Sunday, December 6, 2009

STI Education

Post is long. If the beginning is boring, stay patient because it gets more interesting as it progresses.

On Saturday, another volunteer and I did an STI and HIV/AIDS education event in a nearby town (Boumia, population 30000). We were working with an association that we had done events with before.

After setting a date last week, I got to Boumia at 930 on Saturday morning. I happened to run into a couple guys from my town, Mohamed and Rachid (all Moroccan names changed). Mohamed is one of my best friends from my community. They got me to come eat breakfast and drink tea with them at a cafe. While we were talking, they told me they were in Boumia to go see prostitutes. They tried to get me to come. When I refused, Rachid told me he would pay for everything. Hearing my friends talk like that is pretty upsetting; it was especially poignant given that the group of people that we had targeted for the education: sex workers.

After a little while, my PCV friends showed up at the cafe. They talked with my Moroccan friends for a while as we had tea and scrambled eggs (which the Moroccans insisted on paying for).

My PCV friends and I left the cafe to go find our friend, Smail, who we were working with. We found Smail and Brahim (another guy helping with the project) at a different cafe. Brahim left to do some other work and Smail, Falisha and I went to invite girls and women to the event (scheduled for 3 that afternoon).

I've invited sex workers to one previous event and it's an emotionally difficult thing to do. Frankly, the prostitutes are a depressing group. Something about the alleys reeks of sex. The women are smoking (which is something that only prostitutes do in most of Morocco). They are dressed inappropriately. And groups of men and boys prowl the street, laughing and joking loudly with one another. Having Smail with us is crucial. He has a comfortable relationship with many of the women because he wrote his master's thesis on the sex industry in Boumia, which included surveying and interviewing. Inviting the women gave Falisha and I a chance to introduce ourselves - a long term goal we have is to build relationships with the women. One very positive part about the recruiting was that we got feedback about the previous event we had done: the women really liked the distribution of medicine (STI meds). In addition to the emotional difficulty of inviting the sex workers, I also had the shock of running into Mohamed and Rachid back in the "red light district." They were sufficiently embarrassed that they ran away without talking to us (or did I run away from them?). I told Smail that they were my friends. We are helping him learn English and he replied "they search."

After inviting the women, Smail, Falisha and I got into a car, suppossedly to go to another part of town to invite more women. We ended up driving around town without any aim as Smail's friends kept calling him and asking him to pick them up, only to disappear when we arrived at the rendezvous spot. Weird. Then we drove 5km out of town to pick up a clay tajine for Falisha (which apparently you can't get in town despite their ubiquity on dinner tables). The drive out of town was notable for the "tarkarbusht" that we were driving (takarbusht means something like "piece of shit car" in Tamazight). Every time Smail tried to shift into 3rd gear, the car went into 1st gear, sending the engine revving to 5000 rpms and causing the car to jerkily slow down. Smail attemted the shift approximately 16 times on the 30 minute round trip, each with the same result. It got old quickly.

On our return, we picked up Sam, the new PCV in Boumia. Then we went to the Caid's for formal permission from the Ministry of Interior. The Caid was at lunch (1245 pm), but we called someone and got the go ahead. Next, the 4 of us went to Brahim's house for lunch.

Brahim's house felt like a whole other world. Brahim lives in a very nice house with 2 cute kids. We had a good lunch and watched his 5 year old daughter, Samira, dance to a song played on repeat on her brother's cellphone. This girl had huge dimples and probably could not have been any cuter.

After lunch, Smail, Falisha, Sam and I went to the Dar Chebab - the site of the meeting. A Dar Chebab is like a youth center. It just so happens that another member of our association, Driss, has access to the center, allowing us to us the space for our meeting.

The meeting got started a little late (330), but attendance was good. There were 27 women there; we only directly invited 10. I was able to greet a couple of the women by name - always a good step. Smail did an excellent job leading the meeting. Falisha and I gave introductory remarks, but mostly we were silent because the meeting was conducted in Arabic.

The first half of the meeting was devoted to sex/reproductive health. Smail talked about condoms, disease transmission, and prevention and treatment of STIs. The women were mostly quiet during this part of the meeting, but I think the topic was appropriate. Smail talks about the subject in a PG way that allows people to feel comfortable, while still getting the point across.

The second half of the meeting (which consumed the majority of the time) was Smail leading a discussion about alternative options for work for the women. This is really Smail's primary agenda for the meeting. He thinks that if we can find work for the women, we can free them from sexual prostitution. I applaud this hope, but I think that he is overly optimistic. As a powerful man in Boumia, however, he has access to real resources that could be helpful. He proposed having a carpet making workshop, a couscous making project, having the women take care of cows, and starting a patisserie. Hopefully, one of the projects works out. Some of the women were enthused.

