“I feel confident whereas before I just had fear.”
When Uganda Reproductive Health Bureau (URHB) first met Stella, she was engaged in sex work on the streets of eastern Uganda. Life was dangerous for Stella - she was frequently beaten and raped. Unaware that she had contracted HIV and with her health deteriorating, she was struggling to survive.
A 2011 report from ECPAT (Every Child Protected Against Trafficking) found that 6,000 Ugandan girls had been recruited into sex work since 2006, with the average age of entry being 13. Poverty, gender discrimination, violence and abuse at home, in schools and in communities are forcing girls into sexual exploitation. The majority (63%) are orphans and 80% live without any connection to their families.
Girls are attracted to transit towns with promises of education and a better life made by groomers and traffickers.However, once in town they find a very different reality. Left with little alternative, they use their bodies to survive, despite the considerable health risks and the constant fear of harassment and arrest as sex work is illegal in Uganda. High demand from truck drivers and poor community awareness of child rights and protection measures fuel the trade.
The health and safety of these girls is at serious risk. Sex work accounts for 10% of new HIV infections in Uganda with HIV prevalence amongst sex workers standing at 34.2% (UNAIDS, 2013), as compared to an average of 6.5% nationally amongst those aged 15-49 years (2016 Uganda AIDS Indicator Survey). Since sex work is illegal in Uganda, sex workers are vulnerable to coercion, violence and rape and are unable to report abuse. Discrimination prevents them accessing government health services.
Uganda Reproductive Health Bureau has been active since 1994 and a ChildHope partner since 2004. It operates a hospital in the capital, Kampala, two district health centres and works with community networks and volunteers around the country. It focuses on groups who are at very high risk of getting HIV, including sex workers, truck drivers and fishermen. It provides free medical care for abused children and sex workers.
We have recently completed a four-year project funded by Big Lottery Fund aimed at reducing the risk to children living in five towns along the main highway. We:
• Supported girls to find alternative ways of earning money.
• Improved access to quality sexual and reproductive health information and services for adult female sex workers.
• Expanded awareness of children’s and women’s rights and HIV and AIDS among truck drivers.
Children we consulted while planning this project told us that they were unaware of their rights or how to report abuse. They explained that they were involved in sex work as it was the most lucrative livelihood option. They all said they would exit if given a viable alternative. We worked with girls aged 13-17 to help them find those viable alternatives.
We provided intensive counselling and rehabilitation support, family reunification and educational and livelihoods support. Of the girls we supported to leave sex work, all were enrolled back into school or onto skills training courses. At the end of the programme 100% of the girls said they were not at risk of returning to sex work.
Even though sex work is illegal in Uganda, providing services for sex workers is not. We created Knowledge Rooms located in each of the five towns. Through training and joint implementation activities, we supported local government health facilities to improve the quality of their services for sex workers. Uganda Reproductive Health Bureau also provided direct health services for adult sex workers and their male clients through its existing clinic and weekly outreach programmes.
One of the most ambitious aspects of the project was working directly with truck drivers. Although many HIV and AIDS projects target truck drivers with safe sex messages, ours was the first project in Uganda to also promote child rights and child protection to drivers. We wanted them to understand that they were engaging in child sexual exploitation and abuse when they bought sex from young girls. We worked with networks of truck drivers’ associations to help develop codes of conduct and we delivered training in child protection issues to hundreds of drivers who are now sharing that learning with their peers.
Finally, the project strengthened the knowledge and ability of the communities to protect children. We provided child rights and HIV and AIDS training for teachers, governors, PTA members and other adults who hold positions of trust in children’s lives. We helped to establish child protection policies, positive models of discipline and child rights clubs in 15 government schools. We also supported teachers to find ways to identify at-risk girls and prevent them from dropping out of school.
We are currently seeking new partnership opportunities for our work with Uganda Reproductive Health Bureau. If you are interested in investing in this area, please get in please get in touch.
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