Enabling voices to be heard
HIV, Social Development and marginalized people
Sisters, Friends and Activists,
I am extremely happy to be here today and participate in the largest ever gathering of sex workers and trasgenders in India organized to coincide with the International AIDS Conference. I would also like to congratulate the Durbar on its 20th birthday. It must be a great moment for all those who have gave shape, life and sustenance to Durbar. I would like to applaud them as what they have achieved is not a small thing.
I remember the day in 1992-3 when DFID came up with a proposal to fund what was called the Sonagachi Project. At that time, we were very concerned about port towns like Mumbai, Kolkata and Chennai as it was believed that HIV infection was entering the country through the navy and spread through the scattered sex workers around port towns. Kamathipura was the most famous with over 60,000 sex workers located in a thriving business area. Not long after the launch of the DFID project, preliminary results starting pouring in that showed that HIV and STD infections were very low in Sonagachi while in Kamathipura HIV was almost 50%. Sonagachi was thus the first model we had that had been successfully implementing a strategic approach to prevention of HIV transmission and that too on scale. It took 10 years and Gates Foundation to realize the significance and importance of Durbar as it went onto replicate the model in Mysore and other places. Today we have over a dozen such collectives. Though the other 1600 Targetted Interventions among marginalized groups are run by NGO’s, the core principle of inclusive decision making and empowerment of sex workers are sought to be inculcated. Sonagachi was thus a pioneer in our thinking and understanding of the collectivization of sex workers.
Collectivization is not a formula that anyone can simply apply. The underlying concepts are very profound and are based on a critical understanding of the structural factors that influence sex worker behavior and responses to society. A clear understanding of these factors and deconstructing them into operational tools and strategies in order to replicate and scale up is a complex process.
Such an opportunity came in 2007 when I was DG NACO. While NACP I grappled with trying to understand the disease and how to cope with it, NACP II gave a clear commitment to working with marginalized groups and introduced the concept of Targetted Interventions to be implemented by NGO’s. But the impact was weak and halting due to organizational weakness of NACO at the national and state levels. By 2007 when NACP was born, we had Avahan adopt and adapt some of the learnings from the field with excellent results.
My first contact with sex workers was in 2006, when I visited Ashodaya in Mysore and where I met the remarkable people – sex workers and transgenders in leadership positions, talking with confidence and authority about their vulnerabilities, problems and challenges. Later in the year I visited Sonagachi which stunned me with the organizational scale. It was interesting to see how the two approaches differed – while Sonagachi was a collective of women who chose to step out of society and find a place for themselves, Ashodaya, was a collective where women continued to live within their family structures and struggle to find their spaces within society.
I was inspired by both and at NACO we sought to aim at making 50% of TI’s as collectives modeled on Durbar. But we have barely a dozen, the reason being that collectivization needs sustained leadership and is based on trust.
While collectivization meant empowerment, giving space for participation and a voice in decision making, the underlying principle was respect for the sex worker as opposed to viewing them as immoral and therefore to be reviled and treated as outcasts. NACO neither approved not condoned sex work – it merely stated that all those vulnerable to HIV need to be viewed on principles of humanism and equality. Thus NACP III adopted these principles and values as underpinning its TI strategy.
The second gap that we at NACO found was that in the process of providing space and voice to sex workers and transgenders, there was little effort made to ensure that such empowerment also enabled them to value themselves which meant their own health and wellbeing. Access to condoms and treatment of illensses and diseases, early diagnosis of HIV and early treatment, access to abortion and reproduction services were not factored in and therefore not monitored or provided for. I am happy to learn that impressive work has been done in this regard and nearly half of the marginalized groups are able to access basic health care. Accessing basic health care services, to stay healthy and well is the right of every citizen and of sex workers, transgenders and other marginalized groups. Social empowerment must translate into being healthy and living a disease free life and dying in dignity. Of what use is a loud voice of freedom if the individual at his or her most vulnerable time, struggling for life, left uncared and unattended for ? I commend Durbar and other collectives and NGO’s who have worked hard to bring among the sex workers an understanding of valuing their own life and health in the first instance. More needs to be done and I look out for the day when marginalized groups will demand their dues from the health providers.
The challenge that NACO and sex workers face today however is the changing face of sex work in keeping with the rapid changes in the external environment – cell phones, easier mobility and a different demand and understanding of sex work.
The biggest challenge today is that compared to ten years, today sex workers have come a long way. Sex workers are able to voice their concerns, articulate their problems and demand that they be socially accepted and treated like all others on basis of equality for obtaining say house sites, bank loans, credit, ration cards, employment etc. In few places some sex workers and trasgenders have been able to negotiate a more positive response with the local authorities, but the challenge has and continues to be in the legal and social status accorded to this profession.
All of 2008 and 2009 NACO fought with the Women and Child Development Department against brushing all sex work as trafficking and punishing clients. The view that all sex workers are exploited, need to be rescued and rehabilitated with economic schemes continues to prevail and it is such traditional attitudes that refuse to accept the concept of choice or that sex work be treated as a profession like any other.
The basis of such thinking is correct. A majority of women in sex work got into sex work due to social and economic compulsions that they could not overcome. But thereafter, and increasingly, women are getting into this profession as a matter of choice. This means that many today have the option to come out of this profession or not get into it but do so by making their choice. Social acceptance of sex workers will continue to be a struggle as sex workers are seen to challenge the sanctity of the institution of marriage and family.
In this regard, our experience of the struggle to amend Article 377 pertaining to MSM’s is instructive. We need to further strengthen the advocacy for the rights of sex workers to enjoy the same freedoms and entitlements under the constitution as other citizens do since the Constitution has not and does not discriminate against anyone based on choice of profession. This requires advocacy at the political level and debates with the judiciary and media to create the environment. Compared to 2000 today there is a far greater understanding and acceptance of MSM. Similar should be the effort to have society not criminalize sex work but regulate it the way it regulates other professions
(Ms Sujatha Rao, ex Secretary and Director General (National AIDS Controal Organisation), India delivered a key note address in Hindi at Sex Worker Freedom Festival, Alternative International AIDS Conference held at Kolkata. Here is the English version of her address. Thanks to Ms. Rao for sharing.)