How to support sex workers during a health crisis

Written by Sarvojana Coalition, India

This guide was written in 2020 in response to the COVID-19 pandemic.

Some of the information will not be so relevant to the current situation, but we think this guide offers useful advice to SRHR advocates.

Please describe the context in which your work has highlighted these learnings:

When COVID-19 arrived, the government of India ordered a total lockdown of the country. They banded areas with different-coloured zones to indicate risk. Within this context, supplies and financial support was slow and difficult for marginalised groups to access, such as the sex workers (SWs) in our project communities. Without ‘family cards’ they were unable to access food and medical rations, despite some being single mothers with families to feed. Without clients, their only source of income ceased immediately.

What did you discover about the challenges that advocates face in this situation?

Stigmatised communities are even further demonised in times of national crisis, being irrationally blamed or feared for it. We have seen increased evictions and violence toward SWs, even though there has not been one COVID-19 case among them. This happened with the HIV/AIDS crisis too. It is crucial that government protects marginalised communities in times of emergency.

Government attention and funding has turned almost entirely towards the crisis, neglecting crucial basic services like SRH and medical care. We therefore decided to provide as much practical help as we could to meet these needs.

How were those challenges tackled – what was achieved?

SIAAP and its partners, Sangama in Karnataka and Saheli Sangh in Pune city, have several projects supporting the health of sex workers. During this time we pivoted to provide the practical help they desperately needed. 

In Tamil Nadu, following initial SW support from the National Network of Sex Workers (NNSW), SIAAP crowdfunded to continue relief work through Vadamalar Federation of SWs. We raised enough funds to ensure none in our project communities go hungry. SIAAP is also distributing dry rations to SWs, linking SWs with the state government and recharging phones for SWs so they can keep in touch and support each other.

To provide counselling and informational support, we asked the peer counsellors network in all three projects areas to support SWs, with supervisors identifying common issues and responses. We also hold ‘COVID Talks’ by inviting medical and psychiatric experts to interact with SWs in Tamil Nadu; most questions are related to transmission, precautions, and feasibility of practising sex work.

In Karnataka, we are buying and distributing dry rations and basic medicines in 27 districts through our participation in the civil society organisation’s newly formed Karnataka Task Force for COVID-19. Sangama has distributed dry ration kits to 4,832 sex workers through Karnataka Sex Workers Union, Uttar Karnataka Mahila Ookutta and CBOs in 27 districts of Karnataka. We have also raised the funds.

In our project in Pune, where we work with over 2,500 SWs in and outside brothels, we helped SWs who could not leave their brothels. Saheli Sangh has extended support to 1,200 sex workers and 100 children of sex workers. Along with food we sourced mobile phone chargers so they could support each other by phone. We also provide psychological support via telephone as mental health is often at risk.

Would you like to tell us more about the challenges you saw advocates facing in this situation?

Sex workers have talked about learning the importance of saving, so that they are not entirely unprepared come emergencies like this. They are also pivoting to other work such as selling fruit and vegetables to make up for lost income.

The crisis has further underlined the links between poverty and sexual and reproductive health (SRH). Sex workers have been talking about considering riskier (more lucrative) sex work to compensate for their loss of income, and will also explore safer sex options, including phone and video sex; capacities must be built for this.

Most importantly, national governments are unprepared to divert funds towards social protection from HIV programmes for SWs (and other Key Populations [KPs] such as female sex workers, men who have sex with men [MSM], transgender, intravenous drug users), even though no other national programme caters to them.

What did advocates learn from this experience?

There is incredible strength and solidarity within even the poorest and most marginalised communities.  We have seen SWs taking in other SWs – total strangers – who have been evicted.

The crisis will impact the communities long-term and need to form part of our support. SWs will suffer poverty for many reasons: fewer clients because of lost jobs, restricted movement, evictions due to non-payment of rents.

There is a high possibility that these adverse conditions will remain for many months.

What are your tips for someone facing the same or similar issues?

  • Participation of the client community is vital in times of crisis. We are reminded of how SWs were major drivers of prevention during the HIV/AIDS pandemic.
  • Reach out to all communities; you may work with groups you never thought you could. We saw Police and SWs sharing hand sanitisers and writing thank you notes for successful collaboration!
  • Listen to what clients say they need. In this case basic needs like food and medicine, but also mobile phone chargers for social support and coordination of assistance.
  • Start linkages with state and local governments as early as possible. Use this crisis to ensure that SWs are covered by government welfare measures.
  • Mental health is an important area that needs attention during such crises due to loss of livelihood and uncertainty about the future. Give psychosocial support and show we are all in this together.

Did advocates use any external resources to help this solve this issue that you would recommend to other organisations?

Donor organisations providing funds for relief support to marginalised communities were approached. One such organisation, Mariwala Health Initiative, funded us to support 80 sex workers with relief kits.

We are also reached out to the general public to pull in donations.

Further, we collaborated and networked with women’s organisations and labour groups working with unorganised sector labours.

Sarvojana Coalition, India

Sarvojana is a coalition of 6 CSOs from Tamil Nadu, Karnataka, Andhra Pradesh and Maharastra. South India AIDS Action Programme (SIAAP) in Tamil Nadu is the lead partner, with Sangama in Karnataka and Saheli HIV/AIDS Karyakarta Sangh in Pune as partners of Sarvojana Coalition.

Sarvojana aims to strengthen the agency of sex workers, sexual minorities and people living with HIV (PLHIV), to enable them to exercise choice to pursue safe healthy and creative lives. We emphasise ethics, community monitoring and context-driven approaches to generate evidence and influence laws, policies, and programmes.