Bengaluru, Kolkata and Neemuch: Forty-one-year-old Pinky, a sex worker in Mumbai’s Kamathipura, does not have the money to buy her HIV/AIDS medication because she no longer has an income. “I don’t have the money to eat properly, how will I get money for medicines? I have never before seen a situation like this in my life,” Pinky told IndiaSpend, blaming the lack of customers on the lockdown enforced by the government to contain COVID-19, the infectious viral disease. She took the last dose of her medicine--a month’s dose costs Rs 5,000--on April 6, 2020, she said.

On April 14, 2020, India extended its lockdown, which was supposed to end on April 14, 2020, until May 3, 2020.

Hit by the lockdown and advised to practice social distancing, sex workers in Mumbai, Kolkata and Neemuch (Madhya Pradesh) told us they have received no assistance from the government, and have barely any money to get by, feed their families and buy medicines.

The exact number of sex workers in India is unknown. A 2014 government estimate said India had 2.8 million sex workers, with most in the states of Maharashtra, West Bengal and Andhra Pradesh, while a 2016 estimate by the United Nations said India had about 657,800 sex workers.

“When men need sex, they come to us, but now when we need them, no one will even care if we are alive or dead. I request PM [Narendra] Modi to provide some help to us,” Pinky said.

Under the Prime Minister’s Garib Kalyan Yojana, a financial package to reduce the impact of COVID-19, Rs 500 per month would be transferred to women’s accounts under the Jan Dhan Yojana for three months, the government had said on March 26, 2020. None of the sex workers we spoke to had a Jan Dhan account. Even if some would qualify for the assistance, it is too little to sustain a family, they told us.

The government’s assistance will fall short in helping the poorest, IndiaSpend reported on March 27, 2020.

Few have health insurance, alternative income

Half of Maharashtra’s sex workers depend only on sex work for survival, and do not have insurance, as IndiaSpend reported in August 2019. Two-fifths of sex workers in Tamil Nadu and a fifth in Karnataka are in a similar situation.

Around 31% sex workers living in Maharashtra, Karnataka and Tamil Nadu remain financially insecure, making them vulnerable to poverty and unable to pay for treatment if they fall ill.

“So what is happening is that, in this epidemic, you are not supposed to make close contact, so how do you have sex? So suddenly they ran out of money and their families are suffering because they don’t have anything to eat,” said Harish Iyer, founder of the Jimme Foundation, a lesbian, gay, bisexual, transgender-plus (LGBT+) rights group.

With meagre savings, these women have room rents and electricity bills to pay, making them the ‘worst-affected during a crisis like this’, said Urmi Basu, founder of Kolkata-based New Light, a nonprofit working among the children of sex workers.

Several sex workers we spoke to said they were falling short of money to pay rent and buy enough food for their families.

Pinky, 41, suffers from HIV/AIDS and ran out of medicines on April 6. With no customers because of the lockdown, she says she has no money to buy medicines.

Pinky said she does not know whether she is eligible for the free antiretroviral drugs provided by the government, she told IndiaSpend. When she had visited a government centre two years back, after she was diagnosed, she was refused medication because she did not have an Aadhaar or any other address proof, she said.

Some sex workers, who do have the required documents, prefer the private sector as they believe they will get better treatment. At government centres, there are long queues and a shortage of medicines, Pinky said other sex workers have told her.

Currently, with no transport, little money for food and a strict curfew in the city, it is difficult to even try to reach a centre, she said. The nearest government centre, JJ Hospital, is about a half an hour’s walk away, she said.

Sex workers ask for government aid

“I think that daily wage labourers are still covered under some social welfare schemes but there is no scheme for these sex workers at all, they are like the ‘informal of the informal sector’”, said Trina Talukdar, of Mumbai-based nonprofit Kranti, which works with children of sex workers.

“Frankly speaking, I have not still done anything for this but we will surely do,” Rekha Sharma, the chairperson of the National Commission for Women, told IndiaSpend on April 3, 2020. “We will be taking it up with the police and the authorities, mainly we will talk to the district magistrate of the place where they live and will take their complaints forward.”

On April 15, 2020, the NCW wrote to the governments of West Bengal, Delhi and Maharashtra to provide sex workers with “basic necessities” and “encourage community feeding with the assistance of civil society organisations”, Sharma told us. “Proper measures should be taken for relocation, if required, to maintain social distancing as they are compelled to live in dilapidated accommodation,” the letter to the states said.

On April 3, 2020, Maharashra’s women and child development minister Yashomati Chandrakant Thakur told IndiaSpend that she would talk to the chief minister, Uddhav Thackeray, and provide food and sanitation facilities to sex workers. On April 15, 2020, the minister said she would have to follow up with the department to find out whether anything had moved on the ground or not. “I guess the department is taking care of it, and we will help them,” she said.

Though the West Bengal Commission for Women cannot allocate funds towards sex workers, the government has been trying to help these communities, said Leena Gangopadhyay, the chairperson of the commission.

