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Back on the streets, but with a new mission

A former sex worker returns to the streets of Kochi, but this time for a worthy cause – to fight what state health authorities admit is a gradually growing epidemic in the state, and to clear up some popular misconceptions about women sex workers. Anosh Malekar hears her story

Don’t reveal my name, she requested at the end of an hour-long interview held in a modest tenement on Judges Avenue Road in downtown Kochi rented by an NGO, Swantham Social Service Society. So we shall call her Abhaya, a former sex worker, who has been an active member of Swantham for the past five years. She wished to remain anonymous to protect her educated daughter’s future prospects; the proud mother gave a detailed account of her daughter’s academic achievements and prestigious job, none of which can be disclosed here.  

But Abhaya had a lot to say about other matters, based on ground realities and personal experience of the AIDS epidemic, right from the time it hit India. She had strong and perhaps controversial, opinions: If only all the money pumped into HIV/AIDS campaigns went directly to the rehabilitation of sex workers and other high risk groups instead of to NGOs that spend huge sums on pamphlets, workshops, meetings and travel…Believe me, there are more HIV-positive persons inside respectable homes than on the streets of Kerala…and so on.

Swantham was founded nearly a decade ago by social activist K V Mary as a collective of sex workers. It was registered as an NGO in 2003 and is currently headed by a feisty activist named Maniamma. It has 350 sex workers as active members, who interact closely with 1,166 of the 1,550 sex workers identified by the NGO on the streets of Kochi as their target group.  

Figures differ. “There are 1,630 sex workers in and around Kochi if one goes by NACO figures for 2008,” according to Saju Joseph, project manager of the state government’s Suraksha Project – being implemented by Swantham - to control the transmission of HIV and related diseases in the state. He claims that Kerala is perhaps the only state in the country where 10 organisations managed by sex workers are working to achieve this goal together with the social welfare department.  

Kochi has an estimated population of 600,000, with an extended metropolitan population of about 1.5 million, making it the largest urban agglomeration, and the second largest city, in Kerala after the capital Thiruvananthapuram.  

It was on the streets of this city that Abhaya began life as a sex worker after having run away from her home in Alleppy some three decades ago. “I was 13 and a class seven dropout. One day my elder brother beat me up for some domestic reason and I ran away. Out on the streets I got sucked into the sex trade when still a teenager.”  

For nearly a decade it was a high-risk life selling her body for a living. It was the mid-seventies and AIDS was still unheard of. “We never used condoms, and sexually transmitted infections and diseases were commonplace as basic hygiene was our last priority. The customers kept coming well past midnight and if they could afford it, we booked into a cheap hotel or else the business would be conducted inside a municipal garden or an open ground,” she recalls. 

Abhaya heard of AIDS for the first time in 1982. “I distinctly remember it was the year I gave birth to a daughter. There was this animated talk everywhere on the streets of the disease occurring in far-off America and Africa. It was widely perceived as a foreign disease and none of us thought about it then, much less that it would arrive at our shores within a few years.” 

The first HIV-positive person in Kerala was identified in 1987, roughly around the time Abhaya started seriously thinking of leaving the sex trade, but not because of the HIV/AIDS threat. “My daughter had grown up and started going to school. I was lying all the time, to my neighbours, at the day-care centre and the prestigious convent school where I had admitted my daughter. Once I went there to attend a parents’ meeting and bumped into a couple of men who were my regular visitors.”  

Shocked and disturbed, Abhaya shifted her daughter to another convent school with a boarding facility. But as much as she tried to shield her daughter by concealing her real identity, she would invariably come across someone who had known her from the streets. 

“In 1989, when my daughter turned seven, I finally decided to get out of the sex trade and married a man who knew my past. To lead a normal life was such a relief after a decade spent on the streets! All the uncertainty and lying was suddenly over, though there were newer challenges.” With some difficulty they found a place to live in a quiet area of Ernakulam and Abhaya started doing odd jobs like selling milk to supplement her husband’s meagre earnings as a mechanic.  

Didn’t they ever think of migrating elsewhere in search of anonymity and perhaps a better income? “Thank God, no,” she says in a flash, and reminds me that the prevalence of HIV/AIDS is lower in Kerala compared to others parts of the country. 

If one goes by NACO estimates based on data from the annual HIV Sentinel Surveillance Survey (HSS), and other available data from the population based surveys such as the National Health and Family Survey, the HIV prevention and control strategies adopted by Kerala are going in the right direction.  

According to the HSS, conducted from October 2007 to January 2008, HIV prevalence in Kerala has shown a marginal decrease from 0.30% in 2006 to 0.26% in 2007, putting the estimated number of people living with HIV in Kerala at 55,176. This is lower than the national prevalence of 0.34%, which translates to 2.31 million people living with HIV in the country. 

Activists say that in Kerala today, for every two infected men, there is one infected woman. Swantham president Maniamma says: “Most of the infected women get it from their husbands. The infected men and women are generally in their late twenties or early thirties.”  

Surveillance data shows that more than 86% of HIV infections in the state were acquired heterosexually and very few infections were acquired through blood transfusions or injecting drug use. State health authorities admit it is a gradually growing epidemic in the state. According to the findings of the latest ‘Behavioural Surveillance Survey in Kerala’, 89% of sex workers had unprotected sex with one-time clients and 67% with regular clients.  

