By Faith Kadzanja & Andrew Mkandawire:
For 44 years, Joyce Banda of Chipoka in Salima District has been on streets of towns and cities enticing men to bed in her desperate struggle to survive.
“I started sex work at Mchesi Township in Lilongwe in 1977. Eleven years later, I moved to Chipoka in Salima, where my mother was staying. I continued with my work here,” Banda says.
When her mind wanders back to the days she was forced into the oldest profession, she shakes her head in defeat.
Several sex workers state that they opted for the trade due to poverty or failed relationships.
For Banda, a failed marriage pushed her into sex work. At 16, she married a man she later discovered had a wife.
Frustrated by the unfortunate turn of events, she decided to become a sex worker.
It has been a rough 44 years. In her day-to-day life, she used to encounter all forms of stigma, sexual and gender-based violence (SGBV) and physical abuse from her clients, peers and law enforcers.
“Police officers used to arrest us on what they called rogue-and-vagabond charges. They could sleep with us against our will or ask for money before releasing us,” Banda narrates.
She discloses that she has spent some time at Zomba and Maula prisons and after that arrested on the same charges which were later cast off by the courts as unconstitutional.
Even after such scenarios, she has not abandoned the profession that has been part of all her adult life.
Those in her trade are extremely exposed to HIV and Aids and Banda has taken it upon herself to help in fighting the epidemic which the United Nations (UN) wants to cease being a public health threat by 2030.
Sex workers are over five times more likely to contract HIV and face much higher risks of unwanted pregnancies and sexually transmitted infections.
“I tested positive for HIV in 2003 and started treatment. I have not skipped the medication for a single day. Around this area, Chipoka, I constantly remind 52 other female sex workers who are HIV-positive to stick to their medication to live healthy lives,” Banda says.
In 2016, the UN General Assembly’s Political Declaration on Ending Aids committed countries to specific targets in fighting HIV— that by 2020, 90 percent of those who are HIV positive should know their status; 90 percent of them should be put on medication and 90 percent of those on medication should have their viral loads suppressed.
The final essence of the targets is preventing the spread of HIV.
In Malawi, according to figures with the Ministry of Health, tremendous progress has been made in meeting the targets.
Still, key populations such as sex workers are being left behind.
That is why a project called ‘Linking Female Sex Workers to Services’ was introduced. Family Planning Association of Malawi (Fpam) has been implementing in two phases the project with support from Global Fund through ActionAid, which is the principal recipient of the fund’s grant.
The first phase was implemented from 2016 to 2017 while the second was implemented from 2018 to 2020.
Fpam, as a sub-recipient, implemented the project in Karonga, Kasungu, Mchinji, Salima, Dowa, Dedza and Ntcheu districts while Pakachere Institute of Health and Development, as a sub sub-recipient, implemented the project in Nkhatabay, Nkhotakota, Thyolo and Mulanje.
Project coordinator Dziwani Chiunjiza says its goal is to reduce the number of new infections among female sex workers by 2030.
“Specifically, the project aims at increasing demand for and utilisation of HIV prevention, care and support services among sex workers in the targeted districts, among others,” Chiunjiza says.
She adds that during the implementation period, female sex workers accessed HIV testing services and were reached with a complete package of services which included HIV ascertainment, provision of condoms and family planning methods.
Banda was trained as a peer educator and then became a peer navigator.
“Our job is to reach out to fellow sex workers, encourage them to get tested and, if found positive, to start and adhere to treatment. We, sex workers, are now empowered and cases of us being arrested and sexually abused by police officers are now a thing of the past,” she says.
Community reproductive health promoter, who led the project in Salima, Rector Barnaba, says sex workers in the lakeshore district have been linked to services.
“We have been giving the sex workers information and providing service delivery. We are trying to make them know their rights and even know where they can get services,” Barnaba says.
Where the sex workers work, clinics were being made available at night so that they could access services including HIV testing.
Judith Lumwera is a peer educator in Salima and says she is now able to teach fellow female sex workers the benefits of knowing their status.
“If our friends test positive for HIV, we encourage them to start treatment right away and to faithfully take their medication. We also urge them to use condoms to protect their clients,” Lumwera says.
Fpam District Manager for Ntcheu, Saukira Sitima, says the moonlight clinics have proved to be an efficient vehicle that links sex workers to services.
“The essence of the moonlight clinic is to take services right to the sex workers’ hotspots. When we go to their hotspots, we make sure that there is privacy and confidentiality,” Sitima says.
In Ntcheu, community policing and victim support unit coordinator Willy Bunya reports a drastic decline in cases of violence among female sex workers.
Here, too, the work of individuals such as Banda, who have been propped up in Fpam’s project, is bearing fruits.