Meeting community needs for

HIV prevention and more:

Intersectoral action for health in the

Sonagachi red-light area of Kolkata

Authors:
The Durbar Mahila Samanwaya Committee (DMSC)
Theory and Action for Health (TAAH) Research Team1

1
The following members of the DMSC/TAAH team contributed directly to the writing of this paper: Mercedes
Mas de Xaxàs, Kevin O'Reilly, Catrin Evans, Donna Higgins, Pamela Gillies, Smarajit Jana
CONTENTS

I. INTRODUCTION .............................................................................................................. 1

II. SCOPE ................................................................................................................................ 1

III. METHODOLOGY ............................................................................................................. 1

IV. PROJECT OVERVIEW ..................................................................................................... 2

V. PROJECT CONTEXT
1. Baseline information on India, Kolkata and the Sex workers of Sonagachi ........... 3
2. Key characteristics of the policy environment ........................................................ 5
3. Nature, origins and objectives of SHIP ................................................................... 6

VI. PROJECT APPROACHES................................................................................................. 7

1. SHIP’s key intervention values ............................................................................... 8
2. SHIP’s value- led interventions ............................................................................... 11
a. Building a cohesive and inclusive sex work community .............................. 12
b. Creating mechanisms for decision-making, nurturing ownership
and mobilizing for action .............................................................................. 14
c. Challenging social exclusion and reconfiguring power relations at
the local level ................................................................................................ 16
d. Providing access to financial resources ......................................................... 18
e. Providing access to cultural resources ........................................................... 20
f. Providing access to social resources .............................................................. 21
g. Relations with the state and government officials ......................................... 22

VII. PROJECT IMPACT ........................................................................................................... 23

VIII. CONCLUSION................................................................................................................... 27

List of Acronyms........................................................................................................................... 28
References ..................................................................................................................................... 29

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 Intersectoral action for health in the Sonagachi red-light area of Kolkata

I. INTRODUCTION

The Sonagachi Project has been in existence for more than a decade. Over that time, it has grown,
formed new bonds, taken on new activities, seized new opportunities and responded to the expressed
needs of the communities it serves. It is one of the first large-scale examples of how intersectoral
action can have a measurable benefit for HIV prevention. It is also a strong example of how action that
is values-based, as opposed to theoretically based, can grow, develop and take advantage of
opportunities that present themselves over time. This case study traces the history, delineates the
development and the rationale for the approach taken in Sonagachi and highlights the impacts that
have been measured.

II. SCOPE

This case study aims to provide an overview of a community-led intervention that demonstrates how
intersectoral action for health can successfully take a bottom-up approach to simultaneously (1)
improve the health status of a target group, in this case the sex workers of Sonagachi, and (2) empower
them to break barriers and fight for their individual and collective social, economical, and political
rights. The case study covers the time period from 1992, the year in which the project was created, to
2007.

A note on terminology

In the early years, (1992-1995) the project was known as SHIP (Sonagachi HIV/AIDS
Intervention Project). In 1995, with the expansion of the scope of SHIP and the creation by sex
workers of their own organization, the project adopted the name of Durbar Mahila Samanwaya
Committee (which is also known as DMSC or Durbar). The large scale community based effort
managed by DMSC is now commonly referred to as the Sonagachi Project. The terminology
used throughout the case study reflects this.

III. METHODOLOGY

The case study is based on the findings of a Bill & Melinda Gates Foundation funded research study
that included secondary analysis of existing data from Sonagachi as well as primary data collection
and analysis. The methods for studies that were used as secondary data sources included the following:
1) cross-sectional, random sample surveys of sex workers in Sonagachi over a 12 year period -- data
were analysed using standard descriptive, inferential, and correlational analysis methods 2) mixed
methods studies that used both quantitative and qualitative methods; and 3) qualitative studies that
used purposive sampling methods and data reduction strategies including thematic content analysis,
and grounded theory methods.

Secondary data analysis utilized thematic synthesis and data reduction strategies. Primary data
collection used purposive sampling methods and included qualitative methods using focus groups,
individual open-ended interviews, and observations. Data analysis relied upon standard data reduction
strategies including thematic content analysis and grounded theory methods. Content analysis
methods were used to examine the publications produced about Sonagachi over the years of its
existence. All of these studies were conducted in Bengali and then interpreted into English. Data and
findings were back-translated from English to Bengali and reviewed by teams of sex workers for

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Intersectoral action for health in the Sonagachi red-light area of Kolkata

clarity. Multiple data sources provided the opportunity to triangulate findings and provide a solid
foundation for this case study.

The team involved in all of the research noted above consisted of academics, the Sonagachi STD/HIV
intervention project (SHIP) project advisors and sex workers. This team worked closely with the peer
educators, sex workers and staff of DMSC. All non-academic team members were trained in
appropriate data collection and analysis methodologies by senior academics on the team (Ph.D.s,
M.D.s, J.D.s and Masters levels).

IV. PROJECT OVERVIEW

In 1992, the All India Institute of Hygiene and Public Health (AIIHPH) was contracted by WHO to
conduct research among sex workers in the Indian city of Kolkata. The research showed that the
prevalence of HIV was low at 1%, but that sexually transmitted infections (STI) were common: nearly
80% of sex workers reported symptoms. Not surprisingly, condom use was negligible at 1%.

Subsequently, AIIHPH initiated in Sonagachi, the main redlight district in north Kolkata, the as
Sonagachi HIV/AIDS Intervention Project (SHIP) with a conventional focus on STI treatment,
condom promotion and peer health education. SHIP started on a relatively small scale, with the
opening of one clinic and the employment of a few of sex workers as peer educators (PE) to provide
health education and distribute condoms (Jana et al 2004, Jana et al 1998). From the start it became
evident that the sex workers, being poor and marginalised women, had little or no power as individuals
to demand condom use from their male clients. Furthermore, sex workers were much more concerned
about addressing the more immediate problems they faced, like violence, the health and welfare of
their children and the denial of many of their basic rights than they were about HIV/AIDS. Realizing
this, SHIP director (S. Jana) determined that the best way to enable sex workers to protect their health
was to target the social context in which they lived and worked, meet their immediate needs and
empower them both as individuals and members of a community to protect their rights. The sex
workers readily embraced this strategy and made it their own by instilling their principles and ideals
into this tactic. Responsiveness, egalitarianism, and empowerment are just a few of the strong values
that have imbued SHIP from the beginning, which have influenced every strategic decision that has
been taken over the years and fostered the growth of the large scale community based effort that is
known as the Sonagachi Project.

As a result of the needs and concerns expressed by the sex workers, the first 5 years of SHIP were
devoted to implementing key interventions to supplement the activities of the clinic and the peer
educators, both of which were expanded. Among these interventions were: vaccination and treatment
services for the children of sex workers; literacy classes for sex workers and their children; political
activism for workers' rights; advocacy with political leaders and law enforcement; community
mobilization; micro credit schemes, and cultural programmes.

Using participatory methods, by 1995, the project had assisted sex workers to create and register their
own organisation, the Durbar Mahila Samanwaya Committee (DMSC or Durbar) and their own
financial co-operative, USHA, offering savings schemes and micro-credit to sex workers. In 1997,
DMSC brought sex workers’ rights into the public arena by hosting India’s first ever national
conference of sex workers. By 1999, DMSC had formally taken over management and leadership of
SHIP, including all external donor funding, and the former key directors had become employees of the
community. Since then it has scaled up to include more than 40 redlight areas across the State of West
Bengal (DMSC, 1997; Jana, Bandyopadhyay, Mukherjee et al., 1998). It currently has an active
membership of more than 2,000 sex workers, and an informal support base estimated to number more

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 Intersectoral action for health in the Sonagachi red-light area of Kolkata

than 65,000 Durbar’s current structure comprises a loose affiliation of five different sex worker
organizations,1 each one of them operating by a strong egalitarian and democratic culture. Durbar is
engaged in a large range of activities at three inter-connected levels: 1) the sex worker community,
2) the sex industry environment and, 3) wider society. These activities encompass service delivery
(e.g. sexual health, condom social marketing, HIV treatment and counselling, micro-credit and
banking, education, vocational training) and social, cultural and political activism (e.g. conferences,
rallies, cultural performances, advocacy, networking).

Durbar sits on the steering committee for HIV/AIDS targeted interventions convened by the West
Bengal State AIDS Prevention and Control Society (WBSAPCS), and is a founding member of the
Indian National Network of Sex Work Associations. It has joined forces with a number of global sex
work, HIV/AIDS, anti-trafficking and other civil society organizations and is now a frequent
participant in international and national level policy discussions.

Durbar is now self-sustaining in many of its activities, and extensive networking and alliance building
have brought about significant financial, social and human capital from a wide range of institutions.

In sum, sex workers associated with Durbar have successfully moved from being project beneficiaries
of an externally managed intervention, to being the owners of that intervention, with recognition of
their rights, the power to set their own agenda and to participate as active citizens lobbying for
structural change.

V. PROJECT CONTEXT

1. Baseline information on India, Kolkata and the sex workers of Sonagachi

HIV is a growing threat in India and a serious problem for the health and welfare of the nation
(National Intelligence Council, 2002). India’s National AIDS Control Program, the World Health
Organization and UNAIDS recently revised the estimates of HIV prevalence in India. The new 2006
estimates indicate that approximately 2.5 million people were living with HIV/AIDS in India in 2006
(NACO, UNAIDS & World Health Organization, 2007); HIV prevalence According to the new
estimates,”there are some signs of a decline in HIV prevalence among sex workers in areas where
focused interventions have been implemented, particularly in the southern states. However, overall
prevalence levels among this group continues to be high.” (UNSIDS, WHO, NACO 2007)

Previous HIV seroprevalence rates of 50% to 90% among Indian sex workers have previously been
reported in Bombay, Delhi, and Chennai (Gangakhedkar et al., 1997; NACO, 1999, 2001; UNAIDS,
2002). In 2005, almost a quarter of female sex workers tested in Karnataka were infected with HIV;
for women working in brothels, the proportion infected was nearly half (UNAIDS & World Health
Organization, 2006).

