Posted by TJResearcher on May 06, 2001 at 01:00:55:
In Reply to: Writings from the field posted by TJResearcher on May 04, 2001 at 21:05:59:
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Servicios Medicos Municipales (official city run clinic for sex workers) I will be working at SMM about 3 days a week for the rest of the summer. I have initiated a joint project to be done in collaboration with Dra. Lozada of ISESALUD, Lic. Gudelia Rangel of COLEF, and Dr. Lopez of SMM, each of whom specialize in HIV/AIDS data collection for Tijuana. I visited the office with the hope of doing my own investigation and found out that Dr. Lopez collects an enormous amount of unpublished, unanalyzed data that has not been entered into a computer system. After discussing my objectives with him, and determining what data he has already available, I modified my own survey and volunteered to do data entry, analysis and publication of SMM data. SMM has about 6 years of data on registered sex workers including: place of origin, age, substance use history, condom use practices, STD and HIV rates. Only this past year (2000) has been entered into a computer system using Excel spreadsheets, the rest is all on paper. I suggested converting the entire thing into a more sophisticated software package, which I will buy (Nudist* is the only one I’m familiar with that would work well) – cost $500 (unless I can find someone to bootleg a copy for me), and a LOT of my own time. My own survey will focus on migration, family, and economics of sex work as they relate to household and extended family support, business ventures, and investment. A condom use survey by Tom Patterson at UCSD has also begun, and because I have already been in contact with Tom through other connections, I will try to collaborate with him as well. I’m finding that some US researchers don’t even bother to find out what data is available – i.e. the UCSD survey repeats similar material to that already collected by SMM, and Dr. Lopez commented to me that their clients (sex workers) are really getting tired of answering the same questions. I will be providing coffee and snacks to the women who participate in my little survey – as I have run out of funding for anything more substantial. OK HERES WHAT I’VE FOUND OUT SO FAR – Who usually has health cards? Contrary to popular opinion and even epidemiological evidence from other cities: Why is this? Male health officials (who Dr. Lopez calls “supervisors”) make the rounds to ensure all working girls have up to date health cards – no women allowed because apparently it can get violent when someone is caught. Dr. Lopez says because many of the sex workers are using alcohol or other drugs they can resort to violence in order to escape. The supervisors are also walking around at night in a dangerous area of the city in order to catch them. I asked if I could attend them on one of their rounds to observe the action – I was told he would need special permission because I am female. I’m interested in going because I want to see how things are negotiated. What happens when a girl is caught working without an up-to-date health card? I asked do they ever go to jail? Dr. Lopez says multiple infractions don’t generally occur because the women get scared and embarrassed at being picked up and fined. I had hypothesized that women would be reluctant to register for health cards because it might eliminate their chances of moving to the US. (US Immigration law states that women who have engaged in the sex trade are not allowed to enter the US – see www.ins.gov for specifics) This hypothesis was initially supported through my observation of US customer conversations and concerns about helping sex workers migrate to the US. BUT GUESS WHAT??? Health card registration data is confidential unless a warrant is given by the police in which a woman is either involved in a crime or a witness to a crime and the police need contact information. At NO TIME are actual medical records given to the police. The INS DOES NOT and CAN NOT check to see if a woman is registered. There is no central reporting system and medical records are not even computerized. This is info that could be used to increase registration and therefore access to medical services. HOWEVER, by default, anyone without legitimate pay stubs can be denied a work visas to enter the US. My next question was – well, if a woman gets fined for working without a health card – can the INS find out that she is a sex worker. Dr. Lopez said that even the police have no central reporting system, the women do not get fingerprinted when they get fined, and the crime is actually a misdemeanor and does not appear on one’s “record” so to speak. I will be requesting an interview with the police chief in order to confirm this information. I will also be requesting an interview with INS to discuss these issues. I have also spoken with a well-known US based activist who has been involved with sex workers in Tijuana who has confirmed this to be the case (Selina Espinoza of Planned Parenthood US and born and raised in Tijuana). What about corruption? Apparently the police now send a receipt to SMM when someone gets picked up and fined for working without a health card. Dr. Lopez says that this prevents the police from fining women on the spot and therefore committing extortion (“mortida”). This is a common issue in most countries, and is considered a regular part of their “overhead” – my question is, do the sex workers themselves know this? Cause if they don’t there is no reason why they wouldn’t just pay off the cop. There were 29 new sex workers registered in January, 67 in Febuary, and 106 in March. When a woman tests positive for HIV her health card is confiscated. I asked if any are still working and was told that most return to their home community in another city. This was confirmed by Selina Espinoza who stated that most women are completely devastated when their HIV status is positive. They go home to die. Be aware that it is common for women in other countries to continue to work in order be able to pay for AIDS treatment, which is not affordable without it. Las Magdalenas (the sex workers union made up primarily of street workers) are all registered, and have played in important part in lobbying for improved medical standards, and a more dignified and hygienic medical building. Previously, STD exams were given without a speculum, with no hospital gowns or privacy provided. Exams used to take place in groups. Among Las Magdalenas, the most common infection is a yeast infection. None have tested positive for HIV. Lots more info to come on Las Magdalenas… |
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