Abhaya recalls: “I was lucky to escape the streets and get married. I was not at risk any more, having settled for a secure life. But I could not help thinking of those still trapped in the sex trade. These women ran a high risk of getting infected.”  

To go back to the streets proved one of toughest decisions she has ever made, Abhaya says. Her husband and daughter were firmly opposed to any plans involving contact with sex workers. She had spent the intervening 15 years educating her daughter and supporting her husband through various income-generating activities like stitching, soap making and manufacturing paper bags. Why seek out the old life again?  

But when the opportunity to help others trapped in sex work came her way in 2003, she took it.  

Swantham founder Mary recalls: “The organisation was looking for someone to train sex workers who were rescued and rehabilitated as part of our initiative, and she appeared at our door armed with a beautician’s course. At that point of time her only concern was to get as many women as possible out of the sex trade and empower them to lead an independent life.”  

Abhaya vividly recalls her early days with Swantham: “Most sex workers visited the premises for rest, mostly in the afternoon, having spent the night on the streets. I would ask them why they didn’t learn some useful skills that would help them become self-employed. I would narrate my own experience of leaving the sex trade to lead a normal life.”  

A few months later, she approached the municipal corporation for seed capital to start a business, but the request was denied because the women had no permanent address.  

Abhaya then approached the Kudumbashree Mission, a state government initiative to eradicate absolute poverty through concerted community action. With its help she started a stitching unit with 10 women and a seed capital of Rs 2.5 lakh, including a bank loan of Rs 1.25 lakh. This was a big success: within six months the bank loan had been repaid and the sex workers realised, for the first time, that there were other means to earn a living.  

While such income generation activities expanded over the next couple of years, the big break came when Swantham was chosen to implement the Suraksha Project targeted at underprivileged women and their partners like migrants, rickshaw drivers, and hostel students, who are already infected or are particularly vulnerable to infection. 

“We received funding in November 2006 to run the project for a year among our target group. But in the initial stage it was very difficult to convince many of our members to participate,” Maniamma recalls. One of the first questions the sex workers would ask Mary and Maniamma was “what benefit is there for us in this?”  

There are 52 organisations working in HIV/AIDS across Kerala, of which 15 are exclusively for female sex workers. But very few can claim to have first hand knowledge of the problems faced by female sex workers.  

“Our case is different. We started as a collective of sex workers so a majority of the active members were once sex workers. We use to say that we are sex workers like you and know your problems,” Abhaya says. 

Having worked in the field, Abhaya knew that it was impossible to curtail risky sex activity on the streets. But it was possible to curb the risks for the women. “There must be around 25,000 sex workers in Kerala. Half of them operate from the streets in the absence of permanent brothels. Sex workers, legally marginalised by a system that criminalises prostitution, have no legal or political rights, nor do they have any health rights, though they have specific health needs due to indiscriminate sexual activity that involves physical and mental traumas.” 

There are targeted interventions among such ‘high-risk groups’ by the national and state AIDS control societies with foreign aid from the likes of the Gates and Ford foundations, promoting standardised international strategies and programme components like condom promotion, STD care etc.  

The Kerala government has recently started counselling and voluntary testing of those with high risk behaviour, and offers help to get access to care and plan for the future. Every district now has a Voluntary Counselling and Testing Centre (VCTC), where people can obtain HIV testing as well as avail counselling services at a nominal fee of Rs 10. 

These interventions have been fairly successful in their prime objective of restricting the spread of HIV and related diseases, but Swantham believes that governments and agencies are not focusing enough on the power relations in sexuality that go against the women.  

“What use is counselling when female sex workers are still unable to persuade their male clients to wear condoms? The only alternative for them is to use condoms themselves. But the condoms supplied to them are male condoms. If the government and NGOs promote female condoms in targeted interventions, it would succeed immensely,” says Abhaya. 

She is of the firm opinion that change cannot come through force. There have to be practical solutions. “We are given high targets by the government, but there is only one voluntary testing facility for the whole of Ernakulam district, where sex workers who work the entire night are expected to report for tests at 9 am. That has to change.”  

Saju Joseph acknowledges that Abhaya’s active involvement in the Suraksha Project has given government agencies unique insights into the problems of sex workers.  

“She is a talented and determined woman and has become our main link with the sex workers. It was largely due to her that Swantham grew from a small women’s collective to one of Kerala’s leading NGOs,” Mary says. 

Today, Abhaya is at the forefront of Swantham’s efforts to launch an ambitious project to rehabilitate around 100 sexually-exploited women and also set up a legal-aid cell to help sex workers in distress. “So much of money is donated and wasted on HIV/AIDS, but we want to do real work that directly benefits the high risk population of women sex workers,” she says. 

Personally for Abhaya the last five years spent with Swantham have been the most satisfying years of her life. Recently, she even contacted her brother in Alleppy, while her daughter and husband have come to accept and appreciate her social work.  

“I feel I am lucky to be able to do what I wanted to do. Swanthan will achieve much more in the coming years,” says Abhaya confidently.  

But she says her job would not be completed until popular misconceptions about women sex workers are cleared - that they are moral hazards, vectors of disease, and objects of pity. This despite official statistics that female sex workers form less than 1% of the HIV infected female population in India. 

“My next task will be to take steps so that society stops treating us as a public health threat.” At 46, Abhaya has plenty of time to accomplish her objective. 

InfoChange News & Features, April 2009