Vietnamese refugees in Hong Kong face a bleak future with no way out of the camp they are forced to call home. Rachel Downey visited a camp and found out what life is like for its inhabitants

Picture an old desert town in a Western film. Fill it with shacks housing hundreds of people and you can imagine Pillar Point refugee camp.

Lying just outside Tuen Mun in the New Territories of Hong Kong, there is an air of unreality about Pillar Point. There are no roads, just sandy paths. Overlooked by a grassy hill, the camp is dry and barren. The sense of isolation is intensified by its distance from central Hong Kong - it's a 40-minute ferry ride to Hong Kong island and a bus ride to the nearest town. Fences 15 feet high topped with barbed wire surround the camp and higher fences segregate areas within. Gurkhas from the British army manage the security, which is seen as a way of keeping people out rather than in.

Twenty-seven plywood blocks, two or three storeys high, were erected as a temporary measure when the camp opened in 1989. Each floor houses up to ten flats, which are, in fact, rooms measuring roughly nine feet by nine feet. Each serves as the complete living space for a family where they must eat and sleep. A small shower room is attached but there is no space to section off the cooking area.

Privacy is impossible. At an AIDS awareness day, community workers saw children as young as five draw pictures of people engaged in anal sex. There are no communal buildings but the residents use the limited space between blocks to congregate. Some of the blocks are disused and are only used by heroin addicts as 'shooting galleries'. The intense heat produces a smell of rotting food in parts of the camp, where signs warning of rats are common. It is home to 900 Vietnamese people who are living in limbo - stateless, hopeless and in despair.

They were once 'boat people' who pricked the world's conscience in the 1980s when they fled the communist regime. Before a screening programme was introduced in 1988, between 10,000 and 30,000 people arrived in Hong Kong each year. They were held in detention centres run by the territory's prison service. At their worst the centres held tens of thousands of people all wanting refugee status, but only 1,400 were lucky. Most others were sent back to their point of origin.

The 13,000 boat people still living in Hong Kong detention centres are being returned to Vietnam under repatriation programmes, run by the Hong Kong government in conjunction with the United Nations High Commissioner for Refugees. There are two repatriation schemes: one is forced, the other voluntary, with more money made available to those who choose the voluntary scheme. Almost 1,200 Vietnamese are returning each month, 600 on each scheme.

But those with refugee status at Pillar Point face a different dilemma. They cannot be forced to return to Vietnam. Their dream is resettlement in the US, Europe, Canada or Australia but countries are not accepting them. They are stuck. And time is running out.

China says it wants all the Vietnamese removed from the camps by July 1997 when it takes over sovereignty of the territory from the UK. Negotiations are under way between Hong Kong and UNHCR but there is no solution in sight. A UNHCR spokesperson says the organisation is continuing to search for resettlement places. 'An ideal situation would be for these people to be accepted somewhere else - the US, Canada, Australia, but that's looking increasingly unlikely. Nobody wants them. We hope it will be solved before the 1997 deadline. We still have a year to go - things can change.'

Meanwhile, about 400 of those granted refugee status have moved into Hong Kong city. But they are finding it difficult to integrate and feel they are second-class citizens. They are paid less for the same work and are often excluded from the Chinese community.

The 900 people at Pillar Point include a recent arrival of 200 Vietnamese refugees from Taiwan, but because of the camp's poor reputation, they opted for internal segregation and are living in two refurbished blocks in a cordoned-off area.

After years living in temporary, sub-standard accommodation, burdened with the pressure of not knowing where they will be living next, and having their hopes of resettlement constantly dashed, the refugees' moods swing from elation to despair.

'The people are anxious,' says Christophe Stokes, head of the Médecins Sans Frontières mission in Hong Kong. 'They lead a marginal life, in uncertain conditions. Less than 100 have been resettled to Australia and Europe. They have been there since 1988, now they are nearing the end and have wasted those years. If they went back to Vietnam, they would lose face. They carry the hopes of their families and even villages. Because if one person gets resettled, for example, to the US, it opens doors for others.'

A high number of the adult male population misuse drugs. Heroin in Hong Kong is cheap, widely available, of excellent quality, and the refugees have easy access to it (see box). They used to smoke opium in Vietnam but years in the camps have seen them turn to intravenous heroin use. Stokes argues the extensive drug use is contextual - the men use heroin because of the limbo-like situation in which they have been placed.

Stephen Brooker, co-ordinator of the MSF medical clinic in Pillar Point, says: 'This camp is going to be the political hot potato. The residents have refugee status but what does this mean in Hong Kong? It's different from having immigrant status as the mainland Chinese community does. There are rumours that the Chinese government might move them to an isolated part of China because it does not want them. Vietnam does not want them. The rest of the world does not want them.'

Stokes has a solution - let the Western countries which have already accepted some of the boat people take the remaining refugees. 'It would be a small burden for the countries which have already accepted Vietnamese - we are talking about fewer than 1,500 people,' he says. His solution appears simple but it depends on the will of the countries which the refugees wish to enter.

And there is a further complication. The majority of the men in the camp now have criminal convictions, primarily drug-related. The refugees believe criminal convictions will bar them from ever leaving Hong Kong. Wives are divorcing their husbands in an attempt to keep their dream of resettlement alive. But the UNHCR says there is no such ban. Every case is treated individually and some of boat people who were originally accepted into the US had convictions.

What is clear is Western countries, which do not want to take these people, are using criminal convictions as an excuse to keep them out. And leaving them to remain in the desolation which is Pillar Point.Handling drug misuse at Pillar Point

In 1988 the Hong Kong government invited non-government organisations to work in the detention centres in response to the worldwide outrage at the appalling conditions there. Most have left as the deadline for the takeover by the People's Republic of China approaches.

Médecins Sans Frontières is one organisation which remains. It continues to provide medical services in both the detention centres and at Pillar Point. 'If we don't do it, nobody will,' says Christophe Stokes.

The agency has just set up the first needle exchange programme in Hong Kong. And it is doing it in an isolated refugee camp. English nurse Stephen Brooker, co-ordinator of the medical clinic, is at the forefront. The programme is just one part of a broad-based drug project, which includes methadone programmes; education about vein control; rotating sites; and needle fixation.

Aided by a Vietnamese counsellor, Brooker has distributed the first needle packs to reduce the amount of sharing and risk of infection. Installing individual boxes to dispose of used needles is under consideration.

Vietnamese people may feel somewhat isolated, and are even excluded from the drugs services run by Chinese people for Chinese people, Brooker explains. The drugs clinics in Hong Kong have a progressive attitude but they may lack cultural appropriateness.

But the drug users do not use the medical clinic - only mothers and people with chronic conditions. Brooker has to build up their trust, just as he has with the mothers in the camp.

He faces an uphill battle. 'Drug users are really looked down on in Hong Kong,' he says. 'If you are a nurse and work with them, you are at the bottom of your profession. In relation to people with HIV and people who misuse drugs there is so little education and training. The approach is like that in the UK 20 years ago.'