The Development And Implementation Of A Sex Worker Advocacy And Intervention Programme In Post-Apartheid South Africa With Special Reference To The Western Cape City Of Cape Town.

Shane Petzer: Shane is a Social Worker and the Co-ordinator of the Sex Worker Education and Advocacy Taskforce.

Dr Gordon Isaacs: Gordon is Associate Professor in the Department of Social Work at the University of Cape Town, a clinician and a consultant to SWEAT and NAPWA.

TABLE OF CONTENTS

• Introduction
  
• Background and Areas of Concern
  
• Points of Concern
  
• Conclusion
  

INTRODUCTION

In 1984 AIDS was identified amongst gay men in South Africa. An interfacing of first and third world patterns of HIV transmission has emerged. Sex workers, like gay men were a convenient minority to blame for the spread of HIV infection. The rapid spread of HIV in South Africa has meant that sex work is currently high on the agenda of the National AIDS Programme. As a result sex worker issues have become highlighted and a focus of health authorities attention.

In South Africa life expectancy is estimated at 63.4 years and is expected to decrease to 40 years with AIDS by the year 2010. (Clem Sunter, Sunday Independent, March 2, 1997). The rate of HIV prevalence in South Africa currently stands at 800 new infections per day. In the provinces the following prevalence rates are:

• Kwa-Zulu Natal leading with 18,2%,
  
• Mpumalanga with 16,2%,
  
• Gauteng with 12%,
  
• The Free State at 11%,
  
• and the Western Cape Province having the lowest of 1,7%.

(National AIDS Programme, Dept of National Health, March 1997)

South Africa and especially the Western Cape Province consists of rapid urban sprawl, a growing population of 3 500 000 people, interfaced with existing pre-apartheid townships and squatter camps, middle-class suburbs, semi-rural and rural localities. The metropolitan area of Cape Town is situated at the most south westerly tip of the sub-continent of Southern Africa.

SWEAT (The Sex Worker Education and Advocacy Taskforce) emerged as a direct need to address HIV and health issues and human rights abuses experienced by people working in the greater metropolitan sex industry alongside withprofessionals working in the fields of sexuality and HIV/AIDS, law reform and mental healthcare.

In 1994, Shane Petzer, a social worker and Ilse Pauw, a clinical psychology intern consulted with various sectors of the city's diverse sex industry and an organisation focusing on health promotion and human rights advocacy was established by November 1994.

Originally SWEAT was affiliated to the AIDS Support and Education Trust (ASET and now known as Triangle Project) which offered technical, administrative and financial support. In October 1996 SWEAT left Triangle to become independent with financial support interalia from the National AIDS Programme, AIDS Foundation of SA and Levi Strauss Foundation.

[Table of Contents]

BACKGROUND AND AREAS OF CONCERN

The following identified areas of concern are noted within the broader context of development in a society undergoing rapid transformation.

With this premise the principles directing SWEAT include accessing broader community issues so that sex work is acknowledged as a legitimate sector of labour alongside other mainstream sectors of labour. Furthermore it is hypothosised that sex workers themselves will be empowered to access mainstream structures and delivery systems through a deliberate change in the social, legal and political status of sex work as a profession.

Macro, Meso and Micro Components

In order to understand SWEAT's educational and advocacy role it is important to have some insight into the macro, meso and micro components which contribute towards SWEAT's intervention methodology.

Macro components include inherent racism, a culture of discrimination and bias towards prostitution in all its forms. SWEAT on the otherhand seeks to situate prostitution within a human and civil rights flatform. This has been met with some interest in some sectors and opposition in others. However a platform for advocacy in terms of the new Constitution facilitates some access towards the debate of decriminalisation.

Legislation handed down through colonialism and apartheid reflects an anti-sex work position in terms of the South African Sexual Offences Act 23, of 1957. To date this crimminalisation of prostitution still exists in crimminal law.

Meso Components: SWEAT has been linked to AIDS organisations, human rights organisations and sexuality centres, both in the metropolitan area of Cape Town and nationally.

Recognising that HIV/AIDS and health issues cannot be seen in a developing country through vertical AIDS initiatives, SWEAT has undertaken to locate health promotion in the context of development and advocacy. *** (flesh this out) The gross inequalities in welfare and healthcare delivery systems and criminalisation mean that health promotion has to be integrated*****

It has also received State and local Municipal acknowledgement. In principal the State's perception of SWEAT legitimacy is articulated in its partial funding, its representation on the National AIDS Advisory Committee and recognition in its participation in other Civic Forums.

SWEAT is also a member of the AIDS Consortium, the National AIDS Council, the Coalition for Lesbian and Gay Equality, the Network for Sex Work Projects, and the Coalition Against Child Labour.

