Children as young as 18 years old involved in prostitution are without any doubt victims of sexual manipulation. Compared to their adult counterparts, these children are apparently much more helpless and vulnerable, in the face of the conferred interests and established structures in the sex sector, and are much more likely to fall victims of the trafficking, torture, debt servitude or physical mistreatments. The commercial sexual exploitation is a significantly serious form of human rights violation, moreover, when it comes to children, it has life-threatening and life-long consequences. It is, nevertheless, a living reality in most parts of the Asia continent, though somehow not given a considerable attention by the Asian States.
The Thailand government has been comparatively open on this issue, it has made a significant effort in confessing it and collaboration with NGOs and private organizations; thus, the government has attempted to combat this exploitation. There are some positive lessons that the government have learned in the process of combating prostitution among children. The current work will try to highlight some of these efforts. The situation in Thailand as it has been illustrated in this paper may be generalized to the rest of the Asian countries.
The Extent of Problem
Recurrent challenge may not be a justification for the lack of action. Prostitution, essentially everywhere, has always been an elusive challenge. The prices may shift and economies transform, but prostitution will always continue. The significant query, in the current and many other contexts, should be on whether the prostitution impacts are on rise or are decreasing.
As it is with adult prostitution, owning to the undercover or illegal nature of the trade, and due to the dynamics of this work, it has been difficult to determine with precision the figures concerning the magnitude of a child prostitution across the world. Several Thailand governments and non-government organizations have, however, made substantial efforts in collecting and providing information on this topic.
Change of Sites
According to the yearly survey that was carried out in 1999 by the Ministry of Public Health of Thailand, there were approximately 8,500 recognized prostitution establishments and facilities within Thailand, with about 70,000 confirmed sex workers, of whom 95.5 per cent were female, and about 45,000 staffs, who were either prostitutes or otherwise.
The identified facilities included beer bars, brothels, restaurants, traditional massage, and karaoke. The total number of such establishments were compared to the similar study in 1995, recorded an increase of 15% from 7,320 establishments, with a significant increase in the number of prostitute. It is worth to note that the total number of these facilities and the number of prostitutes have significantly decreased over the last decade. Nevertheless, over the same period, the number of karaoke facilities where, prostitutes operate, has increased to a considerable degree. The number of traditional massage-providing facilities, where here is a prostitutes’ trade, has also increased significantly2.
In addition, the numbers of beer bars and restaurant, where sex services are on offer, have been on rise. From the look of things, one may conclude that commercialized sex is spreading from exclusive places, such as brothels, to various, less obvious establishments.
Uneven Increase in the Child Prostitution
It is a cause for alarm that despite the only insignificant increase in the total number of sex workers, the number of children in prostitution has increased at alarming rates.
The reason for this drastic increase in the numbers of child prostitutes may be the fear of sexually transmitted infections among the clients and the wrong perception that having sex with underage is safer, than it is with adults.
There are claims that the number of child sex workers in the year 2000 was approximately 20,000 in Thailand.
Considering the organization involved in carrying out the Ministry of Public Health demographic study and the methodology applied, the available statistics should be treated as the reliable bottom line, while the real numbers may be higher, given that the studies covered only those facilities, where sex-related infection cases were rampart, and not all respondents, who participated in these surveys, have admitted to be sex workers. In addition to the suspicion of the under-reporting, there is a fact that a significant number of the mature girls entered the prostitution sector, while they were under 18 years of age, either through a socialization process or directly.
Considering the factors mentioned above, the estimates in 2009 of the Office of the National Commission for the Women’s Affairs, the number of Thailand prostitutes has increased significantly. The number is estimated about 200,000, whereas about 40,000 prostitutes are below the age of 18 years.
The prostitution among children should be condemned with the strongest terms possible by all people and governments. However, the existence of this illegal trade must be at the same time acknowledged, and it should be accepted if any effective measure is to be taken.
Girls as Easy Target
Girls and by extension women are given a lower social status in Thai societies as compared to their men counterparts. This, together with the insufficient education, information and presence of abject poverty among the Thai tribal and rural societies, makes girls an easy victim of sexual venality. Girls that are unlucky to finish the compulsory education up to grade 6 at the age of about 13 years are more vulnerable to prostitution. These girls with their level of education have a reduced range of occupations to choose from as compared to their males’ counterparts.
Some industries, such as textile, entertainment and prostitution, will absorb female staff, and prostitution is one of the best paying among these industries. Considering the absence of the social welfare organization, prostitution becomes the only viable option for girls to cope with a severe poverty and other social obligations. The precedence set by girls, who are already earning from prostitution sector, serves as the bait for younger girls.
According to the study conducted in 2010 by the MoPH (Ministry of Public Health), there is an indication that the number of girls, who are forced to get into prostitution has decreased significantly. However, the numbers of girls, who are persuaded to join prostitution voluntarily, have increased. This may be attributed to the ignorance on the part of girls about the precise menace, nature and stigma associated with the prostitution sector by the society. The trend has also been confirmed by the major Thai NGOs, including CPCR, which assist child victim of prostitution in Thailand.
