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KHANA, a national public health organization in Cambodia, conducted a series of in-depth interviews and focus group discussions to better understand the concerns of the workers and how they might benefit from a hotline.

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Someone to Listen to: A Hotline for Female Entertainment Workers in Cambodia

Female entertainment workers in Cambodia confronted severe challenges during the lockdown due to the pandemic. Work dried up and in desperation many worked covertly in entertainment establishments despite government mandates. As a result, they faced increased harassment by clients and police.

The daily worries made them more anxious and some even developed suicidal thoughts. But KHANA, a national public health organization in Cambodia, last month conducted a series of in-depth interviews and focus group discussions to better understand the concerns of the workers and how they might benefit from a hotline.

The initiative, as part of the SVRI-funded project, followed discussions with the workers that KHANA had last year—before the pandemic—to explore the support they needed because of gender-based violence. A few women said they preferred legal and medical support but many sought emotional support—someone who would listen to them.

Although the idea for a hotline emerged last year, discussions picked up because of the urgency due to COVID-19. KHANA is currently developing a 24-hour hotline with chat and voice options, staffed by trained peer outreach workers. The outreach workers will undergo a five-day intensive training and simulation on using crisis intervention, health education, and supportive counseling skills to offer emotional support. They will also identify and respond to red flags such as suicidal thoughts and refer survivors to services available to them.

As part of efforts to develop the hotline, KHANA presented participants with visual aids such as a comic strip of a young woman using the chatline after experiencing emotional and verbal abuse (see below).  We also provided a mock audio transcription of a hotline call between a young woman and a call line staff. These techniques helped to inspire conversation about the aspects of a hotline service that would work for the participant and what would not.

During our conversations, the female entertainment workers opened up about their hopes and challenges, which will help better inform our responses—so we can meet their needs.

Impact of COVID-19

First, they said they have been hit hard by the pandemic. The impact of COVID-19 wasn’t the focus of our research, but we couldn’t avoid this topic in our interviews. These workers were earning less income because the entertainment venues where closed and many engaged in direct sex work through their networks or on the streets to offset their lack of income. Some received money from their family, whom they usually support. All of these challenges, including working covertly against government mandates, put immense psychological pressure on them.

Resilience in the face of adversity

Second, the female entertainment workers discussed how they were trying to cope with the challenges. They discussed healthy coping strategies, such as depending on friends or taking up meditation, and unhealthy coping strategies such as drinking. They reported asking and receiving emotional support from friends, family, and peers. Some have relied on service from local community-based organizations.

Words of hope

Third, when discussing the emotional support hotline, the workers said they would prefer to call a trustworthy, nonjudgmental, anonymous person. A person who would console them, provide encouragement and practical solutions, career guidance, and use kind words to lift their moods and help them feel safe. They also want referrals, such as immediate help when experiencing violence or medical attention.

Our next steps are to take these responses and use them to inform the development of the hotline’s technical aspects and our staff training.  This hotline will be a portal for emotional support as well as escorted referral s for health and gender-based violence (GBV) support services.

Written by Carinne Brody and Siyan Yi

Authors Bios:

Carinne Brody, DrPH is an Associate Professor at Touro University California and a KHANA research team member.  She has been working to improve access to health care for female entertainment workers for the past eight years.

Siyan Yi, MD, PhD is Assistant Professor at National University of Singapore and Director, KHANA Center for Population Health Research, Cambodia.  He has been working on improving the health of key populations in Cambodia for over ten years.


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