Uncovering the realities of prostitutes and their children in a cross national comparative study between India and the U.S.

This qualitative study examines the needs and challenges of prostitutes and their children. A review of research regarding prostitutes indicates that the needs and experiences of prostitutes, their children, and stakeholders who provide services to this population have been neglected. The first part of the study looks at the challenges prostitutes face trying to be successful mothers. The study was conducted in the U.S. and India. The findings of this study reveal that these women face difficulties in their daily lives. Due to the distinct differences between the interventions and policies in both countries, each group shares a different relationship with their children. The findings of the study strongly advocate for joint programs for prostitutes and their children to help ensure them all a better future. The second part of the study was conducted with children of prostitutes who live with their mothers in red light areas of Mumbai, India. The participants discussed the experiences and challenges they face in their daily lives as children of prostitutes, their relationships with their mothers, and support programs needed for a better life. All of the child participants conveyed that they did not want to be separated from their mothers. The children had good relationships with their mothers and wanted to support their mothers as they aged. The final part of the study examines challenges stakeholders encounter while providing services to prostitutes and their children. The stakeholders also shared their views about the difficulties that children of prostitutes and their mothers face. The stakeholders expressed what support they thought would be helpful for this group. This study is presented in the form of three distinct scholarly manuscripts. Each of the manuscripts has its own research questions and findings that contribute to the overall research agenda in unique ways. Each study makes its own specific recommendations for social work policy, practice, and research. Together, the three manuscripts add to our knowledge about prostitutes as mothers, as well as defining their children's needs and challenges.

UNCOVERING THE REALITIES OF PROSTITUTES AND THEIR CHILDREN IN A CROSS NATIONAL COMPARATIVE STUDY BETWEEN INDIA AND THE U.S. by Hena John-Fisk A dissertation submitted to the faculty of The University of Utah in partial fulfillment of the requirements for the degree of Doctor of Philosophy College of Social Work The University of Utah August 2013 Copyright © Hena John-Fisk 2013 All Rights Reserved The Univers i ty of Utah Graduate School STATEMENT OF DISSERTATION APPROVAL The dissertation of Hena John-Fisk has been approved by the following supervisory committee members: Caren Frost , Chair 4/27/12 Date Approved L. Henry Liese , Member 4/27/12 Date Approved David S. Derezotes , Member 4/27/12 Date Approved Patrick T. Panos , Member 4/27/12 Date Approved David Hawkins , Member 4/27/12 Date Approved and by Jannah Mather , Dean of the Department of College of Social Work and by Donna M. White, Interim Dean of The Graduate School. ABSTRACT This qualitative study examines the needs and challenges of prostitutes and their children. A review of research regarding prostitutes indicates that the needs and experiences of prostitutes, their children, and stakeholders who provide services to this population have been neglected. The first part of the study looks at the challenges prostitutes face trying to be successful mothers. The study was conducted in the U.S. and India. The findings of this study reveal that these women face difficulties in their daily lives. Due to the distinct differences between the interventions and policies in both countries, each group shares a different relationship with their children. The findings of the study strongly advocate for joint programs for prostitutes and their children to help ensure them all a better future. The second part of the study was conducted with children of prostitutes who live with their mothers in red light areas of Mumbai, India. The participants discussed the experiences and challenges they face in their daily lives as children of prostitutes, their relationships with their mothers, and support programs needed for a better life. All of the child participants conveyed that they did not want to be separated from their mothers. The children had good relationships with their mothers and wanted to support their mothers as they aged. The final part of the study examines challenges stakeholders encounter while providing services to prostitutes and their children. The stakeholders also shared their views about the difficulties that children of prostitutes and their mothers face. The stakeholders expressed what support they thought iv would be helpful for this group. This study is presented in the form of three distinct scholarly manuscripts. Each of the manuscripts has its own research questions and findings that contribute to the overall research agenda in unique ways. Each study makes its own specific recommendations for social work policy, practice, and research. Together, the three manuscripts add to our knowledge about prostitutes as mothers, as well as defining their children's needs and challenges. For the women and children of the red light area - for letting me share their stories My mother, who has always been my inspiration and strength Thank you all for being in my life TABLE OF CONTENTS ABSTRACT……………………………………………………………………………...iii ACKNOWLEDGMENTS………………………………………………………………..ix Chapter 1. INTRODUCTION……………………………………………………………….....1 Statement of Problem……………………………………………………….....1 Purpose of the Study…………………………………………………………. 2 Literature Review………………………………………………………….…..4 Review of Policy……………………………………………………………..13 Theoretical Framwork………………………………………………………..22 Research Design……………………………………………………………...25 Methods of the Study………………………………………………………...29 Data Analysis………………………………………………………………...30 Manucripts…………………………………………………………………...32 References……………………………………………………………………37 2. COMPARATIVE STUDY OF MOTHERING AMONG PROSTITUTES IN THE U.S. AND INDIA………………………………………………………44 Abstract………………………………………………………………………44 Introduction…………………………………………………………………..45 Theoretical Framwork………………………………………………………..46 Literature Review…………………………………………………………….49 Methods ……………………………………………………………………...56 Findings...........................................................................................................59 Discussion……………………………………………………………………70 Social Work Policy and Implications………………………………………..73 Limitations…………………………………………………………………...73 Conclusion…………………………………………………………………...74 References……………………………………………………………………76 3. UNDERSTANDING THE VOICES OF CHILDREN OF PROSTITUTES FROM MUMBAI, INDIA.....................................................................................80 Abstract............................................................................................................80 vi i Introduction......................................................................................................81 Literature Review.............................................................................................81 Theoretical Framework....................................................................................84 Methods............................................................................................................86 Findings...........................................................................................................89 Discussion......................................................................................................100 Limitations.....................................................................................................102 Conclusion.....................................................................................................103 References......................................................................................................105 4. UNCOVERING THE LIVES OF CHILDREN OF PROSTITUTES THROUGH EYES OF STAKEHOLDERS IN MUMBAI, INDIA.........................................108 Abstract..........................................................................................................108 Introduction....................................................................................................109 Literature Review...........................................................................................110 Theoretical Framework..................................................................................112 Methods..........................................................................................................115 Findings.........................................................................................................117 Discussion......................................................................................................132 Social Work Policy, Research, and Implications...........................................135 Limitations.....................................................................................................136 Conclusion.....................................................................................................136 References......................................................................................................138 5. CONCLUSION....................................................................................................140 Disseration Summary.....................................................................................140 Conclusion of Overall Research....................................................................147 Social Work Policy Implications...................................................................149 Strengths and Limitations of the Dissertation Studies...................................150 Future Research.............................................................................................151 References......................................................................................................153 Appendices A. INTERVIEW GUIDE FOR PROSTITUTES.........................................................154 B. INTERVIEW GUIDE FOR CHILDREN...............................................................157 C. INTERVIEW GUIDE FOR STAKEHOLDER......................................................159 D. CONSENT TO PARTICIPATE IN RESEARCH (PROSTITUTES IN THE U.S.)...............................................................................161 E. CONSENT TO PARTCIPATE IN RESEARCH vi ii (PROSTITUTES IN INDIA)..................................................................................165 F. PARENTAL PERMISSION DOCUMENT............................................................169 G. ASSENT TO PARTICIPATE IN A STUDY (CHILDREN OF PROSTITUTES).....................................................................................................173 H. CONSENT TO PARTICIPATE IN RESEARCH (STAKEHOLDERS)...............176 ACKNOWLEDGMENTS Thank you Almighty God for all the grace and blessings in my life. I am humbled by the unending support so many people in my life have given me to make this dissertation possible. I am grateful for the financial support from the College of Social Work, Dean Jannah Mather, and the JACL's Rev. H. John Yamashita family scholarship. I want to thank the participants for allowing to me share their stories, dreams, fears, and ideas. Thank you to my committee for your encouragement, suggestions, and important critiques. My Chair, Dr. Caren Frost, deserves a special thank you for not only supporting me with her constant encouragement, guidance, and financial support for my research, but for also supporting me when I was sick. I would like to extend my gratitude to Dr. David Hawkins for always being there for me. I would also like to thank all of the faculty and staff of the College of Social Work, especially Dr. Emma Gross, Dr. Hank Liese, Dr. Scott Boyle, Delva Hommes, Wanda Brown, and Candace Minchey for their encouragement and support. I would also like to thank Dr. Edward Buendia, Dr. Frank Margonis, and Dr. Jeanette Misaka from the College of Education for all of their support. I want to especially thank my friends and colleagues Marcella Hurtado, Lakhvinder Maan, Sharvari Karandikar-Chheda, Augustina Naami, Miseong Kim, Dena Ned, Irene Ota, and Henry Poduthas for their constant encouragement during this doctoral program. I would like to extend my gratitude to Abhigya Mookherjee, Roxan Bagban, Diana Peters Rawat, Delphine Mur, Dan Gebhardt, x and Jennifer Julander for their help during my research. My research would be incomplete without the generosity of the following families: Mangat-Grewal, Peter- Rawat, Marques, Thorat, and Radha Rokhe for providing me a home during my research in India. I would like to thank Priti Patkar and her staff for all of their support. I would also like to extend my gratitude to Dianne Cunningham for being a wonderful mentor. Lastly, my deepest gratitude goes to my mother Chhaya John, who has never once wavered from her unconditional love and support. I would like to thank my extended family, especially great-grandma Hazel Houchard for her blessing, Guy, Lisa, Chieko, and Fred Fisk, Keith and Juan Humbert, and Jana, Chaz, and Charlie Cassel for all providing wonderful vacations, which let me take a break from my work and motivated me to finish my dissertation. This dissertation would not have been complete without you being in my life. I would also like to extend my gratitude to all my friends and family whose names I might not have mentioned here. Thank you all-from the bottom of my heart. CHAPTER 1 INTRODUCTION Statement of the Problem Prostitution, including the exchange of sex or sexual activity for food, money, drugs, or other commodities (Dalla, 2000), is an institution linked to a number of social problems, such as the transmission of HIV/AIDS, increased drug use, increased violence, and more. There has been much research about understanding the risks, antecedents, causes, solutions, and prevalence of prostitution (Hope, 2007; Hughes, 2004; Hughes, 2005; Potter, Martin, & Romans, 1999; Rankin, 2002; Raymond, Hughes, & Gomez, 2001; Sanders, 2004; Valandra, 2007; Weiner, 1996); however, there is a lack of research about the needs and risks that children of prostitutes face or what support prostitutes need to be successful mothers. Previous research found three important concerns associated with prostitutes and their children. First, prostitutes often remain in the sex trade in order to support their children financially (Dalla 2000). Second, women who work in prostitution and who lose custody of their children as a result often report that this fuels their drug use; prostitution then becomes a means to support their habits (Hope, 2007). Third, children of prostitutes are victimized in a multitude of ways, including neglect, malnutrition or abandonment, loss of shelter, and an increased risk of entering prostitution (Dalla, 2000). In this research, I used the lens of Human Ecological Systems Theory and Social Exclusion Theory to further understand the social issues of prostitutes 2 and their children in Denver, Colorado and Mumbai, India. Purpose of the Study Previous research regarding prostitution has considered only the risks, antecedents, and prevalence of prostitution (Hope, 2007; Hughes, 2004; Hughes, 2005; Potter, Martin, & Romans, 1999; Rankin, 2002; Sanders, 2004; Valandra, 2007; Weiner, 1996) or evaluated the impact of diversion programs (Wahab & Davis, 2004). These studies did not examine the needs of children of prostitutes or what supports prostitutes