Surprisingly, in Kolkata the rate of HIV infection among sex workers appears to be about 11%, even
though Kolkata is directly on the drug route into the heart of India and one of the most impoverished
urban centres in the world (UNAIDS, 2002). Condom use has been consistently rising among sex

1
USHA co-operative, Durbar Mahila Samanwaya Committee (sex workers collective), Komol Gandhar (cultural
wing), Binodini Shramik (trade union) and Shramajeebee Mahila Sangha (sex workers’ organisation from the Sett Bagan red
light area)

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Intersectoral action for health in the Sonagachi red-light area of Kolkata

workers in Kolkata, from 3% in 1992 to 90% in 1999 (NACO, 1999, 2001), while rates of condom use
remain low among sex workers in other Indian cities (UNAIDS, 2002).

Sonagachi is one of the oldest and largest sex work sites or redlight districts in Kolkata. More than six
thousand sex workers live and work in Sonagachi. Already identified as a critically underserved area,
Sonagachi was further threatened in the early 1990's by the appearance of HIV/AIDS. The situation in
which sex workers lived and HIV was entering did not lend itself to easy remedies.

a. Lack of community cohesion, social organisation and safer sex practices

Prior to SHIP, sex workers lacked a sense of community. The local community was defined through
the neighbourhoods . Women’s sphere of ‘power’ was focused around particular individuals and was
very much dependent upon the patronage of local men and local institutions. Community action by sex
workers was not unknown, but was primarily oriented to local concerns.

Relations in the sex trade were characterised more by competition than co-operation. This lack of
unity meant that sex workers were constantly faced with the threat that customers could be poached by
other women if they tried to depart from the standard, expected services. Safer sex was such a
departure and this often affected their decision making, as this statement from the beginning of the
SHIP project shows:

If the customer doesn’t want to use then I look and sit him. What can I do? If I don’t sit him he
will go to another girl and it will be a big loss for me. We are not one in this place (Sonagachi
sex worker)

Once the threat from HIV became known in Sonagachi, madams or pimps played an important role in
influencing sex workers' practice of safer sex. PEs explained that even where madams were ostensibly
supportive of condom use, they would rarely push the issue.

The extra time that it could take to negotiate safer sex was a constraint for many madams. Thus a
major problem faced by some sex workers was that if using condoms with their customers took extra
time their madams would not allow it and the sex workers themselves would be made to pay for it.

Sex workers’ actions around safer sex and security more generally were also constrained by
relationships of patronage, protection and control that exist in redlight areas. Sex workers generally
described their relationships with local power brokers (gangs, club members) in terms of dependency.
These men provided some protection and help at crucial times, not just control and exploitation, and
the sex workers did not want to jeopardise those relationships. Hence they were in a weak position to
adopt safer sex practices on their own and to negotiate condom use if these steps angered clients or
hurt business.

b. Limited access to financial resources

Equally important in determining sex workers' power and independence, a number of factors conspired
to prevent them from managing their earnings effectively. Credit facilities were provided through
complex networks of madams and money lenders (Khisti wallahs) who charged extortionate rates of
interest, but who were preferred over banks because of their immediate availability, flexibility of
payment options and general lack of the discrimination they would experience from bank staff. Most
sex workers managed their money on a daily basis as they often had no place to keep it safely in their
rooms. Khisti wallahs could be repaid per day or accessed on the spot to meet an immediate need.
Families and boyfriends (babus) also put pressure on sex workers to give them money. They would

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 Intersectoral action for health in the Sonagachi red-light area of Kolkata

frequently be asked to send large sums of money home to the village, and many sex workers
effectively supported their babus financially (and sometimes also their babus’ other wives and
families). In reality, although sex workers earned more than most women in other informal sector
jobs, they were caught in a web of exploitation which made it very difficult to control their earnings or
save for the future.

c. Poor access to health services

Sex workers’ health seeking strategies prior to SHIP have been documented extensively elsewhere
(Evans & Lambert 1997). Most sex workers used the services of the many private doctors working
around the redlight areas. Government hospitals were rarely used because the time required to get
through the system (a whole working day could be lost), the perceived discrimination from staff and
the perception that quality of care delivered was inferior. Quality of care in the private sector,
however, could also be poor. Treatment of suspected sexually transmitted infections generally relied
upon the sex worker's description of the symptoms, rather than examination or laboratory tests, and
was often associated with exploitative charges. In common with most poor communities, the cost of
consultations and medications inhibited sex workers from seeking treatment unless seriously
incapacitated. In some cases, sex workers’ use of health services was controlled by the madams as
well. Sex workers also relied upon their babus for help in accessing services and usually lacked the
confidence to seek treatment independently.

d. Strained relations with state actors and limited participation in public life

A natural conflict often exists between the police, charged with protecting the public order, and HIV
prevention in sex work, charged with protecting public health. Prior to SHIP, the relationship between
the sex industry in Sonagachi and the local police was (and to a large extent still is) consistently cited
by sex workers as one of their biggest problems. On the one hand local police turn a blind eye to the
atrocities inflicted on sex workers; they even exact regular protection money from all major sex
industry stakeholders. On the other hand, pressures from the city vice department to meet specified
targets often result in regular raids and arrests of sex workers who are soliciting. Such raids disrupt
business for sex workers for days, driving customers away and increasing indebtedness and the
inclination to accept any client regardless of safe sex protection. Sex workers who are arrested usually
pay large fines or bribes, exacerbating the cycle of indebtedness and the pressure to earn.

The lack of socio-cultural and legal recognition of sex work as an occupation foreclosed sex workers’
participation as sex workers in many arenas of civic life. Unable to represent themselves collectively
to charities, health services, the judicial system or government agencies, sex workers were
traditionally cast in the role of ‘objects’ of policies and programmes that often characterised them as
immoral or hapless victims in need of rescuing and reintegration. Though often well-intentioned,
these policies and programmes result in denying sex workers' their agency and in showing little regard
for their own needs and priorities.

2. Key characteristics of the policy environment

Though the police were charged with protecting the public order, in many cases they colluded with
local gangs and profited from sex work. In some cases, this was done with the tacit support of some
local political leaders. The active participation of some of the police and the local politicians in the
exploitation of sex workers complicated the early efforts of SHIP.

Though the situation in Sonagachi was dire, as it was in the other twelve red light districts of Kolkata
and among the street-based sex workers, West Bengal in general has a relatively stable, communist,

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Intersectoral action for health in the Sonagachi red-light area of Kolkata

pro-poor government that has successfully implemented redistributive policies and a decentralized
system of local government. A vibrant civil society exists, made up of closely overlapping left-leaning
social networks. However, significant stigma and discrimination towards sex workers existed and this
influenced the early progress and evolution of SHIP. The leftist sentiments of the state government do
not imply automatic support for sex workers rights as workers, however. The government has been
supportive of the Sonagachi project in its focus on some of the poorest citizens in the state and its
efforts to help them out of poverty. It has never and still does not endorse the efforts to extend
workers' rights to sex workers, however.

3. Nature, origins and objectives of SHIP

SHIP started in 1992 as a public sector initiative promoted by WHO Global Program on AIDS in
collaboration with Indian National AIDS Control Office (NACO) and undertaken by the AIIHPP.
Funding was initially provided by NORAD and WHO but was then taken over by DFID in 1993/4 as
part of a major bi-lateral ‘Partnerships for Sexual Health Programme.’ Through this programme,
technical and managerial support for SHIP was initially provided via the local British Council Office
in Kolkata but was later taken over by a separate Project Management Unit (PMU).

SHIP was originally designed to address a challenging yet narrowly defined objective: decreasing high
levels of STI and increasing low levels of condom use among a marginalised and vulnerable group of
sex workers in Sonagachi. The ultimate goal of the project was to reduce the risk of HIV/AIDS for
these sex workers, their clients and the population of Kolkata. The initial approach was a fairly
standard targeted intervention following an epidemiological model of STD/HIV prevention. Its main
strategies were: providing direct STD treatment facilities through an easily accessible field-based
clinic; and using field outreach strategies including peer education to increase the availability and
acceptability of condom use. SHIP started with a small group of twelve peer educators (PEs)
supported in the field by social workers, referred to as ‘supervisors’.

From the beginning the leadership of SHIP considered its target group to be “sex workers” instead of
prostitutes and framed the efforts in terms of occupational safety and health. Such a framing broke
many existing stereotypes about sex workers, their rights and their role in the community’s economy.
At that time, the concept of "sex worker" was completely foreign to the Indian public health system, as
well as to the sex workers themselves. However, for the SHIP director, Dr. Smarajit Jana, a physician
with a background in occupational health and social justice, sex workers had the same inherent rights,
constraints and responsibilities as any other workers. Equally, sex work, as any other employment,
needed to be free of health and safety risks, not only for the sex workers and their families, but also for
the larger community of stakeholders and gatekeepers which played a role in the sex trade (including
madams, babus and clients, as well as the police and political parties). In his view, it was therefore the
collective interest and responsibility of this broader community to increase condom use and establish
safer sex practices in Sonagachi.

This different orientation, that sex work is an occupational health issue that needs to be addressed by
the collective action of the sex trade community in Sonagachi and by targeting the context in which
the women are employed, set the project apart from the standard HIV prevention approaches at that
time and had a major empowerment effect on sex workers. That empowerment, in turn, influenced the
objectives, processes, outcomes and impact of SHIP in a manner that had not been anticipated at the
beginning of the project.

