Reaching out to women caught in sex industry

Esselen Street Clinic, in Johannesburg's edgy, bustling inner-city suburb of Hillbrow, houses the only health centre in Johannesburg offering medical care aimed at sex workers.

Business is brisk: at 8.00 a.m. the first clients are waiting outside the door of nurse Tryphina Matsena, who dispenses treatment for sexually transmitted diseases (STDs). Tall, short, light skinned, French-speaking, the women come from almost every country in southern Africa, and beyond the region as well, trying to earn money in Hillbrow's gritty sex industry. 

"They work at night and sleep during the day," said Matsena. "That's why they come by here every morning after their night duty, and then proceed to their rooms to sleep."

The University of Witwatersrand's Reproductive Health Research Unit (RHRU) began working with the clinic in 1996, as part of a 'Women At Risk Project', providing information and fixed and mobile clinical services to sex workers in Hillbrow.

Services on offer include STD treatment and HIV counselling, as well as an outreach programme geared specifically to meet the needs of sex workers operating out of Hillbrow's scruffy flats and hotels. Next year the unit plans to begin a support group. "What these women go through is horrendous, they come crying to me every morning," said Matsena.

She sees as many as 30 clients a day, with gonorrhoea the most common problem. But not all the women properly identify the cause of the telltale discharge that often accompanies STDs; a common folktale blames potatoes for the reaction. "I'm attending to all kind of cultures with different beliefs, some that I have never heard of!"

The prevalence of STDs points to the frequency of unprotected sex, either with clients or boyfriends.

"You know if a condom busts when a sex worker is engaging with a client, she is very offended, yet they have unprotected sex with their boyfriends," said Matsena. "We are trying as much to have the boyfriends come along with the women for counselling on safe sex, and for sure some have turned up."

Photo: Anthony Kaminju/IRIN
Kholi Shongile heads out to the neighbourhood hotels

Sex work does not always mean hanging around a bar all night, and not all prostitutes admit to their spouses what they do. Thato, 23, a mother of one, told PlusNews her boyfriend does not know she is in the trade. "I even have different clothes that I wear at home, and he has never seen my night clothes, which are more tight than normal."

She says she doesn't use condoms with her clients, is earning over US$2,000 a month, and doesn't plan to quit the business anytime soon.

Kholi Shongile, 32, is a former sex worker now working as a volunteer counsellor with the RHRU. Every morning she goes out with other counsellors attached to the clinic, visiting the hotels-cum-brothels to talk to the women.

"Whenever they see me talking to them on positive lifestyles they listen, as I was one of them, and they can see the changes that I have gone through. I'm a living example to them that one can stop the sex trade and do something else."

Shongile told PlusNews that she had lost many friends, killed either by clients or AIDS. Poverty and pregnancy led women into the business, she shrugged, because "selling sex becomes the most easy option".

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