Slumped across a bag of rubbish near a busy Phnom Penh market as he awaits his first heroin hit of the day, Yim is one of a soaring number of drug addicts in Cambodia.

He is the human face of a crisis threatening to unwind development progress in this war-scarred society.

Wearing a long-sleeved shirt covering his trackmarked arms, long pants and plastic thongs encrusted with dirt, the 23-year-old street dweller says he began injecting the drug three years ago with friends.

"It made me feel good and sleepy. Now I want to stop but it’s difficult. I’m not patient enough," he said.

For now he endures his habit, scavenging to earn the five-dollar price tag of three or four hits per day, or stealing when the opportunity arises.

A doctor and counsellor from non-government organisation Mith Samlanh (Friends), the only agency in Cambodia running a comprehensive drug programme, check on his health and chat with him and a dozen other children hanging around.

Because of the group’s intensive harm reduction efforts, Yim has stopped sharing needles and knows how to safely inject. Remarkably, he reveals trackmarks that show no sign of infection.

Addicts like Yim were non-existent in Cambodia just a few years ago, with substance use largely limited to older men smoking marijuana or opium, said Friends technical assistant David Harding.

But in 1998, when decades of war here finally ended, solvent abuse first emerged. A year later Friends began annual surveys of the street-living population which have shown evidence of "skyrocketing" drug use, Harding said.

Methamphetamines, mostly originating from Myanmar but now produced locally as well, overtook glue as the drug of choice last year.

Heroin, also trafficked in from Myanmar, arrived three years ago and is growing in popularity among the estimated 25,000 street-children in Phnom Penh.

An increasing number of middle and upper-class children are moving onto the streets due to their drug habits, with some becoming gangsters and using their well-connected families to protect them from prosecution.

According to Friends’ 2003 survey, 70.4 percent of the street-living population were regular drug users, around 15 percent of whom are injecting, mostly heroin.

"What effectively you’re talking about is zero to a pandemic in seven years," Harding said, adding that addiction patterns were also highly accelerated compared to the west due to the ease of procuring the drugs and a near complete lack of education on their dangers.

"You’re seeing 14-year-old kids who have been using heroin for two years injecting six or seven times a day who don’t have any veins left apart from their groin. You don’t see that chaotic process in most other countries," he said.

Of particular threat is the spread of HIV-AIDS.

"We have the establishing of injecting drug use, we have a very well-developed sex industry here and we have the highest prevalence of HIV infection in the world outside of Africa," Harding said.

"The combination of those three factors could be disastrous."

The reason for the explosion in drug usage are complex, but one major explanation is simply boredom: As aid-dependent Cambodia struggles to rebuild its infrastructure, spending on services for young people is non-existent.

Playing computer games or snooker, gambling, going to a brothel or taking drugs are the main options, Harding said.

"And really, taking drugs is the most cost effective. It’s very cheap and it’s becoming cheaper all the time."

Cambodia’s health system is unprepared for the crisis, meaning families of addicts have nowhere to go to seek help, said the UN drug agency’s Graham Shaw.

"If you are a destitute young person there are one or two NGOs you may be able to get assistance from.

"If you have a family with a lot of money, there is one private treatment and rehab clinic. But for all those in between, the vast majority, there is nothing," he said.

The government, which signed a contract with Friends for it to provide support for new projects in two provinces last month, is at last recognising the gravity of the issue but donors need to step up to the plate, noted Shaw.

"We would like to see the international donor community recognise the severe threat of drug abuse to social and economic development," he said, noting the billions of dollars they have poured into Cambodia in recent years.

"All of that development is going to be undermined and destroyed if the country does not get to grips with the drug problem."

/ Current Affairs