As SHIP leadership engaged in dialogue with the sex workers it quickly reached the conclusion that
the initially formulated project goal could not be realised unless a much broader perspective on sex
workers’ health was taken:

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 Intersectoral action for health in the Sonagachi red-light area of Kolkata

"Even to realise the very basic programme objectives of controlling transmission of HIV and
STD, it was crucial to view sex workers in their totality – as complete persons with a range of
emotional and material needs and not merely in terms of sexual behaviour, as it was essential
to address the range of issues that determine the quality of their lives and to locate these in the
broader context within which they live" (SHIP nd).

SHIP subsequently evolved what it calls an ‘integrated approach’ and the project’s fundamental goal
became:

“to address the structural issues that affect the health and lives of sex workers and to

create an enabling environment for sex workers to affect significant change” (SHIP 1999:5).

Project workers identified three areas where SHIP would need to target its efforts:

• Within the sex work community itself – to create a unified community with a positive self
image willing and able to mobilise for change

• Within the broader milieu of the sex work industry – to challenge oppression, to re-
distribute power and resources, and to create space for sex workers’ mobilisation and
participation in the project

• Within social institutions of state and civil society – to work towards social recognition,
participation and inclusion

In recognition of the role played by the legal and political environment in perpetuating the
marginalization of sex workers, Durbar’s long term political goal is to achieve full legal recognition of
sex work as a profession and to decriminalize prostitution.

While SHIP was characterized from its early years by a commitment to mobilisation for social justice,
it is interesting that there was no clearly formulated strategy for how this could be achieved or even
what exactly was going to be achieved. In this sense then, the Sonagachi model can be characterised as
organic, relatively a-theoretical and value-led:

The Sonagachi project was largely unplanned and a-theoretical at its inception (Jana, Basu,
Rotheram-Borus et al, 2004:1)

We must admit that many of these developments ‘happened’ as part of a very complex social
process. It was not just ‘made’ or ‘done’ (A.I.I.H.P.H., 1997:19)

VI. PROJECT APPROACHES

SHIP’s approach targeted the sex workers of the Sonagachi red-light district. As stated earlier, the
intersectoral actions undertaken by SHIP developed over time but were largely centered around
HIV/AIDS prevention. The approach was also incremental, in the sense that objectives and strategies
were changed or added at different times throughout the project’s life, in response to both the
community’s needs and unforeseen events. This continues to be the case. To a large extent, then, it
was not possible at the outset to predict that the SHIP project would have grown into the areas and
activities that it addresses today. The policy entry points of the project evolved. They began with

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Intersectoral action for health in the Sonagachi red-light area of Kolkata

aiming to reduce exposure of the sex workers of Sonagachi -- a disadvantaged community -- to

HIV/AIDS and STI’s. Soon thereafter, they embraced other aims, including reducing the societal
stratification of sex workers, reducing their economic and cultural vulnerabilities and promoting their
human rights. No underlying theoretical logic guided these decisions and developments. One defining
characteristic of the SHIP approach to intersectoral action, however, is the strong values framework on
which it is based and that guides all interventions.

1. SHIP’s key intervention values

Early in SHIP’s evolution, Dr. Jana and other project workers articulated three key principles
underpinning the project. These are: -

• Respect (for sex workers as people who have the same rights as other citizens, and for sex
work as a livelihood option rather than as a moral condition)

• Reliance (on sex workers own understanding and capabilities)

• Recognition (of sex workers’ agency, of their human and citizenship rights and of their
workers’ rights)

The above principles became enshrined in SHIP and permeated its everyday work. In reviewing the
history and the approach of the Sonagachi Project, the team participating in the Gates-funded research
mentioned in the methodology section, the Theory and Action for Health Project (TAAH) identified a
clear value structure that guided and informed the decisions made and which explains the directions
taken (Figure 1).

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 Figure 1: Values based dynamic model of the Sonagachi Project
OVERARCHING VALUES
Collective Amelioration Development for All
Equal Equal Equal Political
Decision of Priority community members
Moral Liberty Status
Making Needs
Worth
Respect for Anti-stigma, Egalitarian
PROGRAM Good Community Equitable access
human dignity anti- organizational
VALUES governance Ownership to quality
and diversity discrimination, culture
services and
anti-violence
resources
and anti-
Responsive Power sharing at Translating
exploitation
ness to all levels the role of
other, non- agency
HIV needs
PROCESSES Addressing
Inclusive Social/Political Alliance and Consultation Peer education gender and
Collectivisation Activism partnership and sexuality
building Dissemination
Development and
implementation of Cultural Education Addressing Mechanisms Advocacy
democratic processes expression economic for active and
and systems insecurities participation negotiation

IMPACTS AT INDIVIDUAL, COMMUNITY, NATIONAL AND INTERNATIONAL LEVELS

Economic Health Cultural Social Physical/spatial Political/citizenship

HIV Non-HIV

(1) HIV/STI Prevention (reduction in HIV/STI), (2) Increased individual & community access to and control over HIV/health care resources, including treatment & care, (3)
Increased individual & community capacity to exert control over HIV/health-related risks (4) Increased coverage (5) Influence on policy
Intersectoral action for health in the Sonagachi red-light area of Kolkata

The overarching values at the top of the figure were present and discernible from the earliest days of
SHIP. These values influenced the strategic direction of the overall project and are reflected in the
programme values which derive from them (second level in Figure 1). The challenge was to find ways
to employ these programme values in the development of the Sonagachi project and it is through the
processes (third level of Figure 1) that these are applied. As outlined later, the impact of these value-
derived processes has been most closely measured through health outcomes but are also detectable in
the other impacts identified in the last level of Figure 1. Though these values have been specified in
detail in the figure, they can be summarized in the following categories: participation and
egalitarianism; dialogue and reflexive interactions; flexibility and responsiveness to community need;
empowerment and community ownership; and equitable access to services and resources. It is the
interaction of these values that led the particular success of the SHIP interventions.

a. Participation and Egalitarianism

From the outset, an egalitarian, non-hierarchical culture was fostered by the organisation. SHIP had a
very flat structure with no middle management layer, enabling sex workers and staff to have frequent
and direct access to the project director. SHIP’s daily operations were characterised by frequent
meetings in which everyone was encouraged to participate. Sex workers and staff ate together and sat
side by side in these meetings, symbolising the organisational value that all are of equal worth and that
all have something to contribute.

SHIP’s non-judgemental approach also meant that project staff very quickly built up trust and
developed a good rapport with its peer educators and other sex industry stakeholders. Sex workers
comment how SHIP’s approach was very different to their experience with other NGOs: -

We were struck by the professional courtesy and respect with which the clinic staff treated us. The fact
that we were sex workers did not seem to bother them. This was new to us………..for the first time we
came across a group of outsiders who were not judging us….but who were prepared to listen to us, to
hear our side of the story. So we….were prepared to give them the benefit of the doubt (sex worker,
Horizons 2002)

In addition, peer educators’ knowledge was given great importance. Where possible, peer educators
were encouraged to take the lead and all staff were given the freedom to make and follow up on their
suggestions, as well as to express dissent.

….it was the sex workers who led the process based on their understanding and zeal. Frankly
speaking, I only respected their views and aspirations. I did not develop their understanding and
zeal (Dr. Jana, interview, 2004)

Whatever work we had done in all this time, we had the freedom to do it, there was a flexibility
in the very fabric of the entire process. (Project co-ordinator, 2004)

Another notable organisational feature was that the non-sex worker project staff was exceptionally
committed to their work and over-stepped ‘professional’ boundaries and barriers in many ways. For
example, sex workers were able to visit staff in their homes, they were invited to weddings, and food
was freely shared between sex workers and non-sex workers. As a result, PEs often described their
relationship to staff in terms of fictive kin. This discourse signified an environment of trust and
closeness.

Within the organisation therefore, an environment of respect and trust was created to foster PEs’
confidence and participation and to develop their aspirations.

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 Intersectoral action for health in the Sonagachi red-light area of Kolkata

b. Dialogue and Reflexive Interactions

Right from the outset, staff and sex workers were challenged to examine their own assumptions on
gender, sex work and morality and to re-assess the value and status of their own knowledge and skills.
For staff, this meant recognising their own limitations, recognising their own socially constructed
attitudes towards sexuality and sex work and developing a willingness to learn from the community:

Dr Jana guided us right from the start to accept that we knew nothing about prostitution
and sex workers and that we will have to learn everything from scratch. And in the sex
workers we came across we had the best possible teachers for teaching us whatever there
was to learn about sex, sexuality and sex work (supervisor, Horizons report:36).

Hence, much of the initial period of the project was spent in long informal discussions and debates.

c. Flexibility and Responsiveness to Community Needs

Project staff note that another key feature of SHIP’s leadership was its flexibility and willingness to
change course to meet community needs:

To my mind, the key to the success of the Sonagachi Project has been the flexibility of its
approach and adaptability of its design. When it started its focus was on disease
surveillance and control, but with feedback from the sex workers, peer educators and
other field staff, suggesting that sex workers demanded other services addressing their
immediate felt needs, the Project promptly included additional services like immunization
for sex workers’ children, literacy classes for Peer Educators etc. the Project realised that
for fighting HIV/AIDS too it is essential to address the environment within which sex
workers live and work, and which makes them too powerless to take steps to protect
themselves. And how did the Project learn this? By listening to the sex workers, by
enabling them to articulate their own priorities and aspirations and responding to the
needs they perceived as important (Supervisor, Horizons Report: 36).

d. Empowerment, community ownership and equitable access

At the core of Durbar's values is the concept of empowerment. This can be defined as: “the ability to
make strategic life choices and to participate in the processes of decision making which help to frame
those choices. Empowerment therefore refers to processes of change by which those who have been
denied the capacity to make these choices become enabled to do so” (Kabeer 2003:3). Durbar
empowered sex workers by giving them a sense of self-worth and dignity. In addition, all sex workers
were able to participate in the democratic processes that guided Durbar and to be shareholders in the
entire enterprise and its assets. Durbar also provided them with access to key tools and resources to
fight for their rights individually and collectively.