need to be successful mothers. The purpose of this study is to understand the needs and experiences of prostitutes and their children. In India following the outbreak of the HIV/AIDS epidemic in 1981, research on prostitution and trafficking became increasingly important. As a result, most of the studies concerning the sex industry in India have been conducted on the topic of HIV/AIDS and the prevention and spread of HIV infection. These past studies can be broadly divided into two areas. The first area of study addresses HIV risks for prostitutes (Marten, 2005; Pauw & Brener 2003; Wojciki & Malala, 2001). These studies have examined the correlation between violence and HIV risk among prostitutes. The second category involving gender-based violence among prostitutes (Dalla & Kennedy, 2003; El-Bassel, Witte, Wada, Gilbert and Wallace, 2001; Karandikar & Prospero, 2008; Monto, 2004; Raphael & Shapiro, 2004; Simons & Whitbeck, 1991; Wechsberg & Lam, 2005) has investigated the forms and severity of violence among prostitutes, street vs. brothel-based prostitution, and substance abuse. In both of these categories, studies have not considered the experiences and needs of prostitutes and their children, nor have they 3 explored the types of support the children of prostitutes and their mothers need to overcome their current situations. Present legislation in both the U.S. and India does not address the needs of prostitutes and their children such as education, housing, job training, or health care. Children face constant stigmatization and discrimination due to their mother's profession. The importance of this study is twofold. First, the literature reveals a lack of empirical study about the needs of prostitutes and their children. Furthermore, there is also a gap in research on stakeholder views of the services they need to help this group as well as the challenges they face in providing services. My prior work with prostitutes in India has highlighted the number of problems these children face, increasing my interest in this research. In addition, I wanted to understand the experiences and needs of this population here in the U.S. where the services for prostitutes are limited. Last, the findings from the U.S. study will be compared with the Indian study to understand and evaluate the needs children of prostitutes and prostitutes in a more in-depth manner. The term prostitution is politically loaded (Kesler, 2002; Overall, 1992; Pheterson, 1990) and has changed over the time. Moreover, many prefer to use other terms to discuss individuals who work in the industry, including commercial sex workers, whores, call girls, etc. For this paper, I will use the term "prostitute," a term that is distinguishable from "sex worker" because sex work is a broad category that might include those employed in phone sex, pornography, stripping, and poll dancing (Hope, 2007). Also, in both the U.S. and India, "prostitutes" is the term used in all prostitution-related laws. Using a legal term will help in the comparison of the problems of children of prostitutes. 4 Literature Review Prostitution According to prostitution laws in Colorado, "prostitution means any person who performs, offers or agrees to perform any act of sexual intercourse, fellatio, cunnilingus, masturbation, or anal intercourse with any person not their spouse in exchange for money or other things of value" (ProCon.org, 2008). Similarly, in the Immoral Traffic (Prevention) Act of India (PITA) in 1986, prostitution "means the sexual exploitation or abuse of persons for commercial purposes, and the expression prostitute shall be construed accordingly." Based on these definitions, prostitution is considered illegal in both the U.S. and India but is still a concern for lawmakers and police. Although it is illegal, prostitution continues to be widely practiced in both countries. The Indian Constitution and U.S. federal and state laws prohibit any forms of trafficking and prostitution (Hughes, 2004; Nair, 2005). Prostitution is illegal in the U.S. except for in 11 rural counties in Nevada (ProCon.org, 2009). The number of prostitutes in the U.S. is unknown due to a lack of reliable source data. Despite law enforcement efforts to curb its spread, as well as general social disapproval, prostitution has maintained a persistent (if not conspicuous) place in the U.S. In 1992, the U.S. ranked tenth in the world in the arrests of prostitutes (McClanahah, McLelland, Abram, & Teplin, 1999). In India, prostitution is part of a larger network of criminal activity and is a multi-million dollar business (Karandikar, 2008; Menen, 2007). Even though prostitution is illegal in India, the country still has Asia's largest red light district called Kamathipura (Karandikar, 2008; Menen, 2007). The prevalence of prostitution cannot be accurately described because the number of prostitutes involved in prostitution changes everyday. 5 According to UNAIDS' country report, there are 1.26 million female prostitutes in India (UNAIDS, 2010). The BBC news in 2006 reported that the number of prostitutes in India has risen by 50% in less than a decade. Mumbai has over 125,000 prostitutes; the majority of them come from the states of Nepal, West Bengal, Orissa, Bihar, Andhra Pradesh, and Karnataka (Ghosh, 1996; Karandikar, 2008). Additionally, there are 5.4 million children of prostitutes in India, most of whom live with their mothers in the red light area (NHRC, 2008). Causes of Prostitution The reasons women have entered prostitution have varied over the last 150 years. There have been multiple studies devoted to this subject (Benjamin & Masters, 1964; Bullough & Bullough, 1978; Esselstyn, 1968; James, 1980, 1976; & Silbert & Pines, 1982). Two important factors that can help explain why certain women become prostitutes are susceptibility and exposure. Susceptibility refers to certain psychological characteristics, such as "a feeling of complete worthlessness" (Bess & Janus, 1976), "alienation" (Brown, 1979), or "self-abasement" (Bullough, 1965). These characteristics are believed to predispose certain women to become prostitutes (Jackman, O'Toole, & Geis, 1963). These personality attributes, when coupled with personal crisis (Maerov, 1965), traumatic events such as incest or rape (James, 1976), serious deprivation, physical and sexual abuse, overindulgence, crime, violence, substance abuse, or emotional problems (Silbert & Pines, 1982) make some women particularly vulnerable to prostitution. In a recent study, Hughes (2004) discussed four reasons why prostitution happens. First, prostitution is caused due to the demands for sex by men. Second, women 6 are actively recruited by traffickers, pimps, brothel owners, organized crime members, and corrupt officials. Third, states tolerating or legalizing prostitution contribute to the demand for prostitution. And fourth, there is cultural impact, particularly from the mass media, that plays a major role in normalizing prostitution by portraying prostitution as a glamorous way to make a great deal of money quickly and easily (Hughes, 2004). In both the U.S. and India, women and children come into the flesh trade due to a constellation of these reasons. Sixty percent of female prostitutes in the U.S. are of international origin, while the remaining 40% are native citizens (Raymond, Hughes, & Gomes, 2001). Many prostitutes are recruited into prostitution through organized businesses and crime networks, such as escort services, bars, brothels, clubs, "biker gangs," and the mafia (Raymond et al., 2001). In addition, U.S. servicemen have also been involved in recruiting Asian women, especially from Korea, Vietnam, and Japan, into the sex industry in the U.S. Husbands and boyfriends have acted as pimps for some of these international (20%) and U.S. (28%) women (Raymond et al., 2001). In India, women are trafficked into the flesh trade from all parts of the country (HAQ, 2001). Many minors also are forced into this flesh trade, especially the children of prostitutes who have grown up in brothels. Trafficking happens in a very organized manner with the sole objective of selling women to brothel keepers. The women, who become the victims of the sex trade, are mostly poor, unemployed, and lacking in social and economic support (Joardar, 1984; Mukerjee & Das, 1996). These circumstances make it easy for a trafficker to lure young women to cities with the promise of a job and better livelihood. Furthermore, many traffickers exploit family connections and 7 acquaintances to target young women for the sex trade (Raymond et.al, 2001). The mere vulnerability of these marginalized and disadvantaged groups renders them increasingly more amenable to harm (Sanghera, 2002). Once induced or forced into the sex trade, women are then brought to a main city like Kolkata, Mumbai, Delhi, or other metropolitan areas (Nair, 2006). In most cases, traffickers then take the women or minors to the brothels where they can sell them for more than $200 U.S. Afterwards, the women are treated as the sole commodity of the brothel keepers and are forced to solicit. A woman who arrives at a brothel this way is then bound to earn the money to pay back the brothel keeper the price paid to the trafficker (Patkar, 2001). The challenges endured by prostitution mentioned earlier leads to a vicious cycle of poverty and slavery. Types of Prostitutes According to Harcourt and Donovan (2004), there are two types of prostitution based on how service is provided, which are "direct" and "indirect" forms of prostitution. Types of "direct" prostitution are street, bar, brothel, escort, private, window or doorway, and transport, to mention a few (Harcourt & Donovan, 2004). Street prostitutes do not have a fixed place to solicit (Joardar, 1964). Street prostitution is widespread in the United States, Europe, United Kingdom, Australia, Eastern Europe, Southeast Asia, Latin America, and in some parts of Africa (Harcourt & Donovan, 2004). In street prostitution, women solicit to customers who are passing on foot or in automobiles (Joardar, 1984). Services are performed in customers' cars, trucks, in nearby hotels, alleys, doorways, and so on. These women typically charge less compared to other types of prostitutes. This form of prostitution is considered undesirable and dangerous due to the violence involved in it (Harcourt & Donovan, 2004). On average, these prostitutes have the least bargaining 8 leverage over condom use and choice of sexual practices, and they have the highest risk of harm from customers or others (Law Library, 2009). Due to their visibility, these women face higher risks of arrest and are also associated with drugs, diminished neighborhood property values, and other criminal activities (Law Library, 2009). In the bar, club, karaoke bar, and hotel type of prostitution, prostitutes visit places where client are easily available, and solicit to customers of those bars, clubs, and hotels (Harcourt & Donovan, 2004). Services may be provided in the club or bar itself, or in a hotel room rented by either the prostitute or the customer. The prostitute's income varies according to the prestige and price range of the bar, hotel, or establishment and its client's wealth. These women receive a share of the money they charge customers, and their share can vary based on the percentage of fees demanded by the manager of the club or employee(s) for referrals or protection. The prostitute's risk of harm and arrest are low to moderate as long as the collaborative relationship with the establishment is maintained and the prostitute does not venture into unfamiliar territory (Law Library, 2009). Another type of direct prostitution is brothel prostitution, which is the most common types of prostitution in Nevada, Australia, New Zealand, Southeast Asia, Europe, Latin America, and India. According to the Indian Immoral Traffic Prevention Act of 1956, a "brothel" "includes any house, room, conveyance or place, or any portion of any house, room, conveyance or place, which is used for purposes of sexual exploitation or abuse for the gain of another person or for the mutual gain of two or more prostitutes" (p. 1). In India, this kind of prostitution is illegal, whereas in the U.S., this is the only legal form of prostitution and hence less risky for police violence. Conversely, in India, this form of prostitution is more coercive and violent because brothel keepers have 9 total control of the women and their money. These women face a great deal of violence from the brothel keeper, pimps, and customers, and are thus very vulnerable and do not have any say on the price, kind of service, or condom use. Escort prostitution is another kind of "direct" prostitution. In this type, prostitutes receive a phone call, text, or email by an agent. This is different from other forms of direct prostitution like street walking and is not bound to a particular location (Law Library, 2009). Escorts "rely upon referral and screening either by an agent, by a restricted circle of other prostitutes in the same market, or by familiar clients" (Law Library, 2009). The prices in this type of prostitution are high and they can influence sexual acts and condom use. Since the clients are often affluent and intermediaries are used, there is a lower risk of arrest and violence (Law Library, 2009). The second type of prostitution is "indirect." This kind of "prostitution is not always the sole of primary source of income for individuals" (Harcourt & Donovan, 2004, p. 203). Some "indirect" forms of prostitution are "bondage and discipline, [sexual fantasy through role play] lap dancing, massage…[which] involve little or no genital contact and therefore have little sexual health risk" (Harcourt & Donovan, 2004, p. 203). Effects of Prostitution Prostitution is associated with an increased risk of rape, assault, and sexually transmitted diseases, just to mention a few issues. In a study of 294 female street-based prostitutes in Miami, Florida, 76% reported experiencing violence in the previous 90 days (Kutz, Surratt, Inciardi, & Kiley, 2004). In addition to these problems, women in prostitution are often single mothers who have borne children from different sexual partners (Dalla, 2006). The average number of children per mother is 2.4 (Dalla, 2000; 10 Weiner, 1996). Additionally, because prostitution is illegal in the U.S., these women are at greater risk of facing interruption or termination of parental rights, denial of social services, and expulsion from family support services (Weiner, 1996). Drug use and legal issues also lead many women to abandon their children. Studies by Dalla (2000, 2001, 2004, and 2006) found that of 105 children who had mothers in prostitution, fewer than 20 remained in the care of their mothers. In a separate study, Weiner (1996) found that only 19% of 1,963 prostitute participants retained custody of their children. Thus, it is important to understand the struggle of these women and children caused by this type of abandonment. The current detention and foster care programs do not address the needs of this population; hence, there is a need to know what kind of services will help this group. Women who are trafficked into prostitution in India face similar challenges upon arrival at the brothel. Apart from the stress of being trafficked (Saarthak, 2002), these women often face the daunting task of having to raise their children within the context of an unfamiliar environment (Pardeshi & Bhattacharya, 2006). The child of a prostitute faces extraordinary danger; female children face difficult prospects and are expected to enter the trade like their mothers, while males are expected to help in the trade. Moreover, the brothel keeper has vested interests in maintaining this