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Asha Mahila Sanstha (AMS) operates in the Bombay Municipal Corporation (BMC) Eye Hospital off Maukat Shaukat Ali Marg. Here the organization runs a soup kitchen for 100-150 HIV and TB infected Commercial Sex Workers (CSW) who, as Bhagwan informed me on the first day, “have a residential problem.” This, of course, is putting it mildly as most CSW, when they are found to have HIV or TB, are thrown out of the brothels that have become their homes and forced onto the street. Even there they are still persecuted, driven away by shopkeepers who typically harbor unwarranted fears of airborne transmission of the virus. The CSW then have no choice but to wait until the wee hours of the morning when the shops close in order to sleep on street in front of them. This incredibly precarious situation is partially relieved by the AMS soup kitchen, run on an entirely volunteer basis, which provides breakfast and dinner to the most vulnerable women in Mumbai. Despite this ray of hope, the ramifications (even beyond the direct health implications) of contracting HIV or TB are severe. One of the most difficult things I’ve had to witness since I’ve been here was meeting an elderly KP in one of the pills who was worried that her friend had TB. The woman spoke frantically to the Outreach Workers who tried to calm her to no avail. After about ten minutes the woman broke down and began crying. The Outreach Workers assured her that her friend could come in for testing the next day, but even in that instance, what happens if the results come back positive? I nearly burst into tears coming back to the apartment that day, and later confided to Kanakdeep in a moment of rage/frustration that if I were one of these CSW and I knew I had TB or HIV, I wouldn’t get tested only to risk being thrown on the street. I would try to infect as many clients who had done this to me in the first place as possible. It’s a terrible thing to say, especially since I’m aware that such an attitude only perpetuates the cycle of infecting innocent women (clients then transmit the virus to other CSW, or to their wives and unborn children). Still, how KPs manage to care about other people after they have been so violated, mistreated and traumatized, is beyond me.

Asha Darpan, a drop-in centre for CSW, was formed as an off-shoot of AMS in order to provide services to brothels in the Dreamland Theatre area (whereas the Mumbai District AIDS Control Society or MDACS focuses on the nearby Kamathipura and Khetwadi areas). The following is a list of the pills (no idea on the spelling or exact meaning of this word, for now I’m going with “brothel buildings”) within the Dreamland Theatre area that I’ve visited:

• Simplex
• Dayanand
• Jamna Mansion
• Dewalkar
• Radabhai
• Dharwallah
• Omniwas
• Dilsaa
• Delvar

It’s important to note that each brothel thus far has had a completely unique character, and it’s been difficult for me to generalize the conditions I’ve seen. To begin with, the brothels range in size from four (Radabhai) to 450 (Jamna Mansion) residents. All in all, AD has an active population of 2200 KPs (KP stands for “Key Population,” referring to demographics at risk for contracting HIV and other STIs. Within Aastha it’s used synonymously with the term CSW), about 1200 of whom are members of smaller self-help groups or gurts. All KPs are assigned an ID number, and each day after their visits, Peer Educators keep a written record of the women they spoke with and the services provided, noting the woman’s site, floor, room and ID number. Gurt attendance hovers around 600-700 KPs at any one time as perfect attendance is not mandatory (or feasible), but in order to be considered an “active” member, a KP must have used one of Aastha’s primary services (condom distribution, STI testing, one-to-one meetings, etc.) within the last six months. If the KP does not, she is dropped from the list. She can, however, choose to re-register at a later date and obtain a new ID number. “If we force people into a gurt,” one PE explained, “they won’t attend. The only change would be a drop in our percentage of participation.”

It’s not just a numbers game, however. Gurts operate successfully purely from positive peer pressure. One day I accompanied Peer Educators Kumar and Salma to their regular pill, Jamna Mansion, one of the largest at 5 stories. Santosh, an Outreach Worker, came along to induct some new gurt members and hold a few “exposure meetings.” Santosh was initially very concerned about my welfare entering the building, explaining that because other areas (Safed Gully or “White Alley” historically being one) are home to European CSW, some clients could see me and be confused. This fortunately didn’t happen, although my presence certainly caused a stir amongst the women. After the first exposure meeting, Santosh called me over and pointed with indignation at the stairwell. Thinking he was using the stairs to describe the condition of the building itself,  I was a little confused, especially since Jamna is much nicer than some of the other pills such as Simplex or Dayanand. For one thing, there are windows. Pointing again, Santosh started to explain, “See how the stairs, they slope? That is because of how many customers come. A woman, she has 15 a day. 400 to 450 women in this brothel.” Indeed, the stairs were sloped from foot traffic, and despite perhaps the unusual rhetorical method, Santosh certainly drove his point home.

