The Work of Sangram: Sex Workers Claiming Their Rights

Audacia Ray

Watch Meena Seshu, co-founder of SANGRAM, a sex-worker's rights organization, deliver the Jonathan Mann Memorial Lecture at the International AIDS Conference (IAC) Thursday in Vienna.

This article is published in partnership with the International Women’s Health Coalition as part of a series of articles and opinion pieces on global AIDS and HIV in conjunction with the International AIDS Conference in Vienna, which ended this weekend. We welcome vigorous policy debates on these and other issues.

Watch Meena Seshu, co-founder of our Indian partner SANGRAM, deliver the Jonathan Mann Memorial Lecture at the International AIDS Conference (IAC) plenary yesterday in Vienna (her speech starts around the one hour mark in the taped webcast embedded above).

In her speech, Meena details SANGRAM’s path to success in working collaboratively with sex workers to claim their rights, including missteps based on good intentions. It’s interesting to hear these stories and see the way Meena’s thinking has evolved, and most importantly, how she has listened to the people she’s trying to help and let them take charge of their own projects, their health, and the destinies of their communities.

Appreciate our work?

Vote now! And help Rewire earn a bigger grant from CREDO:


Here’s an excerpt from Meena’s follow-up post on the IAC website:

When I, an educated, upper-class woman began to spend time with sex workers as a population “vulnerable” to HIV, I found that they were treated almost as non-humans by society, and I could hardly fathom how they could live and work amidst so much social disdain and dismissiveness. I quickly realized that I knew nothing about them, their community, or their work. But, as I learned by letting them teach me, amongst themselves they were not disempowered. They managed their work, their clients, their families and the community that they made for themselves. AIDS was a terrible threat in their world, but they only needed the right tools, and they would manage AIDS too.

But instead of listening to them, the AIDS establishment – led by well-intentioned health service providers and educators – wanted to teach them “client negotiation skills” and turn them over to the same health services that had always treated them with hateful abuse. It was ridiculous that anyone should think they could teach sex workers anything about clients.

Meena, who came from an upper-class background and worked for years as a social worker, was admittedly new to working with sex workers. She describes going to a meeting of sex workers in which she handed them a plan for dealing with clients and convincing them to use condoms. The sex workers in the meeting listened patiently, but couldn’t stop laughing. They made her understand how “ridiculous” the plan was, while asking if she had any experience dealing with men. Then they told her, “you get us good quality condoms, we’ll do the rest!”

She also describes her role in a collaborative project with a local hospital in which ten doctors set up a clinic just outside the brothel area. Sex workers not only didn’t come to the clinic, but actually fled from their houses and the city to avoid getting treatment. This made the doctors furious, but taught Meena that you can’t tell people that they must get tested and treated, and that it must be a collaborative process based on free, informed consent: At-risk populations have a right to say both yes and no to medical treatments.

In her speech, Meena outlines SANGRAM’s Bill of Rights, a set of great guidelines for programming interventions around HIV and AIDS:

  1. People have a right to be approached with humility and respect.
  2. People have the right to say YES or NO to things that concern them.
  3. People have the right to reject harmful social norms.
  4. People have the right to stand up to and change the balance of power.
  5. People have the right not to be “rescued” by the outsiders who neither understand nor respect them.
  6. People have the right to exist how they want to exist.

Alex Garita, IWHC’s Program Officer for International Policy, had this to say about this Bill of Rights: “This fundamental set of human rights principles, if upheld throughout developing policies, programs, and budgets for HIV prevention and treatment, would change the course of the epidemic. I am convinced by the experiences of rural women; of HIV positive women; of transgender, male, and female sex workers; and gay rights activists, that only when communities and people are empowered to know and claim their rights, will there be a reversal in the spread of this disease. As one of the stories in this lecture illustrated, putting the power of prevention in women’s hands can achieve this. I hope the world is listening.”

Commentary Abortion

The Helms and Hyde Amendments: More Than 40 Years of Human Rights Violations

Jamila Taylor & Yamani Hernandez

It’s time for U.S. advocates who condemn other governments that force women and girls to carry pregnancies to term to look at our own sexual and reproductive health policies, starting with the Helms Amendment, a funding restriction that turned 42 on Thursday.

Earlier this year, a sexual assault case involving a child in Paraguay sparked international outrage.