Through its values and processes, Durbar enabled a radical change in access to and control over social,
economic, cultural, health care, prevention and political resources.

2. SHIP’s value-led interventions

Below is an overview of the principal interventions led by SHIP as a reflection of its values. At the
theoretical level, although SHIP consciously avoided theories to focus on meeting sex workers’ every
day needs, one could say that the project’s interventions expanded horizontally across all members of

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Intersectoral action for health in the Sonagachi red-light area of Kolkata

the sex work community, and vertically, between the sex work community and the outside power
brokers. Key members of the community include first (i) the sex workers themselves - initially of the
Sonagachi district and later on of other districts in the entire state of West Bengal; (ii) the sex workers
enrolled as peer educators; (iii) the children of sex workers, and at a different level, (iv) the madams
and babus. Vertical relations developed by SHIP with the outside power brokers include first the local
money lenders and petty criminals and second the police and district and state government officials.

It is important to note that SHIP interventions were not implemented separately and therefore can not
be analyzed, separately. They occurred sequentially and concurrently and had overlapping synergistic
effects. These interventions are:

a. Building a cohesive and inclusive sex work community. Creating mechanisms for decision-making,
nurturing ownership and mobilizing for action.

b. Challenging social exclusion and reconfiguring power relations at the local level

c. Providing access to resources (financial, cultural, social)

a. Building a cohesive and inclusive sex work community.

Peer educators played a critical role in laying the foundation upon which the sex workers community
was first built and later mobilized for change. Dr. Jana states that the key to SHIP’s ‘community
development’ approach lies in the way the project has developed and defined its peer education
strategy, and, in particular, PEs’ participation in the project. At the time SHIP was started, the peer
education approach had been successfully used in a number of countries, but was often conceived in
an instrumental way – i.e. as a strategy for overcoming the difficulties of gaining access to, and
building up rapport with, a ‘hard to reach’ population. While these functions were also an important
consideration for SHIP, Dr. Jana felt that peer educators could also play a crucial role as community
workers, mobilisers and advocates for sex workers’ rights. In this connection, care was taken to recruit
peer educators who were relatively well-connected socially and politically in the sex work sites, who
were articulate, and who showed leadership qualities.

Our initial peer education programme was designed not only for outreach activities but
also for attainment of self-reliance, confidence and dignity and to transfer that image to
influence other members of the community which actually facilitated the creation of a
base whereby the sex workers could network among themselves and function as a group
for collective bargaining….initially they started as health educators but they gradually got
transformed and they fit themselves into the bigger canvas of society to act as a
community leader, community mobiliser and as an agent of social change (AIIHPH
1997:9).

Peer educators were exceedingly proud of their new role as ‘respectable’ health workers. They were
provided with an initial period of training by SHIP supervisors, after which they were given a small
stipend, a uniform and a bag and were expected to attend work on a daily basis just like regular
employees of any organization. Bolstered with a new, higher status and with access to SHIP’s social
and symbolic capital, the PEs soon found that ordinary sex workers were seeking their advice, and
confiding in them on a whole range of non-health issues.

SHIP’s leadership ensured that PEs were valued as experts in their own right, and ensured their
participation in every forum of the project, at every level. PEs began to engage with the new ideas on
sex work that were emerging within SHIP. By engaging with the discourse of workers’ rights, PEs

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 Intersectoral action for health in the Sonagachi red-light area of Kolkata

came to see that sex work too could be considered a legitimate profession, and that they too should
have the same rights as other workers and other citizens of society.

The day I first heard Sir say, ‘Just as I am a doctor by profession you are sex workers by
profession; I sell my medical knowledge and skill to cure people and you sell sexual
services to men in the market’, I was aghast! How can Sir compare us to him – he who is
a doctor, a vocation respected by the entire society?…………………………… We have
always been used to hearing prostitution being described as pap byabsha (sinful
business). I never dared to say that I really did not mind being a sex
worker……………….But before these Project people came along I could not even dream
of saying this to anybody. Once I realised that these people were not terribly bothered by
my occupation I found the courage to say – even to myself – that I am not committing
any sin. If doctors are respected for treating people when they are ill, we sex workers
should be respected too as we too meet a basic and urgent need (PE quoted in Horizons
2002)

PEs were also regularly meeting ‘outsiders’ – meetings with visitors to the project, advocacy meetings
(e.g. with politicians) or events designed to increase the social visibility of sex work and to generate
public debate (e.g. meetings with journalists or with the city’s intelligentsia). These meetings
generated horizontal and vertical relationships -- instilled with various levels of capital (political,
social, financial).

PEs soon expressed a desire for further education - including more basic literacy/numeracy skills, a
greater knowledge about HIV and health but also about society more generally. They saw that in order
to avoid being cheated and being dependent, and to be able to challenge, debate and participate in
society’s discourses and practices, they needed to be equipped with the requisite skills. In response,
SHIP introduced a highly innovative Freirean education programme that was developed from, and
rooted in, the sex workers’ own lives, worlds and experiences. The capacity to read and write made
them feel a sense of pride and achievement as well as power.

When sex workers shared with PEs the problems they were having in accessing child care or schools
for their children, SHIP developed a wide range of informal and formal educational and after school
programmes, in addition to organising occasional events such as picnics or ‘sit and draw competitions’
designed to bring the community together, and to enable the children to have some fun. SHIP also
extended the services offered in its clinics to include general health treatment, children’s immunisation
programmes and reproductive health services. This decision to “bring in” the children of sex workers
had a powerful impact on the latter’s perception of SHIP as a project that cared about them as
individuals. Sex workers’ children were not only brought in as project beneficiaries but also as actors
(for example, the director of Durbar from 1999 to 2006 was the son of a sex worker.)

In addition, SHIP linked with other NGOs in the city to provide legal aid and drug/alcohol de-
addiction and counselling for sex workers. All these activities were implemented to respond to
expressed community needs and were not part of the initial intervention plan. These intersectoral
relationships and actions have expanded the services available to the sex workers dramatically.

Finally, it is important to reiterate here that the personality and background of the non-sex work staff
of the Sonagachi project played a crucial role in the creation of an inclusive and cohesive community
as well as in all other breakthroughs of SHIP. Indeed, SHIP’s director, Dr. Jana and other members of
the project leadership were liberal professionals (doctors, health practitioners and lawyers) well known
for their deep commitment to social justice and human rights and with an extensive network of social
and political contacts, as well as media experience, that were put at the service of the project’s goals.

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Intersectoral action for health in the Sonagachi red-light area of Kolkata

These connections combined with the outstanding achievements of SHIP enhanced vertical relations at
the community, city, state, national, and international levels

b. Creating mechanisms for decision-making, nurturing ownership and mobilizing the

community

In response to the PE’s growing confidence, SHIP developed new structures that placed them at the
center of decision-making of the organization. As noted earlier, SHIP initially had a ‘conglomerate’
management structure which included the AIIHPH, representatives from WHO, from the WBSAPCS,
from the British Council/PMU as well as partner NGOs. These NGOs (Human Development and
Research Institute (HDRI), Health and Eco Defence Society (HEDS) and Society for Community
Development) had seconded their social workers to provide ancillary services (such as de-addiction
services and education programs). The Conglomerate also included several local CBOs like Mahila
Sangha2, Palatak Youth Club, Swapan Smriti Sangha3, who provided physical space and logistical
support to run the health clinics and also helping in mobilising the community to participate in SHIP.
In 1994, the Socio-Legal Aid Research and Training Centre (SLARTC), a NGO, joined the
conglomerate and helped in providing legal awareness training and legal aid for the sex workers'
community.

In 1994, as SHIP expanded, a variety of internal committees were formed. Their aim was partly to
create forums within the project for the PEs’ participation, partly to provide a mechanism for
responding to the problems of abuse and exploitation that the sex workers were reporting, and partly to
undertake advocacy with local power brokers. Well-connected PEs were given positions of leadership
within these committees. One committee in particular (the liaison committee) was given the specific
task of building supportive linkages with local municipal councillors, local party leaders and members
of the Legislative Assembly. This was an intentional strategy to create social change with the results
of building intersectoral action for health and health equity.

These committees were the precursors to the establishment of the formal sex workers' organisation in
1995 - the the Durbar Mahila Samanwaya Committee (DMSC or Durbar) – India’s first registered sex
workers’organisation. DMSC represented the first time in recent history that sex workers had
managed to transcend the geographical and structural barriers that traditionally separated them, and
unite as an occupational community.

Overall policy guidance and ratification of the Conglomerate’s decisions were provided by a multi-
agency Steering Committee made up of representatives from the funding agencies involved. All
Conglomerate members had a permanent seat on this committee from 1995 onwards (before this they
were invitees).

