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Bias against sex workers in health facilities

Health & Science

By Lucy Maroncha

The sun is scorching and the day does not look good for Grace*, a sex worker based in Makindu town.  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 each day. Some take her to big five-star hotels while others pay her only Sh200! But she has to put bread on the table for her children.

With no other source of income foreseen she does sex-work, notwithstanding the risks that come with the job. Yesterday, a client took her to the room, raped and beat her up before robbing her of her phone and some money she had in her handbag. She has woken up full of bruises and a cracking headache.

Abuse

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 personnel stare at her with a look that suggests ‘we-know-you-well, you are no stranger to violence.’ Of course she is known here; she comes to this hospital for her anti-retroviral drugs regularly. “I do not expect anything better from this clinic, but I need them more than they need me,” she said in an interview.

After two hours of waiting in pain, one nurse snaps: “So whose husband have you stolen this time?” Grace has to play along if she has to get treatment. She narrated her ordeal: “You can’t get treatment here until you bring a police abstract!” the nurse rants. 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 defeated to continue with this game. She gives up and goes home without accessing the treatment she rightfully deserves.

Trauma

This is not a rare scenario in many parts of 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 given findings and recommendations on how to treat sex-workers fairly, the battle is far from being won.

A survey carried out by the Federation of Women Lawyers in Kenya (Fida) in 2008 sampling areas of Nairobi, Nyanza, Rift Valley and Eastern Provinces revealed that sex-workers are vulnerable to discrimination because they barely understand their rights.

Fida’s senior programme officer Annie Ireri says nothing much has changed in addressing stigma against sex workers five years since the survey was carried out. “There are still complaints of harassment and discrimination against sex-workers,” she said in an interview.

Condoms As Exhibit

Another 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 court during prosecution.

Dr Helen Barsolai a Kenyan reproductive health researcher pointed out the importance of law enforcers working closely with health providers as an intervention to address the health rights of sex workers.

She condemned the idea of police using condoms as exhibits in court saying that it thwarts prevention efforts since it makes sex workers fear carrying condoms, even though it is their right to do so.

“We encourage sex-workers to carry condoms in order to protect themselves and their clients from HIV, STI infections and unintended pregnancies,” the researcher said.

A report of a public inquiry into violations of sexual reproductive health rights in Kenya released in April this year condemns harassment of sex workers in health facilities and other quarters by citing the Universal Declaration on Human Rights, that says, “All human beings are born free and equal in dignity and rights.”

Grace* is not her real name

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