|
Fighting for their health, India's sex workers mobilize
By Nicole Rajani
April 2, 2003
At the age of 12, Laxmi was traveling north from Bangalore in southern India
when she was kidnapped from a train platform in Mumbai. Her captors forced her
into the city's burgeoning sex trade. Although she is no longer a sex worker
herself, Laxmi has become a brothel owner, a peer leader, and a strong voice
for safer sex among her "girls." She simply tells them and their clients,
"Either you listen to me, or you will die of this disease." The clients' money
is collected beforehand, and she has a stock of condoms at her brothel. She
gives them out if a client does not have his own. If her supply runs out, Laxmi
asks for money. "I tell them, if you don't use condoms, you can have no
relations here and send them out," she said.
Laxmi is a Bai (a mother or elder woman) participating in the Saheli Project, a
peer education program for commercial sex workers (CSWs) that focuses on sexual
health and social welfare. The Saheli Project is an initiative of People's
Health Organisation (formerly the Indian Health Organisation) that began in
1991. It was dubbed the "Bombay Model" for HIV prevention at the IX
International AIDS Conference in 1993.
"The original approach we took even prior to HIV was a peer-based model," said
the project's founder, Dr. Ishwar Gilada. "We realized that to work with the
sex workers, we needed to work at the community-based level, and we realized
that the best people to work for them was they themselves. It had to be a
self-help model."
Saheli concentrates on the red light areas of south Mumbai, including Falkland
Road, where they estimate about 2,000 prostitutes ply their trade. The women
line the road on both sides, standing in front of their brothel houses, often
with one hand on the wall and the other provocatively propped on their hip.
Most wear bright red lipstick and tight tops. Above them, children and men —
who could be their husbands or their clients — peer outside through barred
windows. Down the street, the Silver Cinema advertises films with titles like
"A House of Love," and a rusted but functioning machine dispenses Masti brand
condoms for one rupee ($.02) each.
Estimates of the sex workers population in Mumbai have ranged up to 500,000,
but recent surveys suggest the true number is about 15,000. Like other cities,
Mumbai's sex trade has an established hierarchy, with brothel owners at the
top, brothel managers in the middle, and "regular" sex workers at the bottom.
A highly structured model
The Saheli Project works within the existing hierarchy to create its
own pyramids. It selects leaders from the three groups to raise awareness of
HIV and sexual health issues among their peers. For every 25 regular sex
workers, Saheli chooses one leader to be the Saheli, which is "friend" in
Hindi. And for every 10 Sahelis, the organization chooses one brothel manager,
or Tai, which means elder sister.
By educating one Bai, 10 Tais, and 100 Sahelis, the Saheli Project can reach
2,500 female sex workers. The Project now covers about 5,500 sex workers in
Mumbai and also has a program in Pune, a city approximately 100 miles southeast
of Mumbai. "Once we pass the message onto one girl, it gets passed on to the
others," said Laxmi.
The Project has a mobile clinic that provides primary health care and
distributes condoms to south Mumbai's red light areas every Saturday. It also
offers referral services for those who need further care and treatment, as well
as counseling and support services. Every Friday, the Saheli Project and the
National Association for the Blind provide eye treatment for the women in the
Falkland Road area. Here they can get glasses, treatment for eye infections,
and cataract surgery if needed. Laxmi said of the Saheli Project, "All my
friends are happy now because they are getting treatment and care and their
needs are being met."
Like the highly successful and well-documented Sonagachi Project in Calcutta,
the Saheli Project uses economic incentives to recruit workers. The Sahelis
receive 150 rupees ($3.20) per month for one hour of peer education work a day,
and the Tais receive 700 rupees ($15) per month for part-time daily work in
peer education or 1,500 rupees ($32) for full-time work. Bais do not receive
stipends for their peer education work because they are considered to be of
senior stature in the social hierarchy. "Sex workers are in a trade, a
business, where they are paid for each act. We feel obliged to pay them if they
are giving up their time for our project," said Dr. Gilada. "We pay them in
lump sums every two to three months, but we also provide them with ID cards,
which is much more to them than economic incentives. They take this as a badge
of pride."
