Introduction

Reda is combating the spread of HIV and other STDs among sex workers in Egypt in order to combat the spread of such deadly diseases to the Egyptian population and especially women and children. In a country controlled by customs and religion, sex workers although active and in abundance, are neither recognized nor respected by the government, the citizen sector nor the community. This attitude of denial and negligence has only led to their marginalization and exposure to violence and diseases that in turn affect the health of the whole population.

Reda’s non-traditional and unique idea is to protect the health of both women and men from HIV and STDs through addressing one major but “taboo cause” which is prostitution. Her focus is on providing health knowledge, care, and distribution of condoms to reduce the prospects of spreading HIV/AIDS and STDS.

It is a well-known fact that HIV and STDs are transmitted to wives and consequently children through husbands/men who use the sex workers’ services. Since prostitution is an illegal profession in Egypt, there is no health or legal care for sex-workers and therefore they are usually sick and can easily transmit diseases to their clients. Sex workers are also ostracized from society and abused by their pimps, their clients and the police.
Reda’s idea has a distinctive approach to health care among the socially despised and isolated sex workers; she perceives their self-image and their choice of livelihood as part of their overall health and has devised a new and brave technique to strengthen their capacity for increased well-being.
Reda’s idea is to provide them with knowledge, skills, legal and health rights. The provision to them of awareness/service about their legal rights and knowledge/services about their health, is an entry point so that she promotes health care messages and the use of condoms in order to combat HIV/AIDS among them and thus, reduce its transfer to the whole population.
Through offering them knowledge and skills she grants them the power to change and through offering them health care, she protects the whole of the Egyptian society from any fatal diseases.

According to the Egyptian Health and population Ministry, there are approximately 1,800 cases of AIDS and asymptotic HIV in Egypt in 2005. The Human Rights Watch report titled AIDS Conference Whitewash, 2001, states that HIV/AIDS spread is in large due to the discrimination against women, sex workers, gays, drug addicts and others whose status halt their access to services, information and social support.

The UNAIDS program reported in 2004 that 540,000 cases of HIV/AIDS were documented in the Middle East, with estimated 28,000 deaths due to AIDS last year.  In 2005, the World Health Organization reported 8,000 cases of HIV/AIDS in Egypt. Egypt’s National AIDS program reports the majority of HIV/AIDS cases were transmitted through heterosexual relations. The majority of which occurred among individuals aged 20 to 39, the male-to-female ration among HIV/AIDS cases in Egypt is 8:1, with 43 % of cases occurring through heterosexual contact and 20 % of cases occurring among men who have sex with men. Thus, Egypt has the highest level of infection in the Middle East. International experts claim that the number of AIDS patients, which is 8,000, is relatively low to its 70 million populations; however, the challenge facing Egypt is to keep that figure constant or even lower.

 

The National AIDS program announced that Egypt’s infected cases are only 879 were over 73% have already died!!!  When working on awareness against AIDS and STDs, only religious messages are used where abstinence is the only solution.

 

According to the UNAIDS, although Egypt is a low prevalence country with 8,000 AIDS case in a population of 70,000,000; it is also a country that has all the ground for the virus to sky rocket due to the unattended and marginalized risk groups of addicts, gays and sex-workers. In addition, due to the subject of the cultural tendency to deny sex related issues, it is believed that current statistics are inaccurate.

 

Egypt by all accounts has a vibrant sex industry and sexually active prostitutes’ network. Egypt positions itself as a country where religion and traditions dictate people’s lives, while the real shifting gear of people’s life is poverty and in a country where 17% are living below poverty line, it is no surprise that prostitution exists. According to the Middle East Report of 1995, Egypt is not only a country where prostitutes are a major local attraction, but it is also a country for sex tourism where an average of 1,000,000 Arab tourists visits on annual basis. If this is the international demand level only and if we combine it with the local demand, it is estimated that there is an average of 150,000 commercial sex workers in Egypt.Through her work, Reda estimates that there is an average of 14,000 sex-workers of the 1,200,000 local population of Ezbet El Haganah squatter area. She estimated that at least 1% of the women living in squatter areas engage in prostitution at one period of their life mainly due to poverty or as a result of domestic sexual abuse. There are at least 18 million people living in squatter areas around greater Cairo. This could give another indication of the size of this profession.

