Our AIDS Patient Family Support Program provide the 18 fragile families who remain in our program , with modest, bare bones living assistance. Determining the amount of financial assistance is complex, taking into consideration actual expenses like rent, utilities food as well as unexpected needs, such a medical or other family emergency. Beyond the actual cost factors, we also have to look at the ability of a family or family member to contribute to their living expenses through regular or occasional work. Budgets overall and by necessity are tight and extremely modest. The monthly total program costs per family currently range from $150 to $200. A recent hospital visit for one program participant added another $ 130 .
It is now estimated, by our staff on the ground, that it costs about 10,000 riel ( about $ 2.50 ) per day per person for food, which totals about $75 per month per person. Current “ official” statistics estimate food inflation at 3% per year, but numbers like these can often be stated to represent a desired political message that may not reflect the purchasing power of real people. Program food subsidies currently range from $50 to $ 70 per household. Our long held policy is that families need to try to contribute to their own support whenever possible, but each family situation is unique. For example, in cases where there is but a single person in the household whose health does not support any sort of employment income, we will determine the amount of additional support that may be needed. Consequently, we have raised some food allowances in recent months and we continue to evaluate the subsidies that we provide each family in the program.
In memory
We recently lost a member in our program family. Ms. S. who had AIDS, came to us 17 years ago from a Catholic program in Phnom Penh, where she had been treated for other medical reasons. Ms. S was in her mid 40’s when she passed away. Her numerous health programs did not allow her to work. Our program allowed her to live and die with simple dignity. Her ashes have been returned to her hometown in the countryside.
Your kind and generous donations support the fragile families remaining in our program to live in dignity in a modest , simple lifestyle and to assist them in their final journey at the end of their days.
Barbara & Mark Rosasco
Mark was in Cambodia in April. During his visit, Mark met with and reviewed the circumstances of all of our program's families. All of our families in one manner or another , are struggling to make ends meet. The financial reality of our program’s limited resources and the financial reality of each family in our circumstances requires a constant balancing act.
The families in our program live just outside the edge of desperation but who, because of our program, have a basic economic “ survival platform”. We urge and typically require that the families in our program ,if they are at all capable of doing so, find ways to earn money to supplement our support.
The current economic boom in Phnom Penh continues to push food and rent prices higher as land values soar, forcing unwanted change upon some of our fragile families. Here is the story of one family.
The story of “ Grandmother”
Grandmother joined our program about 16 years ago. Then at A 65, she was struggling to care for her daughter who was dying from AIDS and her two young grandchildren. Her grandson, then A 10 had mental capacity of about A 3 or A 4. Her granddaughter was about A 7. The mother soon passed away and Grandmother continued to care for the two children. She earned some money through a tiny vegetable stall at a market near by and the family managed to survive because of the support that our program provided .
Grandmother is now A 81, her grandson A 26 and granddaughter A 22. Sadly, little has changed. Grandmother and granddaughter sell vegetables in the market 7 days a week. Grandmother nets, after expenses, about $4 to $5 per day, which is a monthly income of $112 to $135. We provide a food allowance of $70 per month and housing assistance at $50, which gives the family at best $255 per month to support a family of 3 people.
Immense challenges face this family
Grandmother is now A 81 and she is beginning to become a bit frail. Another challenge facing this family is the reality that the grandson, A 26, is mentally only 3 or 4 years old and he cannot be left alone , even for short times. He accompanies his grandmother to the market every day so that she can watch over him.
Now a new and unexpected challenge faces the family. The land, where the market has been located for at least the 20 years we have been working in Cambodia, recently has been sold to a developer. This means that the market will close and those who earned their living at market stalls like Grandmother, will be forced to relocate to survive. That is if they can find a place and afford to move.
One possible , partial solution
Grandmother is trying her best to come up with a way to care for her grandchildren. She has approached us with an idea. It seems that Grandmother has access to a tiny plot of land in the countryside about an hour’s drive from Phnom Pennh. This sort of thing is not unusual, a tiny plot big enough for a thatch shack owned by a friend or relative. The land is essentially worthless, too small to farm , but it could provide a just enough space to build a thatch and wood house where the family could live. Homes like this are often just a single large room with no plumbing or electricity. Grandmother estimates that the cost of materials and building would be about $ 300, so she is asking us to consider advancing that money to her to build the home.
