Members dealt better with situations of violence than non-members. Street-based sex workers faced more instances of violence than home-based.
While home-based member sex workers reported fear of violence from clients who were drunk, street-based sex workers reported an increased frequency of violence from clients during holidays. Most respondents, from both typologies, expressed confidence in facing situations of assault. Presence of other female sex workers, self-confidence, the ability to gather cues about a client’s behaviour, the capability to counsel clients and the possibility of seeking help from the NGO office were (listed as) factors that enabled the respondents to address situations of assault. The respondents did not fear repercussions of their resistance to violence. Lodging a police complaint immediately after the incident, support from the NGO office and loss of interest from the client’s side all contributed to this confidence.
“If we are subjected to assault we can always come to the office and lodge a complaint and they will solve the problem.”
(home-based FSW, member, Shimoga) “We can read a client when we see him and do not entertain them if we feel they will be violent.”
(street-based FSW, member, Shimoga)
However, members, especially street-based sex workers, expressed their helplessness to deal with police violence. Half of the street-based FSWs expressed their helplessness in dealing with police violence. Many of them, with their work site away from their place of residence, found it hard to face police brutality. Once arrested and sent to the remand home, more often than not, they found it difficult to secure a release as only family members are permitted to post bail.
“We can face problems from the clients and rowdies but we cannot face problems created by the police. The female inspector who has come here now beats us up for no mistake of ours and I have marks on my body to show for it.”
Compared to members, non-members found it more difficult to handle drunken clients or multiple client scenarios. Here too, the nature and frequency of violence reported by street-based sex workers were much higher than that reported by home-based sex workers. They found it difficult to deal with violence in public places or in a location of client’s choice.
“At that point of time we do not mind losing all our belongings as long as they let us get out of there alive.”
(home-based FSW, non-member, Shimoga) “Clients who take us outdoors for sex create a lot of problems if we don’t satisfy their demands… It is very difficult to run away from that situation. We have to agree to their conditions and make sure that we come out of there alive.”
(street-based FSW, non-member, Shimoga)
“We never used to come out in the open before and we had to face assaults then. But now after coming to this office (NGO) and with information and knowledge we are empowered to avoid such problems and if it still happens we are confident of facing it.”
(home-based FSW, non-member, Shimoga)
As an exception, few of the home-based non-member sex workers reported a change in their situation from the past. They reported that their interactions with the NGO Abhaya Action Aid empowered them to face situations of violence.
In summary, sex workers in Shimoga, who are members of the group, expressed more confidence in dealing with violence compared to non-members. They expressed better ability to gather cues about a client, sought help from the NGO and were better networked with their peers, all of which helped in times of need.
III. e. Membership in a group and usage of clinical services
The IBBA analysis showed that approximately 94 percent of the members and 90 percent of the non-members had ever visited the sexual health/STI clinic run by the NGO. Of the women visiting the STI clinics, a significantly higher proportion of members than non-members (63.5 percent versus 53 percent) had ever received a grey pack.
Availability and accessibility
In Shimoga, majority of the sex workers accessed clinical services regularly. Membership in a group did not emerge as a determining factor for accessing services as both members and non-members experienced similar challenges and had sought solutions for it from the NGO.
Majority of the sex workers were well aware that in order to maintain good health, they needed to regularly visit the clinic for STI check-up and not just make occasional visits when plagued by an illness.
“Some STI is visible but some are invisible and it is better we go to the clinic for a check-up.” (home-based FSW, non-member, Shimoga) “Some clients kiss, bite, pinch, etc., and it is better we go regularly for a check- up.”
Some respondents shared that the NGO provided them with cash support for transportation costs. Except for street-based non-member sex workers, all respondents expressed the need for easier access to the clinic.
However, home-based member sex workers were satisfied with the accessibility of the clinic and did not want the clinic to be closer. Most of the home-based member sex workers visited the clinic when affected with a health problem. Some of them reported visiting the clinic twice a month. Home-based sex workers preferred the clinics to be away from their homes so as to avoid the consequences of family, neighbours and the larger community discovering about their visits. They reported the present central location of the clinic to be convenient for the women from different villages to attend.
“In Shiralkoppa, we spent Rs.4 on bus charge one way, to get to the government hospital and we do not have any issues with the distance since we can always tell them we are going to the town and then visit the clinic.”
“We can manage the questions posed by our family members but answering our neighbours is a serious problem. All of this can be avoided if the clinic is at a distance from our home.”
(home-based FSWs, member, Shimoga) “It would have been better if there were STI clinics in the same way as private clinics.”
(home-based FSW, non-member, Shimoga) “Sometimes we won’t have money for bus charge. The doctor would have left for the day by the time we adjust money for bus charge and reach the hospital.”
(street-based FSW, member, Shimoga)
Distance to the clinic continued to be a barrier to access. Most respondents expressed the need for the clinic to be at a closer and a more convenient location. For sex workers from the villages, long distances to the clinic increased the travelling costs incurred for visiting clinics. Also, often long distance meant that they would not reach the clinic in time to see the doctor who would have left by the time they reached the clinic. Some of the street-based sex workers said they would prefer to have clinics near their cruising points.
The women especially mentioned membership in the CBO and the active involvement of peers, as factors which ensured that they receive treatment at the right time.
Except for home-based member FSWs, majority of the respondents reported distance as a barrier to access. Home-based member sex workers seem to have benefited from membership in the group and were reached better by the peers to ensure that they received clinical services as and when needed.
“Peers when they come on field visits usually enquire about our health and if we tell them we have a problem they will take us to the clinic for treatment.”
“It’s been five years since I got married and I did not have a child even after three years due to STI. After I came here I went to the clinic and got treatment and I had a child the very next year.”
“Stomach Ache, Cold.”
“When we visit the STI clinic the doctor knows about the symptoms”
(home-based FSWs, member, Shimoga)