By Megan Schmidt-Sane, MPH ’13 in Sociomedical Sciences
I landed in Kolkata, India amid the heat and humidity of the July monsoons. Over the years, India has become a second home of sorts, and I feel more comfortable among the chaos and colors and smells of my father’s country than anywhere else. India has a singular perfume – redolent of spices, car exhaust, and millions of people baking in the heat. At the risk of sounding positively clichéd, India truly does assault the senses, and this is particularly true in Kolkata.
After college, I spent nearly three years abroad in India and Vietnam. It was in this context that my commitment to public health grew beyond an idealistic aspiration. Visible health disparities, particularly among most-at-risk populations, including sex workers, fueled my desire to pursue a career in public health and brought me to the Mailman School. As an MPH Global Health Track student, I am currently abroad for my six-month practicum with a rights and advocacy organization in Kampala, Uganda, that focuses on adult female sex workers and providing them with various health and support services.
Recently, I was fortunate enough to return to India to attend a conference in Kolkata with delegates from the NGO in Kampala. It is in Kolkata that over 500 sex workers representing 41 countries gathered from July 21-27 for the International AIDS Conference 2012: Sex Workers’ Freedom Festival. Sex workers were shamefully left out of the International AIDS Conference in Washington, DC due to U.S. visa restrictions that ban the entry of anyone who has engaged in prostitution. A recent study published in The Lancet found that female sex workers in low- and middle-income countries are 14 times more likely to be infected with HIV. It is imperative that those of us in the global public health community insist on the full participation of sex workers in policies that relate to them, and we must challenge impediments to their rights to health.
The conference was organized by the Global Network of Sex Work Projects and Durbar Mahila Samanwaya Committee. DMSC is one of the most well-known sex worker collectives – consisting of 65,000 members. The conference provided a forum to discuss numerous issues specific to sex workers—issues relating to human rights violations, police abuse, and HIV/AIDS. Conference participants also debated a more recent concern over anti-trafficking campaigns and raid-and-rescue tactics, such as the ones described by Aziza Ahmed and Meena Seshu in the Anti-Trafficking Review and the guidelines outlined on the Empower Foundation website. It included numerous panels, presentations, and cultural events as well as a live link with the conference in Washington, DC. The Kolkata conference was an opportunity for the female, male, and transgender sex workers to share their experiences in different countries with vastly different policies.
Some highlights of the seven days of meetings, workshops, and keynote sessions:
- Sex workers called for the international community to recognize their work as a valid and acceptable profession. In other words, to quote a common conference slogan, “sex work is work.”
- Sex workers also called for the decriminalization of all aspects of sex work; and rejected the “Swedish Model.”
- The UN’s Special Envoy for AIDS in the Asia-Pacific region, Prasada Rao, also called for decriminalization and argued that criminalization is directly linked to high HIV rates.
- Sex workers should be involved at the policy level both locally and internationally.
- Many sex workers, particularly those who were HIV positive, were concerned about current attempts by the U.S. to stop India from producing cheap, generic anti-retroviral drugs.
- Public health policies that involve “at-risk populations,” even those motivated by good intentions, must be implemented with great sensitivity and the involvement of the populations affected. Sex workers at the conference said that 100% condom use programs were a problem for them. They discussed the abuse that often occurs during the implementation process, such as the stigma and discrimination as detailed in The Lancet and by the Center for Advocacy on Stigma and Marginalization.
My initial exposure to the impact of public health policies on people in sex work happened when I volunteered at a local community-based organization in Pune, India in 2010. I saw, first-hand, the injustice of various international policies, including the US PEPFAR anti-prostitution pledge requirement, and how this has led to a lack of adequate services for sex workers. In my next post I will discuss these debates and my work in Uganda.
As I continue my work in public health, I will keep in mind the sex workers and activists I met at the Kolkata conference. I will remember their stories; their experiences and knowledge will inform decisions throughout my career. This is one of the great benefits of being a Mailman student—that I get to combine real-world experience with theory learned in the classroom. This approach will undoubtedly help me to become a more effective public health professional in the future.