The Afghan Madam Helping Sex Workers Take Charge of Their Sexual Health

In "Unscrewing Ourselves," we explore the state of sex ed today by highlighting the individuals changing our sexual health for the better.

Qadria (who requested using this nickname to protect her identity) is also a sexual health peer educator with Bridge Hope Health Organization, an Afghan NGO that is implementing a small regional United Nations Development Program (UNDP)/Global Fund grant for HIV prevention. She and another peer educator had recently conducted outreach visits to Kabul sex workers. Bridge's target was to reach 150 women, but Qadria and her colleague reached 480, according to Ata Hamid, the legal advisor to the project. Raheem Rejaey, Bridge's founder and program director, says most of the women work from homes, not the street.

Qadria refers women to HIV and hepatitis testing at clinics, conducts sexual health information consultations, and distributes condoms. She's enthusiastic about aid work, having previously served as a Human Rights Commission complaints officer and conducted sex worker outreach through a World Bank-funded project. "I do this work because there are new threats, like HIV," she says. Two thousand people have been identified as HIV+ in Afghanistan, but the number is likely higher, according to the UNDP.

The UNDP/Global Fund grant supports peer education on HIV prevention referral services for those at greater risk, such as injecting drug users and sex workers. Rejaey, himself a former heroin user, founded Bridge in 2015 and now leads a team of male peer workers who provide HIV education, hepatitis prevention, and wound care through outreach trips, mostly focused on drug users.

More elusive, Rejaey says, are "women with high risk behaviors," including those who are married to drug users and might use drugs themselves, along with those engaged in sex work—which is where Qadria comes in.

"For far too long, HIV prevention programs and services have been focused on the risks and deficiencies of women who use drugs and sex workers," said INPUD (International Network of People Who Use Drugs Executive Director Judy Chang, who has facilitated focus groups with marginalized women in Kabul. "Effective and successful HIV, health, and harm reduction programs for women who use drugs and sex workers should leverage the strengths, resiliencies, and competencies that inherently exist in communities."

In a country where average literacy and labor force participation rates remain low for women, Afghan wives who are widowed or abandoned by their husbands might be forced into sex work to feed their families. Qadria knows this well. At age 14, she was married off to a man 25 years her senior. He beat her and abandoned her by the time she was 20, leaving her to support her children on her own through sex work. Another woman in her community saw her problems and decided to help her. She told Qadria, "You are beautiful, you can use your beauty," and introduced her to a married man who would become her provider, supporting her family.

"He put me in a house, then later introduced me as his wife," Qadria told Broadly through a translator. This relationship as a mistress grew more supportive than her marriage. In fact, it saved her family. After almost 15 years, they parted ways. He moved on to a rich girlfriend "who was famous," while she had to work again and entertain. By then, she was "well-known" to other men, she said. Her absent husband would reappear from time to time "for entertainment"—her term for sex—but did not support her or their children. Her kids know nothing about her career other than the aid work she does.

Today Qadria is a madam for other women. In return for a percentage of their fees, she handles renting a house in a quiet neighborhood, "negotiating" with the neighborhood elder, meeting local police, and providing clients, sometimes rich ones like war lords. This work is called kharabat, or "sexual entertainment," in Dari, a dialect of Persian spoken in Afghanistan.
"When we get new girls, the 'big dogs' [war lords] come. Sometimes they ask for me, but I say I am retired," she said with a laugh. "Sometimes, they will say 'we need you,' and I will entertain them." Qadria only stays in a neighborhood "a few months" before moving houses again, "because the neighbors notice the men coming to the houses," she added.

Their relationship with the police is friendly. "The police don't take us to prison," she explained. "They just ask for tips," which range from 5,000 afs to 15,000 afs ($75 - $224) each week, depending on income flows—around what a "high-end" woman might make per session.
Qadria's work helped her escape an abusive marriage and buy a house, but she acknowledges that women in her profession face threats. "We have had many cases of men [clients] taking a girl by force, posting it on social media, and not paying them," she recalled.

Many of these women also face abuse at home from their husbands. "When we were working with the Human Rights Commission, other husbands were forcing their wives to bring them money," said Qadria. "So instead of doing something illegal or kidnapping [for ransom], they entertain."

Whether in sex work or aid work, Qadria's resilience is apparent in her attitude. Though male peer workers speak more openly to media and use their real names, marginalized Afghan women face stigmas that can get them killed. Female peer workers wear burkas out on the street, which Qadria views as an advantage. It allows her to covertly bring condoms to homes, concealed in packages, delivered only when there are no guests. Each outreach visit delivers about 300 condoms a day, according to Bridge, and Qadria conducts visits as many as four days a week. She hopes to extend this distribution to Kabul's outskirts and reach 1,000 sex workers.

"In the street, no one can stop us," she says. "In traditional culture, no one can stop us."