Four months after recovering from mpox, Sifa Kunguja, a sex worker in eastern Congo, is struggling to regain her clients. Fear and stigma surrounding the virus have driven away potential customers, leaving her with a dwindling income. “It’s risky work,” says the 40-year-old, “But if I don’t work, I won’t have money for my children.”
Kunguja is one of many sex workers in Kamituga, a town with an estimated 40,000 sex workers, many of whom are single mothers pushed into the industry by poverty. The town’s economy revolves around gold mines, where miners comprise the majority of clients for sex workers. Doctors estimate that 80% of mpox cases in Kamituga are sexually transmitted, highlighting the vulnerability of this population.
Sex workers face a double whammy: the risk of contracting mpox and the financial hardship it brings. Fear of reinfection and the stigma associated with the virus make them reluctant to seek medical care. Sex work is not illegal in Congo, but related activities like soliciting are. This, coupled with widespread violence and abuse, further discourages women from seeking help.
The situation has sparked a debate about how to contain the outbreak. Health officials advocate for closing nightclubs and mines, and compensating sex workers for lost income. However, local officials claim they lack the resources to implement such measures, placing the responsibility on sex workers to protect themselves. The Mayor of Kamituga, Alexandre Bundya M’pila, argues for awareness campaigns while suggesting that sex workers seek alternative employment without offering any concrete solutions.
The reality is that sex work is deeply intertwined with the local economy. Tens of thousands of miners flock to Kamituga, fueling a thriving sex industry. The African Sex Workers Alliance estimates that 13% of Kamituga’s population are sex workers, organized into 18 local committees dedicated to protecting their rights and advocating for their safety. However, sex work in Congo is often fraught with danger. A report by UMANDE, a local sex worker rights group, highlights the systematic violence faced by women in the industry, often fueled by poverty or the need to support their families.
The mpox outbreak adds another layer of hardship. Many sex workers are terrified of contracting the virus, fearing lost income and potential business closure. Those who recover face stigma and isolation within the community. Kunguja, for instance, has seen her client base plummet from 20 to 5 per day since contracting mpox in May. The pain of lesions made walking a challenge, and her 9-year-old son also contracted the virus. She’s now forced to sell alcohol to supplement her income, barely able to afford basic necessities for her 11 children.
Disease experts emphasize the importance of information and awareness in stemming the spread. While 250,000 vaccines have arrived in Congo, their distribution to Kamituga remains uncertain. Community leaders and aid groups are conducting awareness sessions, focusing on condom use and symptom recognition. However, the limited supply of condoms and the low rates of condom use in the industry are major obstacles. Some sex workers report seeing up to 60 clients a day for less than $1 each, making it difficult to afford adequate protection.
The variant prevalent in Kamituga seems to be more easily transmitted sexually, further compounding the challenges. Even experts acknowledge that the limited information about the virus makes it unclear how effective condoms are, as lesions often appear in areas not covered by them. Some sex workers resort to using flimsy plastic bags when condoms run out.
Experts emphasize the need to involve sex workers in designing public health initiatives. “The government should proactively reach out to sex worker organizations, at the local and national level, who are experts in what their communities need,” says Erin Kilbride of Human Rights Watch.
Miners are also crucial to containing the virus. While mpox is primarily spread through close contact, it can also be transmitted through contaminated surfaces. This is particularly concerning in the mines, where sanitation conditions are often poor. Miners lack access to handwashing facilities and may go days without showering. Open defecation and lack of hygiene practices in the mines can further contribute to the spread of the virus.
Miners themselves are not fully aware of the risks. Debus Bulambo, a miner who contracted mpox in February, observes a lack of seriousness regarding the virus among his colleagues. The high earnings of miners, sometimes reaching $120 a month, make them vulnerable to risky behavior, including paying for sex without condoms. The lack of fear and understanding among miners poses a significant obstacle to controlling the outbreak.
The situation in Kamituga highlights the vulnerability of marginalized populations during public health emergencies. Without adequate support and resources, the fight against mpox will be an uphill battle. Addressing the stigma surrounding the virus, providing essential healthcare and resources, and empowering sex workers to protect themselves are crucial steps in containing the outbreak and protecting the health of the community.