Micro Components: SWEAT in conjunction with its fulltime co-ordinators and volunteer fieldwork personnell (sex workers and non-sex workers) have implemented a series of direct service based interventions, Some of which are supported by academic research, others are experimental and prototypical and are currently under evaluation. Such programmes include safer sex education, a Drop In Centre, a monthly newsletter, direct fieldwork, an extensive condom distribution network, legal advice, training, establishment of direct sex worker and police liaison forums and self empowerment programmes

Safer sex education is conducted in masage parlours, escort agencies and amongst street sex working people. Workshops using groupwrok methods have proved a viable means of communicating health messages to sex workers.

A vibrant Drop In Centre was established at the SWEAT Centre in May 1996. Weekly Wednesday afternoon activities include meeting the social needs of sex workers (predominantly street women and transgendered workers) and an opportunity for the fulltime co-ordinators to provide counselling services, give advice and provide information. Statements lodging complaints against clients and police are taken at the Drop In Centre and handed over to authorities for investigation.

A skills training curriculum has been developed to attract sex workers to the Centre for social activites and self development. Workshops have included massage skills training, hair care, manicuring, safer sex, primary health care et al.

[Table of Contents]

POINTS OF CONCERN

Protected (safer) sex and health issues

With the pandemic spread of HIV, with STD's and TB as co-factors in the spread of HIV, one of SWEAT's primary functions is to support sex workers in understanding and sustaining the importance of protected sex alongside other primary health care needs.

Therefore protected (safer) sex education is presented as a holistic package which includes hygiene, womens concerns, self esteem and the inclusion of significant other persons in their lives. For example, agency bosses, pimps, primary sexual partners and if necessary family members and friends are embraced into this educational process.

The link between decriminalisation, human rights and non-discrimination based on the new South African Constitution.

Whilst the debate of sex work (prostitution) is both national and regional in respect of parliamentry process, prostitution is one of the most discriminated and marginalised sectors of the South African labour force. SWEAT's position on appropriate law reform in regard to sex work is rooted in a human rights persective and governed by the World Charter for Prostitutes Rights (ICPR, Amsterdam 1985).

In this instance the driving force behind SWEAT's mission is to ensure that the democratic principles enshrined in the new Constitution namely the freedom of economic activity and freedom of association are extended to include sex work.

SWEAT's intervention thus far has included the formation of a national lobbying network (Decriminalisation of Prostitution Network - DECRO) in January 1996 with a primary emphasis on political lobbying and has forged a formal link with a national association of progressive lawyers (Lawyers for Human Rights).

Of fundamental concern is the ongoing violation of human and civil rights illustrated by violence towards sex workers, dismissive attitudes of police and healthcare workers and a unique hierarchy of sex work activity based on :

1. urban and rural differentiations
   
2. massive forms of migrant labour
   
3. violence in the context of families
   
4. the perceptions of the community and of sex workers themselves based on existing racial hierarchical structures and a classist society.
   
5. and migrant influx of unemployed men and women, from the sub-sahara
   

Criminalisation has ensured that sex work remains marginalised and without apparent legal redress perpetuating the ongoing struggle experienced by sex workers. To compound the concern the fundamental definition and perceptions of sex work as criminal activity needs to be changed. This point is seminal to the human rights debate in order to shift the attitudinal change of both policy makers, legislators and community opinion.

The rapid emergance of massage parlours, escort agencies and street work with little or no recourse for sex workers to address areas of concern.

Sex work in Cape Town has grown dramatically in the last five years and reflects the racial divide and social inequalities fostered by the apartheid regime.

This divide is experienced within the sex industry in that city based massage parlours and escort agencies reflect some first world characteristics with strong sub-cultural overtones, including vernacular, location and clientele. Whereas township and city street sex work, although having its own sub-cultural overtones, vernacular, broader locations and diverse clientele has a different set of activities which includes a greater lack of resources, stronger community censorship, and aggressive if not often violent police harrassement, gang related activities, child and forced prostitution. (Often linked to multi-toxic abuse). This latter point has strong implications for SWEAT's education and advocacy programmes.

A paradox exists in that alongside with democratisation and assumed liberalism, massage parlours and escort agencies have emerged. Despite criminalisation, agency based workers face less police harrassement and more tolerance from the greater and inner city community. Street sex workers including township and rural sex workers face regular and violent police harrassement which has included rape, false arrests, kidnapping, extortion and blackmail.

Agencies are on the one hand able to become legitimate businesses in that the local authorities allow for licencing and advertising in the provincial and local media. Harrassement comes in more subtle forms in this sector.

On the other hand street workers presence coincides with the high incidence of homeless people on the streets of Cape Town and therefore are regarded as double nuisance factor. This point supports the ongoing mystique that sex work is seen to be dirty, immoral and degrading.

The noticed increase in harrassement, entrapment and abuse by police officials towards sex workers.

South African society is noted both historically and currently for its discrimination against women. Patriarchical and sexist attitudes still feature in behaviours of law enforcement personell towards sex workers.

