Skip to content

‘I wake up in the morning and start looking for money so that I can feed myself and my siblings…this is not about me. I have responsibilities and I never want for my sisters to sell their bodies. But when I die, then what?’

Female head of household, 16 years, Kakuma

Survival sex is hard. Try being 16 and dependent on sex work for survival for the past 4 years. Then add being the mother of two and living with HIV. If you have any imagination left you can add fleeing from war, being separated from your family or any other adult support since you were 12.

In April, a routine project evaluation took me to Kakuma refugee camp on the border between Kenya, South Sudan and Uganda. As a midwife, I have been working with reproductive health and GBV in humanitarian settings for many years, but the degree of misery and despair that these girls live with hit me hard. I was in no way prepared for the stories that were coming my way.

When you prepare for qualitative research you go through the proper steps of thinking through your research questions, preparing and testing questionnaires and getting ethical approval. You are aware that interviews might be inconvenient, make people sad and bring unrealistic expectations, but you try to factor all of that in and make sure that the ‘human subjects’ are taken care off and that their contributions will eventually lead to better services. That is how I typically prepare; only this time, in the Kakuma refugee camp, it was different.

‘I used to want something better. Now I just want to find someone who can take care of my child so that I can die’.

Female sex worker and peer group leader, HIV positive, 19 years, Kakuma

I spoke to adolescent girls who had seen their parents being killed and had to flee from home on their own, girls who were raped more times than they remember, girls who were already mothers to several children without knowing any of the fathers, girls who had survived doing sex work since the age of 11, girls heading households of up to 4 younger siblings and girls and girls who have sex with up to 5 men per day in order to make a few dollars for food and clothes.

I know the statistics and I have read the reports. Survival sex is a reality for many women in refugee camps. I just wasn’t aware of the extent to which girls were involved.

When I left Kakuma to go back to Nairobi, I sincerely wanted to take all the girls with me to show them a place where children are allowed to breathe, where adults protect children and where child sexual abuse is a crime, not a currency.

So I am angry, I am as angry as I have ever been. Even against the backdrop of war, displacement, hunger and human rights violations, this is an all-time low.

‘Everybody hates us. We hate us. One day God will judge me and that is ok. It can never be worse than now’.

Female sex worker, 17 years, Kakuma

I am of course angry in general that some men think it is perfectly normal and justified to buy sex from a girl and, in many cases, beat them up and steal back the $1 once the job is done. I am angry that women harass and physically abuse the young girls who depend on survival sex instead of protecting children from abuse.

Most importantly I am outraged that extremely vulnerable girls as young as 11 years old depend on sex work in order to survive. Children with refugee status. It makes me wonder if the true purpose of refugee camps is to provide assistance and protection.

The humanitarian system is under pressure these days. In 2016, only 60% of the humanitarian budget was covered and 2017 is not going to be any different. Those are the facts. The UN system fails when we don’t manage to protect the most vulnerable such as unaccompanied children. Protection agencies fail when we make survival sex a necessity in order for children to eat and drink. And healthcare providers fail when we plan projects that aim to provide free services to child sex workers with the objective of reducing the spread of HIV in the general population. We all fail if we allow for this generation of refugee girls to grow up under such conditions.


To read more about the IRC’s work with sex workers, please visit:

Read the SVRI Guidelines for the prevention and management of vicarious trauma among researchers of sexual and intimate partner violence

The International Rescue Committee responds to the world’s worst humanitarian crises, helping to restore health, safety, education, economic wellbeing, and power to people devastated by conflict and disaster. Founded in 1933 at the call of Albert Einstein, the IRC is at work in over 40 countries and 26 U.S. cities helping people to survive, reclaim control of their future and strengthen their communities.

Follow us on Twitter and Facebook and Medium

Written by Sanni Bundgaard, Advisor for Care for Women Survivors at the International Rescue Committee


Sanni Bundgaard is the International Rescue Committee’s Advisor for Care for Women Survivors. Follow her on Twitter at @sannibundgaard.

Svri Stay


Address: Sexual Violence Research Initiative (SVRI)
2nd Floor, Lourie Place, 179 Lunnon Street, Hillcrest, Pretoria, Gauteng 0083, South Africa

Privacy Notice

SVRI NPC (2019/197466/08)

Subscribe to our newsletter

Svri New Look Feb22 23


Address: South Africa

Privacy Notice

SVRI NPC (2019/197466/08)


Become a member
Back To Top