Taking healthcare to Delhi’s red light district

An ophthalmologist surgeon recounts her personal experience and the insights that she gained into the lives and needs of sex workers and the larger community on GB Road in the national capital, where she organised an eye care camp.

My team and I had the first detailed meeting with our local NGO partners from GB road, an infamous red light district of Delhi, in the summer of 2016. It was at the very outset that they warned us that the intended beneficiaries of our scheduled project, which aimed to provide quality eye care at their doorstep, were likely to have reservations about interacting with us, ‘outsiders.’ These were the sex workers and their families residing in the brothels of GB Road.

Our partners, Lalitha Nayak (from SPID org), a very experienced educator and social worker and Geetanjali Babbar and Ritumoni Das, two vibrant and friendly social activists (from KatKatha) explained to us that many sex workers – ‘didi’ as they are referred to – are fairly isolated, and have a deep mistrust of the police, officials and even some NGO workers. The ‘raids’ conducted here to rescue children from being trafficked, though executed with good intentions, are unwelcome as the officials ride roughshod over them, leading to a general feeling of mistrust among the residents.

An encouraging start

When we did arrive for our first camp in the area, we found ourselves in a little MCD school (run by SPID for children of the workers) with a cowshed on one side and a small police chowki on the other. Dr Modi, respected homeopath, who volunteered with us would later describe this as an area of “crowded streets, filthy surroundings, dark dingy rooms, no ventilation and people hoarded like animals.”

Our team consisted of two optometrists and supporting staff from my eye centre at Dwarka, apart from family physician, Dr Achala Sethi and me as the ophthalmologist cum project director. We have been working towards providing quality ophthalmic care for the underprivileged for several years now through the Sagar Trust founded in 2009 along with Kapil Mehta, my husband. This was part of a long project we were undertaking.

The rooms being small, we divided our equipment between the room and the porch — half inside and half outside. The sounds and smells from the street behind wafted in through the barred windows in the back. A couple of hours later, we had already examined sixty visitors to our first camp. The young Kat Katha volunteers had clearly done a good job of mobilization.

When ‘stepping out’ calls for celebration

Over the next one and a half years we conducted thirteen eye camps in this area. This was made possible by the sponsorship provided by ONGC who funded ten camps over a period of one year.

The women became frequent visitors, opened up about other illnesses as well; they used spectacles we provided and collected free eye medicines and vitamins from us. What was most heartening, however, was that over time the women felt less isolated and slowly gained the confidence to venture out, all the way to our centre in Dwarka on their own.

This was a very significant development given their background. Nearly all women practicing commercial sex work have been forced into it. Typically, young girls are kidnapped from financially destitute families in far flung villages. After being brought to metros, they are locked in narrow confined spaces by ‘handlers’, physically and mentally abused, and given hormones to ‘ripen’ their bodies.

The psychological trauma of being wrenched from a loving home environment and flung into a harsh lifestyle, replete with great physical and emotional abuse, and the thought of never seeing their family again is terrible. Their lives are constricted in every sense of the word. Thus stepping out for a normal eye check-up was an important and joyous milestone.

Our camps also attracted other residents of GB Road and over time, we built a good relationship with the community, local partners and Anganwadi workers of the area. Stephany Joseph, educator at Kat Katha and Neela on behalf of the Anganwadi group expressed their gratitude to us for holding these camps for sex workers, handlers and NGO staff.

The camp attracted not just the sex workers, but also members of the larger community in the area. Pic: Anjali Mehta

As we came to know more people, we were also inspired by the likes of individuals such as Arjun, a sex worker’s son, who had initially dropped out of school as his peers teased him about his mother’s profession. Today he is a young entrepreneur proud of his hard-working mother and unashamed to be called a sex worker’s son.

Medical and other challenges

Conducting the camps was an enriching experience. The women were energetic and vibrant, often seen squabbling among themselves in the initial days, but always courteous and respectful to the team that had come to attend to their illnesses. Of course, they were quite particular about the frames of the spectacles being donated to them.

Medically, we examined a total of 1195 patients (522 males, 673 females, including children). Many required spectacles. Some whose eyes were more accustomed to the dark, experienced glare in daylight.

Several sex workers suffer from back and knee related problems, gynaecological issues and skin rashes, most often fungal. Many have anaemia leading to palpitation, breathlessness (especially while climbing the stairs) and headaches. Diabetes is common as are calcium and mineral deficiencies. HIV infection is believed to be prevalent though only one such patient gave this specific history. Jaundice and liver weakness are common.

The most common addictions were gutka and tea. Alcohol was saved for special guests and special occasions.

We are currently awaiting permission for Phase 2 of our project in which we will expand the scope to address and treat orthopaedic issues and skin diseases. We also plan to include gender and social activists in our team this time.

The biggest challenge for us, apart from gaining acceptance by the women themselves, was the intense scrutiny by their handlers who view NGOs with suspicion as they feel the women may be lured back into normal society, thus putting an end to their (the handlers’) source of income.

Learning on the ground

Overall, this series of eye camps has been a learning process for us, the organizers, as we gained deeper insights into the problems, fears, hopes and aspirations of the sex workers.

This marginalized group, living in a twilight world full of insecurity and social isolation, needs support in a holistic and focused manner on several fronts – medical, mental, economic and social. Their physical well being can be addressed through frequent medical camps, yoga, & physiotherapy, economic security through insurance schemes and vocational training. They can be mobilized to form self-help groups, thus creating an alternative means for supporting themselves.

The government can work in tandem with civil society to achieve these goals and employ stricter laws against human trafficking. The schemes started by the government must be implemented here just as for any other part of the city or populace. Health and insurance schemes for the urban poor could be extended to sex workers as well, just as a massive cleanliness and sanitation drive in the area under the Swachh Bharat mission would go a long way in improving the living conditions of the people here. The Ministry of Social Justice and empowerment must take this disadvantaged group firmly under their wing and facilitate vigilance to prevent the physical and mental abuse of sex workers.

On our part, we intend to exchange ideas about best practices with other red light areas in the country, so that all areas benefit and grow with this shared knowledge. You can read our white paper on the project here.

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