What drives Irish women to trade their Lycra-wrapped bodies on city streets nightly? A night's work can mean standing for hours on stilettos in unforgiving weather while men eager to barter for sex eye you up and down. Every client brings the risk of assault, rape or even murder.
According to Mary O'Neill, who helps to co-ordinate a health service for prostitutes run by the Eastern Health Board, the public is deluded about the true nature of prostitution.
"Society wants to believe that prostitutes are coerced into selling their bodies by a mutilated view of sexuality or abuse they suffered as children," she says. "In reality, it can be a clean economical decision that elevates their standard of living or offers the chance to scrape at survival."
The EHB's Women's Health Project is run quietly from Baggot Street Hospital. The project is the only one in Ireland committed to improving prostitutes' health. Since its genesis in 1991, it has thrown a lifeline to hundreds of women.
Back in the mid-1980s, the hospital's staff identified a need for a health service for prostitutes. The EHB acted on the recommendation and now funds the clinic. An all-female team of seven counsellors, a nurse and a doctor have advised more than 300 of the city's prostitutes through a two-hour weekly group clinic and back-up, one-on-one counselling. The project also provides family planning information, free condoms and medical check-ups.
The focus is on psychological and physical health which is dished out in non-judgmental doses. One of the project's aims is to enhance peer companionship and support which stretches beyond the clinic's walls on to the streets. O'Neill, a senior outreach counsellor, spent many evenings over the project's first two years combing Fitzwilliam Square, Fitzwilliam and Benburb streets, winning the trust of prostitutes and coaxing them to drop in to the clinic. Seven years later, she holds their trust. (Outreach is the branch of counselling that interacts with clients in their community rather than practising exclusively in a medical setting.) She regularly seeks out prostitutes while they work and also visits brothels.
Society, especially women, she says, tries to explain prostitution. "They don't want to hear that a middle-class woman with a child simply wants to make money. The feminist side says it's abuse, it's slavery, it's a distorted self-image but it can be as simple as the dole, drugs and bills." Women feed the mystique that surrounds prostitution in Ireland, she explains. "But prostitutes could be in your own social circle, could be sitting next to you in the pub." O'Neill, whose background is in public health nursing, says when she first began working with prostitutes, she supposed many were victims of abuse and this fuelled the motivation behind it. She assumed prostitutes have low self-esteem which is why having sex for money is within their threshold. Hundreds of cases later, she sees money as a primary influence.
"They see it as a job. They put on work clothes, go out, come home later and have a bath," O'Neill says. It is not necessarily depressing work (another public myth), she contends, as the job is only a small part of a woman who can be upbeat, confident and functional.
"Many have day jobs and take to the streets at expensive times during the year, to pay for First Communions or Christmas presents," she says. Others take advantage of potentially lucrative times such as nights before rugby internationals when the streets are thronged with drunk men. The clinic's non-judgmental approach has defined its success. Its brochure promotes a service that is sensitive to the special needs of prostitutes.
We don't encourage ex-prostitutes to use the clinic, O'Neill says. "They can create judgment with an attitude of `I'm respectable now, I'm out of the area'.
"Some of the women don't tell us their real name. They can be Lisa one week and someone else the next," O'Neill says. The anonymous nature of the project means the counsellors may know little about the women's identities and their backgrounds. Anonymity, however, encourages return visits.
The Women's Health Project commissioned a study in 1995 that analysed the practices of more than 80 women who went through its doors. Some of the findings contradict O'Neill's experience. One-third said they were sexually abused as children.
The clinic promoted lectures on self-esteem as a component of a series of talks but it was not popular. The women prefer to hear advice on physiological issues. O'Neill acknowledges that their reluctance could, in part, be denial on behalf of the women on a link between their work and self-image.
Another society-perpetuated myth is the incidence of HIV and STDs among prostitutes. O'Neill's experience is that the main health problems suffered by street prostitutes are chest infections, flus, colds and other illness caused by being outside for hours in freezing temperatures. STDs are rare, she says. She has come across one or two cases of HIV-infected prostitutes which corresponds with the profile of HIV in Ireland. The women who attend the clinic are from varied backgrounds and classes. Many left school early, worked in unskilled and semi-skilled jobs, such as in factories, cafes and bars. Young women, planning to attend university, fall into prostitution often to scrape together a deposit for accommodation, O'Neill says, pointing out that "digs" need to be secured in August while grants don't find their way into students' bank accounts until November. Earnings from sex can bridge the gap.
Like students, other women who take to the streets are prompted by crisis, she says. The oldest woman O'Neill worked with was 59 years old, but may have retired as she hasn't been spotted recently. The youngest attending the clinic is 17 years old. Most prostitutes she sees are between 25 and 30 years old. The majority of prostitutes are in relationships, whether married, cohabiting or seeing a boyfriend. The partners of drug-using prostitutes usually know how the funding for the "fixes" is earned but the partners or husbands of the other women either aren't aware or pretend they are not, O'Neill says.
Some women, she says, do not want a sexual relationship outside their work, while others say they don't have a difficulty with the emotional demands of a physical relationship with their partner. During clinic sessions, the chat frequently turns to their relationships.
"They say things like `he bought me flowers last week and we had a row this week', and so on," O'Neill says. Not so different, she adds, to other women's groups.