The 10-year-old child’s stepfather allegedly raped and impregnated her, and government officials denied her mother’s request for an abortion. Abortion is legal in Paraguay in cases where the life of the pregnant woman is threatened, but Public Health Ministry officials stated there was “no reason to interrupt the pregnancy,” unless she developed life-threatening complications. Instead, they argued that it would be “even more dangerous for the girl to undergo [an abortion] procedure.” Despite the clear health risks a pregnancy posed on the young child because of her age and the alleged rape incident, the now-11-year-old gave birth in August by cesarean section, as her doctors judged a natural birth to be too dangerous.

Following the incident, human rights groups in the United States and abroad condemned the government and the anti-abortion law that forced the young girl to carry to full term. Amnesty International said in a statement she was “lucky to be alive” due to the risks associated with her pregnancy, the Guardian reported.

It’s easy to point the finger at extreme cases of human rights violations from overseas. We like to think of the United States as a country where human rights are protected, and that something like what happened in Paraguay could never happen here. But it’s time for advocates here who condemned the Paraguayan government to look at our own sexual and reproductive health policies, starting with the Helms Amendment, which hinders a person’s ability to access abortion care in equally devastating ways.

Appreciate our work?

Vote now! And help Rewire earn a bigger grant from CREDO:


Abortion is extremely safe when it isn’t restricted. In fact, abortion carries a lower risk than childbirth. But restrictive laws create barriers to timely and compassionate abortion care, forcing people to seek unsafe abortions provided in unhygienic conditions and/or by untrained providers. Every year 21.6 million abortion procedures occur in unsafe conditions, and approximately 47,000 women die needlessly, almost all of them in developing countries, according to the World Health Organization.

The Helms Amendment—which congressional conservatives, including its namesake, the late Sen. Jesse Helms (R-NC), put in place 42 years ago today, December 17—restricts any national government or non-governmental organization (NGO) that receives U.S. foreign assistance from using those funds to provide abortion care, even if abortion is legal in their country. It is the predecessor to its domestic counterpart, the Hyde Amendment, which is almost 40 years old. Reproductive rights organizations and anti-choice activists alike view these amendments as policy constants—Hyde is annually renewed in our country’s spending bills, while Helms is a permanent statute in the U.S. Foreign Assistance Act—with little opportunity for change, despite repeated calls to eliminate the funding restrictions.

Under Helms, the restriction applies regardless of whether the U.S. funds are targeted for maternal health, family planning, or refugee assistance. Although the amendment clearly states that no U.S. foreign assistance money “may be used to pay for the performance of abortion as a method of family planning,” the U.S. government’s interpretation of the law is unduly strict and to date has not allowed exceptions for cases of rape, incest, or life endangerment.

At Ipas, a non-governmental organization that supports safe abortion access, we have seen the chilling effects of the Helms Amendment firsthand in countries where we work like Ethiopia, Nepal, and Ghana, where abortion is legal but confusion, misunderstanding, and inhibition around abortion care and information exist. In many U.S.-funded family planning and reproductive health programs, the unofficial policy is for doctors to avoid performing, offering referrals, or even, as reported by the Huffington Post, being “present while abortion [is] merely being discussed.”

On U.S. soil, the Hyde Amendment is also damaging and unjust. When abortion first became legal in 1973, virtually all women had access to abortion care. The Medicaid program, which covers health care for low-income people in the United States, covered abortion just as it did other medical procedures. But then, Rep. Henry Hyde (R-IL) authored the Hyde Amendment, passed by Congress in 1976, which banned Medicaid coverage of abortion for the sole purpose of preventing as many people from accessing abortion as possible. This budgetary amendment has affected not just those covered by Medicaid, but also people covered by federal and state health insurance plans, military personnel, Peace Corps volunteers, Indigenous people benefiting from the Indian Health Service, insured and uninsured immigrants, and even some private insurance plans.

We have heard first-person accounts of low-income women selling their belongings, going hungry for weeks as they save up their grocery money, or risking eviction by using their rent money to pay for an abortion, because of the Hyde Amendment. Nonprofits like the National Network of Abortion Funds and its member organizations seek to fill the gap, but 60 percent of callers to abortion funds will not get the assistance they need due to funding shortages.

Anti-choice legislators who have made abortion expensive for low-income women are forcing them to carry their pregnancies to term. These human rights violations are creating an undue burden carried disproportionately by low-income women of color. No one should be denied care and forced to carry a pregnancy to term regardless of age, income, race, or nationality.