Social Cultural Elements
Social-cultural elements are substantially significant in setting the overall framework. The prostitution sector is resolutely established in a double standard of the morality for women and men and in the sense of obligation and level that children feel they value their parents’ principles.
Traditionally, girls are brought up to believe that it is their duty and responsibility to support their families by earning income through the available means to do so. Such social attributes are so entrenched in the Thailand societies that they have established a concept of duty for children to support the parent financially – “todtanbunkhun” or repaying the breast milk. These attributes, combined with the rising greediness and consumerism, have established a force that leads girls to prostitution in Thailand and Asia by extension.
There have been significant statutory measures that have been instigated in Thailand over the last decade. The 1997 Constitution reform provided a window of opportunities to fight against the child sexual corruption. The reformed Constitution outlined that all children are entitled not less than 13 years of the compulsory and free basic education. If the education sector implements this law, it will be a significant opportunity to curb the underage prostitution. The Constitution further indicates that youth and children have the legal right to be protected by the government against any form of sexual exploitation.
The teenagers, who do not have custody, should be raised and protected by the state’s welfare. Under this Constitution, all people notwithstanding their gender, social status, race, religion, among other factors, shall be treated equally. The Human Rights Commission in Thailand has been established to protect the human rights as they have been stipulated in the reformed Constitution.
Most people working in the prostitution sector have been associated with the sexually transmitted diseases (STDs), and there is a massive body of clinical documentation, identifying prostitutes as the vectors in the transmission of the sexually transmitted diseases, including HIV, and more concisely as the core cohort of high frequency transmitters of STDs.
Sex work involves more than a direct act of virginal, anal and oral intercourse, and the occupational protection and health dangers associated with the prostitution are not limited to the sexual transmitted diseases. They also include physical injuries and other forms of infectious diseases, drug abuse, and emotional stress. Moreover, though HIV infections and physical violence are obviously the serious hazards in prostitution in terms of a mortality risk, the two vices are not essentially perceived as the most scaring factors by prostitutes on their daily operations.
Repetitive Stress Injuries and Distress
Severally, sex workers have indicated musculoskeletal damages as a significant occupational risk, there is also recurring stress, injuries to the arm, shoulders and wrist due to recurring hand jobs; there are also complains of painful jaws caused by the repeated performance of blow jobs; knee injuries that are attributed to the working position for a long time in stripper’s clubs; back pain due to long hours of working on beds and massage tables; and foot muscle damage that are related to walking on high heeled shoes. Furthermore, there are several sex workers, who have reported recurring kidney and bladder infections during their first few months of prostitution.
According to one informant, when women start working as sex workers, they are not able to position themselves, when serving their clients in order to prevent the damage of bladder, focusing on the significance of urinating between clients. There are those, who have resorted to the use of diaphragm, which is associated with further bladder infections. Though it is easy to treat and control bladder infections using antibiotics, some patients end up developing chronic cystitis.
As illustrated above, some sex workers face the considerable risk of occupational violence at work, including physical assault, rape and other sexual assault, as well as murder. While risks associated with this occupation have a greater impact on the street sex workers, those, who work off-street, also undergo a similar assault. The study on the occupational risks among the sex workers in Canada and Brazil established that transgender and female sex workers in both countries faced expressively higher levels of violence than the male counterparts.
Prostitution sector is defined as pathological in psychiatric documentations. Though most prostitutes discard this representation of their profession, they have acknowledged that there is a significant amount of psychological stress that is related to sex work, which is also a result of stigma and illegality of their trade. The highest psychological stress may be experienced by prostitutes, who serve their clients on street. It has been established that there is an increased risk of arrest, and violence serves as a determinant of sex workers’ sense of controlling their lifestyle.
There are two papers, which examined the presence of psychiatric symptoms among prostitutes, though they did not identify specific attributes of prostitution that contributes to the psychological stress. One of these studies, however, indicated that women, who practiced prostitution on street, suffered more from a psychological depression as compared to their counterparts, who operated in brothels. The second study illustrated that there was a higher occurrence of the paranoid ideation among the crack users, who engaged in prostitution, than among those, who did not trade in sex work.
The other factor that affects the prostitutes’ emotional state is in line with the management of shame and compound impact of the legal and social discrimination, marginalization and disapproval. The significances of being associated with prostitution are a serious social humiliation.
In the United States, for instance, it may be used to deny an individual a visa, work permit and citizenship, and for immigrant, prostitution may cause a deportation. Even the immigrant women and girls, who have been forced to engage in prostitution under the slavery conditions, are often deported, with little effort being put in place to bring the actual culprits behind the bars for human trafficking. The present, as well as the past works concerning prostitution may be used to justify the action to remove children from their prostituting parents and guardians.
One way, through which prostitutes restrict the influence of the stigma and discrimination, is by using various terms in reference to their work, abandoning names that are directly connected to prostitution. For instance, some prostitutes may use different names in promotions to imply different skills and services that they may offer; while on the street, sex workers use names that are different to their clients, making it difficult for the law enforcers to keep track of them.
