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LILONGWE, Malawi – “We were harassed, sexually abused and arrested for being in clubs and bottle stores. We would be taken to (the) police and then to court to pay a fine. Eventually, this was common.” These are the words of Ndaziona Kamisa, a 23-year-old sex worker hailing from Chitipa district, more than seven hundred kilometres north of Dedza.

Yet this was before her life improved, thanks to a UNFPA-supported sex worker intervention by the Pakachere Institute of Health and Development Communication. This initiative ensures that the sex workers enjoy their full rights and are able to access sexual and reproductive health services without being stigmatized.

The Pakachere Institute brought together sex workers, health workers, the police and magistrates to orientate them on the laws relating to rogues and vagabonds, as well as the rights of sex workers.

Discussing sex workers' challenges

Since this intervention began, the arrest of sex workers has stopped and instead the police have begun working with sex workers to fight crime. If any sex workers are arrested by police officers under laws relating to rogues and vagabonds, in defiance of the agreement against such arrests, they will be acquitted by the magistrate.

Sex workers in Dedza meet fortnightly under the auspices of the Tidziwane group, which distributes condoms and conducts peer education sessions. The group has more than 30 registered members and attendance during meetings usually includes 15 to 25 people.

“These girls need protection because their job is challenging. The police have helped them significantly. I offer them a place to meet for free and discuss their challenges as a group,” said the anonymous owner of Zabwino, a bar in Dedza that Alice and Ndaziona frequent.

We were given special passport books for use at the hospital and this has helped us to access health services without any problem. – Ndaziona Kamisa, 23-year-old sex worker, Dedza

Sex workers who contract sexually transmitted infections now have a point of contact at the district hospital. They are able to seek medical assistance at the hospital and get treatment for STIs and other ailments.

“We were given special passport books for use at the hospital and this has helped us to access health services without any problem,” said Ndaziona, who has lived in Dedza since 2011 and has no desire to move to another district. She has a child, a girl named Miracle, who was born in 2013.

For a group that is used to being marginalized when it comes to their sexual and reproductive health, being able to access health services represents a major step forward.

Scope of sex work in Malawi

Malawi has an estimated 20,000 sex workers, representing 0.5 per cent of the adult female population, according to the FPAM 2011 report, Counting the uncatchables! Report of the situation analysis of the magnitude, behavioural patterns, contributing factors, current interventions and impact of sex work in HIV prevention in Malawi.

This figure, however, is significantly lower than estimates from other studies in Eastern Africa.

Sex workers are often arrested by Malawi Police under the laws relating to rogues and vagabonds. Law enforcers usually carry out night raids and arrest anyone found loitering in entertainment and public places, with sex workers making up the majority of those arrested.

Once arrested, they are charged with minor infractions such as being found Idle and Disorderly, or Rogue and Vagabond – crimes that generally do not attract severe punishment.

However, the result of such arrests is that sex workers attempt to remain undetected and in so doing, fail to access health services. This leaves them vulnerable to becoming infected with and transmitting STIs.

They become a potential source of HIV transmission along major transport routes and in major urban areas, commercial and agricultural districts, tourist destination sites, border areas, places of entertainment and within the communities where they live.

The reduction of HIV transmission among sex workers and their clients can, therefore, limit the spread of HIV to the general population.

I encourage my colleagues to use condoms and to access health care services, including HIV testing and counselling at the hospital. – Alice Matambo, sex worker, Dedza

Empowering sex work peers in health care

Alice Matambo move to Dedza in 2006 and stayed. She has an 11-year-old girl named Jasinta, who stays with her dad in Blantyre, about 250 kilometres away. As Tidziwane chairperson, she distributes condoms to fellow sex workers and promotes their empowerment.

Richard Mtengula, HIV and Aids Coordinator at Dedza Police station. © UNFPA / Henry Chimbali

“I encourage my colleagues to use condoms and to access health care services, including HIV testing and counselling at the hospital. Our job is risky and we have to fight a lot of challenges, including men who offer more money in exchange for unprotected sex. I tell my friends not to risk their lives (by accepting this),” she explained.

By working with the police, they now feel safe and can ply their trade without fear of being arrested for being found in drinking and entertainment establishments.

Sub-Inspector Richard Mtengula, HIV and Aids Coordinator at Dedza Police station, received training together with sex workers and a magistrate. “Our relationship with the sex workers is good and has improved since the training was conducted. The unnecessary arrests of sex workers stopped. In the event of a police officer not being aware of this relationship and making an arrest of a sex worker, I work with the magistrate to (secure a) release without a fine,” he said.

By Henry Chimbali