Commodification, Deterritorialization, And Public Health - Understanding the links between globalization, the sex trade, and HIV/AIDS
Rasa is a character created to give context to the problems of globalization and their impact on health. Unfortunately, individuals, mainly women, who live in conditions similar to Rasa exist - even in Canada. Rasa, like many other women, came Canada to in search of a better life. The unfortunate reality is that dreams of domestic work and modeling careers often turn out to be tricks used to lure women and girls into the sex trade. Particularly at risk are women and children in developing countries, especially the former Soviet-block countries and Southeast Asia.
It is not difficult to imagine the fear Rasa must have felt upon arriving in Canada. She does not speak the language. Her money and passport are confiscated. She is threatened with death to herself or to her loved ones remaining in Lithuania. She is forced to provide sexual services to “customers“ in squalid conditions. Her movements are monitored. She feels she has no escape because she could be arrested, imprisoned, and deported as an illegal immigrant. Now with two children, fears for their safety are a constant concern. Besides the risk of violence, her “employment“ is a constant threat to life through the risk of contracting sexually transmitted infections, including HIV/AIDS.
Modern globalization is characterized by increasing connections between people and groups of people across the planet. While globalization has the potential to generate good, it also has a dark side which facilitates human trafficking, promotes the commercial sex trade industry, and exploits women like Rasa. In order to explore the issues between globalization, the sex trade, and HIV/AIDS issues related to the commodification of people, the role of deterritorialization, and public health will be explored.
A series of major credit card commercials place dollar figures on objects and items you can purchase, and the tag line of the commercial is that something like a feeling, an activity with family, or a special moment in life, is “priceless“ - something you can’t put a dollar figure on. This commercial speaks to a larger social concept of there being invaluable things in life. However, as the following statistics show, human life is not one of those things.
Vietnamese and Chinese mafia are increasing operations in brothels in Toronto, Canada. They traffic in women from Southeast Asia. Agents pay recruiters up to $8,000 for a woman, who then sell the women to pimps for about $15,000 .
Adam Jermaine Ingram, 20, and Kevin Roy Woods, 18 are accused of paying $3,000 to buy a 13-year-old girl from a man in Vancouver, Canada, abducting her and her friend and raping them while on route to San Diego .
We live in a materialistic society. Virtually anything can be bought and sold, including human lives. The commodification of people has its origins in colonialism, and continues to be reinforced through cultural norms of power and control. Colonialism, referring to British imperialism during the eighteenth century, was characterized by “the transmission of white, male power through control of colonized women ..... and the imperial command of commodity capital“ . This is not unlike current beliefs and values which promote people as goods. For example, families in Thailand, especially those from the inhospitable, poorer north, view their children as commodities, and may sell a daughter into sexual debt bondage in order to pay for a failed harvest or large debt . This commodification is further reinforced through patriarchal systems. “Prostitution tends to thrive in patriarchal societies where there are two systems of morality, one for men and one for women“ . A patriarchal system supports the premise that men and women have differing sexual needs, and that prostitutes are a necessary “and inevitable social evil“ required to preserve the chastity of “innocent“ women . Therefore, in a culture which is accepting of the commodification of human beings within an environment of gender differences in power, it is not surprising that an industry based on sexual exploitation is able to thrive. And this industry is further supported by the ease with which people can be bought and sold over large geographic areas.
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In a globalizing world, it is possible to travel almost anywhere on the planet. Goods and people can be shipped quickly and easily around the globe along networks of trade, focused at key nodes . These key nodes are typically areas of industrialization and urbanization, and often serve as destinations for trafficked persons. It is impossible to look at the sex trade industry without noting the strong ties to national and international exchange and economy . “It is a significant source of foreign exchange earnings, with links between the growth of prostitution as a highly structured transnational business and the expansion of the tourist industry in these countries, as well as labour exports from these countries“ . Typically, prostitutes in Southeast Asia are brought from rural areas into cities to serve an increasing demand from the labour-centralized male population . They may be plied with promises of a glamorous life and financial earnings, or they may be simply abducted and sold into sexual servitude  . Whatever the circumstances, the fact remains that the major component of human trafficking is the “trafficking of women for sexual exploitation“ . And although trafficking is an international crime, it is a multi-billion-dollar industry with annual profits of US$5-7 billion , which is tied into legitimate trades of tourism and entertainment.
