"I've Been Where They Are" A photo story of Caroline, a peer outreach worker reaching sex workers in Malawi. Interview and photographs by Nicole Ippoliti, FHI 360.

“I’ve been an outreach worker for two years, and before that I was a peer educator with Family Planning Association of Malawi trained in behavior change communication. I will tell you, at times it’s challenging to convince sex workers, especially the young ones, to use condoms. Men often approach these girls and will offer to pay these girls extra money to have sex without a condom, and the girls will accept and charge about 5,000 MK ($6.85). The younger girls will charge 500-1,000 MK ($0.69-$1.37) and they’ll see 10-20 men a night. The girls say, ‘I’d rather have more money than use a condom with a client.’ That’s why health education is so important. These girls, they don’t care about their bodies or themselves. They don’t realize that if they don’t use a condom, they can get HIV or sexually transmitted infections. They just want the money. And money is important, but when I tell girls that condom use, above anything, is most important, they listen to me. They listen to me because I’ve been where they are. I’ve lived their lives, and now I’m trying to help them be safe and healthy.”

“I really feel like we’re making a difference in the lives of key populations. For example, it’s very difficult for key populations to go government hospitals to get treated for sexually transmitted infections, while here it is free. When sex workers go to a government hospital, they are treated like a nobody. Here at the drop-in clinics, we focus on condom distribution, sexually transmitted infection treatment, and HIV testing and counselling. We give them the referrals and then they come here and get whatever service they need. They are so appreciative of how they are welcomed and treated here because they know that they are our priority.”

“Violence is a big problem that sex workers face… If they are not confident in their negotiation skills, they end up facing abuse. Clients are the main perpetrators of the violence. Sometimes they come, they have their good time, and then they refuse to pay. When the girl demands payment, the client becomes violent with her. We have a victim support unit, or we take them to the police. But sometimes the men who are violent with the girls are the police themselves, so they end up not helping you at all. We will open up a case, the police say that they’ll look into it, and after time, the case just disappears.”

“I got into sex work two years ago. A friend of mine at school was doing it, and she was making good money, so I decided to do it too because I needed money to pay for my secondary school fees. Eventually I dropped out of school, because I was making money and would have 3-5 clients a day. Looking back, I wish I stayed in school but at that time, I had a lot of responsibilities. When I was young both my parents died in an accident, so I had to take care of my siblings. Now I am still taking care of them, I pay their school fees, and their living expenses. And now, I have two children, so a lot of people depend on me. But when I have enough money, I want to finish secondary school and then go to university and get my degree in information technology. And you know, I will do it.”

“She’s good at understanding things, though she didn’t go very far with school. If she went back to school, she could do anything. She’s taught me so much about how to work with key populations, how to approach them and get them to trust you. She taught me that it’s not enough to come to them with HIV information and expect them to change. She told me, ‘this work is very challenging, and sex workers are tough people, so it all depends on how you approach them. You have to befriend them, say a few jokes, get to know them as a person.’ That advice really helped me incorporate myself with the sex worker community. Beyond that, she reviews my reports and helps me correct my mistakes, she always calls to check in on how my visits to the hotspots went, and the number of girls I’ve seen. She recognized my passion and helped me channel it into becoming a better outreach worker.” - Liya, outreach worker with LINKAGES Malawi, speaking about Caroline.

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