Also like Calcutta's Sonagachi Project, which enabled that city's prostitutes
to form their own committee and union, the Saheli Project is meant to empower
women to protect their health and address their own individual needs. "There is
a saying in Hindi, ëGhayal ki gati ghayal jaane, aur ne janne koi,'" said
Dr. Gilada. "Only the betrayed can understand the feelings of the betrayed, no
one else can understand. So I being an outsider cannot understand the suffering
of a sex worker. Only they themselves can understand this. As an educated, or
socially conscious person, I can only go there and identify some leaders, with
whatever we think we can better their lives. Otherwise it has to be done by
them."
Linking health awareness to economic welfare has been an integral strategy. As
Dr. Gilada noted, "If a girl is sick with HIV and dying, she is herself losing,
but the brothel owner is also a loser, because 50 percent of her earnings goes
to the brothel owner. The brothel manager is also losing out because she can
only survive when the girls are surviving."
According to Dr. Gilada, condom use among sex workers participating in the
Saheli Project has risen from less than 5% in 1991 to almost 95% currently. Dr.
Gilada estimates that 75% to 80% of sex workers outside the Saheli Project now
use condoms with their clients. He says HIV prevalence among the Saheli sex
workers is approximately 35%. By way of comparison, India's National AIDS
Control Organisation estimates that in 2001, HIV prevalence among CSWs in
Mumbai and the surrounding state of Maharashtra was over 50%.
Communications strategies at work
Across the Indian peninsula is Tamil Nadu, a state with one of India's highest
rates of HIV infection and the country's highest number of AIDS cases. Tamil
Nadu's capital Chennai (Madras) is home to the Community Health Education
Society (CHES), another organization using the peer-based education model to
increase consciousness of STDs and HIV/AIDS among female sex workers. CHES's
"Women in Prostitution" program was established in 1998 and is funded by the
AIDS Prevention and Control (APAC) project in Tamil Nadu (which is supported by
a grant from the US Agency for International Development). CHES is one of six
organizations selected by APAC to focus on HIV and STD prevention among sex
workers.
Emphasizing the social and economic costs of unprotected sex is a key CHES
strategy. Peer educators use a "Loss and Gain Chart," a cartoon flip-top book
that tells the story of how a sex worker can either protect herself and her
family or fall victim to HIV and STDs. "In the field, we meet the sex workers,
and we have to engage them," said field coordinator Al Mahendra. "You can't
always lecture. First you will engage the girl with a story without telling her
what the thing is about. Through innovative games you reach her."
CHES selects three peer educators from each community of sex workers. It seeks
out those who seem to be outspoken and have strong communications skills. All
types of sex workers are targeted, including "floating" sex workers, who are
not necessarily affiliated with brothels or other intermediaries.
The peer leaders are trained in STDs, HIV/AIDS, and general health care issues.
Condom negotiation is a crucial skill that this program and others stress. "We
teach them the techniques for negotiation. If the client is young and
unmarried, we say she should remind him that he has to live long and get
married. She will tell him, 'I will teach you what sex is, but you have to wear
a condom,'" said Mr. Mahendra. "For middle-aged men, she will say 'your wife is
waiting, your children need you, and there are so many diseases, so you must
remain healthy.' And then if an older man comes in, she will say, 'even though
you are older, HIV can attack you.'"
While Saheli distributes at least 500,000 condoms per month, CHES has switched
to the social marketing model. "It's better if the sex workers get into the
habit of buying a condom, instead of getting it free, or if they don't, making
the client buy it," said CHES founder Dr. Pinagapany Manorama. "The present
marketing strategy of Tamil Nadu is you buy one, you get one free. You buy a
packet of washing soap; you get one free. This is a recent trend in marketing.
So that way making a girl who has never spent money on a condom buys one, it is
a very big achievement."
CHES estimates that it has reached 7,000 sex workers through its programs.
According to a 2002 APAC survey, 88% of sex workers use condoms with their
clients, compared with 56 % in 1998. Mr. Mahendra recalled, "In 1998, sex
workers didn't show a concentration on their own care and health. They didn't
show concentration on partner treatment. They didn't know what kinds of condoms
were available in the shops or by the government sectors. They didn't know what
kind of help they could get at the government hospitals. All of these things
have improved since then."
Confronting discrimination
India's Immoral Traffic Prevention Act (ITPA) prohibits the trafficking of
human beings and forced prostitution. Prostitution itself is technically not
illegal. Anyone over the age of 18 engaging in prostitution of her own will,
and not in public areas, is theoretically protected. But in fact, sex work is
criminalized because every act required to carry out prostitution is
characterized as a crime by Indian law. The ITPA punishes anyone maintaining a
brothel or living off the earnings of a prostitute. Moreover, police are
allowed to conduct raids on brothels without a warrant based on the mere belief
that an offense under the ITPA is being committed on the premises. The law also
penalizes anyone who solicits or seduces for the purpose of prostitution, or
who carries on prostitution near public places.