oppressive structure, because it results in the perseverance of the flesh trade and the continuation of future sources of income. Though there are no empirical studies about the oppressive structure created by brothel keepers/madams, this gap in the literature can be filled by future research. One common result of the brothel keeper's oppressive structure is that the children of prostitutes often struggle to meet their basic needs. Frequently, these children 11 do not have adequate food, safe shelter, education, and clothing. Furthermore, brothel keepers take advantage of this deprivation, commonly using children to pressure their mothers into providing sexual acts to customers without condoms or to work extra hours so that the brothel keeper can make more money. This typical pattern is used in red light areas of Kamathipura and Falkland Road, two neighboring red light areas in Mumbai, India. The red light district itself also presents prostitutes and their children with a series of challenges. These areas, which are full of criminal activities such as drug trafficking and use, gambling, and gang violence, create a dangerous environment for women and children. As a result, these districts are not safe for a child's growth and development. There is continuous fear among mothers that their children either will become the victims of sexual exploitation or be forced into the trade. Sanitary conditions are also a concern in these areas, and poor environmental health standards have been known to increase health hazards for children, which in turn can put children's development at risk. Not surprisingly, these districts are not hygienic places to live, and women and children who reside in these areas are at risk for any number of infectious diseases, including malaria, typhoid, hepatitis, and other environmentally related maladies. Past studies have shown that environmental hazards have adverse effects on children's development (Carpenter et al., 2000; Suk, 2002; Wegman, 1999). Hence, it is important to look at what challenges these children face and what support is necessary for them to overcome these situations. In addition to environmental hazards, these women and children are at risk of infection from various sexually transmitted diseases, such as HIV/AIDS, gonorrhea, and 12 syphilis. Prostitutes in India are at an especially high risk of contracting HIV/AIDS. Seventy percent of prostitutes in Kamathipura are estimated to be HIV positive (Avert, 2006), and the incidence of any sexually transmitted infection is an estimated 90% (Legislative Assembly Bill VII, as cited in Gangoli, 2006). These infections put a prostitute's ability to care for her children in serious jeopardy. The lack of family structure in the red light district puts complete responsibility on the prostitute to provide for her children. In the red light area, there is an absence of a traditional family structure. Most children do not know their biological fathers, so they call the dominant male in their mother's life father. This male usually is the mother's lover, favorite customer, pimp, or trafficker. The male does not take any responsibility for the child or the mother. This person often abuses the prostitute physically, emotionally, and sexually (McElroy, 1998) and even takes her earnings (Karandikar & Prospero, 2008). In such a situation, the only family a prostitute may have is her children, who are also completely dependent on her. The problems faced by prostitutes are similar to those faced by other single working mothers. In a study by Rani (2006), single parents who struggle for economic stability usually have to spend more time at work, which leaves their children unattended most of the time. In a similar way, prostitutes often must work from sunset to sunrise, leaving their children unattended during the night, which makes their children more vulnerable to the dangerous environment of the red light area. During the night when their mothers are at work, children either wander in the community or sleep where their mothers are having sex with a client. In addition to the psychological problems this can create, many children also must battle malnutrition resulting from poor diet because most 13 of the time, they do not have enough to eat or their mothers do not have the time or the money to provide them with food. Many prostitutes have to give 50% of their earnings to the brothel keepers and pimps can take up to 30% as well (Patkar, 2006). Thus, a prostitute may be allowed to keep about 20% of her earnings. With this 20%, she has to take care of her child, buy food and medication, and pay rent. The money is not sufficient for all these needs. In these circumstances, women often must work extra hours to make more money in order to provide for the needs of their children. These needs of prostitutes and their children have not been addressed by legislation either in India or the U.S. In the following sections, I will look at the history of prostitution reform in the U.S., and the history of prostitution in India to set a broader context for understanding the needs of these women and their children. Review of Policy Responses History of Prostitution Laws in the U.S. In the U.S., the aid that service providers and lawmakers have made available to women in prostitution has changed based on institutional ideas concerning how to best help these women. Rarely have the opinions of prostitutes been consulted. Legislators, social reformers, and public opinion have generally labeled prostitution as a social evil, leading to the creation of vice-crusades to stamp out brothels, red light districts, and the trafficking of women. Policy makers saw prostitutes as a cause of venereal infection who corrupted young men and threatened the family. The sale of liquor, gambling, drugs, and dance halls and disorderly premises also were often associated with prostitution (Esselstyn, 1964). In the following section, I will examine how the policies and services changed over the course of time based on changes in opinion/attitude regarding U.S. 14 prostitutes. During the mid-1800s, many social reformers viewed prostitutes as victims and set themselves to the task of controlling male sexual aggression and protecting women who lost their "virtue" (Boyer, 1978; Boyer & James, 1983; Rothman, 1978). Early research shows that women during this period were often seen as victims of exploitation. In response, the U.S. Congress passed the Mann Act of 1910, which made it a felony to transport women across state lines for prostitution and debauchery (Sloan & Wahab, 2000). Nevertheless, institutional protection was often a double-edged sword, and many women during this period were also forced to endure compulsory physical exams. Prostitutes were held responsible for transmission of disease and the government made medical examination mandatory for any woman working as a prostitute. Many feminist and other purity reformers argued against this law and viewed it as a form of sexual assault (Hobson, 1987). During the early 1920s, prostitutes were seen as "fallen women" who, due to personality problems, joined sex work. Service providers believed that these personality issues could only be resolved through casework and therapy (Boyer, 1978). Service providers also adopted a colonial approach to solve the problems of prostitution. In the 1950s, the discourse on prostitution was shaped largely by psychiatrists, who thought that the cause of prostitution could be traced back to the "neurotic," "frigid," and/or "masochistic," tendencies of individual women (Hobson, 1987). These assumptions considered personality problems to be the source of the behaviors; therefore, researchers ignored the real reasons women were entering prostitution. The children of prostitutes and their needs were also ignored. 15 It was in the late 1970s that prostitution was finally viewed through the lens of the economic situation. Researchers began to postulate that women's economic conditions might be motivating them to engage in sex work (Bullough & Bullough, 1987). However, there were no services designed at the time on the basis of this view. In fact, some policies, in which prostitutes were considered criminals, seemed to demonstrate a retreat to earlier, less progressive attitudes (Wynter, 1987). These policies viewed prostitutes as criminals and not as victims of various circumstances such as serious deprivation, physical and sexual abuse, crime, violence, substance abuse, and emotional problems (Silbert & Pines, 1982). In recent years, the detention programs that have been developed to prevent prostitution have not been so different from those prevalent during the 1900s, when women's personalities were considered the cause of prostitution. All of these programs have been developed and deployed based on the view of policy makers rather than the actual needs of the prostitutes. History of Prostitution in India The history of prostitution in India dates back to the Indus Valley civilization, which existed around 3000 B.C. Due to the mysterious extinction of this civilization, there are no available written documents to prove the existence of prostitution during this period, but excavations have unearthed a statue of a bronze dancing girl from this era. This statue featured a naked woman wearing heavy jewelry on her neck and one arm, standing in a provocative posture, with one arm on her hip and one leg half bent. Referring to this bronze figurine, Bashan said "…this dancing girl is a representative of temple dancers and prostitutes, such as existed in contemporary Middle Eastern Civilization and were an important feature in later Hindu culture, but cannot be proved" 16 (Singh, 1997, p. 11). The Vedic Age followed this undocumented era of prostitution. The Vedas, authors of one of the holy books of Hindu, referred to prostitution as one of their cultures' organized and established institutions. Even in Indian mythology, there are many references to high-class prostitution in the form of Apsaras, which are demigods, acting as prostitutes; some of their names are Menaka, Rambha, Urvashi, and Thilothamma (Jaishankar & Haldar, 2008). These Apsaras were revered for their perfect form, and possessed unsurpassed beauty and feminine charms. According to legend, prostitutes were highly trained in music and dance, and entertained divinities and their guests in the court of Lord Indira, one of the Hindu Gods (Joardar, 1984). The rulers of the Aryan dynasty of India, which followed the Indus Valley and Vedic Civilization, sought to emulate the system of the Vedic celestial court and developed a system of guest prostitution (Joardar, 1984). As its name suggests, this type of prostitution involves providing guests of the royal court with prostitutes. As such, prostitutes became common during the reign of the two ancient rulers, Pandavas and Kauravas. Prostitutes were an important part of the royal court and having concubines was common even among aristocrats. Even the famous ruler and founder of the Mayuran Dynasty (322-185 B.C.), Chandra Gupta Mayura, appointed a superintendent for prostitutes called Ganikasdyasha. In order to regulate the practice, Kautilya, the prime minister of the Mauryan dynasty, created a code of conduct for prostitutes in his Arthasasthra (Singh, 1997). This period effectively normalized prostitution as a part of Indian court life. Other than the Arthasasthra, there are many ancient literatures that discuss prostitution. The famous book Kama Sutra, written by Vatsyayan, a noted Indian sage of 17 the Third Century B.C., devotes a number of passages to prostitutes and their way of life. In the Rig Veda, secular prostitution is commonly discussed (Singh, 1997). Another ancient scholar, Dandin, gives readers an account of prostitutes in his two classic works Dasa Kumara Charita (Adventure of Ten Princes) and Mrichchha Katika (Clay Cart) (Singh, 1997). Even Kalidas, a famous poet of the ancient era, discussed prostitutes in his Meghadhoot (Jordan, 1987). These are some of the ancient scholarly works that provide us with details about the history of prostitution in India. During these eras, religious practices frequently promoted prostitution as well. In the famous Mahakala temple of Ujjain, holy prostitutes were also commonly seen. The girls of the temple were offered for service of God and their religion. In South India, they were known as Devadasi and in North India as Mukhies (Singh, 1997). These girls performed dances during prayer services of the temple. Over time, spiritual leaders misused the system for immoral purposes. Under the disguise of religious dedication of girls to temples, clandestine prostitution developed. This tradition continued even during the Mughal dynasty (1526-1857 A.D.), except during 1658-1707 A.D when Aurangzeb ruled (Singh, 1997). Rather than resembling these historical occurrences of prostitution, the current state of affairs for prostitutes in India more closely reflects recent political and social development. After the downfall of the Mughal Empire in the 18th century, concubines, as well as dancing and singing girls, came out of the royal palaces. These women lacked literacy and professional training, which left them with no choice but public prostitution (Jordan, 1984). During British rule, the place of women in India further worsened. Conditions continued to deteriorate, and in the absence of state control and regulation, 18 prostitution thrived on a large commercial scale. Social stigma and economic hardships of women made them an easy victim to traffickers (Jordan, 1984). These situations have not changed much in the current Indian scenario. In the following section, we will look at the current legislation for prostitutes in independent India. Prostitution Laws in Independent India The problems faced by prostitutes and their children in India are not addressed by present policies. The main prostitution law in India is the Immoral Traffic Prevention Act (PITA) of 1984, which replaced the Suppression Immoral Traffic Act (SITA) of 1956. PITA does not address the previously mentioned problems; rather, it treats prostitutes as criminals. The current prostitution laws in India that legislate prostitutes are ambiguous. They create a system where prostitution is allowed to thrive, but which also attempts to hide it from the public. According to SITA, prostitution "is the act of a female offering her body for promiscuous sexual intercourse for hire, whether in money or in kind and whether offered immediately or otherwise and the expression prostitute will be construed accordingly" (SITA, 1957, p. 1). This law dictated that prostitution is neither legal nor illegal; rather it is tolerated since prostitutes can practice their trade privately but cannot legally solicit customers in public. In particular, the law prohibited prostitutes from carrying on their profession within 200 yards of a public place. Unlike other professions, however, prostitution does not fall under normal labor laws, and thus prostitutes were not entitled to minimum wage benefits, compensation for injuries, or other benefits that were common in other types of work. They possess the right to be rescued and rehabilitated if they desire, as well as all the rights of other citizens. However, prostitutes can rarely 19 invoke these rights, since they cannot easily escape from the brothels, due to the control of the brothel keepers and pimps. In 1986, SITA was replaced by the Immoral Traffic (Prevention) Act, or PITA. Under this new act, prostitution was defined as "the sexual exploitation or abuse of persons for commercial purposes" (PITA, 1986, p. 1). This law considered trafficking a moral issue and took a preventive approach towards trafficking. Another section of