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1 The practice
2 Hints for an evaluation
2.1 Strenghts
"TAMPEP" prides itself of its network structure all over Europe, which both guarantees a homogeneous methodology and permits enough flexibility to adapt such methodology to each particular context. Thus, for instance, information material (guides, brochures, etc) are not only published in several languages, but also adapted to the specific circumstances of migrant sex workers from different countries of origin, transit, and destination. An interesting part of their methodology is the production of this information material in cheap formats, so as to guarantee its continuous modification at a low cost. The network structure also provides priceless information about migration movements of sex workers all over Europe. Due to the illegal status of the migrant sex work industry, mafias do have a network structure all over Europe which they use for the permanent movement of their workers.
The network structure of "TAMPEP" permits a more global analysis of the migration movements of sex workers. The migration experience of sex workers is not bipolar (from one country to another) but includes a series of endless countries of transit where migrant sex workers might get physically infected, or psychologically affected. Keeping track of those movements and the characteristics of migrant workers situations in every country of transit is a helpful tool for health care providers. It would for instance, be easier to approach migrant sex workers in a country with a culture and language similar to their own than in a completely unknown environment. This combination of research and intervention is most positive and effective when developed by the same agent.
Especially remarkable is the outreach street work developed by "TAMPEP". Most organisations aimed at helping migrants provide services to those who approach their offices asking for help. However, "TAMPEP" understands that migrant sex workers are in an especially difficult situation (i.e. they might not understand the language, might not know the city or are not allowed to get out of their work centres, are scared of any authority, and are controlled by mafias) and tries to approach them in order to offer them "TAMPEP"’s services (which are, of course, free of charge). In a sense, "TAMPEP" follows a very aggressive and individualised advertising strategy closer to the ones used by the marketing system than to those used by a non-profit organisation. In this sense, "TAMPEP" is very innovative and effective. Outreach street work is developed by what could be considered special intercultural agents: cultural mediators and peer educators.
Other organisations used translators or just workers from the same ethnic origin as the target group’s. However, "TAMPEP" goes much further. It recruits and trains previous migrant sex workers from different linguistic and cultural backgrounds (cultural mediators) who can help the organisation approach the target group and help them with intercultural issues, such as language, social rules, legal issues, etc. However, due to the secrecy and double marginal status of migrant sex workers, it is also necessary to find not only previous, but also current migrant sex workers who can help as peer educators in health issues with the target group. Such peer approach to migrant sex workers lessens their distrust of the help they are offered and increases the chances for success. "TAMPEP" makes the target group the most important part of the project not only as target group, but also as participants involved in the development of the project.
However, the most relevant aspect of "TAMPEP" is perhaps that of focus. "TAMPEP" is one of the few organisations that consider intercultural issues an important issue in health care services for migrant sex workers. Being a doubly marginalised group (for being both immigrants and sex workers) the efforts this target group requires are also doubled. Being sex workers, the target group is a risk group in AIDS prevention, but being migrant workers makes the target group especially vulnerable, since this circumstance prevents them from being helped due to intercultural impediments.
2.2 Critical Points
One of the most positive aspects of "TAMPEP"’s methodology (outreach work through cultural mediators and peer educators) is also one of the most difficult ones when taken to practice. Migrant sex workers are a target group particularly difficult to reach due to their illegal status and diverse ethnic and linguistic origin. Since they move in the difficult arena of illegal migration, human traffic, and sex industry, migrant sex workers are not only distrustful of any authority, but also scared of possible repressive measures (such as physical damage, threats concerning their relatives in their countries of origin or their own lives, seclusion, torture, etc.) that the mafias might take against them.
Active intervention might cause problems not only to migrant sex workers who collaborate with "TAMPEP", but also to other "TAMPEP" workers such as cultural mediators and their families. For such cases, it might be necessary to have some action plan developed together with the police, so as to lessen risks.
The health services provided by "TAMPEP" are restricted to information and means to prevent infection in sex work, but it does not include medical treatment for those who are already infected. However, "TAMPEP" works in collaboration with other organisations (different for each partner in their countries of action) in order to supply these services.
2.3 Lessons Learnt
Results
Through this work "TAMPEP" makes HIV/STI prevention among migrant sex workers feasible. "TAMPEP" members have directly contributed to primary prevention through facilitating access of migrant sex workers across Europe to appropriate legal, health and social care services. In the last five years, "TAMPEP" national teams, consisting of cultural mediators, peer educators and street operators of different nationalities, contacted more than 50.000 migrant prostitutes while carrying out fieldwork in the four project countries. More than 300.000 interactive contacts have resulted from fieldwork. The continuous acquisition of empirical data has allowed us to draw a detailed updated map of migration movements within the prostitution industry in Europe, and a map of the demographic composition of the different groups.
Results of Network Methodology
- Identification of needs of migrant sex workers and sensibilisation of medical and social services among the countries belonging to the network.
- Exchange of experience, knowledge and good practices amongst the members, identification of common gaps and the review of the situation of prostitution, carrying out of common training. Using a questionnaire as a common instrument for a national mapping in order to learn about the current trends in the prostitution scene.
- Spreading of "TAMPEP"’s information material, updating of the basic material, making the material accessible for the members of the network and production of new material.
- Participation in strategic meetings of policy makers, giving support and advice to several NGOs and Gos.
Themes
The integration of intercultural issues in health prevention. "TAMPEP" goes ahead of the health needs of its target group. It anticipates to their health problems by preventing them and to their intercultural problems by providing information adapted to their linguistic and cultural needs and also to their specific circumstances as illegal sex workers. "TAMPEP" fights for the acceptance of prostitution as part of the social system so that it ceases to be a taboo. It also fights for social acceptance of illegal immigration as an increasingly relevant aspect of the European social composition. To this group, it is particularly difficult to integrate within a social group who is not only alien to them, but who also refuses to accept them as its components. Such acceptance is the first step towards the improvement not only of the target group’s situation, but also of the community who receives them. In this sense, "TAMPEP" could serve as a model of good practice for any health–care-providing organisation.
Methodology
We would like to underline outreach street work as the most relevant aspect of "TAMPEP"’s methodology subject to be exportable to other projects. Other projects include the development of materials adapted to the cultural differences of the target groups they work for, but they wait for the target group to come to them for help. "TAMPEP" strives to find out where and when its services are needed and takes them where the target group is even when their help is rejected. To most intercultural projects, the sensibilisation of society concerning intercultural issues and immigration is a common objective. However, "TAMPEP" is innovative in their task to sensibilise not only society, but also the target group itself, who might not even be aware of their present and future needs and rights.
In this sense, the recruiting and training of cultural mediators and peer educators is crucial for the success of "TAMPEP"’s project. They are a valuable source of information for research activities and a priceless help in approaching the target group. The practice of making the target group not only the beneficiaries, but also the central agents of a project is a practice that can and should be exported to other experiences with migrant groups. In this sense, the methodology of "TAMPEP" is an example to be followed.
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