“Today dry rations and mask were distributed to 1,500 sex workers in my constituency,” in the area of Sonagachi, tweeted Shashi Panja, minister for state for child development and social welfare, on March 30, 2020. This was the only instance of government aid to sex workers that we found.

There is an acute shortage of food as well as personal hygiene material in the brothels on GB Road in Delhi. Further, these brothels are enclosed spaces where over 2,000 women and children currently reside, wrote Swati Maliwal, the chairperson of the Delhi Commission for Women on April 2, 2020, asking the Deputy Commissioner of Police for an update on the availability of food in these areas. Maliwal was unavailable when we reached out to her several times on April 15, 2020, her assistant told us.

Sex workers more vulnerable to COVID-19

Other than barely surviving during the lockdown, sex workers, living in cramped brothels, are also particularly susceptible to COVID-19.

Nearly 25,000 sex workers and their children live in enclosed spaces in Kamathipura, with six-eight people living in 10x12 feet rooms, said Talukdar of Kranti. Often 50 people share a bathroom that may not have running water. “If they contract COVID-19, it will spread and there is no stopping it.”

Pre-existing diseases also make COVID-19 more dangerous for sex workers. About 80% of those who contract COVID-19 will have mild symptoms and their bodies will fight the disease, but for those who have pre-existing conditions, including HIV/AIDS and tuberculosis, the disease could result in severe symptoms and even death.

Nearly 1.6% of Indian female sex workers had HIV/AIDS in 2017, according to a 2018 study by the United Nations programme on HIV and AIDS.

Many sex workers also have other health-related issues, including addiction to alcohol and tobacco and are more vulnerable to abuse, including by owners of brothels, and lack a social support network because of the disdain this work is looked at with, according to a report by the World Health Organization.

A home for sex workers in Kamathipura, April 4, 2020. In such a constricted space, even if one person contracts COVID-19, it could spread rapidly.

Hospitals overburdened

Hospitals are overburdened with COVID-19 cases and few are offering any other medical services.

“It is really impossible to get access to any healthcare service right now,” said Talukdar of Kranti, and even if services were available, many sex workers do not have the money to pay for treatment.

Kiran, a 55-year-old sex worker, has had tuberculosis for the past 13 months. On April 3, 2020, she started coughing up blood and went to several hospitals--Mahavir hospital in Khar, Holy Family Hospital and Lilavati hospital in Bandra--but was turned away as the hospitals were taking in only COVID-19 cases, her daughter, who works with the nonprofit Kranti, told IndiaSpend. The bleeding stopped on its own and her mother began to feel better, she said, but was not sure how long that would last.

The receptionists at Mahavir and Holy Family hospitals confirmed that they were prioritising COVID-19 patients because of which other services were not functioning smoothly, while Lilavati hospital transferred our call to four departments before cutting the line and declining to comment, saying they were not authorised to talk to the media.

To get to hospital has also become more expensive. When a sex worker with lung cancer fell fatally ill in April 2020, an ambulance had to be called in, Talukdar said. Earlier it would have cost Rs 4,000, but they had to pay Rs 8,000--a large sum for sex workers who support large families on meagre savings.

Nonprofits supply food, essentials

Where the government is not helping, nonprofits have stepped in.

Kranti is providing food or food rations to 60-70 of the 2,000 families residing in Kamathipura every day, its co-founder Bani Das said.

In Kolkata, the Durbar Mahila Samanwaya Committee, a nonprofit trying to end discrimination based on class, caste and gender, is collecting donations to distribute cooked food to sex workers and their families. The nonprofit New Light distributed over 250 food hampers in Kolkata, each of which can feed a family of four for two weeks, they said.

For the Bachchada community in Madhya Pradesh, where women are pushed into sex work and the men do not work, the Vishwa Hindu Parishad is providing one-time meals to families along with food rations for 10 days, said Kamlesh Rathod, the Ratlam city president.

Long-term impact

Even after the lockdown ends, sex workers would have to be very careful about their customers to avoid catching COVID-19, said Ashok Chauhan, a social worker who belongs to the Bachchada community and provides medical aid to sex workers.

Kiran, a sex worker, said she would refuse unknown customers because of the fear of the novel coronavirus, even though this would impact her income.

However, such small steps and scattered help from nonprofits will not suffice and the government needs to step in, social workers said. “If the government can’t do it for them, they should do it to prevent the pandemic from spreading because if it reaches the area, not only these 25,000 sex workers [in Kamathipura] but also the entire city will be at stake,” Trina of Kranti said.

Update: *We have updated this story with the reasons Pinky gave for why she does not go to a government centre to get free antiretrovirals for HIV/AIDS.

(Kapil Kajal is a Bengaluru-based freelance writer and a member of 101Reporters.com, a pan-India network of grassroots reporters. Rahi Bhattacharjee from Kolkata and Vijit Rao Mahadik from Neemuch, Madhya Pradesh, both members of 101Reporters.com, contributed to this story.)

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Kapil Kajal