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Seshu: The Reality of a “Rights-based Approach”: SANGRAM

Posted 22 July 2010, 05:17 A, by Conference Secretariat

By Meena Saraswathi Seshu, General Secretary of Sampada Grameen Mahila Sanstha. Seshu delivered the Jonathan Mann Memorial Lecture at AIDS 2010.

The phrase “rights-based approach” flows easily into the speaking points and materials of many organizations and even governments when they talk about meeting the challenge of HIV.  This is a good thing if the phrase really means something.  But I am concerned that “rights-based approach” loses its meaning when people think that it’s a matter of just inviting affected people to a meeting, or speaking kindly of them, or even just dropping the phrase “rights-based” into a mission statement.

Kothis and transgender sex workers of SANGRAM in west India.

In my plenary speech, I will recount the story of our work in SANGRAM as an example of confronting HIV with human rights as a real – and not just rhetorical – everyday guide to action.  There was nothing easy about our effort to make human rights more than an abstract framework, but achieving this goal is feasible.  I know that we have learnt lessons that can benefit HIV work in many settings and cultures.

The journey of our struggle is too rich to describe in this short blog, but let me try to highlight a few key elements.

When I, an educated, upper-class woman began to spend time with sex workers as a population “vulnerable” to HIV, I found that they were treated almost as non-humans by society, and I could hardly fathom how they could live and work amidst so much social disdain and dismissiveness.  I quickly realized that I knew nothing about them, their community, or their work. But, as I learned by letting them teach me, amongst themselves they were not disempowered. They managed their work, their clients, their families and the community that they made for themselves. AIDS was a terrible threat in their world, but they only needed the right tools, and they would manage AIDS too.

But instead of listening to them, the AIDS establishment – led by well-intentioned health service providers and educators – wanted to teach them “client negotiation skills” and turn them over to the same health services that had always treated them with hateful abuse.  It was ridiculous that anyone should think they could teach sex workers anything about clients. Rather, they needed basic information about preventing HIV and other sexually transmitted diseases, ready access to condoms, and health services that would treat them respectfully.  After much effort and some missteps, SANGRAM, the organization we formed, and VAMP, the sex workers collective that grew from it, achieved good health services for sex workers.  Even more importantly, through our efforts, sex workers became not just patients but agents of health and HIV information and services for themselves, their clients and the larger community.  Within a few months we were reaching more than 5,000 women in 52 sites distributing 350,000 condoms per month. It is no exaggeration to say that sex workers led the charge against HIV in our villages and towns, and they largely won.  Many lives have been saved because they mobilized their own power to beat this disease.

As they took control of the struggle against HIV, the sex workers also took more control of other elements of their rights and safety.  Subjected to consistent police harassment, physical abuse by vigilantes, and at times violent “rescue” operations by outsiders, the women organized against this victimisation.  When I first knew the sex workers, as lower-caste women they did not feel they could enter the police station to make a complaint. After our years of struggle, the police, local officials and community and religious leaders regard SANGRAM and VAMP as a force to be dealt with honourably and respectfully. Sex workers changed the local power structure, and everyone in the community has benefited.

Over time, I continued to be impressed by how this group of women understood that sex work was only one small piece of the AIDS challenge. It was through their initiative and insight that SANGRAM took on HIV prevention among rural women and young people for whom social and gender norms were a barrier to basic information about sexually transmitted diseases and safer sex. The public events we have organized to discuss these former taboos have transformed our communities, including bringing into the open the age-old problem of violence against women and girls. The sex workers also pushed SANGRAM to offer ground-breaking assistance to hijras and kothis – the horribly rejected men who have sex with men in our community – who now also are less hidden and less repressed.

This kind of struggle is never complete. But we continue to learn from each other, to work hard to respect and honour each other, and to help everyone in the community know that he or she has the right to be protected from HIV, from violence, from rejection and exclusion. I hope that our experience can be an inspiration for others.          

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8/21/2010 12:38:15 PM #

A very empowering and motivating write-up. Cheers Meena... to your wonderful and pathbreaking work.

Sridhar Rangayan India