An increasing crime rate often incorrectly associated with sex work per se has focused police attention of their perceived need to target street sex workers for attention. However this reactive approach fails in that it is experienced as no more than harrassement of sex workers and drives the industry further underground, making access for health education and advocacy difficult and in some cases impossible. In addition the police and other law enforcement officers are responding on the one hand to existing legislation which criminalises sex work, and on the other with policy directives that stem from democratic priniciples. The police therefore are in a state of transition which undermines their role and perpetuates the state of tension between sex workers and the law.

In attempt to address the inappropriate policing of sex workers, with direct fieldwork experience in the sex working community, SWEAT has facilitated direct Sex Worker/Police Liaison Forums in three police jurisdictions in the city metropolitan area. Goodwood, Sea Point and Philadelphia are suburbs where the Forums provide a link between police and sex workers. In exchange for less harrassement, sex workers cooperate with police on a number of issues. Sex workers are the eyes and ears of the inner city beats. Sex workers are then taken more seriously when issues of rape, theft and violence are reported to those police stations. The Secretariat of the Ministry of Safety and Security has expressed interest in this prototypical approach. Thus in those areas where forums have been established a marked decrease in crime has been reported and a more trusting relationship between street sex workers and police is emerging.

In response to the violence experienced by sex workers SWEAT also runs self defence training for women. All fieldworkers undergo self defence training under the instruction of one of South Africa's top three karate experts. Fieldworkers then teach sex workers self defence in their fieldwork.

The fact however remains that violence towards sex workers has been a priority of SWEAT's since its inception and despite SWEAT's intervention increased reports of violence against sex workers highlight the racism and sexism of a calvinistic and patriarchal society.

The inappropriate attitudes of health care delivery systems towards sex workers and their significant others.

Stigmatisation of sex workers and the calvinistic values of healthcare professionals has alienated sex workers from accessing appropriate healthcare service. This is made apparent by the lack of healthcare information sex workers possess, the high rate of recurring STD's, and the non-compliance of treatment if and when recommended. There are no specific units which are sex worker sensitive, and many sex workers report that healthcare workers dismiss their complaints.

Sex workers report that disclosure of their occupation to healthcare workers in many cases marginalises them. This creates a currency of mistrust on both sides and endorses the sex worker's need to be personally discreet, feeding into their own and the healthcare workers internalised sexworkerphobia.

Sex workers experience the broader healthcare delivery system as one of a punitive beaurocracy, judgemental, threatening to legally remove minors from their care, reporting them to welfare authorities and especially minimising their healthcare needs in the light of a shrinking and fragmenting healthcare service in general. This highlights the secondhand status of sex workers which feeds directly into the self directed sexworkerphobia mentioned above.

In order to address some of these problems, SWEAT has advocated that sex worker issues are brought to the attention of healthcare workers. Thus SWEAT has been able to participate in the inservice training of national and regional programmes for management and healthcare proffessionals at Family Planning Units, STD Clinics and HIV/AIDS testing sites.

In terms of sex workers themselves, SWEAT regards the functional role sex workers play.

The disabling and disempowering environment in which sex workers are hindered from accessing health, welfare, policing and legal resources.

Sex workers live and operate from a variety of locations unlike, for example, a red light district. In Cape Town sex workers will work in townships, often in sheebeens (drinking houses), their visibilty blurred within the sub-culture of sheebeen life. Others will seek visibility I nthe classic sense whereby they choose open venues which attract differing client populations. Other street workers are connected to homeless people, gangs and nightclubs. Furthermore, many sex workers are mobile, oftening escaping dysfunctional families and backgrounds, hook up with two idiosyncratic markets in Cape Town. These are the harbour and trucking destinations (interborder truckers).

Indoor workers work from upmarket massage palrours, escort agencies, and stripper clubs. many workers leave the formal agency business and work privately from cell phones and apartments, servicing an exclusive and hidden clientele.

The illegitimate nature and diversity of sex work in the city marginalises sex workers from accessing legal and health care services.

SWEAT plays a mediating and advocacy role in ensuring that sex workers are services appropriately by State and non-government agencies. Thus SWEAT seeks to ensure that sex workers are able to access mainstream healthcare and legal aid as any other sector of civil society.

Sexual diversity

One of the most important and fundmental premises governing SWEAT's activities is its recognition of the diversity of human sexuality. Noting that legislating for or against sexuality issues or policies is counter-productive. Sexuality in itself is complex and to begin to understand sex work it is important to understand that the sexualities of both sex workers and their clients is diverse and complex.

Sex work incorporates both males and females, young and old, and accross racial, political, sexual and economic divides. In addition sex work embraces sex for economic survival, forced sex work, sex work by choice and sex work as a laboratory to explore identity issues for both males, females and trasngendered people.

On the other hand the client population is as equally complex and the demand for sex work differs radically in the context of need, fantasy and power issues.

v [Table of Contents]

CONCLUSION

This paper highlights the macro, meso and micro components of a prototypical, dynamic sex work, education and advocacy organisation located in Cape Town, South Africa. It also escribes the development of an appropriate sex work development organisation, dealing with a broad range of macro, meso and micro components influencing an empowerment programme addressing sex worker needs.

[Table of Contents]