With the creation of DMSC and the movement towards community ownership, the government
agencies which had been instrumental in establishing the more narrowly defined SHIP effort became
uneasy. DMSC also had detractors among other NGOs who were uncomfortable with a new strong,

2
A sex workers’ self-help group based in the Sethbagan red light area, formed in the eighties to resist harassment and
violence from goondas (local petty criminals)
3
Palatak and Swapan Smriti Sangha are local youth clubs in Sonagachi red light area. Youth clubs or social clubs are
a very popular and widespread phenomenon in West Bengal, both in urban and rural areas. “Youth” in this context refers
exclusively to men. Out-of-work young men usually start these clubs, now more or less restricted to lower middle class or
poorer classes of any neighbourhood. One favourite activity of most youth clubs is running clinics to provide free medicines
and health care to the locals. So these two clubs were in a way culturally predisposed to lend their space for the Sonagachi
Project to run their STD clinics.

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 Intersectoral action for health in the Sonagachi red-light area of Kolkata

and different, player on the scene. External evaluators, briefed that the project had lost its way, were
brought in to review the effort and encouraged to provide justification to stop the funding and close it.
The conclusion of these evaluators was just the opposite of what had been hoped by the adversaries:
their evaluation report was a ringing endorsement of the effort to address social justice and social
determinants in the context of sex work.

In 1997, the management structure changed and the Society for Human Development and Social
Action was formed to which the AIIHPH transferred overall responsibility of SHIP management,
though Dr. Jana remained SHIP director. Finally, in 1999, responsibility for SHIP was transferred
entirely down to the sex worker community and a sex workers’ son (and ex-project supervisor)
became the Project Director, both for SHIP and other programs. SHIP and other programs led by
Durbar are now run by a complex group of affiliated sex worker organizations, that are accountable to
the Durbar Steering Committee. They are supported by a number of external (professional) advisors.

Over time, the role of social participation by the sex workers and other community members has
spanned information giving, consulting, involvement, collaboration, and now they often have ultimate
control over many key decisions that affect their well being. Although government solicitation of
social participation from sex workers was non-existent to minimal prior to Durbar, government led
meetings about HIV and sex workers always include their representation now.

The evolution of the formation of Durbar and its governance represents the full spectrum of
empowerment as conceived by Longwe (1991). At the beginning SHIP addressed basic welfare needs
(in this case treatment of STIs and prevention) and was run by an "outsider". Today, the level of
empowerment among members of DMSC includes access, conscientisation and awareness-raising,
participation and mobilization, and since 1999, control.

The particular challenge of scaling up

Since 1995, Durbar expanded very rapidly to include the entire state of West Bengal and now has
many activist that are not Peer Educators (PE).This dramatic expansion raises a question: how can the
intensive process that nurtured the PEs to transform themselves from project workers into community
activists be replicated and transferred?

District level networking

After the formation of the DMSC, the PEs began to express the desire to reach out to other sex work
communities in the districts. At that time, DfID was interested scaling up the intervention. The
AIIHPH was awarded a contract for a rapid assessment of HIV vulnerability among sex work
communities in West Bengal. It undertook this work using sex workers as community researchers.
DMSC was also becoming more strategic about its advocacy and activism and had decided to hold a
State conference in an attempt to bring sex work issues into the public arena. The community
researchers conducting the rapid assessment used the opportunity to raise awareness about the DMSC
and sex workers’ rights in the districts. Perhaps as a result, a large number of district sex workers
attended the state conference as well as a subsequent national level conference the following year in
1997.

State and national conferences

State and national conferences were the first time that sex workers had stepped out to publicly demand
their rights. The slogan for the 1997 conference was “sex work is work: we want workers’ rights”, and

15
Intersectoral action for health in the Sonagachi red-light area of Kolkata

it marked the beginning of Durbar’s serious campaign for those rights. The conferences were
extremely well attended by sex workers from West Bengal, other Indian states and a number of other
countries. The organisers had been careful to ensure the attendance of high profile national and state
level politicians, party members, intellectuals, the media, NGOs and international health and
development agencies. These events gave sex workers enormous strength and power. For the first time
ever, high ranking officials had come to listen to them, and for the first time ever, sex workers had
united as a cohesive group.

District sex workers’ mobilisation

For sex workers in the districts, participation in these events proved to be inspiring and, in many cases,
helped to overcome initial reservations and mistrust. As in Kolkata, the process of district-level
mobilization was not always straightforward, and in some areas was bitterly contested by local
stakeholders. By this time however, the DMSC was emboldened by its past successes and reputation;
social connections and its status as a high profile project were strategically used to counter local
opposition.

In contrast to Kolkata, Durbar’s district strategy deliberately emphasized local organisation building
and meeting immediate local needs as a primary mobilisation strategy, to be undertaken prior to any
service delivery. District branches were formed and usually undertook various actions against local
level problems. This was then gradually followed by the development of services.

In the early years of district mobilisation, local Durbar branches relied heavily upon assistance and
advice from Kolkata, in recent years, district branches of Durbar have demonstrated increasing
capacity to act autonomously. Within Durbar, there is now a trend to decentralise and to devolve
decision making down to the district level.

Through its district mobilisation strategy, Durbar has demonstrated a different approach from many
conventional NGOs whose agendas are sometimes driven by funding opportunities as much as by
community needs. By contrast, Durbar emphasises organisation building and political activism as a
primary strategy, followed by service provision. Building upon its reputation, scale and past successes
in fund raising, Durbar often starts new services in the districts (as also in Kolkata) using its own
central funds. Once these services have been successfully established, it is in a stronger position to
approach a donor or a local authority for additional support. In this way, Durbar is able to operate
relatively independently of donor policy trends and challenges the traditional view of sex workers as
helpless “project beneficiaries” or supplicants. In contrast, they display themselves as proactive
capable citizen-agents.

c. Challenging Social Exclusion and reconfiguring power relations at the local level

This section addresses the difficulties in gaining the support of key stakeholders to facilitate the
community development process.

The End of the Police and Goonda Raj (Regime)

In interviews and focus groups, sex workers were unanimous in expressing their feelings that what is
often described as ‘police reign’ or ‘goonda reign’ has ended. Although this assertion cannot be
established empirically, qualitative reports from sex workers in almost every sex work site describe a
significant reduction in police raids, police harassment, exploitation from local gangs and violence.
Although incidents do still occur, sex workers (and the perpetrators) know that they now have an

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 Intersectoral action for health in the Sonagachi red-light area of Kolkata

organization to call on which will take action on their behalf. Durbar activists have become
increasingly confident and capable of organising rallies, street protests, sit-ins, blockades and
advocacy with high level political actors to force action to be taken on their behalf at the local level.

Influencing Madams and Landlords

Sex workers also frequently report that they are now in a better position to negotiate health and work
issues:

Now a girl can tell her malkin “I don’t want to have customers today”, earlier they could
not say this. We have told the madams on behalf of the organisation, that if you are living
off the girls’ earnings, you must allow them the freedom and independence to say ‘no’.
Most madams accept our directives because they know that if they don’t and some
problems arise, then the organisation will get involved. Besides, a lot of madams are
members of the organisation as well. They come to the organisation on and off and
therefore their thinking has also changed a lot over time. Now if a girl says she is unwell
and doesn’t want to entertain customers, the madam accepts it (Durbar leader, 2004)

Personal Relationships

Power relations in the domestic context are the most difficult arenas in which to intervene. Durbar
encourages women to inform them and each other if they are experiencing domestic violence. Durbar
is challenging women’s own perceptions of gender-based behaviour so that sex workers themselves
become less likely to tolerate violence or abuse. Durbar has also tried to address domestic relationship
issues by setting up an organisation of babus called Sathi Sangataan. This pragmatic move recognised
that babus are an integral part of the sex worker community, and can make an important contribution
to the organisation’s overall goals. Slowly, a culture in which intervention in this very private domain
is seen to be acceptable is developing.

Establishing Self-Regulatory Boards: Challenging Trafficking and Under-Age Sex Work

One of the key demands raised by sex workers at Durbar’s first national conference in 1997 was to
have their own boards at state and local levels that would act to regulate the profession and to protect
the interests of sex workers as a professional group. Durbar has been able to operationalise this vision
in a number of sex work sites and continues to expand this work. The primary objectives and activities
of the self regulatory boards (SRB) are (1) to fight trafficking into sex work, and (2) to undertake
social welfare activities.

The SRBs are constituted of a 60% sex work membership, and 40% membership from local
authorities, government ministries, politicians, professional groups and non-governmental
organizations, a success in establishing partnerships and alliances with a very wide range of groups
(for a detailed account of the development of SRBs, see UNDP 2004, Jana et al 2002, Bandyopadhyay
et al 2004). The willingness of these groups to engage in such a sex worker-led initiative is evidence
of the sea-change in social attitudes towards sex work and sex workers that DMSC has helped to bring
about.

Sex worker members of SRBs regularly monitor their respective sex work sites for new entrants into
the profession. Any new entrants are brought before the entire board who clarify their age, and the
motives and process of entry into sex work.

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Intersectoral action for health in the Sonagachi red-light area of Kolkata

The process of establishing the SRBs has not gone unchallenged. Considerable time was needed for
building up relationships and undertaking advocacy with individuals and organisations to persuade
them to join the SRBs as members. A great deal of local resistance from police, madams and goondas
was also encountered.

A particular challenge for the SRBs lies in their ambiguous relationship with the police. In a context
where police collusion with sex trade stake holders and traffickers is well known, as is physical or
sexual abuse in police stations or government rehabilitation homes, Durbar has opted not to involve
the law enforcement authorities in the SRB process. As a result, it continues to face every day
resistance from local level police. In this regard, Durbar’s strategies of building alliances with a wide
range of actors and institutions has proved to be critical.

Durbar’s SRB programme is unique in the region and its innovative model of community-led
regulation is increasingly catching the attention of other groups working on trafficking. Durbar has
become involved in a cross-border trafficking initiative, and is increasingly being invited to get
involved in national, regional and international anti-trafficking forums.

d. Providing access to financial resources

The PEs frequently raised the issue of economic exploitation in project meetings. SHIP suggested
forming a Co-operative that would be run and led by sex workers. This co-operative, called USHA,
has grown into a successful enterprise. From the beginning, however, the creation of USHA faced
many challenges.

