No Excuses: A living experience of the struggle for rights

No Excuses: A living experience of the struggle for rights

Sex workers are the most effective educators of both their clients and other women in sex work. They know best that top-down programs, not guided by community knowledge and participation, do not work. And, after resisting attempts by middle-class social workers in India, who knew very little about sex work, they successfully showed the social workers the way. Within six months, 5,000 Indian sex workers were reached and 350,000 condoms were distributed monthly.

"As we struggled, we learned that pragmatically only rights-centered approaches actually worked," Meena Saraswathi Seshu told a plenary audience at the International AIDS Society conference in Vienna on June 22. She said this is the approach that continues as her organization of sex workers and activists works with rural women, young people, men who have sex with men and transgender people.

Seshu delivered the Jonathan Mann Memorial Lecture after being introduced by Jeffrey L. Sturchio, president and CEO of the Global Health Council. Sturchio told the packed hall that Saraswathi Seshu honored Mann's memory by following in his footsteps in the quest for human rights for people affected by HIV/AIDS.

Seshu is general secretary of Sampada Grameen Mahila Sanstha (Sangram), an organization based in Sangli, West India, which has worked for the empowerment of people in sex work, including mobilization for HIV-related peer education since 1991. In 1996, this work broadened into the organization of a collective of women in prostitution called VAMP.

It was the sex workers in Sangli who saw the importance of confronting HIV and human rights as a real - not rhetorical - everyday guide to action, Seshu said. And this they did by creating the Sangram Bill of Rights:

1. People have the right to be approached with humility and respect.
Seshu said health workers in India were not treating health workers with respect and so they avoided going to the public hospitals. So Sangram set up a temporary clinic outside the brothels, but the sex workers fled the city, abandoning their houses to avoid getting or being "coerced" into treatment.

"We learned our lesson," Seshu said. "You learn you can't tell people they must get a test or they must be treated. You can explain and offer but it must be in a way that allows them agency. It has to be a consultative process."

2. People have the right to say yes or no to things that concern them.
The sex workers realized that "HIV was like a big river and in working with sex workers, we had built only one dam," Seshu said. They said that men listened to sex workers about condom use but never discussed sex or condoms with their wives. They told her, "maybe we need to teach wives negotiation strategies."

3. People have the right to reject harmful social norms.
Sangram had many challenges in reaching rural women. "Giving them the language of rights and urging them to take control of their lives in not only a difficult task, it is near impossible in a rural setting," she said. Still, Sangram activists persisted with the slogan "Pleasure me safely," and held interactive sex education classes that have a strong feminist perspective and deals with controversial issues around sexual diversity, MSM, transgender people and sex workers.

4. People have the right to stand up to and change the balance of power.
"Working with networks of sex workers, women's groups, HIV/AIDS activists, queer activists within the country and outside has resulted in concrete gains," Seshu said.

By mobilizing these groups along with community leaders, the government of India abandoned its plan to amend the Immoral Traffic (Prevention) Act, which would have further stigmatized sex workers by criminalizing the purchase of sex services.
But the "most exciting journey," Seshu said, was influencing the request for proposals to the Global Fund for HIV/AIDS, TB and Malaria, round 10, from India.

The National Network of Sex workers is hoping to be included for the first time to choose their own "home grown" representation and want the sex worker collective to be the primary recipient of the funds.

5. People have the right not to be "rescued" by outsiders who neither understand nor respect them.
Seshu said that HIV became a problem at a time when the political power of religious fundamentalism was growing. Religiously motivated vigilantes from India, and eventually Christian conservative groups from the United States wanted to "rescue" sex workers from "lives of immorality," she said, and targeted Sangram and VAMP for its work. She said the raids have been violent and "were conducted with missionary zeal and thug-like brutality."

6. People have the right to exist how they want to exist.
Seshu said that the activists in India have been marginalized by the "hypocrisies of the system," but they have "the courage and strength to create a world that has much to offer. A world touched not only by their pain but also their dreams for a society and people who will affirm their ‘right' to self worth, dignity and livelihood that no one agency can either confer or deny."

Annmarie Christensen is director of publications and new media at the Global Health Council and executive editor of GLOBAL HEALTH.