Governments and human rights advocates have long recognized the importance of accessible reproductive health care, including safe abortion services, to ensure maternal health and women’s human rights. At the UN 1994 International Conference on Population and Development, 179 governments, including the United States, affirmed that control of one’s fertility is a basic human right. This was reaffirmed at the 1995 Fourth World Conference on Women in Beijing. In 1999, the UN General Assembly agreed that “where abortion is not against the law, health systems should … ensure that such abortion is safe and accessible.”

United Nations committees charged with interpreting human rights treaties have found that the denial of abortion services in certain circumstances is a violation of women’s human rights, including their right to life; right to nondiscrimination; right to privacy; right to be free of cruel, inhuman or degrading treatment; and right to health. Similarly, in 2013, the UN passed two resolutions calling on member states to make certain humanitarian aid for survivors of rape include abortion. Governments around the world have liberalized access to abortion—including, just this month, Sierra Leone—recognizing that restrictive laws increase maternal death from unsafe abortion. By prohibiting domestic and foreign assistance for abortion, the U.S. government is contradicting its human rights commitments.

Millions of people, in the United States and around the world, receive funding from U.S. programs that improve maternal health conditions. Yet, the Helms and Hyde amendments undermine this important work, harming women, particularly low-income women and women of color, in the United States and in the Global South. The Helms Amendment is a dangerous and hypocritical law because the United States is the largest single donor for global family planning efforts and a supporter of international post-abortion care programs designed to treat complications from unsafe abortion.

Without a doubt, these are complex laws, and policymakers won’t dismantle them overnight. It helps when policymakers hear from the people they represent, and when organizations like Ipas and NNAF join forces to build a movement that can result in policy change. But there are steps that the Obama Administration can take immediately that would vastly improve the situation globally:

  • An immediate executive action to prevent misinterpretation of the Helms Amendment and allow for exceptions in cases of rape, incest, and where the pregnant woman’s life is endangered. Planned Parenthood and partners have organized this petition calling for an end to Helms.
  • Remove the Hyde Amendment from the fiscal year 2017 budget proposal. A coalition of reproductive and social justice organizations have created a petition urging President Obama to take this action, and it is now open for signatures.

Ultimately, in order for people around the world to realize full equality and reproductive freedom as our own human rights principles set out to do, these funding restrictions must be repealed. Everyone, regardless of their socioeconomic status or geography, deserves to be afforded the dignity to make personal decisions about pregnancy and childbearing and to access the reproductive health care necessary to make those decisions. For more than 40 years, U.S. policies have been allowed to violate the human rights of women at home and abroad. Isn’t it time the United States makes its abortion funding policies, both national and international, consistent with its other financial and political commitments to reproductive health?

Analysis Law and Policy

With Tribal Jurisdiction in the Hands of the Supreme Court, Native Women Rally for Their Rights

Kanya D’Almeida

While protesters on the courthouse steps were united in their resolve to speak out against sexual assault and affirm tribal nations’ inherent ability to protect Native women and children, the feeling inside the building, observers said, was much more uncertain.

When she was 26 years old, Diane Millich suffered an abusive relationship. A member of the Southern Ute Indian tribe, she lived with her non-Native partner on a reservation in southwest Colorado, where in the space of a year she endured over 100 incidents of being “slapped, kicked, punched, and living in horrific terror.”

She made 20 attempts to leave the man, calling every authority she could think of to come to her aid. Again and again, her plea for help came up against the same answer: There was nothing law enforcement personnel could do to protect her, a Native woman, from her white husband. The Southern Ute tribal police lacked authority to apprehend the non-member, while the La Plata County deputy sheriff had no legal grounds for assisting her on tribal lands.

This legal quagmire, she said, fostered in the couple the notion that the husband was above the law. Time and again law enforcement personnel responding to domestic violence calls in her home would leave, having done nothing but explain that their hands were tied. On one occasion, she said, “after a beating, my ex-husband called the county sheriff himself to show me that no one could stop him. He was right; two deputies came and confirmed they did not have jurisdiction.”

Millich initially shared her experience back in 2012, in a House briefing regarding reauthorization of the Violence Against Women Act, the federal law that seeks to improve the criminal justice response to violent crimes against women. This past Monday, she picked up the threads of that story outside the Supreme Court of the United States, where more than 200 people gathered in protest over a Court hearing that advocates say threatens to roll back years of established tribal sovereignty.