There is a garment factory nearby this plot of land and the idea/hope is that the granddaughter could get a factory job with starting wage of about $ 150. This wage combined with the food support we provide of about $ 70 per month could keep the family on track.
Concerns
We are concerned that the costs of building the house may be higher than estimated. And of course, while we hope Grandmother can live many years longer, the reality is that there is the extremely serious problem of how to care for the grandson when Grandmother is unable to do so. The granddaughter needs to work and so cannot stay at home . The grandson is a toddler in an adult body and cannot be left alone. Unlike the developed world, there is no social safety net to help the family.
The reality is that we can only help this fragile family as best we can for a long as we can and we cannot see a permanent solution. Only time will tell what will happen.....
We remain deeply grateful to you, our wonderful donors for your kind support as we try to work to address the unique needs of each of our fragile families.
Barbara & Mark Rosasco
Life lines then ( 1998 ) and now ( 2019 )
When we started this work 21 years ago, much of the center of Phnom Penh, Cambodia’s capital city, was covered by large slum neighborhoods comprised often of shacks constructed from cardboard, scrap wood and rusted sheets of corrugated metal. Many of our earliest FSP patients and their families lived in those slums. Today, though, the city is a vast construction zone with new high rises going up in every neighborhood and construction cranes looming over the remaining slum areas.
Many of the poorest residents have been forced to relocate to areas far outside of the city center as the old slum neighborhoods were cleared to make way for new development. Some of our former patients, women whom our staff had judged to be capable of caring for themselves, were among those who moved to areas far from the city center once their support from our program was stopped. Distance and Phnom Penh’s now gridlock traffic congestion have made it difficult for our staff to stay in touch with those former patients who were no longer formally enrolled in our program and who, in many cases were forced to find housing far outside the city.
However , several of those patients still return regularly to the city for monitoring by the hospitals to which they were assigned for their anti-retroviral therapy and they have re-appeared on our program radar. In a few cases, we have admitted a few patients back into the Family Support Program after verifying that , without our program's support, they were struggling to survive .
In searh of a lifeline....
Last year one woman (approximately 70 yers old) who had moved to Koh Kong province to live on her son’s tiny farm there, returned to Phnom Penh. She sought our support because life on on the farm was too tough for a 70 + year old with a fragile medical condition and the travel to Phnom Penh for bi-monthly medical checkups was more than she could handle.
In need of a lifeline....
Similarly, this month a woman who had been in our Family Support Program for many years but who had been transitioned out of the program about five years ago by our former director, sought our support again after a chance encounter with our field staff at the hospital in Phnom Penh where she gets a checkup and receives her ARV therapy every three months. Many years ago she lost her teenage daughter to the sex industry which left her with only her son. That boy is now nineteen years old but is severely mentally impaired and he is incapable of caring for himself.
Mark met with her and her son during his February visit and decided to restart our support for them beginning March 1. Those two cases and several others where the women or their children suffer from mental impairment or where they are otherwise unlikely to ever achieve self sufficiency are constant reminders of the ongoing need for a program like our FSP which provides for the essential living needs of some of the most destitute AIDS patients in and around Phnom Penh.
The support of you, our generous donors, has long provided the fragile families in our program with urgentl needed humanitarian assistance and we are deeply grateful to you all for your past and continued support.
Barbara & Mark Rosaso
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Sometimes we win, sometimes we lose, sometimes it is hard to tell.....
Our project report this month features one of the families in our Family Support Program. As we had discussed before, in recent years, whenever possible, we have worked hard to help our familes in this program move toward self sufficiency . Having said that, there remains a core of fragile households, each facing unique challenges which would make it difficult or even impossible for us to end our support . The task of managing the support of these families can be extremely difficult as our report will soon reveal.