Leaving the stairwell, we moved into a couple of the rooms, some of which have have televisions and, the biggest luxury I’ve seen so far, windows. Also the rooms are a bit bigger, although shared between more women (4-5 beds in a 10’ x 12’ room). Each bed has a curtain to pull around it so all of the women can have customers at the same time. The curtain did come in handy when we had a meeting with a few of the sex workers while another one of them entertained a client not five feet away. At this point Santosh gathered some of the women together, including some new women, and had them “play a game.” Each gurt elects one fellow sex worker to serve as Group Leader. The women of the gurt go to their Group Leader with their problems, the Group Leader goes to the Peer Educators, on up through the organizational hierarchy until a solution is arrived at. So, to reinforce group solidarity, Santosh laid out a reed mat and had all the women of the gurt, including the new inductees, stand together on it. He gave them a spiel about unity and how we’re more powerful (sakhti) when we are together. Then the women got off the mat and Santosh folded it in half and told them to get back on, while repeating his speech. Same drill three more times and finally the women are scrunched onto this tiny mat space, hugging one another, laughing and singing. I’m not usually one for team building exercises but it was pretty moving.

Despite the emotional and practical benefits of gurt membership, over 1000 active KPs remain outside the self-help groups. The main constraint is that the majority of these KPs are still “endebted” to their pimps (the women typically must repay their pimps ostensibly for their travel costs from the village to Mumbai, as well as for food, etc. once they live in the brothel. These costs are usually very inflated, and debts can take months or years to repay. When I asked one woman what she looks forward to, she told me that in six months she will have paid off her debt and will be allowed to go home to see her family.) Endebted KPs are extremely limited in their freedom of movement, some aren’t even allowed to visit the Aastha Clinic, and instead Aastha doctors must perform examinations in the brothels themselves. I was privy to one such examination, a PAP smear, in one of the brothels with the worst conditions I’ve seen. There were seemingly dozens of pimps wandering about, much more than in other brothels, or at least they felt much more “present,” asserting themselves and speaking on behalf of the women to the doctors at times. Dr. Weber invited me into the patient’s room (a low-ceilinged closet with a tiny bench bed and solitary lightbulb) for the examination. The woman was young and didn’t speak Hindi or Marathi. I couldn’t help feeling like I was violating her privacy attempting to hold her hand as the doctor inserted the duck lips, urging me (in English) to ask the woman questions quickly because outside of the room in front of her pimp she wouldn’t be able to answer. It wasn’t the last time I’d find myself in an ethical bind while conducting my “participant observation.” Later that day, as I was getting ready to leave Asha Darpan and head home, Dr. Weber called me into the Aastha Clinic next door. On the bed in the exam room a KP was lying on her stomach.

“This woman has come to the clinic, would you like to see her problem?”

Completely caught off guard I stammered, “Um, well, I don’t know, is it okay?”

“Yes, it is okay.” Dr. Weber said something to the woman in Hindi and before I knew it she was spreading her butt cheeks. I stood horrified in the doorway and the doctor gestured for me to come closer and take a look. “She has anal warts. Have you heard of this?”

It took all of my will power not to respond, “Only in health class.” Instead I managed a simple but serious, “Yes, I have heard of this.” I think what shocked me more than anything was the fact that this woman had no qualms about spreading her butt cheeks for a total stranger to gawk at, just because some (male) doctor told (not asked) her to. She has so little control over her own body that obeying a command like that is automatic. It’s very disturbing, and I feel guilty being a part of it. It flies in the face of all of my goals for maintaining an equitable, “feminist research” methodology. Yet, it was so unexpected and it happened so fast that I didn’t have time to stop it. I had my wits more about me by the time the second woman came into the exam room and Dr. Weber volunteered, “She is complaining of vag-eye-nal warts. Would you like to see?” No, thank you, I really must be going.