Intercourse staff in Malawi cope with HIV, contraception and violence

Photojournalist Isabel Corthier met intercourse staff concerned in a programme to assist them entry well being companies in southern Malawi.

Two women

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Isabel Corthier


Malawi has one of many world’s highest charges of HIV, with intercourse staff significantly extra prone to contract the an infection. Charges of undesirable being pregnant and STI infections are additionally excessive.

Since 2014, medical charity Medecins Sans Frontieres (MSF) has been working with Malawi’s ministry of well being and companions to extend healthcare for intercourse staff, together with entry to condoms and PEP (post-exposure prophylaxis), a drug which reduces the danger of HIV transmission.


Ms Corthier took portraits of among the girls, obscuring their id, and MSF’s Kate Ribet talked to them about their tales, and to among the MSF staff.

The names of the intercourse staff have been modified to guard their anonymity.

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Bernadette, intercourse employee, Dedza

Photo of Bernadette

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Isabel Corthier

Bernadette was born right into a household of 11. She misplaced each her dad and mom when she was seven years previous and was raised by her sister and later by her grandparents.

With little monetary assist from her household, she discovered herself going hungry in school and began having intercourse in alternate for meals, pens and books. She quickly fell pregnant and dropped out of college at 18.

Right this moment she is a mom of six youngsters. Her final associate was abusive and left her destitute, so she turned to promoting intercourse in 2018, seeing it as the best choice to outlive.

Portrait of Bernadette

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Isabel Corthier

“I heard of MSF’s companies in November 2018, when their workers got here to the bar to share info and screening about STIs and HIV,” she says.

“This was the very first time I used to be given info on points like HIV testing, sexual well being. Earlier than this I did not know something. I felt liberated, pleased, as a result of I used to be listening to issues I by no means knew about.

“With these companies, I really feel extra empowered than earlier than and I can negotiate safety with purchasers. I understand how to place a condom on correctly and we now have lubricant which prevents accidents.”

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Maria, intercourse employee, Dedza

Portrait of Maria

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Isabel Corthier

Maria, 36, was married for 11 years, promoting farm produce along with her husband. After struggling years of abuse, Maria was deserted by her husband. She struggled to assist herself and her younger daughter, so turned to intercourse work.

“Typically purchasers will likely be violent or they will not pay,” she says. “Two years in the past, I had a shopper. We slept collectively however afterwards he did not pay.

“Throughout intercourse, he intentionally broke his condom. Issues bought violent and he knocked out my entrance tooth. After which afterwards he would not pay.”

Portrait of Maria

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Isabel Corthier

“Earlier than MSF got here right here, we had been being referred to as whores and prostitutes. If we went to the police, they might ship us away.

“Now we will get remedy on the hospital with none issues.”

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Adeline, MSF group well being employee, Bangula

A group of women receive contraception education

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Isabel Corthier

Adeline began as a group well being employee in February 2015.

“As a group well being employee, I’ve realized to maintain myself as an individual and to dwell a wholesome life,” she says.

“Having information means you’ll be able to go to the hospital to get medical consideration, you are able to do your job (as a intercourse employee) and assist your loved ones and group.”

Adeline has been a intercourse employee since 2005. Beforehand she had been married with two youngsters, however after her divorce she discovered she couldn’t assist her household.

She says: “A pal got here to me and stated, ‘Why are you struggling? There’s this various. You can also make cash with intercourse work’.

“I attempted it and realised that I used to be making greater than different methods to earn a living. So I made a decision to take this route.”

A group of women receive contraception education

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Isabel Corthier

However intercourse work comes with dangers, she provides.

“In 2007, I used to be working in Blantyre one night time and a gaggle of males beat me and my pal up. They left us bare with nothing.

“One other time, a shopper raped me throughout a session. I by no means went to the police. The man was well-known within the space and had raped different girls and would come after those that reported it. It was higher to only preserve quiet, so I did nothing.”

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Chrissie Nasiyo, MSF nurse mentor, Nsanje

A group of women receive contraception education

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Isabel Corthier

Chrissie has labored as a part of the sex-worker mission for 2 years.

“For somebody to say, ‘I am a intercourse employee’ may be tough due to the tradition, the stigma, the discrimination that goes with it.

“In fact, intercourse staff can really feel otherwise about disclosing. Some do not care in any respect.”

Chrissie explains the perceived distinction between sorts of intercourse staff in Malawi.

“Most individuals imply ‘industrial’ intercourse staff once they speak about intercourse work, as a result of it is a job for her. She wakes up, will get dressed and goes to discover a buyer.

“However for the ‘transactional’ intercourse employee, she could be working-class, going to her regular job, and having a number of companions in alternate for items, however she will not settle for that she’s a intercourse employee.

“Defining it for these girls may help.”

Chrissie provides the identical companies for industrial and transactional intercourse staff. Members are supplied condoms, HIV and STI testing, household planning, and antiretroviral remedy (ART) if they’re HIV-positive. Chrissie says the vast majority of the intercourse staff she works with are.

A woman hugging another woman

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Isabel Corthier

“I like working with the ladies as a result of they’ve tales to inform.

“Possibly you’ll be able to decide them from the skin however for those who hear their story, you may really feel no matter they’re doing shouldn’t be improper, they’re doing it for a function.”

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Ketisha, intercourse employee, Mwanza

Portrait of Ketisha

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Isabel Corthier

When Ketisha, 16, was in school she was in a relationship that resulted in her getting pregnant. The daddy did not assist her.

She stayed along with her sister for some time however the association did not final. Ketisha tried to keep away from changing into a intercourse employee.

“For me to search out myself being a intercourse employee doesn’t suggest I by no means tried other ways to assist myself financially,” she says.

“I attempted to promote mandasi (fried bread) however issues did not work out. After that I attempted promoting inexperienced maize however in the long run, it was all struggles.”

Portrait of Ketisha

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Isabel Corthier

“Being a young person, plying my commerce as intercourse employee, shouldn’t be simple. I get requested why at my age I’m on the bottle retailer as a substitute of being in school. My dad and mom do not know that I’m intercourse employee.

“After I go searching, a variety of teen intercourse staff are dealing with a variety of challenges. They’re being compelled to sleep with older males with out using any safety and with out getting paid. In the event that they protest, they’re bodily assaulted.”

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Jennifer, intercourse employee, Mwanza

Portrait of Jennifer

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Isabel Corthier

Jennifer, 26, is a single mom with two youngsters. Her husband was an expert thief. When she requested him to go away his lifetime of crime, he refused. They separated and divorced.

In 2008, Jennifer felt that the one option to assist her youngsters was to enter intercourse work

“When my kin heard that I’ve began doing intercourse work, I used to be chased away and informed that I ought to by no means return dwelling,” she says.

“However blood is thicker than water, and afterward after I visited them I discovered that they welcomed me. My two youngsters now stick with my mom.”

Portrait of Jennifer

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Isabel Corthier

“As a intercourse employee there are a selection of challenges. [Once a] shopper paid upfront and got here to my room. He requested me to go and purchase chips, so I did however after I got here again I discovered that he had stolen my cash and garments.

“I intend to cease this [sex work] enterprise. It is actually powerful… If I proceed, I really feel I’ll die earlier than my time.”

Interviews by Kate Ribet, images by Isabel Corthier,.

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