 

The major obstacles to increase awareness of safe sex in general and among sex workers in particular in order to safeguard the health of the population are the cultural attitudes. The Egyptian culture view AIDS as the “foreigners disease” because the Egyptian society assumes that having sex should be between a husband and a wife only. However, the Egyptian society completely denies the presence of sex workers and of any premarital sex relations. In addition, religious leaders in Egypt- Muslims as well as Christians- believe that the best way to protect one is to avoid sex outside marriage.

 

In spite of the above mentioned facts and the nation wide danger associated, the attitude towards this problem remain to be one where denial and negligence are implemented and any action is denied.

 

The attitude of the CSOs working on health development towards this fundamental problem is not that different on this subject. According to the spokeswoman of the Egyptian AIDS Society Sausan El Sheikh illegal sexual encounters are not a cause of AIDS in Egypt because they are not common thanks to the Islamic teachings.

 

As a result of this attitude of silence and denial, sex-workers in Egypt are utterly alienated and left as an easy prey for AIDS and other STDS. This infection does not affect sex-workers alone, but extend to reach their numerous clients and thus the whole of the population. Even the best HIV spread prevention program would not achieve success, if sex workers where not addressed. Though sex workers together with drug addicts represent a very small portion of the population, they will be the leaky boat in any prevention campaign that alienates them.

 

Through her direct encounter with them, Reda perceived that sex workers are usually poor, illiterate young women who were forced into a career that negatively affects them, their families, their clients and the whole of the community.

 

Sex workers are alienated from the government, CSOs and the community as a whole and thus, left to stumble on dangerous grounds where they are not only exposed to fatal disease, but to violence on the hands of their clients and the security forces as well. According to Reda, for a case of prostitution to be filed, the sex-worker must be arrested in action; yet what really happens in reality is that these girls are arrested in public locations and if a condom is found on them, they are incarcerated for investigation. She also states that while in custody it is nothing but normal that sex-workers would be sexually harassed and violated on the hands of the security force. Ignorant of their legal rights, and in absence of any support groups, sex-workers do not have an option, but to accept such inhuman treatment without any complaints.

 

Reda was the first to recognize that legal and health awareness and care of sex workers in Egypt cannot be de-linked from the health and safety of the whole of the population. She defied all conventional norms embraced by this very religious and conservative society where sex by definition is considered safe because it is between a husband and a wife.

Through her fieldwork in Cairo’s most destitute areas, Reda encountered an increasing phenomenon of young women turning to prostitution. She discovered that poverty and abuse are among the main reasons that push young girls to this profession. She also found that girls of abusive families tend to start as early as 11 years of age.

 

Reda began by mapping the locations and timings of sex workers and was able in a short time to build strong ties with a number of active sex workers, gatekeepers and pimps in the area where she works. Her non-judgemental and supportive attitude and behaviour enabled her to penetrate such a closed community.

 

She also realized through her work with them that they have no access what so ever to health, legal and social care or any knowledge about their rights. Reda through her direct interaction with them realized that they have no knowledge about safe sex, the means for the spread of HIV/AIDS or other STDs. She also discovered that they are usually abused by their families, pimps and also the police. With no knowledge about their legal rights, she found that many are illegally arrested and detained by the police.

 

The fact that none of their clients use condoms meant that the possibility of transmitting HIV/AIDS and STDs to innocent wives and children was very high.

 

Reda therefore decided, against all odds to work with this group and to offer them medical care, legal services and other social services. In her CSO, Reda begins by offering the sex workers counselling and medical care as many come from sexually abusive backgrounds. She also provides legal assistance and awareness programme on HIV/AIDS and STDs prevention.

 

Reda’s strategy is tailored to work at two levels, directly with different partners and nationally through working with the media and policy makers. On the grassroots level, she works with four target groups: sex-workers, CSOs, the community, and lawyers.

