Collective Action for HIV Prevention Among Kolkata Sex Workers
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Constructing an actionable environment: Collective action for HIV prevention among Kolkata sex workers Flora Elizabeth Cornish London School of Economics and Political Science August 2004 Thesis submitted for the degree of Doctor of Philosophy Except where indicated by references in the text, and except for help as specified in the acknowledgements, this thesis is a result of my own work. 2 Abstract How can marginalised communities organise a project to yield significant social change? This thesis theorises the resources which enable such community organisation to work. Participation, empowerment and conscientisation are understood, not through a logic of quantity which creates linear dimensions, but through a logic of concrete qualities. A pragmatist approach is taken, to define our constructs in terms of the actions being undertaken by participants, within specific, qualitatively distinctive domains. Activity theory is used to theorise participation as a process of collective activity, which is supported by shared rules, a division of labour and shared goals, and which is challenged by divergences of interest. A community case study of the Sonagachi Project, a successful HIV prevention project run by sex workers in Kolkata (India), is used to investigate participation. The case study is based on interviews and group discussions with sex workers and Project workers (sex workers employed by the Project), and observation of the daily activities of the Project. Sex workers relate to the Project as a source of support in solving their individual problems, gaining new powers, but not acting as collectivity members. Project workers are constituted as collectivity members, whose action interlocks with that of their colleagues, through participating in the politicising discourse of the Project, which states that sex workers should be granted “workers’ rights”, and through learning the rules of participation in meetings and the hierarchical division of labour. To be allowed to operate, the Project has to carefully adjust to local power relations, with madams, political parties, and funding agencies, in collaborative-adversarial relationships. In conclusion, the scope of participation is defined as producing significant, yet circumscribed, local change. To intervene in a fractured community is a political process in which the provision of new resources is both necessary and potentially divisive. 3 Table of contents Acknowledgements 10 Overview 12 Chapter 1: Locating the Sonagachi Project 12 Chapter 2: Participation, power and sex workers’ collective action 13 Chapter 3: The theoretical framework: Participation as collective activity 13 Chapter 4: Research design and method 14 Chapter 5: Sex workers’ problems-being-resolved 14 Chapter 6: Project workers’ participation 15 Chapter 7: The daily activity of participation 15 Chapter 8: Participation in context 16 Chapter 9: Conclusions 16 Chapter one Locating the Sonagachi Project 17 1.1. Constructing the question 17 1.2. HIV in India 20 1.3. Demography and gender in West Bengal 20 1.4. Indian women’s movements 23 1.5. Sex workers’ community mobilisation: Two political controversies 24 1.5.1. Societal change or community mobilisation? 24 1.5.2. Pro-legalisation or anti-legalisation? 26 1.6. Sex work in Kolkata 28 1.7. The Sonagachi red light area 31 1.8. The sexual relation activity system 33 1.9. The activity system of the Sonagachi Project 35 1.10. Central components of the Sonagachi Project 38 1.10.1. Sexual health promotion 38 1.10.2. Problem-solving committees 39 1.10.3. Savings and micro-loan co-operative 40 1.11. The questions 40 Chapter two Participation, power and sex workers’ collective action 42 2.1. Defining participation and empowerment 43 2.2. Why participation? 47 2.3. Obstacles to participation: Problems of power relations 49 2.4. Obstacles to participation among sex workers 50 4 2.4.1. Processes internal to the group 51 2.4.2. Processes external to the group: Sex workers’ relations with others 53 2.4.3. Can participation play any appropriate role in sex worker interventions? 57 2.5. Power and participation 60 2.6. Conscientisation 61 2.6.1. The conscientisation process 62 2.6.2. What is the nature of “critical consciousness”? 63 2.6.3. How is critical consciousness brought about? 