Chee Wen Eng (Moderator): Welcome. Thank you to the co-sponsors: ASEAN SOGIE Caucus, the Forging Intersectional Feminist Futures Consortium, International Womens Rights Action Watch, Women and Harm Reduction International Network, SPINN (Indonesia), IDUCare (Philippines), Health Opportunity Network (Thailand), International Indigenous Drug Policy Alliance, New Zealand Drug Foundation and the International Drug Policy Consortium.
Rosma Karlina, SPINN, Bogor, Indonesia: Our organisation supported the establishment of a collective of women who use drugs, called Womxn’s Voice. Some of the women experience violence, and when they report it to police the police will not take it seriously. Sometimes the women becomes arrested for drug use as well, therefore suffering double layers of violence. We tried to establish this organisation because we need a safe space for women who use drugs. We are humans just like anyone else. We set up emergency housing so that people can stay with us for 7 days. I will show a video on this (video from Rosma and their emergency shelter). It is hard to get access to justice when we face violence, e.g. from husbands. That’s why we are trying to break barriers by facilitating this emergency housing, seeking information, access to justice and health services.
When the police know that I am using drugs, and send me to prison, calling me a bad mum, who is bad, the drug policy or me?
Sarah Helm, Executive Director, New Zealand Drug Foundation: I’m here to represent the Indigenous People’s Alliance. I’m going to speak about the experience of indigenous people, specific to women. It can be very hard for people to understand the devastating trauma of colonisation. For being persecuted for our cultural practices, forcible removal from our families, imprisonment etc. It is not a trauma that happens in isolation but has carried out over time. Even when we become grown adults we continue to experience shame. These stories are common for indigenous people. They haven’t really stopped and colonisation continues today. There is a specific way that colonisation has imposed perspectives on gender, e.g. erasing our third genders and infantilising women. On top of that has come the war on drugs. I don’t believe we have been disproportionately targeted by the war on drugs, we have been deliberately targeted. The mass incarceration of our peoples, the fatalities from the armed conflict and overdose. Indigenous women make up a disproportionate amount of people in prison in Australia, Canada. Maori comprise 16% of the population but over 60% of women in prison. Colonisation also introduced the concept of prison itself and supplanted our own concepts of law and justice. Maori concepts of justice are forward-looking. We also suffer inadequate access to health, treatment and harm reduction services. I want to talk about an organisation that works with transwomen, they are not only more likely to be homeless but also to experience higher risks from substance use. When positive regulatory changes happen, when indigenous women are not at the table, they won’t help us. In 2018, there was a law change giving police more discretion. We have seen a decrease in prosecutions but there is still more non-Maori prosecutions so we have not enjoyed the benefits of those reforms. Research in Canada also shows similar outcomes of reforms. What we want is to be at the table, so that when reforms are taken, we are there in it too from the beginning. We wish to be included and to be free from incarceration. Thank you for including us here, please ask us to be at your tables. You might need to help us along because our lives can be more complicated.
Aire Kamiyama, IDUCARE Philippines: I will share a lived experience from a member of our community. There was a 19 year old mother who was detained for drug use. Shortly after giving birth at a hospital, the infant faced health complications including pneumonia and positive HIV screening. The baby was cared for by other unknown carers. The biological mother tested negative for HIV. The challenges are socio-economic because she is unable to support her child financially inside the prison; her husband as well is unable to provide the child’s medical needs since he just relies on selling candles and key chains for sustenance. Also, when the time comes that she will be released from jail, she will have difficulties in finding a stable job due to her record and will be struggling to care for her family, especially her child. There are also emotional and psychological burdens: 1) Discrimination: The stigma of her having a criminal record and of her child being HIV reactive. 2) Emotional distress due to her child’s condition while them, as parents, are unable to help the child. This would not have happened if she was not arrested and criminalised for using drugs. This is where IDUCARE comes in. We are a community-led organization doing outreach works and runs a community-led Drop-In-Center that focuses on health promotion, medical services, Psycho-Social Services, Motivational Interviewing (especially HIV and HCV infections), and legal literacy and assistance to people who use drugs. In our little ways and best efforts, we help the clients being referred to us, may it be paralegal assistance or medical aid. We also address their emotional and psychological burden by doing motivational Interviewing interventions. We practice a people-centered approach facility or principle. When we engage women who use drugs in decision-making processes, we break down the barriers that contribute to our marginalization. By providing women who use drugs with a seat at the table, we recognize their agency and expertise. Our inclusion in the execution phase ensures that the policies are not only well-intentioned on paper but are translated into felt, positive changes in the lives of those directly affected. Empowering and engaging women who use drugs in drug policy discussions, decision-making, and implementation is not just a necessity; it is a moral imperative for a society that aspires to be just, compassionate, and effective in addressing the complex challenges posed by drug use. Let us commit ourselves to building a Philippines where every voice is heard, every perspective is valued, and every citizen, regardless of their background, is empowered to contribute to the well-being of our nation. So I want to say on behalf of the community of women who use drugs Empowering women who use drugs is not just a matter of fairness; it is a matter of justice. Women in prison deserve more than confinement; they deserve access to essential healthcare services, including sexual and reproductive care. People should not be criminalised and punished for using drugs, especially mothers with a baby to care for.