As a result, sex workers in India are perpetually harassed and arrested by the
police. Dr. Gilada explained the problem with the law: "A policeman can pick up
any girl who is a sex worker from the street and say that you are violating
Section 7A, soliciting in the street. How do you know if she is soliciting or
just walking on the street, going to buy something from the shop? You can't
differentiate."
The Indian police are themselves active partners in the commercial sex industry
and major beneficiaries of the system. Most sex workers must pay bribes to
their local police officers so that they will allow them to work. Yet the same
officers who are paid off often physically and verbally abuse the women.
Organizations like SANGRAM are attempting to transform the public perception of
prostitutes as victims unable to defend themselves. SANGRAM uses peer-based
intervention to help prostitutes claim their basic human rights. Its leader,
2002 Human Rights Watch award-winner Meena Seshu, has gained international fame
for empowering sex workers to be their own agents of change.
In 1992, Ms. Seshu founded SANGRAM in Sangli, a district on the southern edge
of Maharashtra state. Sugar-rich Sangli is about 250 miles from Mumbai and a
major junction for the country's trucking industry. To confront the
stigmatization and violence they face, the CSWs of SANGRAM formed a collective.
"A sustained effort to combat violence is possible only if the women in the
communities are united and organized. Self-organization through empowerment is
one of the primary objectives of SANGRAM," said Ms. Seshu.
SANGRAM's peer educators have also made strides in HIV/AIDS awareness in the
wider community. SANGRAM currently works with 5,000 female sex workers in seven
districts on both sides of the Maharashtra-Karnataka state border. It
distributes 350,000 condoms per month.
Power inequalities continue to play a significant role in the spread of HIV
among sex workers and their partners. Those in positions of authority still
pose a threat. "Although condoms are used with paying customers, they are not
always used with maalaks or lovers, pimps, male brothel owners and the police —
who still have the power to refuse a condom," said Ms. Seshu.
In the course of their efforts, SANGRAM outreach workers have faced intense
harassment from local gangsters and police. According to Human Rights Watch,
sex workers from SANGRAM working in Nippani, Karnataka, were harassed by local
thugs supported by the ruling political party to the extent that they were
forced to flee their homes in early 2002. The women tried to file a complaint
with the police, but their request was denied. The police claimed that they
were not "normal citizens" and did not have the right to file complaints.
Meena Seshu was subsequently accused of using HIV/AIDS education as a front for
promoting and profiting from sex work. However, Ms. Seshu persisted and forced
an investigation into the acts of violence. She gained support from around the
country, and her program survived.
Clumsy paternalism
Sensitizing law enforcement officers to the particular needs of sex workers is
a key component of community-based interventions in India. CHES and the Saheli
Project hold training sessions to enlighten police about the grim realities of
sex workers' lives.
Enhancing such sensitivity has its ironies. Dr. Gilada pointed out that some
officers, who think they are helping by arresting or "rescuing" a [sex worker]
from the street and the clutches of a brothel owner, do more harm than good. He
said, "If you have not given her meaningful livelihood, a meaningful economic
alternative, the sex worker that is ërescued' from here goes to other red
light areas, and after some time, comes back to the same red light area. We
have found that girls become poorer each time they are rescued; when a girl is
arrested and taken away, her belongings, her money — anything precious to her
is left at the brothel. When she comes back, it is all gone — so she has to
start afresh. And once she's rescued, to come back to any place, she has to pay
a bribe."
[Sex workers'] ostracized status remains a fundamental challenge to improving
their lot and reducing the threat of AIDS. Meena Seshu observed, "Being women
in prostitution puts them into a caste — a class of their own. This caste-class
occupies the lowest rung in the hierarchy and is structured outside the
hierarchy, as we know it."
Copyright 1999-2004, AsianSexGazette.com. All rights reserved. No
content may be reproduced in whole or part without written permission.
Please contact us via the link below for re-print and syndication policies.
|
|
Small-town
Indian sex workers put up a big fight
3-7-2002
India
fails the Aids
test
12-1-2000
India,
Bangladesh read warning signs for AIDs
explosion
3-9-2000 |
