By Davi Kallman
After searching numerous case studies on the positive deviance initiative website, tears started swelling at my tear ducks… the familiar cotton mouth sensation swept over my mouth and that gut wrenching feeling formed in my abdomen. What got me so overwhelmed and worked up about the situations that are occurring all over the world is that these victims of sex trafficking, malnutrition, and poverty feel like they have no other choice but to endure such conditions.
I came across a case study of a girl named Kay Thawe also known as K.T. from Myanmar, a 19 year old girl who was forced into the sex worker profession for money when her father died of cirrhosis. Obligated to take care of her other siblings K.T. used the sex trade to make money for her family. Unfortunately K.T. is only one of millions of young girls and boys who are forced into this professional whether voluntarily or coerced.
I remember when I was 19 I had no intention of having sexual intercourse, not because I was unaware of pregnancy and disease protection, but because I felt I was not ready yet alone prepared to handle the emotional stressors that come with sex. K.T. on the other hand works as a commercial sex worker every day and until recently did not use condoms during sexual intercourse. It was not until she met her most recent boyfriend who cautioned her about the downfalls of having unprotected sex. Since then K.T. started to use condoms to avoid contracting sexually transmitted diseases. While continuing to be a commercial sex worker might not seem like a positive deviance approach, the actions leading up to the intercourse is what deviates from the norm. Now K.T. uses a condom before she has sex and for foreigners who do not know what a condom is she will reinforce the word to get the message across. For those clients who refuse to use a condom she tells them she has an STD in order for them to use the condom. While this single act might not seem important, it does have serious outcomes and serves as a prevention technique.
While it is very difficult to stop a person or a group of people from continuing such practices, the way you handle and reinforce these practices is just one stepping stone to changing the entire situation. Just like the story I mentioned in my previous blog post about the 70 year old man wanting to change the whole world immediately, while idealistic, it proves to be impossible. If we want to change the situation first and foremost we have to begin with a realistic goal, once we have that goal, we cannot carry it on by ourselves. As positive deviance reinforces, in order to make a change we must enlist the help of others, those “unusual suspects” who bring their ideals and knowledge to the equation to make a lasting effect. In this case K.T.’s boyfriend and K.T. were the “unusual suspects” who were proactive in disease and pregnancy prevention. K.T. not only helped herself in disease prevention but by spreading the message and meaning of condoms, it serves as a ripple effect for her clients who did not know about condoms in the first place. If there is one thing I learned about this case is that simple acts make a big difference. Eventually we would like to help K.T. and people in similar situations be detoured from joining the sex worker business, disease prevention techniques is the first step to deviant from the norm of unwanted pregnancies and diseases. We are just one condom away from changing the world.
Case studies of PD commercial sex workers
Sector: Public Health (HIV/AIDS prevention and eradication)
Organization: Population Services International (PSI)
Location: Myanmar
Miss KT's Story
K. T. is 19 years old and is the eldest of four siblings ( three girls and one boy). She comes from Mandalay. Her father died of liver cirrhosis. Since then her mother is selling seasonal food at the market and is unable to support the family. So K. T. dropped out of school when she passed 7th standard and entered the sex trade to help her family.
She lost her virginity with her first boy friend whom she dated for 2 years. During that relationship she had unprotected sex and knew nothing about condoms. She started working as a commercial sex worker 3 months ago and works every day.
She met her first broker who sent her to a brothel house at 8 miles Junction, where she worked for one month. There her clients volunteered to use condoms. After that, she was sent to Ma Sein (female pimp) by another broker.
She started using condoms after she met with her most recent Madam who told her to use condoms whenever she is having sex, especially with foreigners, to prevent getting AIDS. Therefore she has been using condoms systematically during her sex work, except for three occasions when her Myanmar clients brought her to their homes and could not purchase condoms because they were unavailable in the neighborhood or it was late at night.
She always uses a condom with foreigners especially with Taiwanese who use double condoms whereas Thai, Japanese and European clients use only one. She has now a second boyfriend, who has been her client for two months and uses condoms whenever they have sex.
Specific factors which enable her to practice this unusual behavior
Since she was young, she has seen information about AIDS on television. When she married, she was afraid to get this disease from her husband. Her recent pimp told her about a driver she knows who has HIV/AIDS. Since then Kay Thawe always uses a condom to prevent this disease. She also takes three months Depo-Provera injection for contraception. Her pimp chooses clients for her and she has never chosen drunkards or a client who asked for oral sex. But she has had to perform this unusual sexual behavior twice and used condoms on both occasions. She has never been asked to perform anal sex.
She does not worry about being arrested since her pimp has protection from a captain in the army who is responsible for the area where the night club is located.
Action to overcome problems engendered by unusual behavior
She said the word "condom" to a foreigner who did not want to use a condom and he agreed to wear it. She says that "she has a disease" to Myanmar clients who refuse to wear a condom and most of them comply. When some clients still refuse to wear it, she threatens to give their money back and not go through the contract. They usually give in. She has never been beaten or threatened when she has asked clients to use condoms. Nor has she experienced having a client requesting to have unprotected sex for extra-money. On one occasion, she has found herself with multiple Myanmar clients instead of one but was able to negotiate for everyone to wear condom and got extra money for each one. She is willing to come and meet with PD team at PSI.
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