Editorial Team
Publication Date
May 29, 2024
Samantha Páez, GPJ Mexico
D., a sex worker, at Hotel México, where she receives free health services via Chicas de la 14.
PUEBLA, MEXICO — Inside a downtown, brown-walled building, a poster reminds people to practice social distancing. At a white plastic table nearby, Mariela González welcomes patients: “Are you here for test results or for a medical consultation?” A woman named Nahomi says, “I’m here for a consultation.” She then joins two other women who are waiting to see doctors.
But Nahomi is not at a clinic or hospital; she is at Hotel México, where she and other sex workers see their clients. The building also houses the offices of Chicas de la 14, a civil association of over 60 sex workers, which González leads, in the historic center of Puebla. Nahomi is one of the 60 and, like her colleagues who were interviewed for this article, she asked that her full identity be protected for fear of stigma.
According to figures provided by González, there are over 1,000 sex workers in the city’s historic center, and many of them had not been visiting health care facilities for basic services out of fear of discrimination or social stigma. However, starting in mid-2022, the Municipal System for Integral Family Development, which is known as SMDIF, for its initials in Spanish, and responsible for promoting complete development for individuals, families and communities, began seeing sex workers for free on a monthly basis at Hotel México.
González organized to have health services provided in the hotel so sex workers would feel more at ease and receive respectful and personalized service in an environment they could trust and not experience discrimination. “They explain everything to us very well. If they have to give us medicine or vitamins, they give them to us together with the instructions,” Nahomi says.
Since 2008, Puebla’s municipal code, which regulates government procedures, functions and services, has treated prostitution as a violation. The stigma and these regulations have led to violence against sex workers. González and another sex worker say that, for years, municipal authorities have carried out arbitrary operations against them downtown. González recalls one in 2014: “They sealed off both street entrances on us, as if [we were] little animals.”
González says her colleagues were detained and transported in municipal police vehicles even though they had been found doing nothing more than walking along a public street, eating or being inside local businesses, not practicing prostitution. Global Press Journal contacted local authorities to request a statement on the matter and received no response.
These circumstances led sex workers to organize. “We started looking for ways to protect ourselves from this situation,” González says. They went to Observatorio Ciudadano de Derechos Sexuales y Reproductivos (Odesyr), an organization that advocates “for women’s sexual, reproductive and health care rights” and provides them with guidance on how to ensure those rights are protected. Odesyr confirms that arbitrary detentions have occurred.
In 2021, upon learning that operations against sex workers were still taking place, the Unión Internacional De Defensores De Derechos Humanos Independientes, a nongovernmental organization that defends human rights, offered its own guidance. The idea emerged to create a civil association of sex workers, whose aim was to gain access to and defend various human rights, including the right to health care.
By the time Chicas de la 14 completed its registration with Puebla authorities in January this year, the association had already been working at least a year and a half to secure free health care for sex workers at their place of work. In mid-2022, González sent an official letter to the SMDIF requesting that medical personnel be sent to Hotel México to tend to her colleagues. The SMDIF did so as part of its Programa Contigo Mujer contra la Violencia, which uses a multidisciplinary approach to meet the needs of women and girls. Ever since, the SMDIF has been going to Hotel México each month to provide free medical consultations and clinical tests.
But those are not the only services available. Sex workers have access to mammograms, Pap smears and ultrasounds. And the hotel shuts down during consultation times. González coordinates with the SMDIF, and they fill the building with medical equipment and personnel. Since 2022, “we have done around 10 events inside the building. They also give them their results and provide them with medical consultation there,” González says.
In December 2023, they held their first health day open to the community. They set up mobile units, similar to ambulances, near the hotel to raise awareness that services were available. They provided testing for diabetes and hypertension, prostate-specific antigen tests, and access to a clinical analysis laboratory, among other services.
Before they had access to this program, sex workers had to utilize private medical services and test for sexually transmitted diseases every six months at Centro Ambulatorio para la Prevención y Atención en SIDA e Infecciones de Transmisión Sexual (CAPASITS), a public health center specialized in HIV/AIDS and sexually transmitted infections.
But a 20-year veteran sex worker says her experience at CAPASITS was not what one would expect. She says that at their facilities in Puebla, it is common for medical personnel to discriminate against sex workers and treat them disrespectfully.
Global Press Journal contacted the CAPASITS in Puebla to request an interview and was referred to the Puebla Ministry of Health, which oversees the center. The ministry did not respond to multiple requests for comment.
Onán Vásquez, of No Dejarse es Incluirse, also known as Vida Plena Puebla, a nongovernmental organization that promotes and defends the human rights of LGBTI populations and people with HIV, says that the care provided at public health facilities like CAPASITS is inadequate because of prejudices against trans women and sex workers. “Combatting prejudice and stigma does save lives. But unfortunately, in a sexist society like ours, they won’t go away.”
By contrast, those affiliated with Chicas de la 14 receive dignified care. A sex worker who lives on the outskirts of Puebla uses their health care services. Last year, she came down with reflux resulting from gastritis, and the SMDIF personnel who came to the hotel gave her the treatment she needed. “They are very kind people,” she says.
The same sex worker also received psychological therapy to help her recover from the breakup of a 16-year romantic relationship. “Many men don’t like it when their partners work,” she says. “I was able to start over, see the years that have gone and rebuild myself.”
Another sex worker, who asked to be identified as D., says the health care services offered by Chicas de la 14 are necessary “because there are very expensive medical treatments.” She also points out that, before the organization’s efforts, sex workers used to do their clinical tests however they could. “Now, it’s every month that we’re getting ourselves checked.” She also receives the medications she needs at each consultation.
Chicas de la 14’s medical assistance goes beyond doctor’s appointments and clinical analysis. González brokered an agreement with a physician in private practice to help with hospitalizations. They utilized this physician’s assistance when a colleague went into labor on the street. In such cases, everybody covers the expenses together. When severe illnesses materialize, such as cancer, the SMDIF refers sex workers to Hospital de la Mujer, a public women’s hospital, for treatment.
“If one of us feels unwell, we help each other,” says D., who has also taken first-aid courses via Chicas de la 14. Besides health services, the association also provides its members with legal advice, food packages, grief support and free vocational workshops.
Before going in for her consultation, Nahomi says she has felt empowered since joining Chicas de la 14. “Sometimes you feel very small, but they’ve explained to us that sex work is an everyday job. … You start taking care of things about yourself that you didn’t take care of before,” she says, adding that the organization has not just opened the door to health for her and her colleagues. “They have taught us to defend ourselves.”
Samantha Páez is a Global Press Journal reporting fellow based in Mexico.
TRANSLATION NOTE
Shannon Kirby, GPJ, translated this article from Spanish.