The meeting got more informal as women came to the head table to sign up for the projects. As I was sitting there, a 45 year old woman came up to me with her daughter. She didn't speak Tamazight, so she spoke through a translator. She told me that her daughter was 11 years old (she looked about 7). Apparently, the girl had some sort of heart disorder. They had been to Meknes and Khenifra (regional hospitals) and gotten medicine, but the condition hadn't improved. The woman asked me to bring some heart medicine when we brought the other medicine (we had told the women that we were planning another STI testing date, which includes medicine distribution). It was really difficult to tell the woman that I couldn't help her daughter. I probably could have been a little more direct, but I managed to communicate that I did not have means to do anything. I told her "God will help," which sounds insensitive in English, but is appropriate in Arabic. Just about broke my heart.

Unbelievably, that wasn't the most upsetting part about the meeting. As the women started to break up into smaller groups, I tried to find some women to talk to. I wanted to see how much Jamal had touched on some of the sensitive details, which I can't understand very well in Arabic. I went up to a group of women and asked who spoke Tamazight. 5 younger girls said yes, which was suprising because normally the younger ones are the Arabic speakers. The girls were 16-19 years old.

I asked them if they knew how to stop STIs. They said condoms. I asked them what they would do if a man asked them to not use a condom. They said they would tell him to leave. That was very encouraging and better than I hoped for (our worry with this project is that targeting women is ineffective because they have no say over condom use). Next I asked them, out of 10 men, how many used condoms. One girl started speaking at length. She said that not a single man uses condoms - they don't like them and they refuse to use them (immediately deflating the hope the previous, probably false answer had created). She started talking about how hard their lives were. How when they were working they didn't think about what they were doing, but being at this meeting made it impossible to forget. One of the girls, who was wearing heavy lipstick, mascara, and had her nails painted brightly started silently crying. Tears slowly leaked from her eyes and she wiped them away one by one. The girl started talking about how the health clinic in town charges them for condoms (they're suppossed to be free) and the ones at the pharmacy are expensive (2.5 DHs (40 cents) for a condom...considering that the going rate for a prostitute is 10-20 DHs, this a lot). She said they hated their work: the men, the illnesses, the government/police (who collect bribes and hassle them) and the "problems." The girl with make up kept crying. She was probably 18 years old and it was all I could to to stop myself from giving her a hug. At this point, despite the long-shot nature of the projects Smail had proposed, it was hard not to hope that maybe we could give them some other options. Telling them just "use condoms" suddenly seemed heartlessly insufficient. Improving their sexual health would make just a small difference in their difficult lives. Moreover, they didn't even have the power to make a decision about condoms. The girl started praising us and thanking us. I told them God will help - my classic "I don't know how to help you" response. She said that we were the cause to help them chane their lives. I don't know if she meant "you have motivated us to change our lives" or "you will help us change our lives with these projects."

The day was emotionally exhausting. The meeting went about as well as it could have gone in terms of communicating a message to a receptive audience, but it revealed such deep-rooted problems that are beyond our capability to make a real impact on. It showed us just how much work there is to do. It was incredibly informative. There is clearly a need to address the availability of condoms and medicine. Furthermore, it seems that a large effort needs to be made in order to reach the male population, which is much more daunting. It is a much larger, less centralized, less receptive population. Mostly though, the meeting was heartbreaking.

It's hard not to draw negative conclusions about the society that I live in based upon the sex industry in Boumia (and other nearby towns/cities). Rural, Muslim, Berber culture has successfully stigmatized female sexuality to the point where it is impossible for a woman to express sexuality and remain a part of society. Men, seeking sex (hypocritically not taboo for them), take advantage of poor women with no other options. By compartamentalizing and isolating female sexuality to the sex industry, society is able to maintain the myth of female purity. The cost (in addition to the suppression of sexuality in the female population) is the creation of social pariahs: the prostitutes. Women in the sex industry have violated one of the most basic social rules, ostracizing themselves from normal society. Marganalized, they are powerless to prevent abuse by the authority figures, who hassle them and collect bribes from their meager earnings. Earning pittances for social suicide, they are unable to protect even their own health: condom use is up to the discretion of the man. Ugh.

6 comments:

mary ellen newport said...

And then don't forget the men take their stds home to their wives...this was the best post ever: thank you for doing this amazing work. Love ma

Franny said...

dunc,

we just had a discussion in class about this. my friends mom is an anthropologist who did work in south africa and namibia. they distributed female condoms to women all over in hopes that if the women could not mandate that the man wear a condom, they could still protect themselves. Although it does not solve all the issues you might want to look into the impact female condoms could have in your area.

Jonathan McKay said...

thanks for writing this.

tagalong said...

It must be one of the hardest things in the world to change their lifestyles after they've been involved with prostitution. Fitting back in their own family and finding someone to marry that will forgive their past life too. Probably easier if they could move to another area of Morocco and start life anew. I wonder how many of these women have been abused as girls, because I've read statistics that prostitution rates are linked to child abuse and incest....another area that is even harder to deal with there.

Marouane said...

Very interesting !!!!

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