As governments across the region scrambled to respond to initial news of the coronavirus outbreak last month, Cambodian Prime Minister Hun Sen, Asia’s longest-serving dictator, didn’t flinch. He saw an opportunity. While other countries enforced restrictions on Chinese travelers, Hun Sen sought to reassure not his citizens but Beijing, which he depends on for political and financial support. “Please continue our cooperation with China. Do not ban flights from China. Do not ban China’s sea transportation, and do not ban Chinese tourists,” he said at a press conference on Jan. 30.
Days earlier, Cambodia had recorded its first and only confirmed case to date—a 60-year-old Chinese man who had flown from Wuhan, where the outbreak began, to Sihanoukville, a casino town booming with Chinese investment.
Hun Sen has held power in Cambodia for 35 years, and he is turning it into a client state of China as he tightens his grip. While the European Union and the United States have recently punished or sanctioned Cambodia over its poor human rights record, especially as Hun Sen moved to crush the remaining opposition in 2017, China has remained its largest source of foreign direct investment, providing nearly $3.6 billion in 2018—much of it in construction. Hun Sen knows that he can’t afford to offend Beijing.
Last week, the Cambodian leader saw another opportunity to assert his loyalty to China—this time, risking global contagion. Hun Sen personally welcomed the Westerdam, a cruise ship that left Hong Kong on Feb. 1 and was turned away by five countries before it was allowed to disembark in Sihanoukville last Friday. Though Cambodian officials conducted a temperature screening and determined none of the 2,257 passengers and crew had the coronavirus, one later tested positive in Malaysia after being stopped at the airport.
The Westerdam incident has raised concerns among health experts that other asymptomatic cases may have gone undetected—especially given the incubation period of the virus, which can last 14 days or longer. While the ship docked in Sihanoukville didn’t produce a virus cluster the size of the Diamond Princess quarantined off Japan, the risks are similar. “The risk is that you have a closed community. You’ve got the incubation period. You’ve got diagnostic tests that aren’t reliable. You’ve got the potential for spread that is undetected,” said Richard Coker, a Bangkok-based emeritus professor at the London School of Hygiene and Tropical Medicine.
After the Westerdam case was confirmed in Malaysia, Cambodia began laboratory testing for the passengers that remained in the country. By then, hundreds had already left. For those that remain, their return trips are now increasingly limited: Thailand, Singapore, Malaysia, and Taiwan have refused to allow in passengers from the ship, making it difficult to reach Europe or the United States. On Thursday, a chartered flight with 283 Westerdam passengers was diverted to Pakistan after the Turkish government refused to allow the plane to land.
If Hun Sen has created an international incident, it was in his own service. By allowing the cruise ship to dock, the prime minister cast himself as a humanitarian—offering refuge to the stranded passengers, many of them European or U.S. citizens. The timing allowed Hun Sen to distract from the bad news of the week: that the European Union had rescinded some of its trade preferences for Cambodia on the basis of human-rights violations.
The move also follows Hun Sen’s government’s general approach to the coronavirus outbreak, which has been to play down the risk to court China’s favor. The prime minister has chided reporters for wearing surgical masks. The health ministry has insisted that Cambodia is too hot for the virus to spread, although around 3,000 Chinese citizens traveled to Cambodia from Wuhan during the Lunar New Year holiday. Hun Sen has refused to organize evacuations of Cambodian citizens from China, including some students in Wuhan—a decision that has not been received well at home.
Hun Sen flew to Beijing to meet Chinese President Xi Jinping on Feb. 5 in an expression of solidarity, making him the first foreign leader to visit China since the coronavirus outbreak began. “He is trying to basically go all in and continue with the narrative that there is no real danger,” said Ou Virak, a Phnom Penh-based human-rights activist and the founder of the Future Forum think tank. “In some ways, he is sending a message to China that Hun Sen and Cambodia are standing with China.”
China, meanwhile, is courting this loyalty: Foreign Minister Wang Yi held a meeting this week in Vientiane, Laos, with his counterparts at the Association of Southeast Asian Nations (ASEAN) about the outbreak. The gathering, called at the last minute, seemed more like a demand for support than a call to action: The ministers were recorded joining hands and expressing solidarity with China. “Fear is more threatening than the virus and confidence is more precious than gold,” Wang said at a press conference afterward.
Still, other ASEAN countries, including Malaysia, the Philippines, Singapore, and Thailand, have imposed travel restrictions or advisories in response to the virus. It is the countries that are highly dependent on and indebted to China, such as Cambodia and Laos—which has reported no coronavirus cases—that have adopted loose attitudes.
But these nations are also poorer and lack the health services to handle even a handful of severe virus cases, much less an outbreak. A 2012 study using models based on the 2009 H1N1 pandemic found that in the case of another influenza pandemic, Cambodia and Laos would have high avoidable death rates based on gaps in critically needed resources such as ventilators and hospital beds. “Their capacity to respond to a significant pandemic is going to be extremely challenging,” said Coker, one of the study’s co-authors.
Though Cambodia’s National Social Security Fund covers health care for some workers, many Cambodians end up paying out of pocket at private hospitals or clinics when they get sick. If the private clinics are not routinely communicating with public agencies, that can lead to a delay in reporting, said Mishal Khan, an associate professor at the London School of Hygiene and Tropical Medicine. “There can be major challenges with early diagnosis of infectious diseases such as COVID-19 in countries where private healthcare providers are used by the majority of people,” she wrote in an email.
While Hun Sen panders to China, some in Cambodia are growing frustrated about the government’s inconsistent communication about the virus, particularly after the Westerdam incident. Cambodia’s Ministry of Health has instructed experts at at least one organization working with the government on the public health response not to speak directly with journalists. The situation is compounded by the fact that Hun Sen’s regime has gutted the country’s independent media, shutting down one critical English-language newspaper and allegedly organizing the sale of another to an investor with government ties.
If there were more coronavirus cases detected from the Westerdam inside Cambodia, would they be confirmed? “Whatever narratives they’re trying to put out, people think they must be the opposite,” said Ou Virak, the human-rights activist. “Because the Cambodian government must have some agenda. The truth must be the opposite.”
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