Meena Saraswathi Seshu: tackling HIV for India's sex workers.

When Meena Seshu fi rst entered a brothel in rural India, she was expecting a melodramatic scene from a Bollywood fi lm, in which poor helpless women were being victimised by brutal, aggressive men. Seshu, who runs SANGRAM, an Indian non-governmental organisation (NGO) that works with sex workers to stop the spread of HIV/AIDS, soon found that the reality was rather diff erent. These women were, for the most part, in control of their lives, but through a combination of prejudice and fear were being mistreated by every section of society. SANGRAM, based in rural Maharashtra, which seeks to empower the women to form collectives and fi ght for their human rights, came along at the right time. But SANGRAM’s initial remit when it was set up in 1992 was more concerned with ensuring that sex workers didn’t spread HIV through migrant workers to “good women”. Its evolution into a more enlightened entity has much to do with Seshu, whose career path has zig-zagged across disciplines. After a degree in life sciences and a masters in social work, she worked as a social worker with widows and abandoned women, later becoming a science teacher, and then a newspaper reporter writing about HIV. But Seshu, who grew up in a wealthy part of Mumbai, says she had to work hard to gain the trust of the women she works with. Sex workers, used to being exploited by most of society, are notoriously closed in their dealings with the outside world. Seshu realised that “fostering a sense of community would be crucial in ensuring that their HIV prevention programme was eff ective”. The organisation has helped create a collective of 5000 women (called VAMP) working in prostitution from seven districts across Maharashtra and the neighbouring state of Karnataka. SANGRAM, which means “struggle”, works with the women to ensure that they are accorded the sexual and human rights they deserve. Seshu’s approach, she says, has been to ensure that sex workers have access to decent health care and that “the health system tries to meet their needs as they would any other part of society”. Too often, she says, “eff orts to off er health care to sex workers have been half-hearted”. For instance, one of SANGRAM’s goals was to convince women to access treatment services for sexually transmitted diseases (STDs). But the government clinics only opened for a short while in the early morning. As Seshu points out, “at that time, sex workers are either asleep or still with a client, which meant that attendance was virtually zero”. After SANGRAM convinced the clinic to change its opening hours, a lot more women accessed treatment. SANGRAM’s greatest achievement has been to untangle the myths about marginalised populations like sex workers. Seshu’s team attempted to educate the women about STDs, in the hope that they would get treatment. One issue, it turned out, was not the women’s ignorance, but healthcare workers’ treatment of sex workers. “The women always sought treatment, but say that some doctors wouldn’t deign to physically examine them, and tended to prescribe a course of penicillin irrespective of the disease”, she says. The women, says Seshu, “were astounded to realise that diff erent infections required diff erent medicines”. Helping to improve health provision for sex workers continues to be an important issue, but Seshu feels progress is being made. SANGRAM is small but widely respected; Seshu is part of the UNAIDS Reference Group on Human Rights and HIV, and in 2002, she won a Human Rights Watch award for her work. Despite these plaudits, SANGRAM has faced antagonism. In 2005, SANGRAM seemingly fell foul of the US Bush administration that would not support HIV programmes unless they opposed prostitution. Seshu says that “SANGRAM refused to sign the anti-prostitution pledge, and decided to return some grant money they had already been given by USAID. Somehow, this fact got twisted into a media storm that claimed that SANGRAM had been cut off from funding because of the issue of traffi cked children.” Damaging allegations were made that SANGRAM was obstructing eff orts to release traffi cked children. The reality, says Seshu, is that sex workers were terrorised by police while they were on a mission initiated by local NGOs to raid brothels to liberate children. As Seshu makes clear: “We have been working on HIV/AIDS prevention and for the rights of people in prostitution for more than a decade; we oppose traffi cking for any purpose and believe it is a criminal off ence. We believe that the use of minors in prostitution is child sexual abuse.” Indeed, the US Embassy in Delhi confi rmed to SANGRAM that “funding was not removed from SANGRAM for traffi cking in persons”. But these events underline just how controversial Seshu’s work can be in defending the rights of marginalised sex workers. Despite incidents such as the “raid and rescue” mission, Seshu thinks the police have slowly changed their attitude to local sex workers, and treat them with more respect than they ever have done. Most inspiring, she says, “is the attitude of sex workers themselves who refuse to give up the fi ght for their human rights”. As Anjali Gopalan, the Founder and Executive Director of the Naz Foundation India Trust, an NGO that works on HIV/AIDS and Sexual Health in India, “Meena’s commitment to advancing the cause of sex workers has brought about a huge change in the way the discourse on the rights of sex workers is happening today.”