Though some prostitutes are open to their society about their illegal trade, the majority tends to live double lives, keeping off even their relatives from knowing how they earn for living. When prostitutes opt to change their occupations, they are faced with challenges on how to describe their past lives.
Drugs Abuse and Prostitution
Occupational related depression is a contributing factor in the abuse of drugs and alcohol among the prostitutes, whereas highest effects are felt on streets. Significant abuse of drugs is among sex-workers on street. Some prostitutes were engaged in drugs abuse prior to joining in prostitution, which led them to sex work as a means of sustaining them in drugs.
Although a lot of attention has been directed on the sexually transmitted diseases and prostitution in Thailand, there is a small amount of literature that focuses on other contagious infections, such as pneumonia, tuberculosis, and possibly bronchitis, as it does in terms of other occupations, where there is an extensive contact with the public. Moreover, it is expected that the risk would be relatively high, particularly among prostitutes and their clients on the streets. Some sex workers in Thailand refuse to kiss their clients, describing kissing as a health risk.
The presence of law enforcers, violence, money and children often feature more blatantly than sexually transmitted diseases in the prostitutes’ issues of concern. Although some researches have to some extent documented high incidents of HIV and STDs in some sex workers communities, other researchers have documented little or none at all. For example, a multicentre research that was conducted under the auspices of the CDC (Centre for Diseases Control) was the first documentation to highlight this reality. The study had about 13 per cent of the respondent testing HIV positive. The prevalence of HIV, nevertheless, varied from 0 per cent among the prostitutes serving in brothels and other off-street establishments to 48 per cent among the sex workers serving on streets.
Generally, the highest prevalence was found in jails and on streets, drugs programs, and in STD clinics. In virtually all cases, HIV infection was related to the prostitutes’ injection of drugs or injection of their regular sex clients, with the prevalence tending to be similar among the communities of female sex workers. As it has been discussed, in Thailand, a relationship has been established between the drug abusers, frequent fellatio, and STDs seroconversion.
Regardless of whether it is a developed country or a third world country from Southern hemisphere, the prevalence and incidence of STDs and HIV are considerably high among the poor prostitutes and their clients.
Though condoms are still considered to be very effective prophylactic against sexually transmitted infections, a number of factors have been obstacles to the application of condoms, including discrimination and emotional factor. The obstacles to the use of condom among the sex workers and their personal life include distinguishing their work from emotional satisfaction and desire for spontaneity. It is the same drive power that affects condoms in other personal relationship.
A United States study focusing on HIV risk as an occupational risk, rather than a private life risk, identified three classes of prostituting plans of work. The other identified consistent protectors, risk takers, and selective risk takers.
The consistent protectors, with which prostitutes tend to operate in private brothels and clubs, are relative to the ones, who take more risks, they earn more money and regulate their drugs usage. They also tend to have a relative relaxed working style, where they maintain a professional distances from their clients, while considering all transaction in prostitution as business. The selective risk takers are somewhat older and have an intense experience. They are frequently the carriers of Acquired Immune Deficiency syndrome epidemic, and they tend to avoid the demands to use condoms, especially with their long-term frequent clients.
The prostitutes, who were identified as the risk takers, were mostly immigrants, with less bargaining power due to communication barriers, and were not established in prostitution. The other group of risk takers consists of prostitutes with a long-term experience in trade, who had been sexually abused at their childhood or were assaulted on street. Though the risk taker prostitute tends to be argumentative in convincing their sex clients about use of condoms, they are less successful in doing so, and they end up compromising their stands.
Although various organizations and individuals have been working to prevent the child prostitution in Bangkok, there are needs for additional interventions to address the health consequences at all levels in society. Most efforts are focused on addressing the increasing demand for child prostitution such as illegalizing of sex tourism. Although Thailand have enacted laws that can prosecute an individual, who tours the country for the child prostitution, these legislation are seldom applied. There is a need for a thorough investigation and implementation of research-based interventions to address the familial, social, cultural and individual factors that drive women and children in Bangkok into prostitution.
At the community stage, health professionals should collaborate with the local organizations and individuals to evaluate the factors, leading to prostitution. This effort should be aimed at enabling the appropriate interventions to be established and implemented.
On the other hand, at the national level, health professionals, NGOs and government agencies should combine their efforts to develop strong policies in order to prevent prostitution of all forms. Globally, health organizations and professionals are supposed to establish and implement policies that would motivate states to increase their efforts in terms of fighting against prostitution.
Projects that prevent a spread of prostitution should be evaluated, and the optimal one should be replicated. A good example is the national campaign that was carried out by the Thailand’s government to prevent the child prostitution.
The campaign was aimed at increasing the number of years a child spends in the education system from 9 to 13 years, raising awareness to shift attitudes on the child prostitution and advocating for a vocational training. In Thailand, it is accepted that the longer the child remains in the school system, the lower are the chances of joining prostitution.
Prevention methods should also entail significant efforts in understanding as to why adults would sexually exploit minors and establish a psychological and physical treatment for such individuals.