Healing unequal access to care

Angelina Jolie at the MCCC

Maddox Chivan Children’s Center

Access to HIV/AIDS treatment and support to children infected or affected by HIV

The Maddox Chivan Children’s Center (MCCC) was born from a chance meeting between actress and director Angelina Jolie and CHC co-founder Dr. Anne Goldfeld on a flight to Cambodia in July 2004.

In Phnom Penh, they visited a dilapidated TB ward—where adults dying from AIDS and tuberculosis lay coughing in crowded rooms while their children played on dirty hospital floors. At the time, HIV treatment was largely unavailable, and the children—many grieving the loss of at least one parent—had nowhere else to go.

What began as a moment of shared urgency became a lasting partnership and the seed of a center dedicated to care, dignity, and saving lives of children affected by HIV and AIDS.

Children on the Frontlines of the AIDS Crisis

Whether infected with HIV or not themselves, children from families impacted by HIV/AIDS had missed years of school—either due to their own illness or because they were caring for sick parents. In Cambodia at the time, many had lost their fathers to AIDS and were living with HIV-infected mothers and younger siblings born with the virus who often were quite ill. It was common that a healthy child in the family as young as 7 or 8, was acting as a primary caregiver—begging for food or scavenging garbage to keep their family alive. Every child touched by HIV/AIDS faced deep stigma tied to their own or their family’s HIV status.

A Lifeline for Children Infected or Affected by AIDS

Founded in 2006, the Maddox Chivan Children’s Center (MCCC) was created by CHC in partnership with Angelina Jolie to meet the urgent and often invisible needs of children infected or affected by HIV/AIDS in Cambodia. As one of the country’s first pediatric HIV treatment sites, the MCCC pioneered a child-centered approach—bringing together medical care, nutrition, education, and emotional support in one safe, welcoming place where children could begin to heal and grow. As of June 2025, the MCCC has provided critical support to +2000 children since opening its doors and to countless others who have benefited from its early role in HIV care of children in Cambodia and beyond.

Our Impact: Healing, Nourishing, and Empowering Children

Expanding Access to HIV Drugs and Saving Lives

The MCCC was one of the first sites in Cambodia to provide HIV drugs to children. In parallel, CHC chose to train national physicians from the Khmer Soviet Friendship Hospital — the largest public hospital in Cambodia — serving Phnom Penh’s poorest families — in pediatric HIV/AIDS care at the Maddox Center.

In 2009, HIV treatment at the MCCC transitioned to the newly established CHC Sullivan Pediatric HIV Center, where MCCC counselors and physicians worked alongside government staff expanding access to HIV treatment while maintaining the MCCC model of counseling and care. An average of 400 children/year living with HIV/AIDS were treated in this outpatient clinic during the worst of the pediatric AIDS epidemic between 2009-2020 in Cambodia.

Pioneering Age-Appropriate Medical Counseling for HIV Treatment

Understanding HIV is essential to living with it. The founding director Marie-Pierre Sanchez-Die developed a trail-blazing age-specific HIV counseling model with the MCCC team (see photos below). Using illustrated counseling cards and child-friendly images and language designed for separate age groups (i.e. under age 5, age 5-12, teen/young adult) counselors help children understand their diagnosis and the importance of daily medication—laying the foundation for lifelong adherence and health, an approach that has become widely emulated.

Fighting Hunger

In its earliest days, nearly all MCCC families faced food insecurity. Nutrition became a cornerstone of care. Children receive a hot lunch and two snacks daily at the MCCC, ensuring they have the strength to grow, learn, and continue treatment. For many, it became a dependable daily meal they could count on. For children who were suffering from malnutrition, which occurred frequently in the early years, intensive therapeutic feeding was undertaken.

A Safe Space

For children affected by HIV and AIDS, stigma can be just as painful as illness. At the MCCC, children—both HIV-infected and not—found a safe, welcoming space where they could simply be kids. Surrounded by peers with shared experiences, they were free to play, learn, and heal without fear or shame.

Helping Children Catch Up in School

Because of illness, caregiving responsibilities, or crushing poverty, many children arrived at the MCCC having missed years of school. With no education, the future of children when they become adults is limited resulting in jobs of menial labor. Achieving the equivalence of a 6th grade education changes all that.

The center offers supplementary education in the afternoon with the goal of catch-up to the appropriate grade level of their age. Since public school in Cambodia is a half day, sessions at the MCCC occur in both the morning and afternoon to complement the student’s ‘regular’ school program. Khmer, math, English, and computer skills are tailored to help each child reach the grade level appropriate for their age. Programs span preschool/nursery through high school, with focus on digital literacy and English for teens.

Supporting Mental Health and Life Transitions and social support

A full-time counselor helps children address behavioral challenges and supports families in moments of crisis. For adolescents living with HIV, targeted guidance and life-skills support is focused on preparing them for adulthood and the responsibility of lifelong treatment. A social worker is on site to help families and children with critical issues such as housing, food, and violent behaviors.