Emily Rowe, Women and Harm Reduction International Network: Today I will be sharing insight into the intersectional issues sex workers who use drugs face in Indonesia, particularly in terms of access to gender-based violence services and recourse as well as a community-based response to these concerns. Female, male and transgender sex workers have historically played a prominent role in HIV- and gendered/sexuality discourse in Indonesia. Sex workers have been both applauded for their contribution to HIV prevention and treatment at the same time as being burdened with the position concept of ‘vector’ of disease, and blamed for HIV and STI incidence and crime (whilst their clients are conceptualised as hapless ‘victims’). Intersectional vulnerability is further impacted when sex workers use drugs, who unsurprisingly do not feel comfortable accessing cis-normative harm reduction and legal aid services or otherwise lack awareness of the services that should be available to them. Indonesian sex workers who use drugs experience unacceptable and damaging levels of stigmatization, discrimination, marginalisation, violence and the risk of being arrested and imprisoned. sex workers who use drugs are particularly at risk to all forms of violence, including intimate partner violence and violence at the hands of police. A culture of impunity in which perpetrators are not held accountable undermines access to justice and creates an environment in which violence against sex workers is normalized and justified. Sex workers who use drugs in Indonesia face barriers to accessing and using services due to the layered stigma surrounding drug use, sex work and sexual orientation, which are all criminalized to varying degrees. In Indonesia GBV towards transgender, male and female sex workers who use drugs (SWUD) is rife, though grossly under reported and addressed. This is particularly manifest in Bali which has a very high HIV burden and the largest sex worker population in the archipelago. Transgender SWUDs are particularly at risk, and often victims of theft/lack of payment for services, rape, mutilation and extortion. Anecdotal evidence from the SWUD community in Bali indicates that GBV is shockingly high- (100% report experiencing some form of violence), yet only an estimated 3% had ever sought assistance/legal recourse, however, 96.3% intimated that if there were a program/mechanism to empower them and facilitate this they would gratefully engage and seek support. I would now like to take this moment to share an experience from one of our colleagues, that details and illustrates the constellation of issues sex workers who use drugs can face, lived impact of punitive drug control and the particular challenges this creates for transgender women engaged in sex work who use drugs.
Monika* is a transgender sex worker uses crystal meth. Monika does sex work directly and via online, through which Monika gets messages from customers to use her services. In this instance Monika agreed to meet in a location quite far from where she lives.. Before leaving to go to the rental place for sexual services, the customer asked her to wait a while to withdraw money at the ATM and left a small bag with her. Within a few minutes 0 policemen came and immediately arrested Monika. After being examined, they found 2 grams of crystal methamphetamine in the bag. Monika was taken directly to the regional police station where she was physically mistreated by the arresting police and stripped naked and head shaved. Due to the lack of knowledge of the sex worker community in Bali regarding legal assistance forms, Monika did not receive the support she required. Monika is also discriminated against in prison because of her gender identity as a trans woman and has been verbally and physically abused and beaten and made to sleep outside because no prisoner would share a cell with her.
Monika is just one of countless transgender and non-binary/gender diverse sex workers who use drugs currently incarcerated or awaiting sentencing for minor drugs offences in Indonesia whose gender identity, sex work status and drug use status combined exacerbate their vulnerability and potentiality to experience violence, be ignored, silenced or failed by existing harm reduction structures/legal aid frameworks. In response to the experience of people like Monika and other colleagues, WHRIN in collaboration with YAKEBA in Bali, is implementing Project GAP: a Gender based violence and sex workers who use drugs Advocacy Pilot. The objectives of Project GAP are to identify and address data, service provision and stakeholder accountability gaps and GBV towards sex workers who use drugs in Bali. As a ‘sex workers know best’ Project, project GAP applies a community based participatory approach which amplifies project ownership/propriety and ensured partnership across the entire project process. Project GAP involves designing and piloting CBM tools to identify and track GBV incidence and improve service provision/linkage for SWUD. These are: 1.Tools to document case studies and capture credible data on GBV incidence among SWUD to address data gaps ; 2. Tools to identify and establish effective legal, health, social, referral services and monitor provision; 3.Tools to track and monitor access to legal aid support and access to recourse, including facilitated engagement and building bridges with law enforcement. The objective of the project is to not only to develop CBM tools but also to facilitate the development of flexible, responsive and creative strategies to improve GBV service provision and support for SWUD experiencing GBV. The Project GAP CBM Tools are not be intended to be static operating procedures, but rather a living document that can be refined through experience and further piloting over time. This approach acknowledges that the lives of sex workers who use drugs are dynamic and the multifarious ways in which they are impacted by violence are constantly changing, therefore cannot be readily generalised. These are some IEC samples we have created, these have been printed into sticker format and put all over sex work sites, on motorcycle helmets as well as shared in closed social media sex worker groups. As part of Project Gap SWUD focal points have been trained in legal aid and harm reduction and legal aid and harm reduction providers have been capacitated in SOGIESC, sex worker rights, and gender responsive services. This project is ongoing but we would be happy to share the tailored legal aid training materials we have created, as well as the community based monitoring tools we have made if anyone is interested in replicating the approach or collaborating further.