"If we include the owners, managers, pimps and other employees of the sex establishments, the related entertainment industry and some segments of the tourism industry, the total numbers earning a living directly or indirectly from prostitution would be several millions" .
Globalization does not cause human trafficking and the sex trade. However, factors and processes associated with globalization, such as deterritorialization, easy travel, and urbanization have certainly contributed to the ease with which human trafficking and the sex trade occur. Furthermore, these same features of globalization contribute to the frightening rise in sexually transmitted infections (STIs), including HIV/AIDS.
Currently, there are more people living with HIV worldwide than ever before - an estimated 39.4 million . A disproportionate number of these people are sex workers and injection drug users - a group frequently tied to the sex trade   . However, this is not strictly a result of their trade:
"While it is true that prostitutes often suffer from (STIs )and the fact is used to stigmatize them, this may actually be due to inadequate health services or because the prostitutes cannot afford private medical services. Measures are not directed at the clients who have unprotected sex with their spouses or others. The transmission could also be between countries, not only through tourist flows but also through the ‘commuter-like’ flows of prostitutes and clients among the Southeast Asian countries. There are reports of young girls from Myanmar and other neighbouring countries brought into Thailand for prostitution who are sent back to their own countries to die when they are found to have contracted AIDS" .
Women are especially vulnerable, not only because of their higher risk within the sex trade, but also because the burden of caring for the sick falls to them . Health myths further increase the risk to children due to the belief that virgins or young children are less likely to be infected with HIV/AIDS, or that they can, in fact, cure the illness .
The United Nations calls AIDS “an extraordinary kind of crisis; it is both an emergency and a long-term development issue“ . Both these acute and chronic issues are tied into processes surrounding globalization: the commodification of people, deterritorialization, and public health. It encourages us to ask, what can global citizens do? Most physicians agree that HIV/AIDS is here to stay. There is no cure presently, and none in the foreseeable future. The focus has, therefore, shifted to harm reduction. The UN targets its efforts at prevention, protection, treatment, policy-making, and empowerment of the most vulnerable . And there is evidence that this strategy is effective:
Studies indicate that sex workers are among those most likely to respond positively to prevention programmes relating to HIV and sexually transmitted infections (STIs) - for example, by increasing their use of condoms with clients .
In Brazil “a comprehensive harm-reduction and drug-access program reduced AIDS mortality among IDUs [injection drug users] by 50%“ .
The World Health Organization (WHO) further supports aims at prevention, and also advocates increasing the availability of anti-retroviral (ARV) therapy to those who need it . Their goal was “3 by 5“: to deliver ARV therapy to 3 million people by the end of 2005 . Unfortunately, the WHO did not achieve its goal within the desired time-frame.
Globalization is a complex process of increasing interconnections. Arising out of British colonialism, it has impacted culture in the way that human beings can be seen and sold as commodities, such as within the sex trade. It is resulting in a loss of territorial and geographic boundaries, allowing for increasing movement of people and goods, along with an increase in human trafficking - mainly for sexual exploitation. And both of these changes have contributed to the current global public health threat posed by HIV/AIDS. We are in dire straits, indeed. However, hope may be found in these very same processes associated with globalization. Biopower, the ability to generate knowledge and change through people , offers great possibilities, such as that seen through the effective education of prostitutes on HIV prevention via condom use. If we truly live in a network society , then we should be able to use technology to spread ideas of prevention and harm reduction, and debunk cultural myths associated with gendered power, human health, and disease. Maybe then, we can overcome oppression and disease, and offer a brighter alternative for every global citizen.
1. Hughes DM, Sporcic LJ, Mendelsohn NZ, Chirgwin, V. The factbook on global sexual exploitation [monograph on the Internet]. Coalition Against Trafficking in Women; c. 1999 [cited 2005 Nov 11]. Available from: http://www.uri.edu/artsci/wms/hughes/canada.htm