The Government Co-operative department informed SHIP that registration of a sex workers’ co-
operative was impossible; regulations stipulated that co-operatives had to be comprised only of groups
of “high moral character”. Instead, government officials suggested that sex workers should register the
co-operative as a housewives’ organisation. The PEs and SHIP undertook intensive lobbying and
advocacy, drawing upon their informal as well as formal ‘connections’, to influence the officials
concerned. SHIP staff managed to gain access to the highest level government officials, culminating in
a number of meetings with the Minister for Co-operatives. Sex workers were involved in these
meetings as part of the advocacy strategy.

The Co-operative regulations could not be changed without the permission of the West Bengal State
Assembly. Hence, once the relevant officials had been convinced, the sex workers’ battle for
recognition and registration went up to highest level of Government, and USHA was formally
registered in 1995.

USHA represented a symbolic victory on two counts. First, sex workers were granted formal
recognition by the State for the first time ever. Second, it legitimized sex workers’ right to control
their own economic resources. Sex workers were in charge of running of the co-operative, and were
assisted by a number of employees and supportive SHIP friends. Nevertheless, SHIP anticipated
considerable local resistance to USHA. As a result, it strategically requested a local member of the
State Legislative Assembly to sit on USHA’s Advisory Board, thereby facilitating linkages with the
Government.

At the local level, those involved in money lending resisted USHA. This resistance has increased as
USHA has become more and more popular among sex workers:

Yes, Khistiwalahs and chotawalas (money lenders) collectively tried to resist the success of
Usha. They made many complaints to the local councillor and he was quite convinced that

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 Intersectoral action for health in the Sonagachi red-light area of Kolkata

USHA is involved in misappropriation of funds, and we had to do lot of advocacy at the State
level and local level of the ruling political party to counter the situation. Khistiwalahs and
Chotawalas, the [local] club members and the malkins operated as a clique. Club members are
very influential –either they are the babus of sex workers or they are local goons, and the
Malkins are also very important. So these club people and Malkins prevented sex workers
from opening accounts in Usha. But the difference in interest paid by USHA and the
Khistiwalah / Chotawala was so huge, that most of the times we won the confidence of
general sex workers

Sex workers themselves initially resisted USHA, even the PEs. Bitter experience had taught the PEs
and other sex workers to be extremely suspicious of “new deals” involving money. In spite of the
extortionate interest rates offered by local money lenders, the sex workers knew these individuals well,
and they were always on hand to provide further loans. Though they were being extorted, sex workers
trusted the money lenders and felt they could be relied on. To overcome this resistance, SHIP made a
rule that all PEs were required to save Rs.100/month with USHA. In time, as the PEs saw that their
money was being returned to them on demand and that they were earning good rates of interest, their
trust in the scheme grew and they began to encourage other sex workers to join USHA. Their
confidence also received a boost when USHA received Rs.100,000 seed funding from the Department
of Co-operatives.

At first USHA grew slowly and had a small membership, in spite of favourable interest rates and a
wide range of financial services accessible to sex workers (for example, a sex worker can open an
account with USHA without any formal documents). However, in the early days, sex workers could
only deposit money with USHA on a monthly basis. It was clear that USHA was not attracting
membership because it was not meeting the daily financial management needs of sex workers; until it
could do so, money lenders would continue to be seen as a more flexible and accessible option than
USHA. After lobbying and advocacy with the Co-operative department, USHA was granted
permission in the year 2000 to implement a daily collection system. The result was dramatic.
Membership shot up and the amount of money deposited with USHA increased five-fold in one year.
The decision to establish a daily collection strategy is an excellent example of Durbar’s organisational
philosophy: be flexible, innovative and responsive to community needs.

The daily collection strategy also enabled USHA to expand its workforce as it now needed a cadre of
‘daily collectors’. USHA decided that sex workers children were best placed to play this role as they
were trustworthy, needed to gain a sense of pride and to learn about the sex work community and the
Durbar movement. Most of the daily collectors, are, therefore, children of sex workers.

Another key activity co-ordinated by USHA was the development in 1998 of a condom social
marketing programme. SHIP’s funders suggested that the free distribution of condoms should be
phased out, and that, for the sake of long term sustainability, sex workers’ should be encouraged to
purchase their own supply of condoms. The demand for condoms in sex work sites had increased
dramatically by the late 1990’s and was outstripping SHIP’s free supply. Sex workers were buying
condoms from local vendors but the quality was often poor. This development again provided the
opportunity to create a new cadre of workers who could also act as change agents within the sex work
sites.

By 2006, USHA was managing more than $850,000 and its active membership was more than
8,080 sex workers. It enjoys the highest loan repayment rate of all the co-operatives in West Bengal
and has begun to provide sex workers with larger loans which enable them to make bolder investments
or to take significant life steps, such as buying land, shops or building houses. In 2002, USHA won the
West Bengal’s prize for most successful co-operative. Durbar is now frequently invited to participate

19
Intersectoral action for health in the Sonagachi red-light area of Kolkata

in national level training events on co-operatives, with the resultant opportunity to influence policy
and practice.

USHA now acts as Durbar’s primary fiduciary agent, enabling the organisation to manage its own
resources independently of other agencies. It is the only sex workers’ group in India with this
independent status. This was achieved by lobbying to gain FCRA registration (permission to receive
foreign funds). Again, this was a symbolic event in recognizing and legitimizing a sex work group. It
has also enabled USHA and Durbar to build up a significant asset base and to safeguard the long term
sustainability of the organisation.

USHA’s financial success has enabled it to take loans and to invest financial surpluses to build up
Durbar’s capital assets, for example, by purchasing land (which the organisation has used to start
income generation and vocational training centres) and a number of properties, including the main
Durbar office building located within Sonagachi itself. The fact that a sex workers’ organisation can
now secure bank loans, and that vendors are willing to sell to a sex workers’ group, is also significant
as it represents a remarkable shift in social attitudes and testifies to Durbar’s success in challenging
sex work-related stigma.

As indicated above, greater financial independence has also enabled Durbar to be extremely pro-active
about developing its own programmes in response to community needs rather than donor priorities.
For example, Durbar has been able to start new clinics or education centres in district sex work sites
before official donor funding has been secured, enabling it to build up trust in local communities and
to provide evidence of the feasibility of a new venture to help secure longer term support.

Durbar is clear about the benefits that greater financial independence brings, and how it results in
power and opportunities available to the whole community to achieve its objectives. Indeed, Durbar’s
goal is to attain full sustainability. Current donors include

• DIFID, which supports the project through the National AIDS Control Organisation
(NACO).
• The National AIDS Control Organisation (NACO)
• West Bengal State AIDS Prevention and Control Society (WBSAPCS)
• Ford Foundation
Supports National Network of Sex Workers of which DMSC is a partner.
• Action Aid
Anti-trafficking activities and support to Durbar Self-regulatory Boards
• UNDP
Supports activities to prevent cross-border trafficking
• CARE-India
Supports Community-based DOTS programme for Tuberculosis control in sex work sites

(Source: Durbar web page <www.durgar.org>)

Durbar also benefits from the monetary contributions of sex workers as well as from the time they
invest to participate in decision-making meetings and project activities which is often not remunerated.

e. Providing access to cultural resources

Komol Gandhar is the name given to Durbar’s cultural wing that was formally registered in 1995. Its
activities are used pragmatically as a tool in Durbar’s HIV prevention work for raising awareness and
challenging stigma. It is also used very strategically as a political tool in Durbar’s movement for sex

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 Intersectoral action for health in the Sonagachi red-light area of Kolkata

workers’ rights, bringing sex workers’ demands into the public arena, and challenging dominant
representations of sex work. In addition, Komol Gandhar gives sex workers and their children an
opportunity to claim the right to enjoyment through cultural expression.

Initially, the development of Komol Gandhar and the publicity it received was facilitated by SHIP
staff’s ability to involve a very wide range of volunteers and well known playwrights, singers and
dancers in the group’s activities. Through discussions and debates with city intellectuals, SHIP
succeeded in stimulating their interest and many came to visit and get involved in the project.

Komol Gandhar’s has written many plays and dances which have now been performed in various
venues all over India and West Bengal. One of the group’s proudest moments was being asked to
perform during the opening ceremony of the 1998 International AIDS Conference in Geneva. The
group also performs at all of Durbar’s political meetings and rallies. Upon request, Komol Gandhar
now also organises specific activities for sex workers’ children.

Their performances integrate a number of different themes (e.g. HIV prevention, social stigma, gender
inequality, the social construction of sex work or trafficking) and they have broken into mainstream
cultural space by, for example, performing in prestigious mainstream venues such as Kolkata’s
Academy of Fine Arts - but they also conduct many performances on street corners and in villages.
They have received numerous prizes and widespread publicity which have greatly boosted the group’s
confidence, and have helped sex workers to recognise and to believe in their own capabilities.

Komol Gandhar has had multiple impacts. Its impact on health and HIV prevention is difficult to
establish directly, however it has undoubtedly contributed to supporting community mobilisation, to
bringing HIV messages to life, to disseminating HIV messages to wider audiences, and to aiding a
greater understanding of the structural and political causes of HIV vulnerability. At a personal level,
participation in Komal Gandhar has had a transforming effect on some of its members, unleashing
previously pent up creativity:

I told Sir (Dr. Jana) that I have never acted in a play before and I do not know much about
it, but when I was small, my brother had taken me to a play in the village and there I had
acted in one scene, that of a young girl. It was my wish that when I grew up I would act in
plays, then I never did, because I never had the opportunity. It was only after joining
Komol Gandhar that I could get this opportunity (Komol Gandhar FGD, 2004)

Somewhat ironically, Komol Gandhar now receives invitations to perform in the clubs associated with
the city’s sex work sites, even though their plays deal with themes such as exploitation in the sex
trade.