the Act sought to punish anyone (with a sentence of not less than 7 years) found guilty of detaining a person on premises where prostitution is carried out. PITA also considers prostitution-related activities such as pimping and keeping the profits made from prostitutes as criminal. The Act draws a distinction between prostitution and the exploitation of prostitution; only the exploitation of prostitutes is considered wrong. The Act prohibits keeping a brothel or allowing premises to be used as a brothel. In order to clarify this point, the Act defines a brothel as including "any house, room, conveyance or place, or any portion of any house, room, conveyance or place, which is used for purposes of sexual exploitation or abuse for the gain of another person or for the mutual gain of two or more prostitutes" (PTIA, 1986, p. 1). Furthermore, detaining a person in a brothel for prostitution, with or without consent, is also a crime. Finally, living off the earnings of prostitution is a crime. For example, a husband living with his wife and allowing his wife to be a prostitute is also guilty of a crime. Even though these laws have been long established, women are still forced by brothel keepers and pimps into prostitution. The presence of Kamathipura, Asia's largest red light district, is proof that PITA is ineffective in reducing the exploitation of women. PITA also considers prostitution within 200 meters of any public place such as hospitals, nursing homes, 20 schools, colleges, offices, and religious institutions as a ‘‘nuisance'' that may be punishable with imprisonment for up to 3 months. This 3-month imprisonment is increased to 6 months in cases where solicitation is accompanied by words, gestures, or willful exposure by the prostitute, even if she is in her own house but can be seen from outside (PITA, 1986). The detainment of the prostitute can complicate matters, especially if she has a child. Due to detention, the children of prostitutes could be left alone in the brothel. This parental gap in the life of these children makes them more prone to exploitation and trafficking. Thus, we see that the PITA magnifies the problems of prostitutes and their children, and there is a need to work with these women to create laws that would support them in their lives. PITA does not distinguish between prostitution and trafficking; instead, trafficking under the Act is addressed merely as prostitution-related activity. According to Article 5 of the Act, trafficking is defined as "procuring, including or taking a person for the purpose of prostitution" (PITA, 1986, p. 2). However, the Act never clearly defines human trafficking and limits the crime of procurement to prostitution. PITA focuses on criminalization and punishment, but it does nothing to prevent prostitution or human trafficking. Nowhere in the Act is there any mention of addressing the root cause of the trafficking infrastructure or the appropriate preventive measures that must be taken to warn young women about the dangers of prostitution or the dangers of trafficking. PITA does discuss rehabilitation, e.g., protective homes for prostitutes who are minors, but these homes do not facilitate the empowerment of these women. The Act also does not recognize trafficked persons/prostitutes as victims, and the Act further stipulates that these women are entitled to trial only if the government determines it is necessary. 21 Hence, structural barriers in the legal system prevent women from bringing traffickers to justice. For example, in the few cases that do come to trial, prostitutes are often the sole witnesses against the trafficker or pimps. The lack of witness protection, however, places these women at risk if they testify. As a result of a lack of witness protection, few women come forward to fight for justice, leaving the trafficker free to exploit more innocent women and children. Finally, even in cases where a conviction is secured, PITA does not provide for the forfeiture of the assets of the trafficker, which may be used to compensate the victims of trafficking. If a provision such as this were to be added to the current Act, the assets could also be used to initiate programs of assistance and protection, as well as provide incentives to police officers who investigated cases of trafficking. In other words, proactive steps like this one could help to defray the cost of enforcing the law. Most importantly, the recognition that the trafficked person is a victim of a crime requires noncriminalization of the victim of trafficking. This victim-centered approach is currently absent in the Act. As it now stands, PITA punishes the woman in prostitution, not the client, except in cases where he is discovered engaged in a sexual act with a prostitute in a public place. To break the chain of prostitution and prostitution-related activities, it is necessary to create laws and support based on the needs of prostitutes and their children. Research will be conducted to understand the needs and experiences of these women and their children, so that support programs and laws can be tailored to empower them and eliminate their social exclusion. In this study, two theoretical frameworks will be used to get an in-depth understanding of the problems of prostitutes and their children. In the 22 following section, I will discuss both these theories and employ them in order to examine these issues. Theoretical Framework Various theoretical lenses have been used to evaluate prostitution, including feminist and Marxist feminist views, domination theory, black feminist theory, differential association theory, labeling theory, strain theory, Goffman's impression management theory, and conflict theory. While these theories offer various contextual approaches, I will use Human Ecological System Theory to understand the lives of prostitutes and the needs of their children. Additionally, employing the lens of Social Exclusion Theory, I will examine how prostitutes and their children have been systematically excluded from mainstream society. Human Ecological System Theory Human ecological system theory, as proposed by Urie Bronfenbenner (1989), is concerned with the interaction and interdependence of humans. In this theory, human development is a reciprocal and life-long process of interaction between persons and their environment, which manifests in a set of nested structures. The names of each of these structures or contextual systems arise based on its distance from the individual (Hope, 2007). Bronfenbrenner's original theory proposed four systems or levels, and later a fifth one, the chronosystem, was added (Bubolz & Sontag, 1993). Each system contains roles, norms, and rules that can shape human development as well as help to explain the specific behavior or experience of an individual, in this case a prostitute (Hope, 2007). The microsystem is the individual's immediate environment (e.g., family, school, 23 peers). The mesosystem is comprised of connections between immediate environments (e.g., a child's school and peer group). The exosystem is the external environment setting, which only indirectly affects the development of children (e.g., parent's workplace). The macro- system is the larger cultural context, including the national economy and laws, as well as political, cultural, and subcultural systems. Finally, the chronosystem, which is time-related, reflects dynamic environment transitions. By identifying these various systems, I will be able to better examine and understand the experiences and needs of the prostitutes and their children. Both micro and meso systems will be used to explore the immediate lives of women in prostitution. These models will also be used to examine the lives of their children in the context of socialization agents, e.g., school, peers, and family. Finally, they will allow us to investigate important questions: How do these children socialize? What are their experiences? What are their challenges? The exosystem will help us to look at the work experience of these women and its effects on their own day-to-day lives and the lives of their children. The macro system also will be useful for researching how the various legal ramifications impact the experiences of these women. The chronosystem will also permit us to survey circumstances that may have affected a sex worker's decision to enter prostitution in the past, as well as her current life situation and future prospects. Through this process, we will achieve a more holistic view of prostitution, as opposed to the more narrow investigations that have been performed in the past, and that have led to disapproval and censure. 24 Social Exclusion Theory Parkin derived social exclusion theory from Weber's discussion on social closure theory (Alexander, 2005). According to Combat Poverty (1986), Social exclusion is the process whereby certain groups are pushed to the margins of society and prevented from participating fully by virtue of their poverty, low education or inadequate life skills. This distances them from job, income and education opportunities as well as social and community networks. They have little access to power and decision-making bodies and little chance of influencing decisions or policies that affect them, and little chance of bettering their standard of living. Social exclusion theory examines the systematic method of discrimination used to isolate people from mainstream society due to their ethnicity, race, religion, sexual orientation, caste, ancestry, gender, age, disability, HIV status, and migrant status or place of habitation (Silver & Miller, 2003). Social exclusion can lead to exclusion from educational opportunities, leading to unequal education (Barry, 2002). In addition, social exclusion can limit access to political participation, which can propel people into a cycle of poverty (Barry, 2002). According to the British Medical Journal (BMJ), social exclusion may contribute to children's poor educational performance and achievements, unmanageable behavior, drug misuse, unemployment, teenage pregnancy, homelessness, crime, and suicide (BMJ, 2001). Importantly, social exclusion can be experienced at different levels because it can affect individuals, groups, or geographic areas (Jermyn, 2001). According to the Department of International Development (DFID) in their social exclusion policy document, Discrimination can occur within public institutions, such as the legal system, or in organizations that manage education and health services, as well as in households and the community. These types of institutionalized exclusion can in turn lead to denial of income, assets and services. (DFID, 2005, p.1) Research by Campbell et al. (2006) found that social exclusion causes changes in 25 a person's brain function and can lead to poor decision-making and a diminished learning ability. The research linked social exclusion to an individual's failure to exert self-control. For instance, people who are rejected in social situations often respond by abusing alcohol, expressing aggression inappropriately, or performing poorly at school or work (Campbell et al., 2006) This theory, then, can help us understand in a profound manner the effect that exclusion resulting from prostitution can have on the life and wellbeing of a prostitute and her children. This understanding will help us develop and determine appropriate interventions. Research Design Rationale The rationale of the study is twofold. First, the literature reveals the lack of a needs assessment about these issues and there have not been studies conducted to understand the needs of the children of prostitutes. Additionally, there is a lack of research on stakeholder views about the needs of prostitutes and their children and the challenges that stakeholders face in providing services to this group. Due to my work with prostitutes in India, I am interested in this research because I had glimpses of their problems. Hence, I want to understand the experiences and needs of this population in the U.S. and India, where the services for prostitutes are limited. Last, comparing the state of affairs among Indian prostitutes with those of U.S. prostitutes may help to reveal similarities and differences that deepen our understanding of their problems. I want to understand the experiences and needs of these populations, which have been neglected by the lack of laws based on the needs of prostitutes and their children in India and the U.S. 26 Research Questions From the literature, I have developed three research questions that I will address in my research. These questions are: 1) What comparisons can be made between the needs of prostitutes and their children in the U.S. and India? What are the models of service needed to support prostitutes as mothers and their children? 2) What are the experiences, educational challenges, and needs of children of prostitutes? What types of services do they need to overcome these challenges? 3) What challenges do stakeholders face in providing services to this population? What do these stakeholders think are the challenges faced by their clients and what support do they think their clients need? Research Study Setting The study was conducted in two parts: one in the U.S. and the second in India. The U.S. data were collected with the help of the nonprofit organization "Empowerment Program, Service for Women" in Denver, Colorado. The Empowerment Program works with women who are infected with or affected by HIV/AIDS and women who are involved with the criminal justice system (Empowerment Program, 2009). For the U.S. study, I contacted the executive director of the Harm Reduction Program, who referred me to the director of the Empowerment Program. I contacted the executive director of the Empowerment Program, informed her about the study and gave her a referral sheet. She then gave these to the program's clients. All the participants who choose to volunteer in 27 the study informed the organization. After I received the participant list, I visited the organization in Denver in order to meet with participants. An appointment was fixed according to their convenience. I conducted face-to-face interviews with the volunteer participants and each interview was audiotaped with the participant's consent. The second phase of the study was conducted in Mumbai where I visited brothels, schools, and NGOs, and informed women, children, and stakeholders about the study. I briefed them about the scope and goal of the study and left a referral sheet with prostitutes, their children, and stakeholders. Participants who volunteered for the study informed me about their decision whether to participate during my next visit. I acquired the mother's consent prior to interviewing children and also took child assent before conducting the interviews. Participant's consent was obtained prior to the interviews, which were conducted based on the participant's convenience. Interviews were also conducted at the participants' choice of location. All interviews were audiotaped with participants' consent. Participation Selection Criteria After acquiring approval from the University of Utah's Institutional Review Board (IRB), qualitative interviews were conducted. For this study, purposive and snowball sampling techniques were used to recruit potential study participants. In purposive sampling, participants are selected based on some specific characteristic (Patton, 1990). The study sample is comprised of female prostitutes who solicit in Denver, Colorado and Mumbai, India. This study included 17 women, six from the United States and 11 from India. The prostitutes from Denver were in contact with the nonprofit "Empowerment Program, Service for Women," and the participants in Mumbai 28 solicited