Appreciate our work?

Vote now! And help Rewire earn a bigger grant from CREDO:


Addressing a crowd on the lawn across from the high court, Millich explained that even when her husband tried to shoot her with a 9mm gun at a federal Bureau of Land Management site where she worked at the time, authorities were unable to prosecute him. In fact, the issue of who had jurisdiction over the shooting was so unclear that investigators used a measuring tape to determine the precise spot from which the shot had been fired.

Because of an amendment to VAWA passed in 2013, Native women can bring criminal charges against domestic abusers in tribal courts. But today, the warren of laws regarding tribal jurisdiction that kept Millich from prosecuting her abuser is in danger of being weakened even further, as the nine justices of the Supreme Court consider the merits of a case known as Dollar General v. Mississippi Band of Choctaw Indians, a dispute that arose when a tribal minor alleged that an employee of the company repeatedly molested him in a store on Mississippi tribal lands in the summer of 2003.

The boy’s family sued for damages in tribal court, a move the corporation has fiercely resisted on the grounds that tribal courts lack jurisdiction over non-Natives. A total of five lower courts upheld the tribal court’s right to adjudicate the case, leading Dollar General to appeal directly to the Roberts Court, asking it to define once and for all “the scope of tribal authority to adjudicate tort [civil] claims against nonmembers.”

For decades, tribal courts have exercised the right to do just that, largely as a result of exceptions laid out in the 1981 Montana v. United States ruling, which allows tribal adjudication of tort claims when it comes to consensual relationships and situations that “threaten the political integrity, economic security or the health and welfare of the tribe.”

“This case falls squarely under Montana, as every single [lower] court has recognized, including the tribal district court and the tribal supreme court, as well as the federal district court and the Fifth Circuit Court of Appeals,” Mary Kathryn Nagle, an attorney at Pipestem Law Firm who sat in on the oral hearings Monday, told Rewire.

“Ever since 1981, the Supreme Court has had numerous opportunities to say definitively that tribes cannot exercise civil jurisdiction over non-members, but it has not done so. It has never categorically eliminated civil jurisdiction altogether and that is what Dollar General is asking for today—they asked for nothing less than the complete elimination of all civil jurisdiction, because according to them it is simply unconstitutional to make non-Natives answerable to any tribal court jurisdiction when they willingly decide to enter tribal lands.”

Thus, advocates charge that a Supreme Court ruling in favor of the corporation could have devastating consequences, particularly for Native women and children.

Organizers of Monday’s protest, including the National Indigenous Women’s Resource Center (NIWRC), FORCE: Upsetting Rape Culture, and the Indian Law Resource Center, said that a positive ruling in favor of Dollar General would block the few remaining channels through which Native women seek recourse for domestic and sexual violence at the hands of non-Natives.

Even by conservative estimates, rates of sexual assault among American Indian and Alaskan Native women are staggering. Department of Justice data suggests that Native people “are 2.5 times more likely to experience sexual assault crimes compared to all other races.” Approximately 34 percent of Native women will experience rape and 61 percent will likely be assaulted in their lifetime. The fact that an estimated 86 percent of the perpetrators are non-Native men, according to Amnesty International, heightens the stakes of the impending Supreme Court ruling.

In a stark visual representation of the scale of the epidemic, participants in the protest wore or carried squares of cloth sewn onto shawls bearing the stories of sexual assault survivors as they marched in a circle chanting “Shame on Dollar General.” Later, they laid them down in the lawn across from the Supreme Court building, forming a vast quilt of red and purple fabric.

One of thousands of quilt squares that carpeted the lawn across from the US Supreme Court on Monday reads "It's Not My Fault".

One of thousands of quilt squares that carpeted the lawn across from the US Supreme Court on Monday reads, “It’s Not My Fault.”

“So far we’ve collected over 1,200 quilt squares from survivors around the country, and displayed them 25 times for tens of thousands of people to see,” Rebecca Nagle, co-director of the Monument Quilt Project, told Rewire on the sidelines of the demonstration.

“By stitching our stories together we create and demand public space to heal and we also build public understanding of the United States’ culture and policies that create the current crisis of rape for Native Americans, including the government’s policy regarding tribal jurisdiction,” she said.

In her public address, Nagle said that as a survivor she is tired of being told that she is “broken.”