For a group of sex workers coming from diverse cultural backgrounds Komol Gandhar has created an
opportunity for them to explore their cultural heritage and to preserve and expand their cultural
expressions. Komol Gandhar has also played a role in creating a sense of identity for sex workers’
children, and in enabling their self expression. Komol Gandhar is not merely an instrument for
delivering effective ‘development’ messages. I stepping out to perform in public places, sex workers
see themselves as asserting their equality with the privileged to whose cultural world they are
otherwise denied access (Bandyopadhyay & Gooptu 2003:14).

f. Providing access to social capital resources

SHIP’s staff (or their families or friends) were politically ‘well connected’ and these personal linkages
were pragmatically used to gain access to people in power. Moreover, SHIP leaders had large

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networks of social activist friends and colleagues. These informal networks were strategically used to
open up doors and to provide access to new opportunities that were eagerly seized. Hence, a large
corpus of existing ‘social capital’ was given (rather than lent, which is what happens in many
development projects) to the sex work community as a resource designed to break through the barriers
of social hierarchies - enabling sex workers to subsequently have access to powerful networks as
citizens, not supplicants4. See page 25 for details about the impact of the social capital assets of SHIP

g. Relations with the state and government officials

From the beginning, SHIP leadership was clear that to achieve its aims the project needed to engage in
advocacy and develop partnerships with key government officials and institutions primarily at the
local and state levels( in later stages of the project, also at the national level.) Therefore, reaching out
to them and trying to involve them in the different project activities was a strategy used by SHIP from
day one. As mentioned earlier, the non-sex work project management had social and political contacts
that helped in this endeavor and one of the criteria used to hire staff was their potential advocacy
skills. Nevertheless, the approach undertaken by the project (very different than that of other
organizations) and the support it received from international institutions and donors, called the
attention of the government and state officials from early on.

What has been the record of the relations with government officials at the district, state and national
levels? And did the political environment of the State of West Bengal play a role in establishing such
a record?

Even though the State of West Bengal is ruled by a communist party, the CPI(M), which in principle
has allowed SHIP to operate in an enabling political environment, it is also true that the party is
allegedly split on the issue of sex workers’ rights. Moreover, in the early years of SHIP, there was
reportedly considerable government suspicion over the nature of foreign funding and foreign
‘interference’ associated with the project.

The record of government support for the work of Durbar shows mixed results. In many instances
(e.g. the registration of USHA co-operative, the holding of the first national conference) Durbar’s
alliances with the state and the administration have been crucial. In others (e.g. the recognition of the
legal rights of sex workers) the opposition has been strong and clear. Nevertheless, it is important to
keep in mind for replication purposes that one of the principal “added values” of Durbar has been the
incorporation of an advocacy component (whether formal or informal) in all aspects of its work from
day one. As such, relationships and activities vis-à-vis policy makers and state institutions have been
sought after and nurtured on a daily basis, not only during challenging or critical times. For example,
whenever possible, the organization has invited government officials, civil servants and
parliamentarians to project events and has involved them in key advisory boards, and committees to
facilitate their understanding and support of Durbar’s activities. The same could be said of Durbar’s
media work, which has often been instrumental in supporting advocacy efforts with policy makers and
raising public awareness of their agenda. Moreover, Durbar has been pragmatic in accepting whatever
support was available, regardless of its ideological ‘purity’5, and regardless of the underlying
motivations (some civil servants have supported the claims of sex workers, as this appeals to their own
histories of political mobilization and agitation. Others have lent their support framed within a
discourse of victim-hood, of doing something to help a ‘poor and unfortunate’ group of women)

4
This point was made in an interview with Nandinee Bandyopadhyay, 2004.
5
These comments are based on an interview with Nandinee Bandyopadhyay, 2004.

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Last, but certainly not least, the comment below illustrates the perception of sex workers about how
SHIP has enabled them to approach policy makers as a cohesive constituency whose claims need to be
taken into consideration:

…………. I want to make a point regarding the Govt. on other municipal bodies etc. providing water,
electricity facilities etc. Prior to 1996 when the sex workers were not organised, people did not think
that sex workers have any rights so they were marginalised. On voting days a before election certain
party officials used to come and order the sex workers to vote for a certain party while they did for
fear of being evicted. But after the sex workers became somewhat empowered and organised, it
became difficult to dictate terms to them because sex workers had begun to understand what was good
and what was bad. It had become difficult to deceive them. So the party bigwigs realised in order to
get their votes some of the needs of the women had to be addressed. Hence they have begun granting
electricity and sanitary facilities in many areas (programme coordinator, district intervention FGD,
2004)

To sum up, without continued and strategic advocacy which resulted in a powerful support base, much
of Durbar’s success in increased social participation would not have happened, and Durbar could have
been confined to the sex work sites, and restricted to a community development and service delivery
role.

VII. PROJECT IMPACT

DMSC’s indicators of success are many. One of the most compelling is the prevalence of HIV
infection. While prevalence among sex workers in most other Indian cities has reached more than fifty
percent, HIV prevalence in Sonagachi remains below ten percent. The data on STIs show similar low
levels. Equally important, Durbar has enabled sex workers to dramatically increase control over their
bodies, living and working conditions. It has also succeeded in placing sex work issues on the state
and national policy agendas.

1. Community building and impacts on sexual health

The social relationships forged by the peers combined with the respect accorded to their status as
‘respectable’ health workers all helped to enhance acceptance of the safer sex message. Put together
with an intensive and on-going interactive peer health education strategy that created space for
community building, SHIP contributed to a dramatic change in social norms around condom use.
After just one year of intensive peer education, evaluation studies showed that condom use had gone
up dramatically to 71.4% (average condom use during previous day’s sexual acts, AIIHPH 1993). This
result is in keeping with studies from around the world that show that sex workers are generally keen
to protect their health from occupational risks.

2. Health implications of increased power at the local level

The Sonagachi project has radically altered the context in which sex workers make health and safer
sex decisions. The minimisation of trafficking and other local level coercion and violence, the
reduction in police raids, the protection of women’s right to secure housing, the establishment of a
strong organisation of sex workers to provide and lobby for health services, the work of the SRBs to
provide education and alternative livelihood options when business becomes poor are just some of the
ways in which the context has changed, affording sex workers greater choice and power in making
decisions. These changes contribute to the development of a culture of safer sex engendered through
peer education and community cohesion.

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3. Impacts and health implications of greater economic security

Increased economic security has directly led to an increased ability to turn customers away, and to
look after one’s own health. It has also increased sex workers' ability to control their working
environment: women can now use their savings with USHA, for example, to help them to become
independent of madams. Greater economic security has also created more stability and independence
in direction and action for DMSC:

We realised the project needed to build up wealth. We wanted to head towards

sustainability, so we needed to increase our assets. That is why we bought a car and a
house of our own instead of renting a place….another good thing is that we have bought
land and we are building a residential home for the children of sex workers. We have
bought 41 bighas of land, so even if we can cannot accomplish our dreams in this
generation, the second generation would be able to support 200-250 children from the
earnings from this land. Having our own offices has increased the confidence of the sex
workers because they feel they something of their own…when we operated from the
clubs, if we did function as per their wishes, they would hinder our activities….that is
why today, almost everywhere we have our own rooms….as a result of this our
bargaining power has increased considerably. We have plans in Domjur to open a hotel in
the first floor and use the profits to pay for at least 5-7 staff members. In the near future
we are thinking of reducing our dependence on the State AIDS Cell and other funding
agencies for money [Durbar Programme Director, 2004]

4. Increased social and political participation

At the individual level, Durbar branches play an active role in ensuring that sex workers are informed
of their rights to vote and to equal participation, without coercion, in political processes. At a more
collective level, Durbar is increasingly seen as a legitimate and respected authority on sex work and
gender issues, and has been asked a number of times to participate in state/national level debates and
in policy making processes. It now plays an active role in lobbying and advocacy at the national, state
and international levels on HIV-related issues (e.g. HIV-related discrimination or access to treatment).

A key question for those interested in project replication will be - how was SHIP, a sex workers’
project, able to forge alliances with such powerful individuals within the state apparatus and civil
society? The Gates-funded TAAH research suggests that there were three main factors facilitating this
process:

First, access to key forums/individuals has undoubtedly been facilitated by the symbolic status and
social positioning that came with SHIP’s location within the AIIHPH, its foreign funding, and its
leader being a member of a socially respected profession (a doctor).

Second, as noted earlier, many of Durbar’s most significant alliances have been made through
Durbar’s use of its own considerable ‘social capital’.

Third and most important, alliances have been forged through shrewd and intensive advocacy
strategies (e.g. setting up meetings for debate on sex work or HIV, undertaking letter writing
campaigns to request a meeting, or bringing individuals to visit Sonagachi), which have succeeded in
alliance-building with key individuals within the state and administration.

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Durbar’s alliances with the state and the administration have been crucial to Durbar’s work. For
example, many of Durbar’s key events (e.g. the registration of USHA co-operative, local rallies, the
national conference) could not have happened without the intervention of their powerful support base.

Clearly, Durbar has been successful in accessing external ‘power’. Another, related, question remains
however over the nature of their alliances – i.e. to what extent do they represent a substantive change
in the nature of the relationships between marginalised groups and powerful institutions?

