Coordinated Strategy for Prostitution - Essay Example

1 I. INTRODUCTION The focus of "Paying The Price" was on the harms of prostitution to both individuals and communities. A series of questions were asked to elicit views and examples of good practice on which to based the development of a coordinated strategy which would address prostitution in a way that could minimize these harms. Prevention, protection and support, and justice were the key elements considered in the consultation paper and the responses provided a significant contribution to the development of a coordinated strategy for prostitution. As there are urban myths surrounding the business practices of bankers, there are just as many misconceptions and half-truths within the annals of sex worker experiences. But amongst all of the myths about sex workers, there are also numerous misconceptions and many facts. Most of the facts about this special group usually go unnoticed or totally ignored. The fact that these workers arte on the front line for some of societies most brutal, and often times most henious occurrences, it would stand to reason that the first lines of defence would be a very accommodating entity in the prevision of safety and protection. Most of these sex workers pursue their trade, either out of financial necessity to support their children and some must work on a daily basis either to satisfy the quota of a pimp, or support a drug habit or both. There are probably more reasons why any given sex worker decided to ply her attributes on this manner, then there are sex workers. However, the deep seated reasons are rarely considered and only occasionally addressed. The abuse they endured as children or in their early adolescence, which has manifested itself in the manner where 2 the low self esteem, which this persons habours due to the hurt and trauma, long ago endured, is often glossed over, by both the police and heal care workers in their effort to address the individual missions which they have either been assigned or required to deal with given and incident or the incidence. Sex workers tend not to trust the police and have a disdain for most health care workers. There is no question that sex workers can trigger an all out catastrophic increase in the HIV/AIDS debacle, and there is also no question that they should be closely monitored by health care professionals to assure that the general public is not adversely affected by their misdeeds. Of course there is no way you can protest the pusher who insists on sex without a condom, as well you can not gauge the sex worker who agrees to participate in spite of, because her needs must be met. These sets of circumstances create a bad situation which can have long term and far reaching negative impacts upon the health and well-being among members of the general population. Consequently, there has become a heightened interest in the possible perpetrators of a mass eperdermic.Albeit this is the reality behind any stratagem which the health care networks might adopt and seek to implement, one must never forget that the workers even though they do what they do, all of the front line health care employees must bring a strong sense of sensitivity to the situation The healthcare providers must sell the idea that they are interested in the individual first and the malady second. Since health care workers as a group, have not been immersed with first hand experience, there will often be times when they can not fully relate to the many variations of psychological and sociological voids which must be addressed before the vaccination can be administered. 3 II. Rationale Following the killing of five prostitutes, many women in lpswich are taking the advice of the police warnings to stay off of the streets. But despite the warnings and growing fears, some women will continue to work the dark street, because of a need for cash. One sex worker in town who has decided to take a holiday until the new year, said women will continue to risk their lives because of the need to buy drugs and take care of children. Harry Shapiro, spokesman for the charity DrugScope" said, I hope the murders acted as a "wake-up call", to the government to put funds into helping women get off of drugs"(Shapiro). Me. Shapiro backed recommendations by health care workers earlier this year for the use of special rooms or "shooting galleries" where heroin users could legally inject drugs. Simon Adler, coordinator of the Suffolk Drug Action team covering Opswich, said "the effects of withdrawing from heroin, is one of the reasons women continue to put themselves at risk"(Adler). Mr. Adler, whose team had been helping one of the murdered prostitutes, Paula Clennel, said that, "pretty much all", of the women working the streets would have some kind of substance abuse problem"(Rodgers). He added, "it was not treatment alone that would stop women from working the streets. He said, "there ae other key issues around poverty, violent pimps or partners and a lot of women have mental health issues, he went on to say, "this is a very complex issue"(Rodgers). Jeremy Pembroke, leader of the Suffolk County Council, believes the recent spate of killings require a change in the way prostitution is regarded. The Archbishop of 4 Cantebury, Rowan Williams said. "perhaps it was wider society that needs to take note, "I think what we are reminded of quite simply, in the last couple of days, is that everyone of these young women is someone's daughter, and someone's child"(Archbishop). He added, and they are human beings who have been very vulnerable and who are made very vulnerable by aspects of our society that need to change"(Archbishop) III. Literature Review Police brutality may force sex workers into hiding, effectively excluding them from basic health and social care services. It is not uncommon for police officers to confiscate condoms from sex workers, including in those areas hard hit by HIV/AIDS, and use them as evidence of illegal prostitution. Well intentional efforts to "rescue" women and men in the sex industry can compound human rights abuses against them, allowing authorities to detain sex workers arbititrarily in the course of brothel raids or forcibly evict them from their homes and communities. Sex workers also face a wide range of abuse within health care settings, such as forced testing for HIV and other sexually transmitted infections, pressure to terminate pregnancy, verbal harassment from health care providers, authorized vaccine trials, and denial of basic health services"(Dorf et al 2006) In many countries government policies on eliminating sex work by applying criminal laws rather than adopting programmatic "harm reduction" interventions that attempt to mitigate harms linked to sex work or by responding with reforms to create environments for sex workers rights promotion. "A comprehensive rights based approach to protecting sex workers health and human 5 rights must confront the harms that eminate from society's response to sex work. Not simply from sex work itself. Such an approach must concentrate on bringing the voices of people in sex work into the mix, so that their experience can inform reform.As such an