Sex workers need vaccines the most, but remain overlooked

Sex worker Asifa (28) works in the Narayanganj terminal area. She has been in this profession for six years now. While the government has rolled out the coronavirus vaccine campaign, Asifa (not her real name) hasn't received the jab as yet. She is part of Akshay Nari Sangha, an organsation for 'floating' sex workers. She tried to get her vaccine through this organisation, but failed.

"I have no papers, no identify and so no one wants to vaccinate me," says Asifa. "I just want someone to ensure that I get the vaccine."

There are 350 sex workers under Akshay Nari Sangha. President of the organisation Kajol Akhter says that 90 per cent of the sex workers haven't received the vaccine. Most of them have neither any National ID card nor any birth registration certificate. When asked about the matter, an official of the civil surgeon's office said they will also be vaccinated after the others get their vaccinations.

Kajol Akhter said, "These girls are in this predicament because they have no addresses, no identity. Yet they come into contact with so many people. They are at high risk, but are helpless. No one bothers about them."

There are around 102,000 sex workers in Bangladesh, according to Aleya Akhter, president of the Sex Workers Network, an alliance of sex worker organisations. She said, "There are around 4000 sex workers in 10 brothels around the country. The rest are floating. And 90 per cent of the floating sex workers are not vaccinated against coronavirus. Many of the workers in the brothels too were not vaccinated as they do not have NID or birth registration."

Most of the sex workers in Mymensingh's Kandipar brothel have not received the vaccination. There are 350 sex workers here. The district civil surgeon Nazrul Islam said that 85 of them have been vaccinated. He said, "I do not know how many of them there are there, but I have a list of 85 whom we have vaccinated."

Light House is an organisation that works with 10 brothels and floating sex workers in the country. During the prevalence of coronavirus they have been providing all sorts of assistance to the sex workers, including arranging for the NID. Light House's chief executive Md Harun-or-Rashid told Prothom Alo that less than 30 per cent of the sex workers in Mymensingh and around 40 per cent in Tangail have received the vaccine. In the Rathkhola brothel of Faridpur, 30 were not vaccinated and in Jashore brothel, 25 sex workers were not vaccinated. And a large number of the floating sex workers remained unvaccinated. They have helped 1,700 floating sex workers to get NID.

The largest brothel in the country is in Daulatdia or Rajbari. A total of 1200 sex workers stay there. It is in the Goalanda upazila. The upazila nirbahi officer (UNO) Azizul Huq said, while speaking to Prothom Alo, it has been possible to vaccinate around 1000 workers. The rest will be vaccinated in the coming week.

The main reason why the sex workers who have not been vaccinated in Daulatdia is because they do not have any NID. Nisha (28) told Prothom Alo, "The UNO office said they would prepare our papers and give us the vaccine. We are waiting."

Light House's Harun-or-Rashid feels the biggest challenge at present is to get the 100,000 or so floating sex workers, who do not stay in brothels, vaccinated.

In the meantime, the spread of coronavirus is on the rise again. If more people could be vaccinated at this time, the spread of the virus and the need for hospitalisation would reduce too. This is all the more relevant in the case of persons involved in high risk professions.

Due to their profession, the sex workers come into close contact with their clients. That is why they are more at risk, feels adviser to the government's Institute of Epidemiology, Disease Control and Research (IEDCR), Mushtaq Husain. He said, the national vaccination plan mentions priority to the risk-prone communities and so these workers should be given priority.

The department of health rolled out the mass vaccination drive on 7 February last year. According to latest reports of the World Health Organisation (WHO), so far 44 per cent of the country's population has received one dose of the vaccine and 31 per cent has received two doses. The government wants to vaccinate 80 per cent of the population.

Initially there was uncertainty over the availability of the vaccine, but that was cleared to a great extent in November and December last year. According to the Directorate General of Health Services (DGHS), 220,237,000 (22 crore 2 lakh 37 thousand) vaccines arrived in the country till 30 December. Till 6 January, 131,572,000 (13 crore 15 lakh 72 thousand) vaccines were administered, including the first dose, second dose and the booster shot. That means, there are over 88,600,000 (8 crore 86 lakh doses) in stock. Health minister Zahid Maleque has said another 90 million to 100 million (9 crore to 10 crore) vaccines are due to come by March.

The health directorate also has an adequate stock of vaccines, but is not being able to speedily bring a large number of people under vaccine coverage. They have recently begun using the Expanded Programme of Immunisation (EPI), but still remain unable to speed up the vaccinations.

Vaccinating the sex workers has not accelerated either. And whatever vaccine drives have been taken up among them, are restricted to the brothels. Most of the floating sex workers remain outside of vaccine coverage, admitted member secretary of the Covid-19 vaccine procurement and management taskforce committee and EPI director of DGHS, Shamsul Haque.

He said, "The biggest problem in bringing the floating sex workers under coverage is that they cannot be located. If they leave their mobile numbers, they can be vaccinated wherever they are."

Speaking to several floating sex workers in Dhaka and Narayanganj, it was learnt that even though they had mobile phones, they did not get vaccinated when they went to the centres.

Member of the parliamentary standing committee for social welfare, Aroma Dutta, feels that a special initiative must be taken up to motivate the sex workers to go to the centres.

She recommends that help of the sex worker organisations need to be taken to speed up the vaccinations for the sex workers. They can be tasked with this responsibility, if necessary.

However, the government has not approached them for any such assistance in this regard, said president of the Sex Workers Network, Aleya Akhter.

Sex workers lag behind in priority of the government's vaccination drive, as is evident in the words of the DGHS EPI director Shamsul Haque. He said, "We have not been able to meet the government's vaccination target. We have come near. Next we will bring bus workers and other communities under vaccine coverage. This will include floating sex workers. But it has been good that this matter has been brought to our attention."