Sex work is a complex and often stigmatised profession in India. Women engaged in this occupation face a heightened risk of HIV infections. The marginalised and vulnerable status of many sex workers, coupled with limited access to healthcare and safe working conditions, contribute to this health crisis.
It is essential to recognise that addressing HIV among women in sex work requires a multifaceted approach, including destigmatisation, advocacy for their rights, and comprehensive healthcare services. Only through these measures can we hope to reduce HIV infections and ensure the well-being of these women, who often face disproportionate challenges and social ostracisation.
Since 2003, the Catalyst Management Services (CMS) and Swasti- The Health Catalyst have project-managed a series of HIV interventions in collaboration with Swathi Mahila Sangha, a women-led community-based Organisation (CBO) of women sex workers in Karnataka.
From designing interventions to monitoring, evaluation, and capacity building of the leaders, the organisations played a pivotal role in bringing equity, equality, dignity and empowerment in the lives of women in sex work.
This article delves into the journey of a community-based organisation comprising 300 women sex workers. The organisation has evolved from modest beginnings to an impressive force of over 14,000 members.
Why a comprehensive aid programme for women in sex work was needed
Prior to 2003, few programmes addressed the unique challenges faced by sex workers, particularly in Bengaluru. During this period, the emergence of HIV infection prompted the establishment of some NGOs to focus on basic HIV and Sexually Transmitted Infections (STI) prevention initiatives.
However, these efforts concentrated primarily on providing information about transmission modes, referring individuals for STIs, and promoting condom use. The scale and depth of programmes required to address the multifaceted vulnerabilities faced by women in sex work were not adequately considered.
The impetus for a more comprehensive aid programme came from movements advocating for the sexual and human rights of sex workers in other regions, such as Bangladesh and Sonagachi in West Bengal. And so, a group of women engaged in sex work in Bengaluru decided to take action. With the assistance of a local NGO named ‘Samraksha,’ these women formed a collective known as Swathi Mahila Sangha (SMS) on December 15, 2003, and formally registered under the Karnataka Societies Act.
SMS sought to enhance the capacities of women engaged in sex work by providing them with the necessary knowledge, skills, and attitudes to safeguard their lives and livelihoods.
The core mission of SMS revolves around mainstreaming the most marginalised women by offering essential services, including healthcare, financial security, social protection, and legal rights, all based on the principles of human rights, dignity, and development.
As a collaborative partner, Swasti helped SMS conduct a needs assessment shortly after its inception, engaging with 300 women engaged in sex work.
The purpose of this assessment was to gain a deep understanding of their specific needs and formulate appropriate interventions accordingly. The findings of the needs analysis highlighted several key priorities expressed by the women. Foremost among these was the need to address and mitigate abuse and violations they faced.
This was followed by a focus on enhancing financial security and access to loans, providing interventions for their children, and facilitating access to government identification and social welfare schemes, whereas access to comprehensive healthcare seemed to be the last priority.
Building upon the insights from this assessment, SMS initiated its vulnerability and risk reduction programme. This programme aimed to bring about behaviour change, promote condom use, address and reduce instances of violence, facilitate financial support, promote access to cooperative Self-Help Groups (SHG), and ensure social protection, among other objectives.
The different areas of work of SMS:
Empowerment and dignity: SMS recognises that empowerment and preserving the dignity of sex workers are paramount. The team works to raise awareness among sex workers, enabling them to assert control over their resources and lives. This empowerment extends to financial independence, healthcare decisions, and advocating for their rights.
Services facilitated include: Behaviour Change Communication (BCC) through peer educators (trained fellow sex workers), formal one-on-one and group orientation on health, legal, financial literacy, life skills etc…, providing services based on their need – 24/7 violence redressal mechanism, access to door step financial services (savings, credit and insurance) and Social Protection Services (Government citizen IDs and schemes), skill building training to start diversified livelihood activities, support for children’s education etc.
Capacity building: SMS places a strong emphasis on building the capacities of women involved in sex work. This includes enhancing their knowledge, skills, and attitudes to safeguard their well-being and livelihoods. By providing education and life skills, SMS empowers sex workers to have better control over their lives.
Healthcare access: A critical challenge these women face is limited access to healthcare services. SMS works to bridge this gap by providing healthcare services, including HIV prevention and treatment.
Social protection: SMS has been facilitating social protection to community members to meet their needs such as voter ID, ration cards, Aadhar cards, PAN Card etc. and eligible schemes under the state and central government.
Financial security & livelihood: SMS facilitates access to supplementary livelihoods for women in sex work through skill-based trainings and enabling entrepreneurship to break the vicious cycle of poverty and marginalisation.
This work also includes enhancing financial awareness, encouraging savings, selling financial products produced by women and community organisations and helping women to prepare their financial goals.
Safety security & justice: SMS has a three-tier system and a committee to address the issues of violence and abuse among women in sex work. The team actively engages in legal reforms and campaigns to change the societal and legal perceptions surrounding sex work.
They also collaborate with the state legal service authority (SLSA) and district legal service authority (DLSA) to mitigate cases of abuse and violence.
- Level 1 – Creating legal awareness and responding to violence cases by peers and staff of community organisations directory
- Level 2 – Solving problems through helplines / community leaders / intermediate agencies
- Level 3 – Taking the help of local stakeholders / NGOs / Committees / and police and legal departments to solve the Violence cases
Community building: SMS aims to build a sense of community among women, by providing a platform for them to come together, share experiences, and support one another. SMS strengthens the bonds within this marginalised group. This solidarity contributes to a stronger, more resilient community.
Partnerships and visibility: SMS collaborates with various organisations, institutions, and government bodies to extend its reach and impact. These partnerships help amplify the voices of sex workers and provide them with better access to resources and support. Additionally, SMS works to raise the visibility of sex workers at national and global levels, advocating for their inclusion in broader conversations on human rights and social justice.