approach must respect the basic right of all persons to participate in determining the public policies and structures that affect them"(Dorf et al) In a Nicaragua study funded by the Elton John Aids foundation and the UK Department for International Development, the Novib foundation, the Netherlands, the researchers sought to find out what methods of HIV prevention worked best for countries in the early stages of the edidemic And How can sexual health care be improved cost- effectively It was found that in the early stages of an HIV epidemic, prevention strategies aimed at groups with a high incidence of STI's are very cost effective(HIV Prevention) The program trains health clinic staff and provides vouchers for free health care to commercial sex workers CSW) and their partners and clients. It is highly successful in reaching CSW's and their clients and reducing sexual transmitted infections"(Gorter et al 2000). A voucher program can be a low-cost, efficient way of improving sexual health care services and reducing HTI's"(Ibid) The study point s to a number of successes over the four year period. Vouchers were distributed eight times during the period. Training for clinic stag aimed to improve both sensitivity and technical skills. Gorter et al found that: "training greatly improves the attitude and sensitivity of clinical receptionists. The technical capabilities are also improved by training clinic doctors. Forty per cent of the vouchers distributed to CSW's are used. CSW's who use the vouchers have a reduced 6 incidence of STI's. CSW's who work in the poorest areas have a higher prevalence of STI's. They also tend to use their vouchers more. More partners and clients use their vouchers less than CSW's. Despite this the program is efficient since the STI prevalence among these men are very high"(Gorter et al) III. Implications for practice The understandable preoccupation with HIV/AIDS has sidelined many other problems relating to sex work. HIV/AIDS intervention programmers correctly identify wo0rkers powerlessness as an important factor in transmission of the disease because it makes them less able to negotiate the terms of the sex act and the clients condom usage. Reports throughout the region consistently state that sex workers ability to negotiate condom usage is limited. Many programmers seek to empower women and hence by extension, to tackle a whole range of problems. Yet for many women involved in the trade, avoiding the threat of AIDS does not appear high on their list of priorities when they are faced with more immediate concerns such as debt, violence, ill-health, and social exclusion for themselves and their children(Dorf et al) Clearly, there is a growing community concern, among everyone on the subject of HIV/AIDS, and the educational aspect is the most important. In a recent report of "Drugscope" members answering questions concerning UK drug policy, which was carried out to inform the Home Affairs Select Committee enquiry on drug policy. The survey addresses the question on how the national drug strategy is working: It has improved local inter-agency work( Drugscope). There has been increased funding and resources made available for drug treatment, which in turn has led to better 7 service development, and better treatment options. There are generally more resources available to tackle a wide range of drug misuse issues, including education and prevention"(Ibid). And it has increased the awareness of drug issues"(Ibid) The Global Fund for Women, believes that the spread of HIV/AIDS, has drawn this attention to, and has increased the visibility of high risk, marginalized groups, including sex workers. In the UK Network of Sex Projects (UKNSWP) is a non profit voluntary association of agencies and individuals working with sex workers. The primary thrust is to encourage networking and the sharing of good practice. There is strong support for detoxification programs including the use of a wide range of pharmacological treatments including methadone, buprenorphein, lofexidine) and the appropriate settings into which interventions would be as strong as the evidence for maintenance and harm reduction programs"(Misuse) GUM was conceived and created to be an efficient and innovative facilitator of health care delivery. In an analysis of the initial patient questionnaire, it was discovered that over eighty-five per cent of attendees had access to a text phone, so a results service with text messaging as the first option was developed. "New patients were encouraged to book a text message for results, and two message options were offered- - a negative text or a request to call the clinic. The impact was a reduction in demand for nurse-led telephone results by sixty per cent which freed up 30 hours of nurse time per month to support other screening clinics and activities"(Clarke) "There was also a reduction in secretarial work load - it was estimated that ten text messages could be generated in the time required to produce one standard results 8 letter"(Ibid) Text messaging has now expanded to become one of the main mains of communicating directly with a person. Performance assessments can result in the ability to view the system from all four sides; assessing which service(s) can be streamlined, need improvement, or can be replaced by another which will enable the clinic or person formerly responsible to accomplish an increase in patients serviced, or freeing up personnel which can devote more quality work time in other areas of critical client need. Such as the way Central Middlesex Hospital GU Medicine North West London, was successful in implementing a number of cost efficient changes which enabled them to reduce the ratio on follow-up activity, which is now 1:0.4. Patients who were cured no longer consume hours of staff time and this frees staff to accommodate those with continuing symptoms. A development of protocol has reduced the number of returning patients returning for results (including HIV) by eighty percent through a telephone service. Maximizing walk-in clinics wherever possible, supported by appointments for ten per cent men and twenty per cent women; use of triage system to manage all quesues of patients waiting for walk-in clinics; nurse-led asymptomatic screening; nurse practitioners undertaking eighty per cent of female vaginal examinations that would normally be carried out by doctors; and nurse led discharge for most patients"(Brook) Works Cited Brook, G., Clinical Lead, GUM Central Middelsex Hospital Clarke, J., GUMS Leeds General Infirmary Dorf, J., et al Health & Rights: Where is the Funding June 2006, Open Society Institute, Accessed on line, from www.soros.org Rodgers, L., Cycle of Drugs and Prostitutes BBC News, Accessed on line on December 20, 2006, from www.bbcnews.com Taylor, D., A Brutal Indifference, The Guardian 12/12/06, Accessed on line on December 20. 2006, from www.society.guardian.co.uk The UK Network of Sex Workers Projects, Accessed on line on December 20. 2006, from www.wknswp.org Voucher for Health: HIV prevention for sex workers Nicaragua, Assessed on line on December 20, 2006, from www.id21.org Williams. R., The Archbishop of Canterbury Read More