in Kamathipura and Falkland Road. The participants were at least 18 years old and had been involved in prostitution for at least 6 months. They all had children. These women were asked to answer questions about the experiences, needs, and challenges in their profession, and the needs and challenges of their children. In the Indian study, 20 children of prostitutes and 8 stakeholders were also interviewed. The children of prostitutes were invited to participate in the Indian part of the study. These 20 children were from 7 to 17 years old and were asked to answer questions regarding their life experiences and needs as children of prostitutes. The 8 stakeholders in Mumbai were comprised of a nonprofit origination's assistant director, social workers, afterschool teachers, and school teachers who work with prostitutes and their children. These stakeholders were asked to answer question concerning the needs of these women and their children. They also answered questions regarding the challenges they face in providing support and the types of help they need to overcome these challenges. I conducted brothel visits in the red light district of Mumbai and informed the women, stakeholders, and children about the nature, purpose, and scope of the study and provided them with a referral sheet. The participants who volunteered for the study informed me on my next visit that they wanted to be involved in the study. I used a snowball sampling process to get more participants for the study. Each participant from the U.S. study was compensated with $20 U.S. and in India with 100 Rupees for participating in the research. Each child participant in India was given a Hindi/Marathi/English dictionary. In the India study, all interviews were primarily done in Hindi. Some participants 29 switched back and forth from Hindi to Bengali or Marathi and English. The participants in India and the U.S. were informed about the study and consent was taken. The participants were informed that the study was voluntary and that they could withdraw from the study at anytime. All personal information such as their name and contact information were kept confidential. In the U.S. study, 1 out of 6 participants and all the participants in the Indian study used pseudonyms. Methods of the Study According to Denzin and Lincoln (1994), paradigms assist me to decide on the methodologies. A good study's methodology is based on a paradigm, and guided by a theoretical framework. For this study, I used the constructive paradigm. According to Guba and Lincoln (1994), constructive ontology is local and specific in nature. There is not just one reality; there are multiple realities based on individual and social experiences. The epistemology of the constructive paradigm is transactional and subjective (Guba and Lincoln, 1994). In this paradigm, I am not finding "truth" but instead creating reality with the research participants. The methodology of this paradigm is a continuous process of interpreting reality through dialogue. Understanding of reality takes place through interactions between participants and me where each interaction builds on previous interactions to reach a consensus about reality. By using the constructive paradigm, I viewed the prostitutes, children, and the stakeholders as experts about their lives. Their stories helped me to understand their reality, which was created through interactions and dialogues. 30 Data Collection I conducted face-to-face interviews with volunteer participants. Each interview was audiotaped with the participant's consent. I could not take field notes because it distracted the participants and it was difficult to successfully manage two separate tasks (interviewing and writing/recording) at the same time. I also maintained a reflective journal where I wrote my personal biases and thoughts about the interviews; this activity allowed me to identify my personal/ emotional responses to the material and subjects and helped me to avoid mixing my feelings with the analysis. The main topics that were addressed in the interview guide were background, work experiences, children, support and needs, challenges in providing support and how to overcome these challenges, experiences, and the needs of the children of prostitutes. Data Analysis In qualitative studies, data collection and data analysis typically go hand-in-hand to build a coherent interpretation of the data (Marshall & Rossman, 1999). I was guided by initial concepts and developed an understanding of these concepts but shifted and modified as I collected and analyzed data (Schatzman & Strauss, 1973). I followed Marshall and Rossman's six phases of data analysis: (a) organizing the data; (b) generating categories, themes, and patterns; (c) coding the data; (d) testing the emergent understandings; (e) searching for alternative explanations; and (f) writing the report (Marshall & Rossman, 1999). Each of these process elements are discussed below. 31 Organizing the Data After the interviews were conducted, they were transcribed and translated by professionals, peers, and by myself. All transcribed interviews were read and reread to become familiar with them. While reading the transcripts, I made necessary editorial changes to make the field notes retrievable, and generally "cleaned up" the data, as suggested by Pearsol (1985). Generating Categories I identified the salient themes, recurring ideas or languages, and patterns of belief that linked the people and the settings together (Marshall & Rossman, 1999.) In the initial phase, I performed line-by-line coding of the data. After going through each transcript, I interpreted and analyzed the emerging themes in the study. By questioning the data and reflecting on my conceptual framework, I created various categories. Each category was then read and reread to identify differences between them and to develop themes. Each theme was studied intensively to see if these multiple themes could be merged or separated. After these themes emerged, they were coded. Coding After reading the transcripts and forming categories and themes, each theme was coded in a different color. Additionally, I used memo writing to more fully illustrate the significances of each category. In order to do this, I wrote down my thoughts on the side of each color-coded themes as memo writing prescribes. This process helped me to analyze my ideas about the codes. 32 Testing Emergent Understanding and Searching for Alternative Explanations I evaluated the data to understand their usefulness and determine whether they helped to answer the research questions. After finding categories and themes, I critically analyzed the data for alternative explanations. I identified all possible alternate explanations and then determined whether my interpretations of events and situations were the most plausible (Marshall & Rossman, 1999). This exploration helped to establish other views and deepened my knowledge and understanding of the data from various angles. Writing the Report Since I used the Multiple Article Path (MAP) for the production of the study report, three manuscripts were written for this dissertation. I tried to capture the vividness and details of the data and present them in an analytical format. I wrote manuscripts on each of the groups interviewed for the study: prostitutes, children of prostitutes, and stakeholders who provide services to this population. The three articles will be submitted to scholarly journals. These manuscripts will also be given to the organizations that helped me to collect data. Manuscripts Comparative study of mothering among prostitutes in the U.S. and India Research Questions What comparisons can be made between the needs of prostitutes and their children in the U.S. and India? What are the models of service needed to support prostitutes as mothers and their children? 33 Methods This research was conducted in two phases: the first in Denver, U.S. and the second in Mumbai, India. This study included 17 women, 6 from the United States and 11 from India. Participants for the U.S. phase were contacted through an intervention program in Denver. The second phase of the research was conducted in India's red light district of Kamathipura and Falkland Road. Purposive sampling along with snowball sampling techniques were used to invite participants into this study. I conducted brothel visits to inform prostitutes about this study. Data Analysis In-depth personal interviews were conducted with all 17 participants. All interviews in the U.S. were conducted in English, but the interviews in India were conducted by me in Hindi and Bengali based on the participant's choice of language. All interviews from the Indian study were translated and then transcribed. Interviews from the U.S. study were transcribed as well. In both cases, interview responses were transcribed in the form of narratives in keeping with the nature of the participants' answers. Data derived from the study were analyzed using the six phases of Marshall and Rossman's (1999) method. Each transcript was thoroughly read, extracts were categorized into themes, and each emerging theme in the study was interpreted. The themes were closely studied to examine if they were related to the research questions. Journal This manuscript will be submitted to the Journal of Sex Research (JSR). This journal centers around various scientific studies on sexuality. This journal also has a 34 history of accepting manuscripts related to studies of prostitutes. In addition, this journal accepts a vast array of scholarly material concerning prostitution research, including international studies. This focus makes it an excellent match for the first manuscript, as it is a comparative study of prostitutes in the U.S. and India. Understanding the Voices of Children of Prostitutes from Mumbai, India Research Questions What are the experiences, educational challenges, and needs of children of prostitutes? What types of services do they need to overcome these challenges? Methods This study included 20 children of prostitutes from the red light area of Mumbai. The participants were enrolled in the study during home/brothel visits that I conducted in the red light district of Mumbai. I used the snowball sampling process to obtain saturation point for the study. Data Analysis In-depth personal interviews were conducted with all 20 participants. All interviews were conducted in Hindi or Bengali based on the participant's choice of language. All interviews were translated and then transcribed in the form of narratives, in keeping with the nature of the participant's answers. The six phases of Marshall and Rossman's method of analysis were used to analyze the data (Marshall and Rossman, 1999). In the initial phase, I did line-by-line coding of the data. After going through the transcript, I determined the emerging themes in the study. After these themes emerged, I evaluated the data to understand the usefulness of the themes and determined whether 35 they helped to answer the research questions. Journal This manuscript will be submitted to Family Relations: Interdisciplinary Journal of Applied Family Studies. This journal focuses on child and parent relationships, family diversity, and cross-cultural/international issues, among many other family-related topics. The journal's focus on relationships between children and parents makes this article a good fit for this journal. Uncovering the Lives of Children of Prostitutes through Stakeholders Interviews in Mumbai, India Research Questions What challenges do stakeholders face in providing services to this population? What do these stakeholders think are the challenges faced by their clients and what support do they think their clients need? Methods The participants for this study consist of 8 stakeholders who provided education-related services to children of prostitutes. Purposive sampling along with the snowball sampling techniques were used to recruit study participants. I conducted visits to schools and nonprofit agencies in the red light area of Mumbai to enroll participants for the study. The interview questions were predetermined and were semistructured. All interviews were conducted either in Hindi, English, or Marathi depending upon the participant's choice of language. All interviews were translated and transcribed in form of narratives in 36 keeping with the nature of the participant's answers. Data Analysis The data were analyzed using the six phases of Marshall and Rossman (1999). I completed line-by-line coding during the initial phase of data analysis. The themes were read and reread to examine if they were related to the research question. Themes were interpreted through the lens of Human Ecological Systems Theory and Social Exclusion Theory. Journal This manuscript will be submitted to International Social Work. This journal focuses and publishes articles on international social work interventions. This manuscript will fit well in this journal since it discusses stakeholder perceptions of children of prostitutes in India. This manuscript conveys stakeholder challenges in catering to this population and what services this group requires. 37 References Alexander, M. L. (2005). Social inclusion, social exclusion and social closure: What can we learn from studying the social capital of social elites? Paper presented at International Conference on Engaging Communities, Brisbane, Queensland. Paper retrieved from http://www.engagingcommunities2005.org/abstracts/Alexander- Malcolm-final.pdf. AVERT (2005). HIV/AIDS in India. Retrieved October, 25, 2008 from http://www.avert.org/aidsindia.htm. BBC (2006). Prostitution "increase" in India by Upasana Bhat, New Delhi. Retrieved on 12th March 2008, from http://news.bbc.co.uk/2/hi/south_asia/5140526.stm. Benjamin, H., & Masters, R. E. L. (1964). Prostitution and morality. New York: Julian. Bess, B. E., & Janus, S. S. (1976). Prostitution. In B. J. Sadock, H. I. Kaplan, & A. M. Freeman (Eds.), The Sexual experience (pp. 564-610). Baltimore: Williams and Wilkens. BMJ (2001). Social exclusion: Old problem and new name. British Medical Journal, 323 (7306), 1-2. Retrieved September 19, 2008 from http://www.bmj.com/content/323/7306/0.1.full.pdf. 323 doi: http://dx.doi.org/10.1136/bmj.323.7306.0 Boyer, D. K., & James, J. (1983). Prostitute as victims. In D. E. MacNamara & Karmen (Eds.), Deviants: Victims or victimizers? (pp. 109-146). Beverly Hills, CA: Sage. Boyer, P. (1978). Urban masses and moral order in America, 1820-1920. Cambrigde, MA: Harvard University Press. Bryan, J. H. (1965). Apprenticeships in prostitution. Social Problems, 12, 287-297. Brown, M. E. (1979). Teenage prostitution. Adolescent, 14, (56) 665-680. Brofenbrenner, U. (1989). Ecological Systems Theory. In R.Vasta (Ed.) (1991). Six theories of child development: Revised formulations and current issues (pp.187- 249). London: UK, Philadelphia: US, J. Kingsley. Bubolz, M. M., & Sontag, M. S. (1993). Human ecology theory. In P. G. Boss, W. J. Dohety, R. LaRossa, W. R. Schumm & S. K. Stienmets (Eds.), Sourcebook of family theories and methods: A contextual approach (pp. 419-447). NY: New York, Springer. Bullough, V. L. (1965). Problems and methods for research in prostitution and the behavioral science. Journal of History of Behavioral Sciences, 1 (3) 244-251. 