“WITHOUT THIS PROGRAM, I’D BE DEAD”
“My name is Fernanda. I was born in Nampula. I live with my parents. I have a son, who is seven. I deserve health care like everyone else.”
26-year-old Fernanda wants you to know her story. She is a sex worker in Mozambique.
“Here, men offer you more money to have sex without a condom,” Fernanda says. “And some girls accept it, but then they have to run straight to the hospital. The thing is, most of us didn’t want to go for health services even when we really needed them.”
As a sex worker, Fernanda dreaded going to the hospital — being stared at by other patients and insulted by providers.
Looking down at her hands, she repeats some particularly cruel words. “’Why are you having sex like that?’ the nurse yelled at me. ‘Your body is rotten. And then you want me to examine that rotten thing?’”
Worldwide, female sex workers are 14 times more likely to live with HIV than other women.
And in Mozambique…
Despite being at greater risk for HIV infection, women like Fernanda are less likely to have equal access to high-quality health care free from stigma, persecution, and abuse.
“This is unacceptable,” says Mahomed Riaz Mobaracaly, MD, Programs Director, Pathfinder Mozambique. “Sex workers have vast needs for sexual and reproductive health care — for family planning; safe abortion services; and HIV prevention, care, and treatment. Yet they often face stigma and discrimination from health care providers. Pathfinder is committed to changing that. Together with our partners, we’re working to ensure that all people can access quality health care and exercise their human rights.”
FOR NEARLY 60 YEARS AROUND THE GLOBE, Pathfinder has helped vulnerable individuals gain the critical information and quality services they need to make decisions about their health — without fear or boundary — just like everyone else.
It’s a plan that requires a strong support system made up of passionate individuals trained and supported by Pathfinder and our local partners, like these three dedicated Mozambican women:
ZITA, a counselor who provides information and HIV testing in a safe and supportive environment
“I work in the city’s ‘hot spots,’ where sex workers gather,” says Zita, organizing her tools — her register, condoms, and a wooden penis model — atop a plastic table. “I offer HIV testing and counseling in full confidentiality, distribute condoms, and help people assess their own health risks. I even accompany women to the hospital. I am their friend. They know it.”
ALICE, a medical officer committed to providing high-quality sexual and reproductive health care free from judgment
“Honestly, until two years ago, I didn’t know any sex workers. I’d only heard about them. But now it’s my job to support them. They deserve to be treated like everyone else,” says Alice. She uses her training to sensitize her fellow hospital staff about how best to serve key populations, including sex workers and men who have sex with men, without bias.
“We’ve made changes to our processes at this hospital,” Alice says. We are reducing the time a woman like Fernanda has to wait in the hall with all the other patients. She can just knock, and I will see her sooner. She gets priority in the lab too. It’s one of the ways we’re making progress.”
FERNANDA, a remarkable woman who is finding her voice and using it to save her friends’ lives
Fernanda remembers the day she became a peer educator. “I was on my part of the street waiting for clients when Zita came over. She was having difficulty reaching other girls. She saw that I could reach them, so she asked me to join the project.”
“When we have a case,” Fernanda says, “like a girl with a sexually transmitted infection who doesn’t want to go for treatment, I encourage her to go the health facility. I talk to her as a friend and give her information. I work closely with Zita to make sure she is not afraid. We make sure she knows we can help her.”
Fernanda, Zita, and Alice are helping. They see the results.
“We are raising awareness,” says Alice. “And with all the counseling and testing being done in the community — all peer educators like Fernanda — we are seeing more women coming here to the hospital for health services.”
Zita smiles. “I am proud of what I do.”
“I really like being a peer educator,” says Fernanda. “Today, my friends are approaching the hospital and getting medicine, doing consultations, getting tests…they feel more comfortable. We have friends at the hospital now. I tell the girls we deserve to be treated well — without violence, without insults. We are people. And we have to take control of our health. Only when we feel good about our health can we feel good with ourselves.”
Pathfinder is proud to have supported the health of female sex workers in Mozambique, Kenya, and India, with funding from the Centers for Disease Control and Prevention, USAID, and the Bill & Melinda Gates Foundation, respectively.
Now YOU can help. Here’s how:
- Share Fernanda’s inspiring story.
- Learn about Pathfinder’s work and our comprehensive approach for meeting the needs of key populations.
- Please consider donating to keep our work going!
Photography and writing by Maren Vespia, Communications Officer at Pathfinder International.