 

To reach out to sex workers, who have been alienated for long and denied services and knowledge, Reda follows a realistic approach in dealing with them. She established direct contact in which she introduces herself and her organization’s work together with the medical and legal services that she offers to sex-workers. She stresses on the fact that her work is judgment free and that sex-workers need not change path to benefit from her organization’s services.  Reda states that as soon as sex-workers benefit from the legal services she offers such as issuing legal documentation papers, having lawyers defend them and/or the health services such as medical testing and medical care; a strong trust bond is established through which Reda is allowed in the lives of sex-workers to raise their awareness about their legal and health rights through awareness sessions. Additionally, sex-workers extend Reda’s outreach through publicizing the organization among their co-workers. Reda does not only conduct legal and health awareness sessions, but she also conducts listening sessions in which sex-workers can vent. This helps her in her campaign of distributing condoms and on encouraging sex workers to have medical check ups and also use the condoms.

 

To date Reda in partnership with UNAIDS and Tanta University in Egypt has trained a group of 13 field workers who are able to professionally deal with sex-workers. The two sex workers who are current staff with Reda, the five sex-workers and three pimps who are current volunteers with Reda work to expand her outreach and publicize her judgement free services. Through health awareness sessions, Reda managed to reach 62 sex workers to raise their awareness regarding health and legal rights. Reda distributed 2000 condoms among sex workers with the efforts of her  staff and field workers and her volunteer sex workers and pimps who reach out to sex workers in their operational areas( Street/ cafes/ closed networks).

 

In addition to the 62 regulars, more than a 100 sex workers and their families have visited the CSO and learned about its services in the last six months. Through the medical clinic hosted at her centre, Reda offered medical STDs check up and free medical care to 17 sex workers. Reda also enrolled one of the sex workers in the microfinance program operated by her CSO El Shebab for Comprehensive Development/ Comet for Comprehensive Development.

 

Although these figures seem small, they are significant because not only did she manage to reach and encompass a group that was alienated and hard to break through, she is creating a precedent and also documenting live cases studies and live testimonies that she will be using in her advocacy campaign. And above all she is breaking through the wall of silence on these groups.

 

To overcome the approach of silence and negligence that CSOs adopts when dealing with sex-workers, Reda works on raising the awareness of these organizations through first hand data and the life testimonies that she documented. She advocates among that CSOs working in the field of health development to recognize the existence and the big number of this target group and also accurately evaluate the dangers involved if they remained ignorant of their health rights. She works hard to abolish the pre-requisite condition of CSOs that sex-workers must change their work prior to benefiting from any of the services they offer, as it is clear that this only leads to further alienation of the sex workers. On the other hand, offering them awareness and services without any  pre- requisite conditions reflects the community’s respect of them as human beings and its understanding of their harsh conditions that pushed them into prostitution.

 

Reda clearly understands that the key to sustain her rapport with sex-workers is not the awareness empowerment, but rather the fact that she was the first who recognized their legal and health rights and attempted to secure those rights. Accordingly, Reda works on the formation of a lawyers’ network with a very strong sense of social responsibility who are willing and able to defend sex-workers and acquit them presently and who would eventually advocate for the legalization of prostitution in Egypt and thus securing their legal and health rights as the only sustainable mean of securing the health of the whole of the population. To date, Reda has two lawyers who work full time at her organization and who have managed to acquit 11 sex-workers who were unlawfully arrested.

 

Through her well-defined plan and strategy, Reda’s short-term goal is to extend her out reach to sex-workers to raise their awareness about their legal and health rights through the awareness sessions together with offering them legal and health services. The expansion of her target group rests on the fact that her services and awareness are all judgement free and that she has sex-workers and pimps who work with her as volunteers, thus extend her outreach, and publicize her services for more sex-workers to attend her sessions and benefit from her services. Through the legal and health awareness sessions that she offers, she creates a more aware and empowered sex- workers who know their rights and hence would defend it, which would protect them along with the whole of the population.

 

Additionally, through workshops, discussion sessions, she raises the awareness of the CSOs specifically in squatter areas about sex-work industry in Egypt and its inevitable damages on the population if un-dealt with in an appropriate manner; she is advocating that CSOs for women irrelevant of their field of work do not exclude sex workers of their services simply due to their professionTo date, Reda has managed to coordinate with two CSOs in Ezbet El Haganah to include sex-workers in their target group.

 

Reda’s Medium goal is to target the media to educate it about the direct link between the alienation of sex workers and HIV in order for it to be a helping tool in creating a more accepting and non judgemental public opinion towards sex-workers who if better accepted in society will conduct their work in a healthy and safe manner and will also have an opportunity to change path if they decide. She also plans that by then she would have a well-established and motivated network of lawyers and activists that together with her would advocate and lobby for her long-term goal.

