affected individuals raised by the Sangha but not provided within the Wat (i.c. care services), and (home-based) spiritual support/treatment. Dhamayutakanikaya sees scope for Wat-based care too.

However, both refer to Thailand as an example. Both stress the importance of prevention over care. Both are in favour of monks using traditional medicines and incantations to alleviate AIDS patients’ suffering. Both are very explicit about what monks can and what they cannot address in their sermons: general moral education, yes, specific condom-use education, no, sermons during funerals or regular monthly holy days, yes, sermons during main religious ceremonies like New Year, Phchum Ben and Visak Bochea, no. Both are in favour of monks being educated about HIV/AIDS in order to enable them to use this factual knowledge in sermons and counseling. Both are in favour of monks collaborating with GOs and NGOs in responding towards the epidemic.

Both Patriarchs have participated in study trips, training activities and awareness raising events. Their willingness to participate and thereby support the legitimacy of monk involvement – more evident with Samdech Tep Vong than with Samdech Bour Kry – is certainly an important facilitating factor for all activities aiming at greater involvement of Buddhist institutions in the response towards HIV/AIDS.

However, their support is not very active:

qThey see no role for themselves as initiating activities themselves.

qNeither identified or argued for creating a stronger acceptance of the doctrinal basis for the Cambodian Sangha to become socially more active than is currently the case, a theme that was mentioned by all other national stakeholders as needing attention.

qAnd related to the above, neither identified the infrastructure of Wats covering nearly every nook and cranny of the country and having a privileged and trusted access to the people as an important asset for the social development of the country.

To summarize: the national leadership does condone involvement of monks in the response to HIV/AIDS but does not seem interested to play an active role.

Our interviews with socially active monks in Battambang showed evidence of two different bases of involvement of monks:

qThe Buddhism For Development model takes the Wats-as-infrastructure-for-development thought as its basis. Programs are developed by the director (an ex-monk), sometimes upon initiative of donors, and monks operate as volunteers within those programs. Their involvement is without doubt part of the success of these programs but they do not primarily conceive of their involvement as being religiously motivated.

qThe Wat Norea, or the social-Buddhism model takes a social conception of what being a monk entails as its basis. Its training is geared towards convincing other Wats to start activities in their own community, with Wat Norea playing an exemplary and a back-stopping rather than a program coordinating role.

Some general observations regarding these local level initiatives:

qA necessary ingredient of what makes both of them rather successful are the leadership qualities of the individual in charge. That leadership is crucial was confirmed by other interviewees, all of whom remarked upon the limited number of religious individuals who actually (manage to) convert HIV/AIDS awareness into an HIV/AIDS response.

qThe Wats-as infrastructure model is attractive because it fits neatly into the current development concept. It makes use of the trust and privileged access of monks for making donor-funded development interventions successful. These interventions are much broader than HIV/AIDS. Apart from the above mentioned advantages, the use of monks as volunteers makes the programs also very cost-effective.

qThe social-Buddhism model is attractive because it not only enlists the trust and privileged access advantages of the Wat-infrastructure but also its income-generating aspect. Within this model community funds, otherwise directed towards Wat-building, or not collected at all, are used for the material support of HIV/AIDS affected community members. This makes this model much less donor-dependant.

qThe scopes of both models are different: the Wat-as-infrastructure model can be used for addressing a much wider range of social issues. The volunteers are primarily development workers. The social-Buddhism model tends towards a charity orientation, looking after the most needy. On the other hand, for some issues, e.g. gender, it has potential for attitude change that the infrastructure perspective lacks. When monks as monks rather than as volunteers/development workers question deep seated attitudes and their scriptural basis, i.c. the Cbap Srey, their impact can be more profound.

qMonks in both models told us that they discuss condom use with lay people. Both met with resistance at the beginning but this proved to be temporary. Their moral authority prevailed. In other words, the fears concerning the loss of respect for religion when monks get into detail about sexual matters, as expressed by the Samdechs, are not confirmed by those ‘on the ground’.

qAll BDF monks had a community-care orientation, squarely rejecting pagoda-based care. Most Wat Norea monks saw scope for pagoda-based care, some on a structural basis, others more in terms of a temporary facility until family/community members are willing/able to take over (again). Wat Norea itself is considering a Wat-based care programme for IDUs, which is in line with Thai examples.

qAll monks interviewed were Mohanikaya. Different abbots hold different opinions about the Wat-as-asylum/hospice. It shows that the differences of opinion that we encountered at the Patriarch level about this matter are individual differences, not sect-related differences.

5.The interpretation of greater involvement of religious institutions of other important stakeholders

Apart from UNICEF staff (reported upon in the next paragraph) we have solicited the opinions of the Secretary of State of the Ministry of Cults and Religions and the director of the National Aids Authority.