Joy, Creativity, and Talent: Horses, Music, Dance, Soccer, etc.

The MCCC exposes children to enrichment opportunities to to find joy, build confidence, and to unlock new potential. For example, Khmer dance and music classes (piano, violin, and recorder) are offered biweekly. Horseback riding with support from the Cambodian Equestrian Association led to several MCCC kids becoming expert equestrians, with some traveling to ASEAN equestrian competitions throughout southeast Asia and becoming members of the Cambodian Olympic Team, and to meet the King. One rider, now an adult works at a horse club in southern Cambodia.

2000+ children and teens have received direct critical support at the MCCC, with additional hundreds benefiting from HIV treatment and the MCCC’s age-appropriate medical counseling approaches to HIV.

Ye How: a new chance

When Ye How was age 6 in 2006 his mother died of AIDS and he was hospitalized in poor condition with advanced AIDS and tuberculosis weighing 25 lbs (TB) (left panel). When the MCCC team met him in the hospital, he kept saying that he wanted to be with his mother in heaven. His TB was treated and he began his AIDS drugs at the MCCC and was feeling much better 6 months later (middle panel). The right panel shows Ye How one year later, in his first grade math class at the Maddox. Ye How continued to attend the MCCC to complement primary school and his schooling as a teenager in a vocational high school. Now, age 25, Ye How continues his HIV treatment and feels very well working in a manufacturing job in Phnom Penh. Story and pictures are shared with permission as are all photos on this website.

CHILDREN LIVING WITH HIV/AIDS

Saving Children’s Lives with HIV treatment

A key to a healthy life with HIV infection, whether as an adult or as a child, includes learning how to take lifesaving and lifelong HIV treatment. It is important to help children understand their illness and how the drugs work to keep them healthy. Towards this goal, the founding director of the Maddox, Marie-Pierre Sanchez-Die (left photo below), developed a pioneering age-specific medical counseling program and manual with the team. An example of counseling cards that the counselors use for young children is shown below (middle photo of 6 different counseling cards). The counselor (right photo below) uses the cards to reinforce the importance of taking daily medication to treat HIV when patients go to the clinic to see the medical team and to receive a refill of their HIV drugs.

Marie-Pierre Sanchez-Die was the founding director of the MCCC from 2006-2010 and is shown in the upper left photo. She conceived and developed the medical counseling program for age-specific explanation of HIV/AIDS through counseling cards shown in the upper right photo. A selection of 6 cards for counseling a young child are shown here in the middle panel above from the MCCC HIV/AIDS Counseling Manual for Children.

These particular cards are from the set for young children under the age of 8 when they are introduced to HIV and the need to take HIV drugs daily. A drawing of the MCCC mascot dog, named Miki, is used as a surrogate for a child sick with HIV infection. See the counseling card on the upper left of the 6 cards (#1) showing that Miki doesn’t feel well enough to play with the children; so, as shown in card #2 (upper middle), Miki goes to see the doctor who does a blood test and find out what is wrong. In card #3 (upper row, far right), Miki speaks to the counselor to understand why she feels sick using these counseling cards. Then in card #4 (bottom left), Miki goes back to the doctor to get treatment. The doctor uses the cards to explain that the HIV drugs are like the superheroes who will fight the HIV virus causing sickness inside of Miki. The last card (lower row, far right panel) shows that Miki feels better after taking the medicine and is able to play with her friends again.

The MCCC counselor (photo upper row, right) uses the relevant ‘counseling cards’ appropriate to the child’s age with the child and their caregiver to reinforce their understanding of HIV illness and the HIV medicines and how and when to take them and to address any adherence issues that could interfere with taking the HIV drugs.

Restoring childhoods

The 8 year old boy in the pictures above came to live with his grandmother in Phnom Penh after his mother died of AIDS. His grandmother brought him to CHC’s Pediatric HIV Clinic for Children at the Khmer Soviet Friendship Hospital (left photo above) where his diagnosis of HIV infection and advanced AIDS was made; and, where he was started on drugs to treat HIV. The MCCC medical counselors helped him and his grandmother understand his disease and the need to take medicines

Another 8 year old boy in the picture on the right who was newly diagnosed with HIV infection and advanced AIDS found a safe place to find friends, be a child, and to begin to catch up in school. He received intensive nutritional supplementation supervised by the onsite doctor at MCCC who also assists with adherence to HIV treatment for all children on HIV treatment who attend the MCCC.

The 9 year old boy shown in the photo to the left, was the sole support of his mother, who is also in the photo and in the one above. He was helping to care for her during a hospitalization for HIV/AIDS at the Khmer Soviet Friendship Hospital in 2003. He had been out of school for years. The MCCC was created to include children like him, who while not infected with HIV himself, had been profoundly affected by HIV/AIDS. MCCC provides a safe place for children like him to begin catching up in school and to provide social support to their families.