38 Bullough, V. L., & Bullough, B. L. (1978). Prostitution: An illustrated social history. New York: Crown. Bullough, V. L., & Bullough, B. L. (1987). Women and prostitute: A social history. Buffalo, NY: Promethus, Books Campbell, W. K., Twenge, J., Clementz, B., McDowell, J., Krusemark, E., & Brunnell, A. (2006). Social exclusion changes brain function and can lead to poor decision-making. Science Daily. Retrieved April 20, 2008, from http://www.sciencedaily.com/releases/2006/11/061108154256.htm Dalla, R. L. (2000). Exposing the "Pretty Woman" myth: A qualitative examination of the lives of female streetwalking prostitutes. Journal of Sex Research, 37, 344- 353. Dalla, R. L. (2001). Et tu Brute: A qualitative analysis of streetwalking prostitutes interpersonal support network. Journal of Family Issues, 22, 1066-1085. Dalla, R. L. (2004). When the bough breaks…examining intergenerational parent-child relational pattern among street level sex workers and their parent and children. Applied Developmental Science, 7, 216-228. Dalla, R. L. (2004). "I fell off the mothering track." Barriers to "effective mothering" among prostituted women. Family Relation, 53, 190-200. Dalla, R. L. (2006). "You can't hustle all your life." An exploratory investigation of the exit process among street-level prostituted women. American Psychological Association, 30, 276-290. Dalla, R. L., Xia, Y., & Kennedy, H. (2003). "You just give them what they want and pray that they do not kill you" ‘street-level sex workers' reports of victimization, personal resources, and coping strategies. Violence Against Women, 9(11), 1367- 1394. DFID (2005). Reducing poverty by tackling social exclusion. Published by the Department for International Development. Retrieved April, 21, 2008 from http://www.dfid.gov.uk/pubs/files/social-exclusion.pdf. El-Bassel, N., Witte, S. S., Wada, T., Gilbert, L., & Wallace, J. (2001). Correlation of partners violence among female street-based sex workers: Substance abuse, history of childhood abuse, and HIV risks. AIDS Patients Care and STDs 15(1), 41-51. Esselstyn, T. C. (1968). Prostitution in United States. The Annals of the American Academy of Political and Social Sciences. 376, 123-135. 39 Gangoli, G. (2000). Silence hurt and choice: Attitudes to prostitution in India and the west. London School of Economics. Retrieved from http://eprints.lse.ac.uk/25207/ Ghosh, S. K. (1996). The world of prostitution (Vol. 1 and 2). New Delhi: APH Publishing Corporation. Govinda, R. (2002). India Education Report: A Profile of Basic Education. New Delhi: Oxford University Press. Gu, J. H., Chen, H., Chen, X., Lau, J. T., Wong, R., Liu, C., et al. (2008). Severity of drug dependence, economic pressure and HIV-related risk behaviors among non-institutionalized female injecting drug users who are also sex workers in China. Drug and Alcohol Dependence, 97(3), 257-267. Harcourt, C., & Donovan, B. (2005). The many faces of sex work. Sex Transmitted Infection, 81 (3), 201-206. doi: 10.1136/sti.2004.012468 HAQ Center for Child Rights. (2001). Child trafficking in India. New Delhi: HAQ. Hirchi, T. (1972). The professional prostitue. In R. R. Bell & M. Gordon (Eds.), The social dimensions of human sexuality (pp. 249-267). Boston: Little Brown. Hobson, B. M. (1987). Uneasy virtue: The politics of prostitution and the American reform tradition. Chicago: University of Chicago Press. Hope, E. A. (2007). Exploring the family lives of people in prostitution: A contextual approach using a human ecological systems model. (Doctoral dissertation). (Accession Order No. AAT 3285654) Hubbard, P., Matthews, R., & Scoular, J. (2008). Regulating sex work in the EU: Prostitute women and the new spaces of exclusion. Gender, Place & Culture: A Journal of Feminist Geography, 15, 137-152. Immoral Traffic Prevention Act, 1986 (ITPA). Retrieved on 14th March 2008, from http://ncpcr.gov.in/Acts/Immoral_Traffic_Prevention_Act_(ITPA)_1956.pdf Jackman, N. R., O'Toole, R., & Geis, G. (1963). The self-image of the prostitute. Sociological Quarterly, 4, 150-161. James, J. (1976). Motivations for entrance into prostitution. In L. Crites (Ed.), The female offenders (pp. 177-205). Lexington, MA: Lexington. James, J. (1980). Entrance into juvenile prostitution. Washington D.C.: National Institute of Mental Health. 40 Jermyn, H. (2004). The art of inclusion (Vol. 35). London: Arts Council England. Karandikar, S., & Prospero, M. (2008). "My one-way ticket to Kamathipura." Rights of sex workers comprised. Research for Sex Workers, 10, 12-15. Kesler, K. (2002). Is a feminist stance in support of prostitution possible? An exploration of current trends. Sexuality, 5(2), 219-235. Kendall-Tackett, K. A., Williams, L. M., & Finkelhor, D. (1993). Impact of sexual abuse on children: A review and synthesis of recent empirical studies. Psychological Bulletin, 113(1), 164-180. Kurtz, S., Surratt, N., Inciardi, J., & Kiley, M. (2004). Sex work and "date" violence. Violence Against Women, 10(4), 357-385. Maerov, A. S. (1965). Prostitution: A survey and review of 20 cases. Psychiatric Quarterly, 39, 675-701. McClanahan, S., Mclelland, G., Abram, K., & Teplin, L. (1999). Pathways into prostitution among female jail detainees and their implications for mental health services. Psychiatric Service, 50, 1606-1613. Marshall. C., & Rossman, G. B. (1999). Designing qualitative research (3rd ed.), California: Sage Publication. Martin, L. (2005). Commercial sex workers: Victims or fighters of the HIV epidemic in Cambodia. Asia Pacific Viewpoint, 46(1), 21-34. Mendes, P. (2002). Excluding undesirables from the local community. Social Alternatives, 21(3), 48-54. Menen, R. (2007). Karma Sutra, Essays from the Margin: Canada Saga Books. Monto, M. A. (2004). Female prostitution, customers, and violence. Violence Against Women, 10(2), 160-188. Mrinal, N. R., & Rekha, Y. S. (1994). Problem of first generation learners. Indian Journal of Psychometry and Education, 25, 69-73. Mukherjee, K. K., & Das, D. (1996). Prostitution in the six metropolitan cities of India. New Delhi: Central Social Welfare Board. Nair, P. M. (2005). Trafficking of women and children in India. New Delhi: Orient Longman Publication. National Human Rights Commission Report, New Delhi. Retrieved on 6th October 2008, 41 from http://timesofindia.indiatimes.com/India/Gay_rights_should_be_respected_prostit ution_legalised_NHRC_chief/articleshow/3565933.cms Overall, C. (1992). What's wrong with prostitution? Evaluating sex work. Signs, 17, 705- 724. Patkar, P., & Patkar, P. (2006). Child trafficking - issues and concerns, Mumbai. Retrieved on 1st December 2007, from http://www.preranaatc.org Pardeshi, G., & Bhattacharya, S. (2006). Child rearing practices amongst brothel based commercial sex workers. Indian Journal of Medical Science, 60(7), 288-295. Pauw, I. B. (2003). "You are just whores -you can be rapid:" Barriers to safer sex practices among women street sex workers in cape town. Culture Health and Sexuality, 5(6) 456-481. Parkin, F. (1979). Marxism and class theory: A bourgeois critique. New York: Columbia University Press. Patton, M. Q. (1990). Qualitative research and evaluation methods (2nd ed.). Newbury Park, CA: Sage Publications. Pearsol, J. (1985). Controlling qualitative data: Understanding teachers' value perspectives on a sex equity education project. Paper presented at the Annual Meeting of the American Education Research Association, Chicago. Pheterson, G. (1990). The category" prostitute" on scientific inquiry. The Journal of Sex Research, 27(3) 397-407. Potter, K., Martin, J., & Romans, S. (1999). Early developmental experiences of female sex workers: A comparative study. Australian and New Zealand Journal of Psychiatry, 33, 935-940. Rani, N. I. (2006). Childcare by poor single mother study of mother- headed family in India. Journal of Comparative Family Studies, 37, 75-91. Raphael, J., & Shapiro, D. L. (2004). Violence indoor and outdoor prostitute venues. Violence Against Women, 10(2), 126-139. Raymond, J. G., D'Cunha, J., Dzuhayatin, S. R., Hynes, H. P., Rodriguez, Z. R., & Santos, A. (2002). A comparative study of women trafficked in the migration process. Patters, profiles and health consequences of sexual exploitation in five countries (Indonésia, Philipines, Thailand, Venezuela and United States). CATW. Raymond, Hughes, & Gomez ( 2001). Sex Trafficking of Women in United States 42 International and Domestic Trends. U.S. Department of Justice Report. Rankin, S. (2002). The sex industry exposed. American Feminist, 9(1), 10-37. Rothman, S. M. (1978). Women's proper place. A history of changing ideals and practice 1970 to the present. New York: Basic Books. Sander, T. (2004). Controllable laughter: Managing sex work through humor. Sociology, 38(2), 273-291. Sanghera, J. (2002). Trafficking of children and women in India: Thinking though, thinking beyond-A critical framework of analysis for strategic action. New Delhi: UNICEF. Saarthak. (2002). The Sound of Silence: A Manual for Forming Therapeutic Relationships. New Delhi: Saarthak and UNIFEM. Simons, R. L., & Whitbeck, L. B. (1991). Sexual abuse as a precursor to prostitution and victimization among adolescent and adults homeless women. Journal of Family Issues, 12(3), 361-379 Sripati, V., & Thiruvengadam, A. K. (2004). Constitutional amendment making the right to education a fundamental rights. International Journal of Constitutional Law, 2(1), 148-158. Stadum. (1992). Poor women and their families: Hard working charity cases, 1990-1930. New York: State University of New York Press. Schatzman, L., & Sehenkein, J. N. (1973). Field research: Strategies for a natural sociology. Engle-wood Cliffs, NJ: Prentice Hall. Silver, H., & Miller, S. M. (2003). Social exclusion: The European approach to social disadvantage. Indicators:New York, 2(3), 5-21. Silbert, M. H., & Pines, A. M. (1982). Entrance into prostitution. Youth and Society, 13, 471. Solan, L., & Wahab, S. (2000). Feminist voices on sex work: Implications for social work. Affilia, 15, 475. The Suppression of Immoral Traffic in women and Girls act of 1956. Typology -prostitution. Retrieved July 31st July 2009 from http:// Lahttp://law.jrank.org/pages/1879/Prostitut-Typology-prostitution. UNAIDS Country Progress Report (2010). Retrieved on March 24, 2012 from http://www.unaids.org/en/dataanalysis/monitoringcountryprogress/progressreports 43 /2010 countries/india_2010_country_progress_report_en.pdf Valandra. (2007). Reclaiming their lives and breaking free: An Afrocentric approach to recovery from prostitution. Affilia, 22, 195-208. Wahab, S., & Davis, R. (2004) An evaluation of the Salt Lake prostitution diversion program. Unpublished report. College of Social Work, University of Utah. Wechsberg, W. M., Luseno, W. K., & Lam, W. K. (2005). Violence against substance abusing South African sex workers: Intersection with culture and HIV risks. AIDS Care, 17(sup1), 55-64. Wojcicki, J. M., & Malala, J. (2001). Condom use, power and HIV/AIDS risks: Sex workers bargain for survival in Hillbow/Joubert Park. Berea, Johannesburg. Social Science & Medician, 53(1), 99-121. Weiner, A. (1996). Understanding the social needs of streetwalking prostitutes. Social Work, 41(1), 97-105. Wynter, S. (1987). WHISPER: Women hurt in systems of prostitution engaged in revolts. In F. Delacoste & P. Alexander (Eds.), Sex work: Writing by women in the sex industry, (pp. 266-270). Pittsburgh, PA: Cleis. CHAPTER 2 A COMPARATIVE STUDY OF MOTHERING AMONG PROSTITUTES IN THE U.S. AND INDIA Abstract There has been much research about understanding the risks, antecedents, causes, solutions, and prevalence of prostitution, but there is little scholarly work about the needs and risks that prostitutes face as mothers. I used Human Ecological Systems and Social Exclusion Theories to further understand the social issues prostitutes face as mothers in Denver, Colorado and Mumbai, India. Purposive and snowball sampling techniques were utilized to recruit prostitutes and ex-prostitutes. The study reveals that women in prostitution need tailor-made support systems to exit prostitution. The research findings strongly advocate for joint programs like counseling, shelter, or self-esteem programs for women and their children instead of separate programs where women are sent to detention and children are sent to foster care. The findings also suggest the need for 24- hour hot line services, outreach programs by ex-prostitutes, job-readiness training, housing, shelters, emphasis on early education for female children, counseling services, and prostitution anonymous groups. Prostitutes in India say that they want to do anything to provide an education and better livelihood for their children. This study also revealed that these women go through sexual abuse, and experience violence from pimps and partners. They face discrimination from family, police, society and the legal system. This 45 study makes specific suggestions regarding research, policy, and interventions for social work profession. Introduction Motherhood is one of the most difficult and stressful phases of a prostitute's life (Dalla, 2000; Sloss 2002; Sloss & Harper, 2004). According to Arendell (2000), "Mothering is the social practice of nurturing and caring of children, which involves dynamic activity and ever evolving relationships" (p. 1192). Prostitutes are often the sole caretakers of their children, unlike other women who may have family support. Even though motherhood is a difficult phase in their lives, many of these women have had multiple children before and/or after entering the flesh trade (Dalla, 2002; Parriott, 1994; Sloss, 2002; Sloss & Harper, 2004). Prostitutes face several professional hazards like stress, oppression, stigma, incarceration, housing problems, financial crises, mental health problems, and lack of appropriate medical and psychological care (Sloss, 2002; Sloss & Harper, 2004); however, these professional hazards have not stopped them from becoming mothers. Even with these challenges, many prostitutes become mothers because they feel it is the only psychological space they have for themselves, and for many, parenthood becomes the primary reason for their survival (Castaneda et al., 1996). It is hard to obtain the exact number of children of prostitutes in the U.S. and India due to the illegal nature of prostitution. According to the National Human Rights Commission (NHRC) report in India, there are approximately 5.4 million children of prostitutes, and most live with their mothers in red light areas (NHRC, 2008). In the U.S., women lose custody of their children if they are convicted of prostitution. Due to this, it is hard to know the exact number of children they have, their whereabouts, or other important 46 information about their children. Though many prostitutes have a desire to become mothers, most do not receive adequate support to become successful mothers. There have been very few empirical studies looking at the relationship between prostitutes and their children or what support the women think they need to overcome their professional hazards and become successful mothers. The research presented in this article builds on the existing literature regarding prostitutes as mothers. The goal of this paper is to understand the challenges and experiences of prostitutes as successful mothers. Specifically, this article will seek to answer the following questions: What comparisons can be made between the needs of prostitutes and their children in the U.S. and India? What are the models of service needed to support prostitutes as mothers and their children? This study uses the lens of Human Ecological Systems Theory and Social Exclusion Theory, with the research being conducted in two phases: the first portion was carried out in Denver with ex-prostitutes and the second part was conducted in the red light area of Mumbai with current and ex-prostitutes. Theoretical Framework I used Human Ecological Systems Theory to understand the lives of prostitutes and the needs of their children. Additionally, I employed the lens of Social Exclusion Theory, and examined how prostitutes and their children have been systematically excluded from mainstream society. 