Amartya Sen, the 1998 Nobel Prize Winner in Economic Science, argues that the ability of one to scale the socio-economic hierarchy and to improve their wellbeing is dependent upon the “centrality of individual freedom and the force of social influences on the extent and reach of individual freedom.” Sen highlights the importance of informal and formal stakeholders in removing “various types of unfreedoms” and their high level of interconnectivity. ¹ Indeed, sex workers are forced to rely on their sole remaining asset – their bodies. Although they can use their bodies in the sex trade to earn profit throughout their lifetimes, their use of the body represents systematic failure of both socio-economic influences (i.e. caste and class, financial distribution, opportunities for women) and drives a pervasive feeling of hopelessness that will inevitably lead many to use their bodies for income generation.

The geography of such a vulnerable population is expansive, and its origins are diverse. In Eastern Europe, countless women (as well as men and children) can be found plying the sex trade, the result of a systematic collapse of formal authority and socio-economic ideology. These sex workers are forced through coercive or economic means to migrate into other European and Asian countries as a means to earn more profit, “preserve personal honor,” or as sex slaves of criminal racketeering organizations. ² In Southeast Asia (particularly Thailand), the sex trade has rapidly driven up HIV infection rates across the region; “An…equally explosive epidemic occurred…among brothel workers in North Thailand whose primary risk of HIV was attributed to sexual intercourse with multiple partners.” ³ As early as the end of 1991, 25.2% of the sex worker population in Thailand was HIV-positive. ³ In Haiti, the poorest nation in the Western Hemisphere, a severe paucity of career opportunities force many women and girls into house servitude and sexual slavery. The medical anthropologist Paul Farmer describes the case of Acéphie, a young woman who is unwittingly forced into sexual work for several soldiers of Haiti’s disorderly army and subsequently perishes of AIDS in her mid-twenties. ⁴

Although the remarkable anthology Voices of the Poor, published by the World Bank on the eve of the twenty-first century, provides an exhaustive outlet for non- Western case studies, ²⁶ the sex trade continues to flourish in the world’s most advanced countries. In San Francisco, individual researchers and interns can assist with St. James Infirmary, a medical clinic dedicated to providing “free, confidential, nonjudgmental medical and social services for female, transgendered, and male sex workers.” ⁵ Beyond HIV/ AIDS advice, treatment, and screening, St. James Infirmary provides resource guides and initiates city-wide support for the sex worker community in San Francisco.

The growing use of Participatory Poverty Assessments (PPAs) in field anthropology as an effective means of collecting ethnographic data has yielded exceptionally positive results in sex work research. PPAs refer to:

Iterative, participatory research process that seeks to understand poverty from the perspective of a range of stakeholders, and to involve them directly in planning follow-up action. ⁶

PPAs allow researchers to live with a localized vulnerable population, often for a considerable duration. This is accomplished in order to learn and observe as much as possible about the respective constituency through their language, culture, and societal behaviors. In the internationally-recognized documentary Born into Brothels, a teacher of photography not only extends her photographic knowledge to children of Calcutta but delves into their entire world, from familial concerns to the failure of the Indian bureaucracy to assist in the development of these impoverished children. ⁷ In accomplishing this, Zana Briski emphasized the integrated, multifaceted nature of such an environment. Diverse stakeholders play considerable roles in the welfare and survival of the children, as well as contribute towards the continuation of cyclic abuse, prostitution, and destitution.

The children’s mothers, sisters, and grandmothers are forced into the sex trade from an early age; caste and class are often inhibiting and confirming factors. Their fathers, if they have not fled from the household, have become drug addicts and alcoholics. The husbands of sex workers “feel displaced when their wives earn more than they do,” and become the principle breadwinner of the household. ⁸ This phenomenon has become global in scope. The leading social development specialist for the World Bank, Deepa Narayan ⁹ described similar situations in Mali, where “there are relatively few alternative strategies to pursue…” and in Latvia, where many “men had collapsed under the current stresses…” ¹⁰ Considerable physical abuse and a high vulnerability for infection lead many sex workers into a self-debilitating cycle of hunger, illness, loss of income, doctors expenses, bribes and extralegal charges, humiliation, and pain. ¹¹ As a result of preconceived fears of dealing with sex workers, a global environment where women earn less money, respect, and rights than their male counterparts, and formal institutional failure, many sex workers are deliberately ignored or exploited. ¹² Sen maintains that, “The richer countries too often have deeply disadvantaged people, who lack basic opportunities of health care, or functional education, or gainful employment, or economic and social activity.” ¹³