The MoCR is the one and only Ministry which has (already) adopted a policy on its response towards HIV/AIDS and is very proud of it (MoCR 2002). The Secretary of State’s opinions were in line with the policy (adopted in May 2002, after a two year development phase, funded and facilitated by UNICEF):

qReligious resource persons (Monks, Nuns, Achars, Pagoda support committee members and Buddhist youth) are an important resource for awareness raising regarding HIV/AIDS, both for prevention oriented messages and for care and non-discrimination messages. This resource is considered important for its access to the population, both in terms of coverage (infrastructure) and in terms of the trust they hold.

qTheir messages should be integrated into their religious work, i.e. be made a part of their moral education. Also, religious resource persons should not turn into health educators or development workers but (only) complement and support the work of these other professionals.

qTheir work should therefore also be closely coordinated with the other stakeholders in the field, through the NAA framework, and the other stakeholders should play the coordinating role.

qTheir work should be community-oriented, i.e. their work should aim at communities taking up their social responsibility towards their HIV/AIDS affected members.

qThe main and so far only strategy followed to realize these objectives is providing HIV/AIDS education to religious resource persons, often intertwined with Buddhist morality education.

qThe initiative for becoming active is seen as lying with the individual religious teacher, and as being independent of the opinions of the religious hierarchy. In other words, as long as the Patriarchs and the provincial level and district level chief monks do not obstruct the program, it can fulfill its promises.

Like the Patriarchs, the Secretary of State explicitly mentioned that he did not object to monks acting as traditional healers.

The NAA strongly supports the involvement of religious resource persons, especially monks, for the same reasons as the MoCR. Obviously, involvement is conceptualized as being within the national framework coordinated by the NAA. The NAA supports the training efforts of the MoCR. Both the MoCR and the NAA are less ‘conservative’ than the Patriarchs regarding the extent to which monks can and should address practical issue like (proper) condom use etc.

But the following additional observations offered the NAA seem relevant:

qThe MoCR human resources are very limited. Only the people at the Ministry directly involved in the program are really aware of it, the others are not and – more damning – are not very interested. The reason offered was that there is not much money involved and the program is therefore not taken seriously.

qA directly related issue brought up was that the training of religious resource persons, especially monks should be accompanied by efforts to convince the public in general that monks have a social role to play. From a pragmatic point of view, getting this message accepted by those staffing local authorities, respected elderly, etc. was identified as a major prerequisite for creating an enabling environment. Training monks is a necessary but not a sufficient strategy to make optimal use of the Buddhist infrastructure.

qThe implicit message conveyed was that neither the MoCR nor the Buddhist hierarchy was active (enough) to publicly – i.e. beyond the confined circles of the national policy-arena - support involvement of religious resource persons.

qThe NAA pointed out that this is one of the reasons that substantial activities carried out by Wats/monks are far and few between and are very slow to develop. Another reason given for this was the dependence of such activities upon committed leadership by capable individuals (whose numbers are limited).

qThe NAA was very positive about Wats (like Wat Norea) developing hospice/orphanage/asylum initiatives. Given the urgency of the issue and the incapacity of the government to provide institutional care the more Wats would take up this role, the better it would be.

qThe NAA explicitly mentioned the potential that popular trust in the Wat infrastructure holds for creating sustainable, i.e. donor independent programs.

To summarize: the visions of the MoCR and the NAA share a lot but the NAA thinks that the religious response initiative lacks a crucial element and is therefore less effective than it could be and the MoCR and the NAA differ regarding the Wat-as-asylum issue and the extent to which Wats should take initiative (rather than ‘only’ participate in programs directed by others).

6.The UNICEF Cambodia Buddhist Leadership Initiative ‘Religious Response to AIDS’

UNICEF supported the MoCR in its policy development regarding a religious response towards HIV/AIDS program and in organizing training activities in a selected number of provinces. The support is ongoing, implying that the translation of policy objectives into strategic interventions will be facilitated and the training extended to other provinces.

Defining features of UNICEF’s approach are:

qGIEBI is important even if only because monks are one of the venues through which the general population can be reached and made aware of HIV/AIDS and how respond to it (other venues are teachers/school system, health workers, mass media,..). The current level of awareness (e.g. as evidenced by the DHS) is quite high and keeping this level up needs constant attention. Monk training is therefore mostly awareness raising.

qAll interventions should ultimately aim at facilitating a community response. Especially regarding the issue of care UNICEF’s policy is clear cut: the Thai model of pagoda-based care arrangements is not supported. The reasons underlying this policy are:

ü(Extended) families are the natural helpers of PLHA and orphans; other facilities should be in 3^rd or 4^th line only;

üFamilies who are not within the community are much worse off; communities need moral and material support to be better able to take up community-based care.

üThe availability of pagoda-based care ‘enables/invites’ villagers to ‘get rid’ of PLHA and orphans;