 

Reda’s long-term goal remains to be changing laws regarding prostitution in Egypt to reach the legalization of prostitution in Egypt as it was before 1953.  This would secure that the health and safety of both sex-workers and the whole of the population would be monitored and sustained.

Reda’s work and her CSO will spread in part because of its usefulness and attractiveness to sex workers. The practical aspects of the program, such as health, legal and psychological services, will and does attract a steady stream of the target group by word of mouth. Reda also plans to expand her work to other major cities in the near future.

Reda’s strategy will have significant impact because it depends on approaching different audiences through appealing non-confrontational language, which ensures initially their acceptance and later, their support. Approaching sex workers, her language is non-judgemental bearing no prejudice or reform advice. Instead, she offers them legal, health and psychological services that the generally lack creating an acceptance atmosphere that sex workers were never offered. Accordingly, she gained their trust and cooperation, which she needs to sustain her idea.

 

Addressing the conservative Egyptian society, Reda emphasized her aim is to protect wives and children from the spread of HIV/AIDS and other STDs. Having public health as an objective ensures compliance of all society levels and sectors even the religious groups. Accordingly, she can provide sex workers with legal and health services being supported by the local community that will comply based on its interest in preserving public health. Such a message will ensure the interest of the different media means and the other citizen sector organizations, thus, providing sex workers with the attention and services they were denied through long period of marginalization and alienation.

 

Reda believes that protecting the whole population against HIV/AIDS and ignoring the three highest risk groups who are the gays, sex workers, and drug addicts is a malfunctioning strategy. These groups were considered the main source of “leak” if not addressed and are considered the highest risk groups by the WHO.

Reda was born in a poor family where she had 4 siblings.  When her mother was 30, her father re-married a younger woman. Her mother decided to separate from father and opened up a grocery shop to be able t o sustain a living for herself and her 4 children. Then it was Reda’s older sister who took care of the house while her mother was at work most of the time. It was Reda who after school helped her mother out at the grocery shop from evening to closing time on daily basis. Reda’s mother managed to buy an apartment and secure a new life for her and her children, yet she always favoured boys over girls in treatment, while it was Reda’s father who believed in equality and always pushed Reda to reach the maximum of her potentials. Her work at an early age and the circumstances of her family life, taught her that she had to lead and be self-dependent in order to have a good life. At school, Reda was a good student who was known as a leader due to her multiple activities in Students’ Unions and to her regular guidance and advises to her friends.

 

Reda always has a strong sense of responsibility towards her community. While in school, she was known as the advisor of all youths in the neighborhood and once she completed intermediate school, she joined Al Tagamu’a socialist party and became a very active member who was fully involved in community service, national awareness and election preparations for five years.Then Reda worked as an executive secretary in El Mahrousa center for consultancy and feasibility studies and also enrolled at Ta’aawoun Institute, which is an institute that offers a two years diploma in business and economic studies.

 

Through her work and community service, she came across Ezbet El Hagannah, which is a squatter area close to Nasser city. She was shocked of the fact that this area lacked any services despite its complete deterioration on the infrastructure, economic and community level. Accordingly, Reda decided to intervene and she established her CSO El Shehab for Improvement and Comprehensive development. El Shehab worked with the community of Ezbet El Haganah to empower it on the social, economic, and legal level. Through her work for late hours at El Shehab CSO, Reda started noticing that many girls are involved in prostitution work and this is when she took the pioneering step of health and legal empowerment of sex-workers in Egypt.

Reda recognized that in order to begin to address the growing  but denied problem  of AIDS in Egypt and maybe later in the Arab world, she had to approach the groups that were most vulnerable to the disease but had the least amount of access to practical information about safe sexual practices: sex workers. This is why she ecided to undertake her initial interventions among sex workers in Cairo.

Reda is happily married and enjoys a healthy partnership relationship with her husband. She has 3 daughters that she educates to be strong willed and independent in their opinions and activities. When her elder daughter wanted to leave to a summer camp in Canada, Reda and her husband supported her decision against all members of their extended family and community. Despite of the fact that Reda was born to a conventional poor family and that she was raised in a traditional community, her independence at an early age allowed for her character to grow beyond the confined norms of tradition, stereotypes and taboos.