One such case is a family that includes a boy, now age 13 and in grade 6. This boy and his mother have been in our program for more than 10 years. The mother has AIDS. Last year the mother met a man, who against our stated policy, moved into the house. It was not a good situation, as the man was sometimes violent and verbally abused the boy. After a few months, the man persuaded the mother to abandon her son and the mother ran off with the man. Before she had met that man, this woman was extremely hard working and took very good care of her son. Despite her illness, she sometimes worked for the city, cleaning sewer drains for $ 5 per day. In addition to that, she collected recyclables on the street earning up to $ 3 per day. Our program staff person, a woman, herself HIV+ took the boy into her own tiny home to live with her family and we provided financial support.
The boy, not surprisingly ,suffered severe trauma and was emotionally scarred by his mother's abandonment. The very good news is that his mother has recently returned after several months away. It is a difficult situation and one which obviously requires careful oversight, placing the well being of the boy first. Having survived several difficult months without his mother, he is overjoyed that she is back. They are now living, just the two of them, in a simple single room. It could be all too easy to judge harshly ,and be completely unforgiving of such a hurtful action, but none of us can even begin know the grinding poverty and extreme hardship that someone in her position has endured year after year, with no hope of respite in sight.Although we continue to support the boy , we are at present, evaluating whether we feel that we can resume support for the mother and we are monitoring the family situation carefully.
Without the support and monitoring of our program, surely this boy would have been "lost". Our deepest hope is that things can return to a more normal state and help this young man move forward in his life.
Your continued support of our program means that we can assist fragile families like these and help them through trying times.
Tuesday, November 27, is Giving Tuesday and marks the start of the GlobalGiving year end giving campaign with $150,000 in matching funds and 30+ bonus prizes (ranging from $3,000 to $100) over a 24-hour period on #GivingTuesday. Matching funds will be determined proportionally at the end of the campaign.
Our hope is that these incentives will encourage you to generously celebrate and support the change you’re making in the world when you support programs like ours.
We are deeply grateful for your support.
Barbara & Mark Rosasco
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Our update this quarter will focus on just one our families, up close and personal to illustrate how our program can make a profound difference.
Most people don’t think about the fact that there are grades of poverty. There are people who are so utterly desperate that their only goal is to eat enough to survive. The simplicity of their desperation is compelling the instant that we see it. Then, there are the others, who, like many of the families in our program live on the outside edge of such desperation but who, because of our program, are lucky enough to have a basic economic “ survival platform”. We have always encouraged and often insisted that the families in our program somehow strive for “more” , that they should seek part time work to supplement what we give to them, which when combined, hopefully, can get them through the month.
The remaining families in our program all have unique challenges. Recently, we learned, to our great dismay that one lady , approximately age 70, told our home care coordinator that she wanted to kill herself because she was worn out from being hungry all of the time. This woman ( HIV -) has been in our program for 8 years . Her daughter is both HIV+ and afflicted cancer. Both women, over the past 8 years have supplemented our program’s support by washing clothes. In recent months, the older woman has been constantly ill and unable to do work of any kind. Now, her daughter has become ill and is often too ill to work and no work means no “extra” money.
Typically, our program pays the rent and utilities per family. After that, each family receives a food allowance of $ 45 to $70, depending upon family composition. In recent months, we have been told that the food allowances are too low as it is now estimated that it costs about $70 per month per person for adequate food due to local inflation.
You may feel angry reading that we are “ only” offering such a subsistence living to our families. In reality, we have always felt that it was better to offer “ just enough” and to encourage our program members to work to help themselves. Our other reality is that there are no extra funds.
In this case , this lady can no longer work. She did not ask us for more money, because she assumed that there was not any more money to be had. So instead, she began to consider suicide…
We have, of course, increased her food allowance and we are monitoring the situation carefully.
Our legacy families each confront unique challenges. They are with us because there is no where else for them to turn. These families and their 17 children face challenges which would make it difficult or even impossible for us to end our support . At this time, we can think of no near term exit plan for these women and their children and, so, we are committed to continuing support for them for as along as we can raise the necessary funds.
We are deeply grateful to all of you for your generous support. Truly, your donations do make a difference to these fragile families.
Barbara & Mark
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