“I am not what’s broken,” she said. “What’s broken is a racist legal framework that allows violent people to prey on Native women and children with no consequences, the fact that whenever I’m in a group of Native women and we start talking about violence and sexual abuse, every woman in the room has a story … What’s broken is a society built on domination and greed where a corporation’s bottom line is more important than justice for a child survivor of sexual assault.”

She said one survivor even wrote on her quilt square, “Dollar General, your attack on tribal jurisdiction is an attack on my body.”

While protesters on the courthouse steps were united in their resolve to speak out against sexual assault and affirm tribal nations’ inherent ability to protect Native women and children, the feeling inside the building, observers said, was much more uncertain.

Mary Kathryn Nagle, author of the NIWRC amicus brief on the case, said that the arguments made on Monday were “incredibly difficult to listen to.” Far from focusing on the experience of the survivor, she said many of the judges seemed more interested in Dollar General’s arguments that a non-Native corporate entity could be stripped of its constitutional right to due process by being forced into a tribal court.

“But even when Justice [Stephen] Breyer asked the Dollar General representative to explain what was wrong with tribal courts, they could not provide a single answer, or give an example of an American citizen whose due process rights have been violated in a tribal court,” she said.

She said the notion that tribal courts are somehow inferior to state courts is both offensive and inaccurate, given that tribal systems of government, particularly the Iroquois Confederacy, predate all other forms of government in this country and provide the basis for the U.S. Constitution itself.

Court transcripts further revealed that much of the hour-long hearing was devoted to the question of consent—the cornerstone of the first Montana exception—with Justices Ruth Bader Ginsburg, Anthony Kennedy, and others debating whether or not the corporation expressly consented to tribal jurisdiction, despite the fact that Dollar General, in leasing land from the tribe to operate the store on the Mississippi reservation, agreed in writing to be governed by both tribal and federal regulations.

“Never once did a justice ask, ‘What about that little boy? Did he consent to being sexually assaulted on his own tribal lands?’” Nagle said.

Other legal experts called the entire proceeding “dehumanizing and racist.” Sarah Deer, a professor at the William Mitchell College of Law who also heard the arguments, said they revolved around the myth that tribal juries—or what Dollar General referred to as “All-Indian” juries—are inherently unfair. “It’s important that we keep our framework around citizenship,” she said. “Because it’s not ‘Indians’ who sit on our juries; it’s citizens of our tribes.”

“The whole thing, the images and the protocols, struck me as being very patriarchal,” Deer told Rewire. “The theme was corporations and their rights—not tribal power or the victims. Granted, the centrality of this case is a mechanical jurisdictional question, but to have no humanity in over an hour of discussions is hard to wrap your head around.”

Significant bodies of scholarship dedicated to the issue of sexual violence against Native women have acknowledged that this very process of dehumanization has contributed to a feeling of impunity among perpetrators that then feeds a pattern of abuse.

In its 2007 Maze of Injustice report, still widely cited given the dearth of current statistics involving Native women, Amnesty International traced the roots of the current rape crisis back to the founding of the United States, when sexual violence was used as a tool of conquest, right up to 1968 when a federal appellate court ruling (Gray v. United States) “upheld a statute under which an American Indian man who committed a rape in Indian Country received a lower penalty if the victim was a Native woman.”

Such legal frameworks that posit Native people as somehow inferior, and which Native lawyers and advocates had assumed were a thing of the past, now threaten to reemerge if the Supreme Court’s June ruling goes in favor of Dollar General, experts say.

“It feels as if all the things I thought had been settled back in the 1990s are back on the table like nothing’s changed,” Deer said. “The abortion battle is starting again, and now this—it’s demoralizing.”

One participant at the rally, a representative of the Cherokee Nation who gave her name only as Cinema, told Rewire that she came to the protest because she could no longer be silent. “I see this case as just one other way in which capitalism and sexism interact, with corporate greed threatening to tear away at our basic human rights. It’s very familiar in terms of how this country was formed—around genocide and the stealing of resources, including people, for profits.”

 CORRECTION: This post has been updated to reflect the correct spelling of Diane Millich’s name.


Vote for Rewire and Help Us Earn Money

Rewire is in the running for a CREDO Mobile grant. More votes for Rewire means more CREDO grant money to support our work. Please take a few seconds to help us out!


Thank you for supporting our work!