Turning suffering into beauty - through capturing the resilience of the human spirit in the face of unspeakable brutality - has been a hallmark of Vann Nath's life and work. As one of only three living survivors from Tuol Sleng prison, his paintings provide an artistic record of the genocidal regime. Yet his work transcends mere documentation - his paintings seek to both illuminate and give meaning to the collective suffering of Cambodians under the Khmer Rouge.

But though his paintings may have become enduring symbols of the Cambodian people's triumph over tyranny, Nath is himself growing increasingly fragile. He survived a year of living hell in S-21; today he fights another battle - his health.

"My health is in critical condition; I am experiencing kidney complications that prevent me from urinating - this can be fatal," he explains. "I receive treatment [dialysis] twice a week - at first in Bangkok, but now at Calmette Hospital."

A recent deterioration in his health has obliged Nath, 61, to return to Bangkok. Kidney failure - the loss of the kidneys' ability to excrete waste - is potentially life threatening and requires intensive treatment. The cost of his dialysis is exorbitant - $100 for the first visit, $50 for the second. Every fourth visit he receives a blood transfusion, costing around $80. Each month, he spends around $600 to $650 on treatment.

Nath receives many donations from patrons, friends, and NGOs, from as far a field as Germany, the United States, England and Canada, and has raised over $15,000 to cover the costs of his treatment. But now he is facing severe financial difficulty as he is obliged to find ways of covering his medical costs himself. In France, the surgery he urgently needs - a colostomy - comes with a steep, non-negotiable, price tag of $80,000.

Chey Sopheara, the director of Tuol Sleng Museum, who last saw Nath in mid February, explained how delicate the artist's health is and urged the government to help with the cost of his healthcare.

"His colostomy damage is 100 percent," he said. "He is a very important person - he is living evidence, a former victim of S-21 who can describe the truth about history. My idea [is that the government] should support him, should treat him."

Despite his failing health, Nath remains dedicated to his work, which he considers a vocation rather than an occupation.

"Painting is not easy like taking the screws out of a car or disassembling a radio," he said. "It requires a tremendous amount of time and discipline to foster this skill. One must understand art's concepts and principles."

For Nath, the concepts and principles of his discipline have been a tool that allowed him to examine his own and his society's evolution. Now, as the KR trial draws closer, he argues that this legal process, by forcing those responsible to acknowledge their crimes, will help Cambodia move beyond this bloody chapter of its history.

"We have been waiting for almost 30 years for this," he said. "I believe in the government. If there were no international trials, senior leaders of the Khmer Rouge would remain distanced from their responsibility for the crimes. They need to be held accountable instead of using the same rhetoric: 'I only did what I was told from the top.' I do not want to hear this. Instead, I want them to admit their responsibility for their actions. The trials would put final judgment on this."

Nath was 33 in 1978 when he was sent to the Tuol Sleng prison, charged with offending the moral order of Angkar - the secret Khmer Rouge organization responsible for policing society's morality.

Nath owes his life to his work. Quickly recognizing that he was a skilled painter, Duch - Chief Director of Tuol Sleng - set him to work painting propaganda portraits of Pol Pot.

When the regime fell in 1979 Nath was one of only seven survivors from S-21. He saw a list of names of all those who had entered the torture center, his name was on the list - but next to it Duch had written "Keep the painter."

Nath's family life was torn apart during the Khmer Rouge regime.

"I was married during the time of the Khmer Rouge and had two children," he said. "Both perished. My wife and I were reunited when the KR fell. Currently, I have three children - two girls, one boy - and am still happily married with my wife, Kith Eng, after whom my restaurant is named."

Nath received formal artistic training before his incarceration, and was working as a painter at the time of his arrest.

"I painted because it was my profession - a profession that supported me" he said. "Since childhood, I disciplined myself because I wanted to excel. When I reached my goals, the war happened, which halted my ambitions and I could not continue my profession."

His approach to painting was transformed by his experiences under the Khmer Rouge and his unique method has since proved an inspiration for modern Cambodian artists.

Sopheap Pich, a contemporary painter and co-founder of Saklapel, an organization dedicated to fostering contemporary visual art creation, says the strength of Nath's work lies in the way he uses personal memory to paint a collective story.

"He had formal training," Pich said. "But at the same time he was also not a very formal narrative painter, a historical painter. I felt that the paintings that he did were very strong - there are no photos of those things he painted. I didn't think of it in terms of high art or low art or self-taught. I respect that [his work is] journalistic in a sense - making up the story as you go along."

Nath's technical skills have taught a younger generation of artists valuable lessons.

"He does not shy away from color," Pich said. "He is not out to show people how to paint, but his influence is unmistakeable."

But it is the unique way Nath has worked his life experiences into his artistic creations that has proved most inspiring.

"He has an affinity to imagination, not just photographic memory," Pich said. "I think he is the greatest Cambodian painter [who says] 'Look at your life and understand your life - learn enough skill to facilitate expression of that life'."

Despite the admiration he inspires, Nath is modest about his legacy.

"I am not going to tell others what they should remember me for," he said. "If they see me as a painter, a Khmer Rouge survivor, a grandfather, an educator, then let it be. My legacy is a matter of personal interpretation."

Co-authored by Cat Barton