Thissadee Sawangying, HON, Thailand: Health and Opportunity Network is working on the project “INSPIRE: Strengthening and Amplifying the Voices of Women and Young People Affected by Punitive Drug Policies in South East Asia”. The project aims to empower women and transgender individuals who use substances, promote their physical and mental health, provide social support, and implement harm reduction programs. The network also intends to develop a mechanism for involvement in drug policy advocacy, reduce the risk and impact of drug use and gender-based violence, and brainstorm ideas and guidelines for advancing the rights and health of women and transgender individuals who use drugs in the future. Over three years of empowerment, a network of women and trans people who use substances was established called “We-TrUST” (Women and Trans who use substances) and has come together to be a voice and representative for the women and trans drug use community. that reflects real problems, situations, and impacts that women and trans who use drugs face in the community. We-TrUST also covers women and trans people who have partners or family members who use drugs. We-TrUST members are women and trans who use drugs (WTUD) leaders from four regions. They reflect the intersectional identities of women and trans people, which affect their way of life in different issues. One similar thing is that she is a woman who has to contend with gender norms and society’s attitudes, probably no different from other women and trans people. If they are not involved with drugs. The violence that women face due to gendered mindsets from societies, gender norms affecting women, and double effects with Trans people, causing the violence with women and trans receive to be at different levels. Different situations call for different perspectives. We need more lenses. It’s important to approach complex problems with an open mind and positive attitude. Look at the many different intersectional identities under being a drug user. (If you want to understand more, please follow these 16 Stories from WTUD from the QR Code on the slide). So, I would like to share the story of a woman who uses drugs. in this limited time. It is Hoe’s story: experience of a formerly incarcerated woman. Hoe is a woman who uses drugs and becomes homeless after being arrested for drug use. Compulsory rehabilitation 45 days. She lives public space, under the bridge in south of Pattaya. She is a sex worker. She got HIV and was sick. and get physical harm from commercial partners. Thai citizen but doesn’t have an ID Card. It was lost until the police arrested her, and she went to prison. Hoe needs an ID card to access treatment, Job, Resident, and Banking when meeting with the municipality. Hoe can’t speak and it seems she has mental health problems. She only has a criminal record on paper from the police station. So, in this case, what can we do? How many women who use drugs are in the same situation as Hoe? Please open your mind, open space, and listen to their life. (show video clip 1 minute of Hoe and others). From WE-TrUST, we envision a world where women and trans people who use drugs can access tools to help manage the risks and impacts of drug use, have unconditional access to employment services to achieve financial security, are no longer subject to stigma, including internalized stigma, have their rights protected and able to report rights violations without fear of backlash, can access gender-specific harm reduction services that are centered on client’s needs, which cover physical, social and legal dimensions, can access integrated secual and reproductive health services (e.g. pre/postnatal care, hormone replacement therapy), and are part of drug policy discussions at every stage of policymaking.
Chee Wen: Thank you to all our speakers. We can now welcome some questions from the audience.
Question: what are the potential unintended consequences of current drug policies in South East Asia or globally. How can these by mitigated by evidence-based approaches to justice and harm reduction?
Rosma: In Indonesia, we have to admit we lack data on women who use drugs. We tried to do a needs assessment involving 54 women and transgender women who use drugs in Indonesia. The situation is the same, around lacking information about drugs, experiences of violence. We need a justice and harm reduction approach. We established an emergency shelter so that people have a safe place to stay and we are documenting the situation so that we can share it with the government. We dream about having a new drug policy that has a gender-sensitive approach in our country.
Question: Why should women and transgender women who use drugs be involved in making drug policy in the country?
Thissadee: About 20 years ago I became involved in ham reduction work in Thailand together with Ozone Foundation and other organisation. But there are no specific programmes for women who are pregnant and use drugs, and so it is important to strengthen the networks so that we can hear from women and transgender women who use drugs and strengthen the government response. We don’t have methadone services specific to women – that is a failure of our country programme. How can we empower women and transgender women to speak out on this, to improve the harm reduction programmes in our country? This is important to do.
Chee Wen: I’m sorry we can’t go through the remaining questions received online but I would like to open the floor to questions that people in the room might have?
Aire: It would be a great opportunity to create a network of women who use drugs in Asia, to empower voices and help improve harm reduction services so that they can be more accessible for women who use drugs, especially in terms of sexual and reproductive health services.
Chee Wen: we hope this discussion can continue beyond this session. Thank you for joining us.