47 Human Ecological Systems Theory Human Ecological Systems Theory, as proposed by Bronfenbrenner (1989), is concerned with the interaction and interdependence of humans. In this theory, human development is viewed as a reciprocal and life-long process of interaction between people and their environment, which manifests itself as set of nested structures (Bronfenbrenner, 1989). The names of each of these structures or contextual systems arise based on its distance from the individual (Hope, 2007). Each system contains roles, norms, and rules that can shape human development as well as help to explain the specific individual behaviors or experiences of individuals in this article about prostitutes as mothers. Human Ecological Systems Theory has five systems or layers: microsystem, mesosystem, exosystem, macrosystem, and chronosystem. The microsystem is the individual's immediate environment. The mesosystem is comprised of connections between immediate environments. The exosystem is the external environment setting, which only indirectly affects the development of children. The macrosystem is the larger cultural context, including the national economy and laws, as well as political, cultural, and subcultural systems. Finally, the chronosystem, which is time-related, reflects dynamic environment transitions. By identifying these various systems, I will be able to better examine and understand the experiences and needs of the prostitutes and their children. Understandings of micro- and mesosystems were used to explore the immediate lives of women in prostitution and how it affects their mothering. The exosystem helped me to look at the work experiences of these women and its effects on their own day-to-day lives and the lives of their children. The macrosystem was useful for researching how various legal ramifications impact these women's experiences. The chronosystem also 48 permitted me to survey the circumstances that may affect prostitute's current life situations and future prospects. Through this process, I achieved a more holistic understanding of prostitution, as opposed to narrower investigations of prostitutes that have been performed in the past that have led to disapproval and censure of women in this profession. Social Exclusion Theory Parkin derived Social Exclusion Theory from Weber's discussion on Social Closure Theory (Alexander, 2005). Social Exclusion Theory examines the systematic method of discrimination used to isolate people from mainstream society due to their ethnicity, race, religion, sexual orientation, caste, ancestry, gender, age, disability, HIV status, and migrant status or place of habitation (Silver & Miller, 2003). Social exclusion can lead to exclusion from educational opportunities, which means unequal education (Barry, 1998). This exclusion or lack of opportunity can cause unpreparedness for college and a lack of skills to succeed. Unequal education can limit access to political participation (Barry, 1998). According to the British Medical Journal (BMJ), social exclusion may contribute to children's poor educational performance and achievements, unmanageable behavior, drug misuse, unemployment, teenage pregnancy, homelessness, crime, and suicide (BMJ, 2001). Importantly, social exclusion can be experienced at different levels since it can affect individuals, groups, or geographic areas (Jermyn, 2001). Social exclusion can cause changes in a person's brain function and can lead to poor decision-making and diminished learning ability (Campbell et al., 2006). Research has linked social exclusion to an individual's failure to exert self-control. For instance, people who are rejected in social situations often respond by abusing alcohol, expressing 49 aggression inappropriately, or performing poorly at school or work (Campbell et al., 2006). This theory, then, can help us to understand in a profound manner the effect that exclusion resulting from prostitution can have on the life of a prostitute and her children. This understanding will help social workers to develop and determine appropriate interventions. Literature Review According to prostitution laws in Colorado, "any person who performs, offers or agrees to perform any act of sexual intercourse, fellatio, cunnilingus, masturbation, or anal intercourse with any person not their spouse in exchange for money or other things of value commits prostitution" (ProCon.org, 2008). Similarly, the 1986 Immoral Traffic (Prevention) Act of India (PITA) defines prostitution as " the sexual exploitation or abuse of persons for commercial purposes or for consideration in money or in any other kind" (p. 1). These definitions clearly show that prostitution is illegal in both the U.S. and India, but its illegality does not mean that it is uncommon in either country. The Indian Constitution and U.S. federal and state laws prohibit any forms of trafficking and prostitution (Nair, 2005; Raymond, Hughes, & Gomez, 2001). There are no reliable data available on the number of prostitutes in the U.S. In India, Mumbai alone has over 125,000 prostitutes; the majority of them come from the states of West Bengal, Orissa, Bihar, Andhra Pradesh, Karnataka and Nepal (Ghosh, 1996). Dalla (2000, 2001, 2003, 2004) summarized studies on the causes that can push women to enter into prostitution. She found that sexual abuse during childhood is linked to female prostitution (Dalla, 2003). No matter the reason these women entered into prostitution, their lives on the 50 streets are difficult. These women face extreme forms of violence from partners, pimps, brothel keepers, and customers (El-Bassel et al., 2001; Kutz et al., 2004; Monto, 2004; Raphael & Shapiro, 2004; Simons & Whitbeck, 1991; Wechsberg & Lam, 2005). Studies by El-Bassel et al., (2001), Monto (2004), Simons and Whitbeck (1991), Wechsberg and Lam (2005), and Raphael & Shapiro (2004) show a connection between violence towards prostitutes and their HIV/AIDS status. Finally, women in prostitution face felony charges, and if they are incarcerated while their children are minors and in their care, they stand to lose their parental rights (Dalla, 2000; Weiner, 1996). Apart from these problems, women involved in prostitution often face the daunting task of having to raise their children within the context of an unfamiliar environment (Pardeshi & Bhattacharya, 2006). In almost all cases, these women are single mothers who have borne children from different sexual partners (Dalla, 2004), and despite numerous challenges, many bear multiple children, before and/or after entering the flesh trade (Dalla, 2002; Parriott, 1994; Sloss, 2002; Sloss & Harper, 2004). According to Dalla (2002), 51% of her 48 participants who were still working in the street had become pregnant, carried on their pregnancy, and had children. In a study in New York by Weiner (1996), 1,963 street level prostitutes were interviewed and among them, 69.4% had children. Each of these participants had 2.25 children on average. Similarly, Dalla (2000) found that 88% of her participants had 2.4 children on average and some had as many as seven children. In spite of these challenges, many prostitutes choose to become mothers because they feel motherhood is the only psychosocial space they have of their own and the only reason for their survival (Castaneda et al., 1996). Like every other woman, motherhood is 51 an important phase in the lives of prostitutes. Motherhood is also one of the most difficult and stressful phases of a prostitute's life (Dalla, 2000; Sloss, 2002; Sloss & Harper, 2004), in large part because she does not have family support and must be the sole caretaker of herself and her child. Even though it is a difficult phase in their lives, many are mothers or will become mothers. They have a desire to be mothers but do not receive any support to become successful mothers, which calls for programs tailor-made for prostitutes with children. In various studies conducted in the U.S., Dalla (2000, 2001, 2003, 2004) considered the relationships between prostitutes and their parents, caregivers, and partners. Dalla found that these relationships are often clouded with sexual abuse, domestic violence, substance abuse, and abandonment from the prostitutes' parents or caregivers. Additionally, similar patterns are reflected in the relationships that the prostitutes form with their own children. Dalla's research found three important concerns associated with prostitutes and their children. First, prostitutes often remain in the sex trade in order to support their children financially. Second, women who work in prostitution and lose custody of their children as a result often report that this fuels their drug use; prostitution then becomes a means to support their drug habits. Third, children of prostitutes are victimized in a multitude of ways, including neglect, malnutrition or abandonment, loss of shelter, and an increased risk of entering prostitution themselves (Dalla, 2003). Like Dalla, Weiner (1996) learned that female prostitutes face a great deal of violence and often lose the custody of their children. Importantly, Weiner's study found that female prostitutes are reluctant to use any social services due to the fear of arrest or losing custody of their children, and this makes these women especially 52 vulnerable to violence, intimidation, and exploitation. Another study in the U.S. conducted by Sloss and Harper (2004) examined the ways in which motherhood affects the work of female prostitutes and found that 13 women out of 16 study participants who prostituted during pregnancy were emotionally strained, and felt ashamed or guilty about working in the street. The women also worried about the health of their unborn child. The participants in the study reported that they continued their work to provide for their children, were careful during work to avoid arrest, and worked around their children's schedule; however, 14 women had lost custody of their children. These studies reflected similar findings in terms of female prostitute drug use, violence faced at work, and issues in a woman's personal life. These women lacked support for childcare from family or partners and most of them had lost custody of their children due to their life style. Unlike these empirical studies in the U.S., there are few scientific studies regarding female prostitutes as mothers in India. The sole empirical study, performed by Pardeshi and Bhattacharya (2006), looked at child bearing, childcare practices, family support, and placement options of children of brothel-based female prostitutes. The study found distinctive differences between Devdasis child-raising practices and family support from those of non-Devdasis female prostitutes. Devdasis are girls who are offered for the services of God and their religion. Devdasis perform dances during prayer services of the temple. Overtime, priest and spiritual leaders have exploited these girls and many of them have been sold into prostitution (Singh, 1997). In addition, Pardeshi and Bhattacharya's (2006) study revealed that many prostitutes find it difficult to get admission for their children in schools due to a lack of 53 birth certificate or a father's name. The study found that prostitutes preferred to keep their children away from the red light area. Women in the study reported that it is hard to raise their children single-handedly and their situation is made even more difficult due to the stigma attached with their profession. The study did not look in detail at relationships between the prostitutes and their children, and the researchers did not ask participants what kind of support would benefit them. In other research in India concerning prostitutes as mothers, Das (1991) presented a report that described various difficulties female prostitutes face when bringing up children. Das (1991) found that prostitutes face violence from brothel keepers who keep children away from mothers in order to increase these women's productivity. Even with these challenges, female prostitutes still want to have children because it is the "only avenue of tangible relationship that is genuine and meaningful and lasting" (p. 34). Also, they have children for emotional, economic, and old age support. Apart from these two studies in India, there has been a serious gap in the research on the motherhood aspect of prostitutes in India or in other countries. In a study conducted in Mexico City by Castaneda et al. (1996), the researchers found that female prostitutes who are parents play a double life, one of mother and the other of prostitute. Many join prostitution to provide for their children, parents, and sometimes siblings. Most reported concerns about their children's education and safety, while fearing that their children's future will be like theirs. This study notes that many prostitutes want to become mothers because "maternity is the only psychosocial space prostitutes have access to, and they perceive it as their principal motivation for living" (Castaneda et al., 1996, p. 230). 54 In a similar study by Chege et al. (2002) in the slums of Kenya, the study team found that female prostitutes are almost always the sole caretakers of their children and that 81.2% of mothers live with at least one of their children in Kenya. Nearly all women provided for their child's immediate needs, and only one third of women had secured resources for the future of their children. The study also found that many women "sent all or some of their children to live with extended families in rural homes" (Chege et al., 2002, p. 387). In this situation, the women still provided for their children to be taken care of financially. Beard et al. (2010) reviewed a large range of literature on the vulnerability and resilience of drug users as well as the children of prostitutes in countries around the world. In several cases, an organization in Zambia that catered to orphaned children of prostitutes faced problems with reuniting these children to extended families because these children often were sold into prostitution. The researchers argued and warned against forceful removal of children from their mothers; placing them in prison with their parent or in protection centers where little care is provided to the children, may lead to a cycle of vulnerability. A study in Bangladesh by Ling (2001) found that children tend to enter the flesh trade like their mothers and that little importance is given to education, particularly for girls. This study also revealed that children's physical, mental, social, moral, and spiritual development are affected due to the brothel environment. These findings are consistent with the frameworks of Social Exclusion Theory and Human Ecological Systems Theory. In accordance with Social Exclusion Theory, all of the studies reflected the systematic discrimination faced by prostitutes around the world due to the public's stance toward their profession. A lack of adequate support, such 55 as alternative job opportunities and safe housing for prostitutes, prevents them and their children from being part of mainstream society. This vicious cycle of discrimination and exclusion can be explained by Social Exclusion Theory, and illustrates why these women are viewed as unsuitable mothers, and why their parental role is overlooked by society and in research. Human Ecological Systems Theory is valuable for this research because it helps illustrate the interpersonal relationships that shape human development, and this theory is needed in order to fully comprehend the lives of prostitutes and their children. In all the studies reviewed, the researchers viewed prostitutes as mothers and not as criminals. When children are involuntarily removed from their mothers, the interpersonal relationship between the two is damaged, and this affects the mother's life as well as the child's development. Human Ecological Systems Theory helps us to understand the effect that a prostitute's environment has on her decision making and how other people can shape her attitudes and behavior. This theory helps explain why some prostitutes turn to drug abuse to cope with the violence they face (Dalla, 2000; Graham & Wish, 1994) while others chose other outlets. The focus in Human Ecological Systems Theory on the effect a parent's workplace can have on children's development is also useful for this study. The findings of this study will add to the research about female prostitutes as mothers. This article looks at how these women go beyond their capacity to be mothers and what support they need to fulfill this role. The women in this study shared their experiences as prostitutes and as mothers. They discussed the challenges they face in providing for the needs of their children, their dreams for their future, and the support they need to improve their prospects for themselves and their children. 