These multifaceted, interconnected issues severely inhibit the availability of process aspects (the allowance of actions) and opportunity aspects (opportunities to advance) for the sex worker population. ¹⁴ A nonfunctional education prevents a vulnerable person from gaining leverage in the job market, or pursing higher education and networking. This inability to gain employment restricts the individual from earning an income utilizing aspects other than their body. The chain of despair is reciprocal. lack of gainful employment and education significantly increases the difficulties in sending their children to school, thus enhancing the possibility that the children will follow their parents into a life of sex work. lack of economic and social activity at that particular step of the hierarchal ladder further restricts the possibility of any of these factors changing the wellbeing of the individual. In Calcutta (focus of Born into Brothels) and across India, the “Permit Raj” bureaucracy utilized thousands of forms, stamps, and signatures to reduce opportunities for sex workers and their dependents to gain access to food rations, medicine, or even formal identification. ^15,16 Indeed, Jeffrey Sachs, the Director of the Earth Institute of Columbia University, contends that such bureaucratic licensing, and “traditional social structure, with its meticulous stratifications by caste,” serves to solidify the outcast status of sex workers, both in India and through cultural variations abroad. ¹⁷

As such, it is imperative that one pursue ethnographic and internship research of sex workers with an understanding of the multidisciplinary character of the respective vulnerable population. Operating within a more traditional scope, the Sex Worker Education and Advocacy Taskforce (SWEAT) in Cape Town, South Africa deals primarily as a civil society organization, acting as a lobbyist and mediator between sex workers and the South African Government. ¹⁸ SWEAT prioritizes health, HIV/AIDS protection, and civil liberties training for sex workers, and attempts to raise awareness of their plight. Researchers or interns have an opportunity to assist the Training and Services Support Programme, The Advocacy and lobbying Programme, and The Research Programme, encompassing a variety of interests and backgrounds that influence varied stakeholders. ¹⁸

The sex trade bears a preconceived notion of “pro- fession often considered shameful” by both formal and informal society. ¹⁹ However, as is correctly stated by Sampada grameen Mahila Sanstha (SANgRAM), women (and men) who are involved in the sex trade are human beings and powerful, albeit often untapped, sources of change. ²⁰ SANGRAM’s mission focuses on local-level awareness and distribution of condoms. Work with the Coalition against Trafficking in Women allows research on a tangent of the sex trade that, although it is a global phenomenon, has remarkable importance in Eastern European and CIS26 human geography. Sex trafficking can occur through two methods: mobility as a consequence of a desire to protect personal honor, and forced trafficking through exploitation and extensive criminal networks. Narayan draws attention to the case of a 45-year old single mother in the Former yugoslav Republic of Macedonia: “I do it in neighboring cities to avoid unpleasant situations in the city I live in.” ²¹ The Coalition against Trafficking of Women serves to combat and prevent trafficking, act as a negotiator between informal society and government, and also lobbies for programs that will restrain male (and, in some instance female) needs to utilize prostitution. ²² Researchers with the Coalition delve into child trafficking, loss of formal authority, ethnic humiliation (i.e. Eastern European women in Western Europe and North America) and systematic abuse. ²²

In spite of the concentrations of respective sex trade assis- tance organizations, they share several common attributes. Such establishments clearly support the argument of Sen: women, regardless of their profession, must be “vindicated.” ²³ Not only are individual aspects of women’s lives addressed; rather, the entire well-being of women is becoming a focal point for assistance and societal growth. ²³ The stakeholders who work with, influence and direct women’s lives become integral members in the success (or failure) of lives marked by “material deprivation; physical ill-being; bad social relations; vulnerability, worry and fear, low self-confidence; and powerlessness.” ²⁴

Indeed, Sex workers, as was justified by SANGRAM are classic examples of the “agency aspect” of women that Sen stresses is inherent with well-being.25 As such, successful organizations will be those who will be able to broker a voice for sex workers across a spectrum of stakeholders, rather than to castigate the entire industry. Traditional methodology sought the criminalization of prostitution which resulted in increased destitution and subsequent abuse as many sex workers have little skilled training or cannot work in other careers due to stigmatization and caste-style distinctions. By increasing the level of agency women, especially those who are sex workers, health levels amongst this vulnerable population can rise and political and societal dreams can be realized. Whether research work is conducted in HIV/AIDS assistance, civil society lobbying, or ‘safe sex’ protection, Amartya Sen’s goal of female vindication and agency can be achieved.