Discrimination against sex workers – who needs sensitization?

The sun is scorching and the day does not seem very welcoming for Grace*, a sex worker in Makindu town within Makueni county, Kenya. Yesterday was not a good day for the 24-year-old mother of two.

By Lucy Kainyu Maroncha

The sun is scorching and the day does not seem very welcoming for Grace*, a sex worker in Makindu town within Makueni county, Kenya. Yesterday was not a good day for the 24-year-old mother of two. In her sex-work life, she meets different types of clients every day. Some take her to big five-star hotels while others pay her only Ksh 200 (less than $3)! But she has to put bread on the table for herself and her children. With no other source of income foreseen she does sex-work, the challenges that come with the job notwithstanding. Yesterday a client took her to the room, raped and beat her up before robbing her of a phone and some money she had in her handbag. She has woken up full of bruises and a cracking headache.

Not only does Grace need medical treatment but she also needs to report the assault and the robbery to the police. But what awaits her is worse than what she has already gone through. At the hospital, the health service providers glare at her with a look that suggests ‘we-know-you-well.’ Of course she is known here; she comes to this hospital for her refill of anti-retroviral medicine regularly.

After two hours of waiting in pain, one nurse snaps: “So whose husband have you stolen this time?” Grace has to play the good one here if she has to get treatment. She narrated her ordeal to me: “You can’t get treatment here until you bring a police abstract!’ the nurse continues. She goes to the nearest police station and has to answer very embarrassing questions. “In your job you must know how to protect yourself!” a police officer mocks. She is pushed back and forth until she is too tired and feels too defeated to continue with this game. She gives up.

This is not a rare scenario in Kenya. Sex-workers go through traumatising experiences in the hands of service providers and often give up before they receive the intended service. While different bodies have risen up to research and give findings and recommendations on how to treat sex-workers more fairly, the battle is far from being won.

A survey carried out by the Federation of Women Lawyers in Kenya (FIDA) in 2008 sampled areas of Nairobi, Nyanza Rift Valley and Eastern Provinces. It revealed that sex-workers are vulnerable to discrimination because they barely understand their rights. Five years after the survey little has been done to address stigma against sex workers, according to FIDA’s senior program officer Annie Ireri. Unintended pregnancies and subsequent unsafe abortions are still rampant since sex-workers shy away from health facilities because of the ill treatment they receive.

Ireri says that more intensified sensitisation for the sex workers is required to enable them to realise that, regardless of their line of work, they are equal human beings who have the right to good health and health services. She observes that, while different organisations have come up to educate sex-workers on skills to negotiate for safer sex as a prevention measure against HIV/STI and unintended pregnancies, most sex-workers are misinformed on what to do should their rights be violated.

While condoms are a major HIV/STI prevention measure, further research by FIDA, which was launched early this year but is yet to be validated, found that condoms are being used as evidence against sex workers in prosecution.

“This frustrates the efforts of organizations that supply condoms to sex workers in a prevention bid,” says Annie.

George Khisa is a project manager at HOPE Worldwide Kenya, an organisation that works closely with most at risk populations, among them sex workers. He points out that police harass sex workers for carrying condoms. They use this as evidence that they are engaged in sex work, which is illegal in Kenya. This thwarts prevention efforts since sex workers fear carrying condoms even though it is their health right to do so.

“We encourage sex-workers to carry condoms in order to protect themselves and their clients from infections and unintended pregnancies,” says George.

Sex-workers face stigma accompanied by derogatory names and physical assaults from their clients. A report of a public inquiry into violations of sexual reproductive health rights in Kenya released in April this year condems harassment of sex-workers in health facilities and other quarters by citing the Universal Declaration on Human Rights: “All human beings are born free and equal in dignity and rights” (Article 1 of the Human rights Declaration of Human Rights).

As different organisations continue calling for interventions to protect sex-workers, hostility remains rife in many health facilities, meaning more unintended pregnancies are conceived and more unsafe abortions procured.

(Grace is not the case-study’s real name.)