|Sex workers in India combat stigma to demand rights and health care|
By Allyn Gaestel. Originally published on April 22, 2010 at Media Global.
As the United Nations calls for a greater focus on reproductive health this week, sex workers in India are independently advocating for their often overlooked needs and rights.
Sampada Grameen Mahila Sanstha (SANGRAM) is an HIV/AIDS organization that works primarily with sex workers. SANGRAM is based in the Sangli district in Maharashtra state. Maharashtra has HIV rates four to five times the Indian national average, and Sangli has the highest infection rate in the state. The HIV rate among sex workers in Maharashtra was 17.91 percent in 2007, compared to the 0.34 percent overall prevalence among adults in India.
The International Women’s Health Coalition (IWHC), an international advocacy organization for women’s health and rights, has partnered with SANGRAM since 2006 and produced a documentary about their work called “SANGRAM: Sex Workers Organizing in India .” Paradigm Shift, a feminist organization in New York, screened the documentary during an event on sex work and human rights in March.
Audacia Ray, program officer for IWHC visited SANGRAM and produced the documentary. She told MediaGlobal about SANGRAM’s approach to reproductive health care in Sangli: “The organization puts sex workers into leadership positions…it’s an organization that builds up the strength, knowledge, and abilities of people from within the community to make changes for themselves. The sex workers are empowered to claim their rights, especially the right to health services and the right to be free from violence.”
SANGRAM takes a unique approach to public health and HIV prevention, as the organization focuses not only on service provision, but also on empowerment for marginalized groups to stand up for themselves and demand the services to which they are entitled. Meena Saraswathi Seshu, founder and general secretary of SANGRAM told MediaGlobal by e-mail: “It is the randi [whore] stigma that pushes women-in-prostitution outside the rights framework, effectively cutting them off from privileges and rights supposedly accorded to all citizens irrespective of what they do for a living.”
Stigma hinders sex workers and other marginalized groups from accessing essential services. Seshu elaborated, “Some of the rights denied to women due to discrimination are: freedom from physical and mental abuse, the right to education and information, health care, housing, social security, and welfare services.”
SANGRAM’s initial program was condom distribution. They worked with women in the sex industry to distribute condoms in their community and advocate for safer sex practices in their relationships with clients. Seshu explained, “Three key concepts characterize SANGRAM’s peer education program: empowering, women-centered, and process-oriented.” Sex workers themselves promote condom use in a manner that makes sense for them and addresses their own needs and vulnerabilities. Because the program is process oriented, SANGRAM focuses more on the strengthening of women’s self-advocacy, rather than how many condoms are distributed. This allows for a more effective and durable program that in the long run is proving to reach more women.
SANGRAM has also expanded beyond the sex work community, forging links with health organizations, local police, truck drivers, men who have sex with men (MSM), children of sex workers, and housewives.
SANGRAM members have developed conflict resolution skills and advocacy strategies to stand up to authorities that have been historically abusive. Seshu spoke of previous “routine police harassment” and raids on sex worker’s houses and workspaces. Now sex workers are armed with rights awareness and self-respect to stand up to authority. While there are still instances of violence, the situation has much improved. Seshu told MediaGlobal “In some cases, VAMP [Veshya Anyay Mukti Parishad, SANGRAM’s sex worker collective] has successfully negotiated an end to police hostility and brothel raids. However, this does not mean that all VAMP members are able to confront and challenge police harassment. What has happened is that more women have become aware of their rights and recognize that they have the capacity to negotiate with others, including those in authority, and to defuse threatening situations.”
SANGRAM presents a multi-layered and humanistic approach to reproductive health. This perspective and methodology are important tools the international community can draw on as they reinvigorate the global reproductive health agenda.