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No Turning Back: Examining Sex Worker-Led Programs That Protect Health & Rights

In  the  late  1990s,  a  group  of  women  working  in  Nairobi’s bars came together to protest. They were disillusioned by the “corruption, tribalism, and poor leadership”  in  Kenya,  that  “translated  to  extreme  poverty,  violence,  and  desperation”  and  prompted  many women to work and sell sex in bars.

When the HIV pandemic hit, “homes were wiped out, and almost the entire country was losing loved ones.” As Peninah Mwangi, a former bar hostess, recalls,   “We   spoke   of   HIV/AIDS   in   whispers   and   with   fear.   Everybody  suspected  themselves  and  each  other  as  having  the  then  ‘death  virus.”

While  researchers  studied  sex  work,  and  posters  were  produced  warning  men   to   stay   away,   there   was   no   funding   for   programs   to   protect   bar   hostesses and sex workers from HIV infection, or provide those who tested positive with treatment and care.

At  the  same  time,  women  working  in  bars  faced  rampant  harassment  and violence   from   bar   owners,   clients,   and   the   general   public.   Bar   owners   demanded  sex  in  exchange  for  employment,  while  members  of  the  public  beat, raped, robbed, and even killed them with impunity. Police were equally abusive,  arresting  sex  workers  on  unfounded  charges,  performing  strip-searches,  and  demanding  sex  or  money  in  exchange  for  release. 

Peninah  remembers  a  “lean  constable”  named  Jimmy,  who  routinely  physically  and  sexually  assaulted  the  bar  hostesses  where  she  worked  and  refused  to  pay his bills. When a bar hostess was docked part of her salary because of his debts and confronted him, Jimmy’s response was swift. 

He blackened her eye, threw her screaming into his trunk, and arrested her for robbery-outraging the other bar hostesses. They reacted en masse, closing the bar, marching to the police station, and demanding to speak to the commander.

Disgusted  by  the  abuses  the  bar  hostesses  described,  the  commander  made Jimmy and five others pay every bill they owed. Buoyed by this success, Peninah floated the idea to her peers to form their own organization, and Bar Hostess Empowerment and Support Programme (BHESP) was born.

Peninah remembers the early hurdles. When she went to register BHESP as a non-governmental organization, she felt “ashamed, small, and inadequate,” and could not afford the $50 dollar registration fee.

She reached out to academics, international organizations, and businesses to seek advice and funding, but few responded.  In  the  end,  it  was  Kenya  Breweries,   the   main   supplier   of   alcohol   for   local   bars,   who   provided   money  for  BHESP  to  hold  its  first  meeting. 

In  1998,  100  sex  workers  and  bar  hostesses  gathered  and  agreed  to  work  together  to  fight  AIDS,  stop  violence,  and  lobby  for  increased  pay.  They  went  to  Kenya’s  National  AIDS  Control Council to describe how AIDS was impacting their community, and the  Council  helped  them  write  a  proposal,  register  as  a  community-based  organization,  and  secure  funding  to  start  teaching  bar  hostesses  and  sex  workers in Nairobi’s bars about HIV.

Peninah says BHESP missed opportunities in its early years due to lack of structures and focus. It had no strategic plan, and much of the organizational knowledge and responsibility sat with Peninah who was swamped with day-to-day  administration  and  had  little  time  to  step  back  from  the  work  and  think  about  strategy. 

BHESP  had  no  policies,  so  “employed  who  [it]  wished,  when  [it]  wished,  and  how  [it]  wished,  putting  [it]  at  risk  of  lawsuits  and  poor  performance of staff.”

When it became clear BHESP did not have the capacity to  undertake  a  project  funded  by  the  Open  Society  Foundations  in  2008,  the  donor  agreed  it  could  use  the  money  to  work  with  an  organizational  development firm to rethink its structure, develop job descriptions for staff, and  prepare  manuals  outlining  policies  and  procedures. Peninah says these steps were critical, enabling it to strengthen and expand its work.

Small Groups, Peer Education, and Home-Based Care

For its first several years, BHESP remained primarily focused on HIV. In 2005, it was selected as a partner for the Global Fund to Fight AIDS, Tuberculosis and Malaria.  This  allowed  it  to  reach  more  of  Nairobi’s  estimated  27,620  female  sex  workers and  expand  to  other  towns,  distributing  condoms  and  hosting  small  group  meetings  to  talk  about  safer  sex. 

In the meetings,  BHESP  would  ask participants if they were interested in working together to address local needs.  This  process  helped  establish  42  sex  worker  groups  in  four  counties,  ranging in size from 25 to 200 plus members.

Thirty of the groups have since registered as community-based organizations, and some are now mentoring others. These groups have become the foundation of BHESP’s work. BHESP  went  on  to  train  many  of  the  group  leaders  who  emerged  as  peer  educators.

Each of its 48 peer educators is responsible for bringing together 25 sex workers per quarter for a series of meetings to discuss work safety and health. The rationale is that, after three months, participants will be comfortable accessing  services  on  their  own  and  may  even  wish  to  form  new  permanent  groups.  Peninah  says,  “That  simple  act  of  reaching  out  really  changes  the  lives  of many of those 25.”

 

Some go on to be peer educators themselves, or get into activism, or go back to school. This was true for Mary Mugure who remembers that  her  struggle  to  find  condoms  first  brought  her  to  BHESP,  and  that  she  became  a  peer  educator  soon  after.

BHESP has three drop-in centers where the peer educators can host meetings. They are modest rooms with little more than  chairs  and  a  table,  but  BHESP  says  their  “safe  and  caring  atmosphere”  helps “dispel [sex workers’ ] sense of isolation and promote solidarity.

BHESP  also  runs  a  home-based  care  program  to  improve  the  health  and  quality  of  life  of  people  who  are  sick  as  a  result  of  AIDS-related  illnesses.  Its  104  community  health  workers  live  with  HIV  themselves, and  care  for  approximately 20 patients each, providing medicines and first aid for AIDS-related conditions.

They offer counselling to patients and families, connect them to support groups, and help with daily chores. The community health workers  also  help  to  identify  pregnant  women  in  the  community  to  refer  them to health services and ensure those living with HIV get the care they need to avoid transmission to their babies.

Source: https://www.opensocietyfoundations.org/reports/no-turning-back

 

Read 1268 times Last modified on Wednesday, 12 October 2016 09:00

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