66 2.6.4. The role of conscientisation in collective action 68 2.7. Conclusion 68 Chapter three Theoretical framework: Participation as collective activity 70 3.1. Cartesian and Hegelian paradigms 71 3.2. The pragmatist attitude 72 3.2.1. Practical validity as an epistemological criterion 72 3.2.2. Getting to where the action is 74 3.3. Activity theory 76 3.3.1. Vygotsky: Semiotically-mediated action 76 3.3.2. Leont’ev and the focus on collaborative activity 79 3.4. Developing activity theory to understand social organisation 80 3.4.1. Activity systems: Resources for collective action 81 3.4.2. Problems and divergences in fractured activity systems 84 3.4.3. Reconstructing the conditions of collective activity through reflection 86 3.5. The theoretical framework of collective action 88 Chapter four Research design and method 91 4.1. Epistemological reasons for the case study 92 4.2. Constraints indicating a community case study method 93 4.2.1. Processes not outcomes 94 4.2.2. Understanding the context 95 4.3. From particularity to generality 95 4.3.1. When particularity is a problem 95 4.3.2. Three responses to the problem of generality 97 4.3.3. Facilitating generality 101 4.4. An outsider approaches the research field 102 4.4.1. Mediators of my relation to informants 102 4.4.2. Ethical considerations in my relation to informants 106 4.5. Data collection 110 4.6. Observation: Getting where the action is 111 4.6.1. Rationale 111 4.6.2. Procedure: Observing the peer educators’ daily activity 112 4.6.3. Sampling peer educators’ daily activity 113 4.6.4. Procedure: Observing the meetings 114 5 4.6.5. Sampling the meetings 115 4.7. Interviews 115 4.7.1. Rationale 115 4.7.2. Procedure 117 4.7.3. Sampling 119 4.8. Group discussions 121 4.8.1. Rationale 121 4.8.2. Procedure 122 4.8.3. Sampling 123 4.10. Data Analysis 124 4.10.1. Practicalities of analysis 125 4.10.2. Reflexivity principles for data interpretation 126 4.11. Conclusion 128 Chapter five Sex workers’ problems-being-resolved 130 5.1. Analytic procedure 130 5.2. Illustrative cases 132 5.2.1. Basanti (int 1) – an independent sex worker 132 5.2.2. Radha (int 32) – a sex worker rescued from exploitative madams 134 5.3. The cross-case analysis of problems-being-resolved 135 5.4. Clients: Managing the economic relation 136 5.4.1. Acting – performing friendship and arousal for profit 136 5.4.2. Eliciting tips or gifts 138 5.4.3. Taking control of the commercial transaction 139 5.4.5. Managing babus 140 5.5. Clients: Managing condom use 142 5.5.1. Condom use becoming an actionable problem 142 5.5.2. Arguments for negotiating condom use 143 5.5.3. Strategies for enforcing condom use 145 5.5.4. Trust in “unity” regarding condom use 146 5.6. Managing relationships with other sex workers 149 5.7. Managing their placement in the system of sex work 149 5.8. Preventing abuse by police or goondas 152 5.8.1. Avoiding abuse 152 5.8.2. The Project’s support as a problem-solving resource 153 5.8.3. Unity as a resource for preventing abuse 154 5.9. Maintaining respect from family and community 157 5.10. Sex workers’ view of the Project as a source of practical support 159 5.11. Conclusion 162 Chapter six Project workers’ participation 164 6.1. Analytic procedure 164 6.2. Illustrative cases 165 6.2.1. Gita - a sex worker leader 165 6 6.2.2. Siuli - a peer educator 168 6.3 Project workers’ actions on behalf of the Project 170 6.3.1. Persuading sex workers to protect their health 170 6.3.2. Influencing others to protect sex workers’ health 172 6.3.3. Solving and preventing conflicts 173 6.3.4. Persuade sex workers to participate 176 6.3.5. Project workers’ relation to sex workers 179 6.4. Project workers’ reported gains from participation 181 6.4.1. Material gains from participation 181 6.4.2. Non-material gains of politicisation 182 6.4.3. Participation: Self-serving or selfless? 189 6.5. Project workers’ relation to the conscientising Project ideology 189 6.5.1 Two expectations from “workers’ rights” 190 6.5.2. Constructing an actionable environment with “workers’ rights” 192 6.6. Critical consciousness? 195 6.6.1. Unrealistic or freed from arbitrary present constraints? 195 6.6.2. Repeating the standardised Project ideology or a new politicised awareness? 196 6.6.3. A general advance in consciousness or learning specific new discourses? 200 6.6.4. Discussion: “Critical consciousness”? 201 6.7. Conclusion 202 Chapter seven The daily activities of participation 204 7.1. Analytic Procedure 204 7.2. The environment of peer education 206 7.2.1. The physical setting 206 7.2.2. The division of labour 206 7.3. Peer educators’ morning meetings 208 7.3.1. Rules 208 7.3.2. Objects of the meeting (i): Concrete tasks as object 209 7.3.3. Objects of the meeting (ii): Project rules as object 210 7.3.4. The voice of authority as a source of reflection 212 7.4. Peer educators’ health-promoting fieldwork 213 7.4.1. Core goals 213 7.4.2. Additional goals: Advocacy, bank collections & condom distribution 214 7.4.3.