Antananarivo — About one in seven residents of Madagascar's main port city of Toamasina are sex workers.
In less than 20 years, the number of registered sex workers in the city of about 200,000 residents has climbed from 17,000 in 1993 to 29,000 in 2012. The increase has been driven by rising poverty levels as well as the city's proximity to the recently opened Ambatovy nickel mine.
Construction of the mine, coupled with recent improvements to the port, saw an influx of thousands of foreign workers. The billion-dollar investments also resulted in an escalation in living costs and the collapse of traditional commercial activities like the collection and sale of cloves and coffee, pushing more young women into sex work.
"Girls come from the countryside to work as maids. Then, when they have a problem with their employer, other girls from their region introduce them to prostitution," Germaine Razafindravao, the president of the local sex worker collective FIVEMITO ('Fikambanaina Vehivavy Miavotena Toamasina' or Women's Future), told IRIN.
Toamasina's growing number of sex workers is part of a nationwide trend, one attributed to an increase in poverty since the onset of a drawn-out political crisis in 2009, when twice-elected president Marc Ravalomanana was deposed by Andry Rajoelina with the backing of the army. More than three quarters of the Malagasy population now live on less than US$1 a day, according to government figures, up from 68 percent before the crisis.
A means to survive
"Prostitution has become a normal phenomenon in Madagascar ... Now sex has become a product, a means to survive," said Ratsarazaka Solomandresy, who is responsible for the United Nations Population Fund's (UNFPA) youth programmes in Madagascar.
Sex work is legal in Madagascar, and although HIV/AIDS prevalence is low compared to other southern African countries - with about 0.2 percent of people between the ages of 15 and 49 living with the virus, according to UNAIDS - the incidence of sexually transmitted infections (STIs) like syphilis is well above regional norms. According to government figures, 4 percent of pregnant women are infected with syphilis, as are 12 percent of female sex workers.
Until six years ago, Antsohihy, the capital of the northern Sofia region, was cut off from the rest of the country, but the 2006 rehabilitation of a road to the capital Antananarivo has reopened the area to commerce, including sex work.
Although the number of sex workers in Antsohihy is unknown, "There are new faces at the bus stops almost every day," Solomandresy said.
Nadine, 15, quit primary school in 2011 and left her home village of Befandriana, about 50km away, to join her 18-year-old sister in Antsohihy. Both girls are now sex workers.
Nadine earns $15 for each client and said, even given the opportunity, she would not return to school. Even though she has been engaged in this work for over a year, no one has told her she is too young for it. "I'm not scared of the police. They are my clients also," she told IRIN.
Access to services and protection
In recent years, commune governments have established an identity card system for sex workers, providing them with specialized health care and legal protections.
Angela, 30, from Antsohihy, turned to sex work after a divorce left her a single parent to two children. She told IRIN she was applying for the ID card. "I have a friend who already has a card. When one of her clients refused to pay and hit her in the face, she went to the court and sued him. She ended up receiving more money than the original amount they had agreed upon."
The cards are only distributed to those who apply for them and only if they are over the age of 18. While this system appears to be providing some protections to sex workers in Antsohihy, it was unsuccessful in Toamasina. Sex worker organisations claim the police harassed sex workers lacking the cards, which were meant to serve as access to benefits rather than a license to work.
"Police used the system to abuse the sex workers. If they found a prostitute without an ID, they would take her to the bureau and mistreat her there. So we have now replaced the official cards with unofficial red books," Razafindravao of FIVEMITO told IRIN.
The red books give sex workers access to a judicial clinic in the neighbouring town of Mahambo, a tourist destination. "Often men come to Toamasina and take a girl to Mahambo. Once they arrive there, they see another girl they like more, and they leave the first one on the street, without any money or way to go back home. So we had to set up a centre there to negotiate with the clients and help the girls."
The association also runs discussion groups with the police in a bid to reduce prejudice. "We tell them that these women do a job, just like the [police] officers do," said Razafindravao.
As with the official registration cards, only sex workers above the age of 18 are eligible for the red books. Engaging in sex work is illegal for girls under 18, though it does not prevent them from doing it.
A 2007 survey by the UN Children's Fund (UNICEF) in Toamasina and the island of Nosy Be found that between 30 and 50 percent of female sex workers were younger than 18.
"Employees of the nearby mining project come down to Toamasina for the weekend. They look for young girls, as they are willing to do everything for little money," Razafindravao told IRIN. A hotel frequented by underage sex workers was closed by the authorities in 2011.
FIVEMITO used to run a vocational training centre for sex workers that enabled them to leave the streets, but the centre was closed due to lack of donor funding. "Our courses really helped. The girls would study and get a certificate to work in the tourism industry as a waitress or receptionist in a hotel. With their salary and tips, they would make enough money," said Razafindravao.
Now the association visits families to convince parents to keep their daughters from sex work. "I tell them about all the health consequences that early pregnancies and STDs will have on their children. But the problem is that I don't have a solution. I can talk, but there's no alternative," said Razafindravao.
To combat STIs and prevent HIV/AIDS from gaining a firmer foothold in the country, UNFPA distributes condoms and advice to sex workers, especially in poorer neighbourhoods. "These women hardly make any money, so they won't be able to buy condoms," said Solomandresy.
In Antsohihy, the local NGO Vilavila takes the condom-usage message to the bars that sex workers frequent, a campaign that has reached Angela.
"Using a condom has become part of the negotiation process now," she told IRIN. "Some of the clients refuse, and then I use a female condom, as I don't want to become pregnant again."
This report does not necessarily reflect the views of the United Nations