In Durbar’s case, the picture is mixed. Some state actors and institutions have been directly opposed to
the sex workers’ movement, whereas others have been extremely supportive. In a context where
patronage politics is deeply enmeshed within the democratic process, the forming of political alliances
does seem to be a highly personalised process and the support that these alliances have provided is not
well institutionalised. The long standing stability of the West Bengal state government has been an
advantage in this respect however – alliances formed with supportive politicians and ministries have
endured over time. On the other hand, the administration changes regularly, and this has created the
need for on-going advocacy.

In other arenas however, significant break throughs have been made in institutionalising new kinds of
relationships between sex workers and state/civil society. The transfer of project ownership to the sex
work community is a powerful case in point. Likewise, USHA is a particularly good example of the
institutionalisation of sex workers’ access to resources through the development of new, equal and
democratic structures. In addition, the linkages that Durbar’s district branches have made with local
municipal authorities, schools, government welfare programmes and other NGOs greatly increase their
access to resources and enhance long term sustainability. The formation of the SRBs are also
tremendous examples of the development of long-standing cross-sectoral community/state/civil
society partnerships. Likewise, Durbar’s representation on the boards of WBSPACS and the State
AIDS Society and its invitations to participate in national policy processes suggests that a formal
space has now been opened for sex workers’ participation in mainstream arena that is no longer
dependent upon having the right ‘connections’.

Hence, Durbar represents an interesting example of how personal connections and the development of
strategic patronage relationships are crucial resources to a social movement, especially in its early
days. It is also an interesting example of how building strategic alliances can be used both to bring in
new resources but also to alter the context in which the intervention has to operate i.e. once Durbar
was accepted as a legitimate organisation through its lobbying and advocacy work, it was able to exert
greater influence on the overall social and policy context.

5. Policy development and institutional impact

DMSC has also helped influence the conceptual framework used to underpin HIV interventions. The
understanding that HIV prevention requires more than a technical or behavioral ‘fix’, that the
environment of sex work has a determining influence upon behavior, and that a pre-requisite to social
justice-oriented structural change is community mobilization, have now become ‘common sense’
within HIV prevention circles, including of state and national-level agencies. SHIP was one of the
early pioneers in this line of work.

The paradigm shift towards a more structural intervention approach is now reflected in the documents
and guidelines of international agencies.

Durbar has no doubt changed the way in which health government agencies at state and city level
approach the issue of community participation. For example, it is now the norm for the WBSACS to
include representatives of sex workers on its committees.

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Durbar has also facilitated changes in policies and institutional approaches in other sectors. State
legislation regulating the creation of cooperatives was amended to allow for sex workers to establish
USHA. The cooperative operation rules were subsequently changed so that USHA could implement
its daily collection system to meet sex workers’ needs. Equally important, in an unprecedented action,
the state of West Bengal granted USHA the permission to receive foreign funds (FCRA registration).

Since the creation of USHA, the banking sector has also changed its approach towards sex workers
and is now eager to seek their business, a situation which would have been unthinkable years ago. The
same applies to city vendors.

Although by law the children of sex workers were always entitled to access public education, in
reality, it was not easy for them to be admitted to schools. The work of Durbar, its close relationships
with education officials at the state and district level (for example, through the SRB) and the increased
social recognition of sex work, has made it easier for sex workers’ children to enroll.

6. Lessons Learned

A number of key lessons are clear from the twelve plus years of efforts in Sonagachi. First and
foremost, it is clear that social capital is crucial for community action and where it is missing, its
development can be fostered over time. The effect of expanding social capital on community action
and on individual self esteem and commitment to community goals is one of the key accomplishments
of Sonagachi. Though social capital took time, the fact that it did develop, even among women with
previously little community connections and apparent competition for economic resources, is an
important lesson for application elsewhere. Given time and nurturing, social capital can develop even
in the most difficult of circumstances. Its contribution to facilitating community action is clearly
illustrated in the accomplishments of Sonagachi.

The importance of working with local government also emerges as a key lesson learned. Working with
the local government, advocating for sex workers' needs and rights and bringing community issues to
the attention of local politicians, was nearly a daily task, not an effort that was undertaken only in
times of crisis or under special circumstances. This frequent contact was helpful in creating a feeling
of partnership between local political structures and the community and in fostering greater mutual
trust. In key times of crisis, this mutual trust was crucial for defusing potentially explosive conflicts.
The efforts spent in nearly daily contact with the local political structures are a clear lesson for
community action elsewhere.

Further, it is important to note that the key goal of DMSC, workers' rights for sex workers, is not a
goal that is shared by the government in power in West Bengal. This fact bears noting in two respects.
First, the failure of the two parties to agree on a key goal was not, in the long run, an impediment to
important collaboration on other issues. The efforts of DMSC for the benefit of sex workers coincided
with the desire of the communist government to alleviate poverty for the poorest of its citizens; this
was sufficient to justify an important collaboration between the two. Second, the fact that such
collaboration was possible despite a disparity of long-range goals lends support to the idea that it was
the methods and approach of DMSC and the Sonagachi project, not just the leftist predisposition of the
government of West Bengal, that helped foster collaboration with local government and contributed to
the accomplishments seen. As such, the possibility of replicating community action like this in other
places, even in the absence of a seemingly compliant government partner, cannot be easily dismissed.
Common ground between two parties can always be found, if the process of dialogue and negotiation
is honest and sincere.

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VIII. CONCLUSION
The efforts that began as SHIP project, an HIV prevention effort, and grew into a multifaceted social
movement under the auspices of DMSC are difficult to describe for those who would like to duplicate
the successes seen there. Some key features have been highlighted in this case study and bear
repeating, however. Perhaps foremost is a cluster of attributes that induced and enabled Sonagachi to
change. As a clearer understanding of community needs and constraints was gained, the project moved
to address these as well. In this regard, it was flexible and responsive. Many of the actions undertaken
seemed far removed from the immediate concern with HIV prevention that stimulated the formation of
the Sonagachi project. While this may be common in intersectoral action, it did pose problems for
Sonagachi in the early years when funders were so influential. But the project was expressly not
limited by a donor driven agenda nor by a particular theoretical perspective. This fact may have
fostered the responsiveness and adaptability that have characterized the Sonagachi effort. All changes,
however, were always influenced by and rooted in the strong values framework that was at the core of
Sonagachi from the beginning. It is by being true to these values and spreading them throughout the
community that Sonagachi has developed into the organic, responsive organization of which large
numbers of sex workers throughout West Bengal are now so proud.

Drawing on that strong values base, the Sonagachi project espoused and lived strong egalitarianism.
Sex workers were actively encouraged to be proud, to be independent, to take action. The result was
an empowerment, both for individuals and for the community as a whole, that has carried Sonagachi
and DMSC, as a political force, into forums and public debates around the world. Through this
empowerment, the voices of sex workers are now heard where policy is made in India and their lives
are becoming less encumbered by discriminatory rules, regulations and restrictions. Economic capital
as well has developed through the efforts of DMSC and sex workers are now taking advantage of
opportunities in ways they could never do before. The empowerment of sex workers was a value that
was so strongly held in the Sonagachi project that the original architects of the effort relinquished all
control, deeded the project over to DMSC, an organization begun and run by sex workers, and in
effect became their employees. Better proof of the importance of the values base in the development of
this important effort would be hard to find.

The Sonagachi project is also one of the first HIV prevention efforts for sex workers that based its
approach on occupational health. This perspective facilitated the Sonagachi project in addressing the
working conditions and environmental threats experienced by sex workers as they practiced their
trade. It also elevated the sex workers from the level of "poor unfortunates needing assistance" to an
occupational group campaigning for and entitled to better working conditions. This reframing of the
more traditional "HIV and prostitution" perspective further enhanced the egalitarianism that has been
so important for the growth and development of the Sonagachi project. It also positioned the efforts of
Sonagachi within the greater area of social justice.

Sonagachi has had many friends along the way and has been able to accomplish what it has by
building and accessing when needed political and social resources. Key political leaders have been
lobbied, the media has been educated, donors have been sought, respected and oriented to the different
approach there. To their credit, donors have usually seen the benefits of helping DMSC and have stuck
by it. Political action in the streets has also been a tool for gaining attention when needed but certainly
not the only, and some might argue not the most effective, of the strategies employed. Careful
advocacy has been employed, again facilitated by the pervasive egalitarianism that has convinced sex
workers to approach the powerful respectfully but to treat them as equals. Their story has always been
compelling but few listened. It is now being told in a clear and confident voice and heard widely and
clearly.

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LIST OF ACRONYMS AND KEY TERMS USED6

AIIHPH All India Institute of Hygiene and Public Health, Kolkata
Chotawalas Money lenders
Babu Boyfriend or permanent sexual partner
DMSC or Durbar Durbar Mahila Samanwaya Committee. (Durbar means unstoppable in Bengali)
DIFID Department for International Development (United Kingdom)
Goondas Local petty criminals
Goonda Raj The regime or reign of local petty criminals
Khisti wallahs Money lenders
Komol Gandhar Durbar’s cultural arm
Malkin Madam or person who rents the premises to sex workers
NACO National Aids Control Organization of India
NORAD Norwegian Agency for Development Cooperation
Para Neighborhood
Para cheles Neighborhood clubs
PE Peer Educators
PMU Project Management Unit
SHIP Sonagachi STD/HIV intervention project
SRB Self Regulatory Boards established by Durbar
STI Sexually Transmitted Infections
TAAH Theory and Action for Health Project
UNAIDS Joint United Nations Program on HIV/AIDS
USHA Sex workers’ cooperative bank
WBSAPCS West Bengal State AIDS Prevention and Control Society
WHO World Health Organisation

6
Key terms used appear in italics.

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