The Prostitutes' Union
By Madhusree Mukerjee
From the Scientific American
Among the poor and most vulnerable, Smarajit Jana has found
a way to slash the incidence of HIV--by organizing sex
workers as any other labor collective
Blanching at the stench of urine, I stumble up pitch-black,
uneven steps to the top floor, which seems to be a rooftop
on which someone has constructed shacks out of brick,
asbestos and plastic. A shaft of light from a street lamp
falls past tenuous bamboo railings onto a figure in a
glittering white sari. She crouches on the bare brick floor
by the roof's edge, holding a mirror in one hand and a
lipstick in another, using the light to make up. Older
residents of the brothel, who expect no clients, crowd into
a tiny room to tell me their stories. “I've spent my life in
this hell,” says Pushpa Adhikari, an ancient woman with sad
eyes who was sold into sexual slavery at the age of nine.
The others demur: thugs used to terrorize the brothels with
nightly rapes and murders, but now that the prostitutes are
united the hoodlums keep their distance. “It used to be
hell--now it's heaven,” corrects one woman, and even
Adhikari nods.
Freeing the brothels from terror is merely a side effect of
the Sonagachi project, an HIV intervention program named
after the red-light district of Kolkata (formerly Calcutta)
where it began. Rural poverty forces millions of Indian men
to migrate to urban centers in search of a livelihood; there
they visit brothels, pick up the AIDS virus and take it back
to their wives. Truck drivers also infect prostitutes along
the major highways. India already harbors at least five
million cases of HIV--the most in the world after South
Africa--but it is too poor, and its health infrastructure
too weak, to permit reliance on drugs. Only if prostitutes
cease to acquire and transmit the virus can the epidemic be
contained, and Smarajit Jana, a public health scientist, has
found a way to accomplish that.
“I strongly believe that for a program to succeed, the
subjects have to adopt its goals as their own,” he explains.
They have: the sex workers run the HIV program themselves.
Jana persuaded them to form a growing collective that now
includes 60,000 members pledged to condom use. It offers
bank loans, schooling for children, literacy training for
adults, reproductive health care and cheap condoms--and has
virtually eliminated trafficking of women in the locale.
Best of all, the project has kept the HIV prevalence rate
among prostitutes in Sonagachi down to 5 percent, whereas in
the brothels of Mumbai (Bombay) it is around 60. Other
sexually transmitted diseases are down to 1 percent. Jana
now works with CARE in Delhi, assisting other social workers
in similarly transferring their HIV prevention programs to
the people they serve. Such community-led interventions have
become integral to the Bill and Melinda Gates Foundation in
its five-year, $200-million effort to combat AIDS in India.