56 Methods Participants This study included 17 women, 6 from the United States and 11 from India (see Table 1 for demographic detail). The participants shared their experiences as mothers, they discussed their relationships with their children, and they identified the support and programs they feel they need to be successful mothers. Participants in the U.S. study ranged in age from 33 to 48. Three identified themselves as African American, 1 as Native American, and 2 as Caucasian. Two women lived in the shelter, 3 women lived alone, and 1 woman lived with a partner. The years of educational experience ranged from 9th to 12th grade (mean 10.25 years). All 6 participants were no longer involved in prostitution, but the period of their last involvement varied from 2 months to 6 years prior to the interviews. All 6 reported using drugs; the choice of drugs varied from marijuana to crack cocaine, and in each case, the length of sobriety coincided with the last incident of prostitution. The total number of children to these participants was 22 (see Table 1 for demographic detail). Among the 11 women who participated in the Indian study, their ages ranged from 30 to 46 years. These women came from different states of India: 4 came from Karnataka, 2 were from Maharashtra, 2 were from Uttar Pradesh, 2 were from West Bengal, and 1 came from the neighboring country of Nepal. The living situations of these women were different from their counterparts in the U.S. Out of 11 women, 8 rented a small space in the red light area or in a brothel itself. One lived in a rented hut in a slum and 1 lived on the streets on her days off from the night care shelter. The years of educational experience ranged from none to 6th grade (mean 1.27 years). Six out of 11 57 participants were no longer involved in prostitution, but the time of the last incident varied from 5 to 15 years prior to the interviews. All 11 participants did not mention using drugs or alcohol; however, this lack of discussion does not mean that there is an absence of alcohol and drug use by prostitutes in India. The total number of children born to these participants was 24 (see Table 1 for demographic details). Research Process This research was conducted in two phases: the first in Denver, U.S. and the second in Mumbai, India. All the participants in the study were prostitutes or ex-prostitutes above the age of 18 years and had at least 6 months experience as prostitutes. I received IRB approval from the University of Utah. All the participants in the U.S. were contacted through an intervention program in Denver. The intervention program works with women who have been infected or affected by HIV/AIDS and women who are involved in the criminal justice system. All participants attended the intervention program as a requirement of the court. The organization informed its clients about the study and 6 women volunteered to participate. Each of the participants had been in prostitution for 10 to 20 years. Five of them were streetwalkers, and 1 was a stripper. All interviews took place in the agency's office in Denver. Each participant was briefed about the study and verbal consent was obtained before the interview. Even though each participant was given a choice of picking a pseudonym, only one chose to do so. The participants who used their real names explained that they did so in order to feel a sense of contribution to the study and society. Interviews were audiotaped with prior permission. The second phase of the research was conducted in India's red light district of Kamathipura and Falkland Road. Purposive sampling along with snowball sampling 58 techniques were used to invite participants into this study. The researcher conducted brothel visits to inform prostitutes about this study. Eleven women volunteered to participate in the research; all had been in prostitution from 5 to 25 years. The interviews were conducted in a vacant room of an old school building in the red light district in Mumbai. In-depth personal interviews were conducted with all 17 participants. Each participant was asked about the challenges they faced as a mother, the challenges they thought their children faced, and what support would be required for their betterment. The interview questions were predetermined and were semistructured, but the order in which questions were asked varied depending on each participant's answer to the prior question. The length of interviews varied from 40 to 90 minutes. All interviews in the U.S. were conducted in English, but the interviews in India were conducted in Hindi and Bengali based on the participant's choice of language. All interviews from the Indian study were translated and then transcribed by professionals, peers, and myself. My colleagues and I transcribed the interviews from the U.S. study word-for-word; in both cases, interview responses were transcribed, in the form of narratives, in keeping with the nature of the participants' answers. I verified all of the transcripts, and read and reread the data to ensure familiarity. While reading, I made necessary editorial changes to make the field notes retrievable, and generally "cleaned up" the data, as suggested by Pearsol (1985). Participants in the U.S. phase were compensated with $20 and Indian participants were compensated with rupees 100 (approximately U.S. $2.50). 59 Data Analysis Data derived for the study were analyzed using the six phases of Marshall and Rossman's (1999) method. Each transcript was read thoroughly and I categorized extracts into themes and interpreted each emerging theme in the study. Themes were chosen based on how the interview extracts answered the research questions. I read and reread the themes to identify differences between them. After intensive study of the themes, I decided to either merge or separate themes. The themes were closely studied to examine if they were related to the research questions. Themes were interpreted through the lens of Human Ecological Systems Theory and Social Exclusion Theory. Findings The findings of the study were based on the analysis the narratives of all 17 participants. Three major themes emerged: prostitutes relationships with their children, experiences of prostitutes as mothers, and the support programs needed to help them be successful mothers. Motherhood is a reality in the life of prostitutes. However, mainstream society views prostitutes as criminals and not mothers, and this attitude most often leads to the discrimination and exclusion of these women. The criminalization of prostitutes makes it difficult for them to have custody of the children and/or provide for the needs of their children. Relationship with Their Children Motherhood for the women in this study was an important aspect in their lives and a main reason for survival. When these women were separated from their children, many chose to abuse substances to help cope with their loss. As a result, these women reported 60 not only losing their sobriety but also their ability to maintain any healthy relationship. After separation, many felt that their children no longer respected them or were willing to have cordial relationships with them. The women from Denver reported wanting to do anything to have a better relationship with their children but failed because their children would not forgive them. Angela is facing a similar situation of loss of children like her counterparts. She is doing everything to keep custody of her 3-month-old son, who was at the time of the interview in state custody. Angela said, "I just love him so much; I didn't think it was possible to love someone so much. He's the greatest thing that's ever happened to me. I love my other children, and I think about them on a daily basis, but Andrew and I have a special bond... it would just kill me if I ever lost him." Faith, from Denver, lost her two children when they were young, and they were forced to grow up in foster care, leading them to have a negative relationship with their mother. According to Faith, "…They are grown now, my daughter is 30, and my son is 27; they haven't forgiven me…We don't get along." Faith's daughter drinks a lot, and when Faith prevents her from drinking, she does not listen and insults her. Faith has tried to take her to her counselor, but her daughter has refused. Constant rejection from her children damaged Faith's self-esteem, and obstructed her process of moving away from substance abuse or prostitution. The relationship of these women with their children has never been the same due to the separation from their children. Unlike women in the U.S. study, the women in the Indian study have maintained a positive relationship with their children, and some have even reported using the relationship as an inspiration to leave prostitution altogether. Gita said, "…After my child was born, I left prostitution completely." Gita left prostitution when her son was growing 61 up. She performed menial jobs to provide for her son. Today, her son is in high school and dreams of completing his college education at a prestigious school in India. All of the prostitutes in India have custody of their children, a significant difference from the experiences of their counterparts in the U.S. Seven out of the 11 women in India have children who live with them in the red light area and attend local schools. The remaining 4 have voluntarily placed their children in government or private boarding homes for educational purposes. These mothers frequently visit their children and communicate with them on the phone. The women perceived a positive relationship with their children because the women have custody of their children. These 11 women faced economic hardships to fulfill their children's needs but it did not stop them for providing for their children. Reena stated that "The money is not enough to look after children…You have to feed the children first ; you cannot keep them hungry even if I do not have enough to eat…Sometimes I borrow money to fulfill the need of children." For these women, providing for their children takes priority. They will do anything for them. Gita said "… I used to fill water for people. I used to carry water from downstairs to the fourth floor of Pandu Maharaj chawl. That's how I brought up my child…" The 6 women, who left prostitution, worked in homes as domestic helpers, or work in NGOs or schools to provide for their children. Sometimes they even borrow money for their children's tuition fees. Rabia said, "I have only one son. I have no one in my life. I will educate him until he wants...He wants to become a doctor… I will do anything for him." These women do not want their children to have the same fate they have suffered. Saanvi stated, "I thought to myself that I was tricked but I do not want my children to be in this line of work." One of the biggest challenges these women face is 62 trying to educate their children due to financial difficulties and lack of support. Even with these challenges, these women want the best for their children-like any other parent in the world. As Mamata said, the women were ready to "work or beg to get a better life for their children." In the next section, the study participants express the various challenges they faced as mothers. Prostitutes' Experiences and Challenges as Mothers In the interviews, participants shared their stories about the various struggles they face bringing up their children. In every case, the women demonstrated remarkable honesty and candor when discussing these experiences with the interviewer. During the interviews conducted in Denver for this study, 4 participants revealed that they no longer had custody of their children or had lost their parental rights due to their profession; in some cases, the women claimed that this separation had been the source of abandonment issues among their children. One mother with six children gave two children up for adoption, while the other four of her children live with family members. Four women had children who were in foster care. Only 1 woman had a day-to-day relationship with her children, due to the fact that she entered prostitution after her children were adults. The separation or loss of a child was cited repeatedly by these women as an instrumental factor leading to depression, re-entry into prostitution, and drug and alcohol abuse. Meredith, a 39-year-old, said that "[s]ome stuff happened with the social services, and they took my kids, so I started back prostituting and using drugs, like crazy, like I was going insane. Because when they took my kids away from me, I lost my mind." Responses like this illustrate the negative effect that separation from children can have on prostitutes. Meredith's account also demonstrates how the vicious cycle of losing custody 63 of children can push mothers back into prostitution and substance abuse. Apart from the constant threat of involuntary separation from their children, these women face the challenge of bring up their children in an unsafe environment. Each of these women realized that the neighbourhoods in which they live were full of criminal activity, including drug trafficking and use, gambling, and gang violence, and this creates a dangerous environment for both the women and their children. These districts are not very safe, nor are they conducive to a child's growth and development and for this reason, some women voluntarily send their children away to live with extended family or in governmental/private boarding homes. Rabia, a 35-year-old from India, realized the danger of the red light area and wanted to protect her child by sending him to a boarding school. Rabia said "I am thinking of getting a house before he [her son] becomes bigger…Yes, the children [from her son's school] do tease him…." This situation was especially common among the participants of the Indian portion of the study, but it is also worth noting that the mothers who chose to send their children away maintained regular contact to ensure the stability of their relationships and wellbeing of the children. Veronica, from Denver, said, "I decided to give him [her son] away. I did not want him to drag him onto streets with me and that's just not the place for children. So I gave all my children for adoption, not adoption but family members…well I have contact with [the] other four and things are going pretty smoothly. But back then when I was getting high, I could not drag my children into this. Some women felt its okay to do that but I did not do it." Veronica, now an ex-prostitute, was involved in drugs when she worked on the streets of Denver, an environment where she noted narcotics were easily available. Realizing how drug