The prostitutes in the Bangladesh brothels are often underage and unpaid and many of them are hooked on steroids that are destroying their bodies. They work in unsanitary and overcrowded conditions and take the medication to gain weight and appear older.
One of the most popular brothels in Bangladesh, in the busy trading city of Faridpur, is like a prison for the hundreds of girls trapped inside. They get sold into sexual slavery by their families for as little as a few hundreds dollars. They're then forced to work without payment for years, turning tricks each day for a little as a dollar, which goes directly to the madam.
The girls are pressured to look attractive and healthy so they men will choose them for sexual services. Competition is fierce with so many woman vying for the attention of the men who come to one of the poorest cities in Asia to spend their meager earnings. The prostitutes can be found in this dirty, congested section of town where tin shacks are connected together, with long alleyways between them to form an enclosed, active sex market.
Women in the brothels, unlike women around the world, want to become heavier to be more attractive to their clients. They take a drug called Oradexon, a medicine used in Bangladesh to make cattle gain weight quickly. The side effects can be serious, dangerous and often deadly.
It is one of 14 official Bangladeshi brothels. All women working here have to have legal documents proving they are over 18, but many are clearly younger than that, reports the BBC's South Asia news.
In these vast brothel, men police them by carrying heavy wooden clubs. The woman aren't forced to stay but once they enter the brothels they are ostracized by their families, forever to become social outcasts.
The sewers of Faridpur are said to have been blocked by used condoms, and by afternoon the walkways are crowded with customers taking an extended lunch break while waiting for the ferry to take them on their way. The brothel becomes a prison and the women remain for as long as they are desirable because they have no where else to go and no money to help them survive. The few women who do get paid, are paid pennies for their work while their madams keep the majority of the money the men have paid.
Although reports say there is no shortage of clients, the prostitutes are forced to take some desperate measures to survive. This is where Oradexon comes in to play. The girls take it to look older so that the police don't interfere with their work and they take it to gain weight. Weight being a sign of good health in these brothels where malnourishment runs rampant. Some sex workers do not use condoms if their madam or the customers refuse to protect themselves from sexually transmitted diseases.
According to the charity ActionAid, Oradexon can cause terrible health problems, and has even resulted in death when misused or overused, according to government statistics.
One user and prostitute named Ashi said she takes two tablets per day, given to her by her madam. Without the pills she says she has no appetite and health problems. Her madam maximizes profit by forcing her five sex slaves to take the Oradexon.
The madam, Joyetta, says its makes them prettier and healthier and attracts more customers. It gives them larger breasts and wider hips, all signs of beauty. Joyetta knows there are side effects but she claims to give them vitamins to counter these dangers.
The pills can be found in the marketplace and are pushed by those claiming to be doctors or pharmacists.
One prostitute said, "If I die because of taking Oradexon I won't have any remorse because my son is all set," and this thinking is shared by most of the women and girls who make the choice to stay and take the medicine that may someday kill them.
Not everyone here in the Bangladesh brothels has the freedom to choose. The brothel is controlled by a group of madams, who used to be prostitutes themselves.They insist that the women who work for them take the pills. Underage girls take them to become stronger, older women to stay fit, says the Bangladesh Blogger.
No one is quite sure how long Oradexon has been a feature of life in the brothels, but it has been a while; long enough for the sardarni, or brothel caretakers, to have found out that there can be long-term health implications, and to have chosen to ignore them, reports the UK Guardian.
According to ActionAid, which has just published a report into the use of Oradexon among Bangladeshi sex workers, the drug is most commonly taken by girls and women aged between 15 and 35. "It's cheap and it's easily available," says Luftun Nahar, who works in the organisation's Dhaka office, and helped compile the report.
In Bangladesh, Oradexon is commonly used to help asthma sufferers but the women in the brothel take them continuously for years. A recent survey, carried out by ActionAid in two different brothels, found Oradexon to be extremely addictive and harmful in many different ways.
It says the pills can affect the women's hormones, cause high blood pressure, skin rashes and liver damage. Over time, they can make the women more likely to get infections.
It also believes that three women died after taking the steroids and has launched a campaign to inform the women of the drug's dangers.
"We are trying to make the sex workers realise that this is harmful for them and that if they can reduce taking it gradually, they can improve a lot," ActionAid's Luftun Nahar explained.
But without government help, this campaign is unlikely to have much impact, as there are so many prostitutes in Bangladesh.
The authorities are unwilling to intervene in the brothels in any meaningful way, apart from occasionally threatening to allow property developers to bulldoze one or other of them.
The drug's manufacturer, Orion Laboratories, says the drug is safe - if used properly. "Oradexon can be used for curing allergies and inflammations. It is very effective and safe, but if anyone misuses it and takes it for a long time, it can cause all sorts of problems," said senior executive Nantu Krishna Kundu.
"We have learnt that prostitutes are taking it to develop their bodies, but we advise them not to as long-term use can be deadly. Nobody should buy it without the advice of their doctor."
"Bangladesh is a poor country and the women who live in brothels are the poorest. Nobody helps us, but we sex workers need help," one sex worker told the BBC. "People are only interested in us when they can exploit us."
The sad fact is that even if the prostitutes are able to escape life in the brothel one day, the effects of these steroids are likely to stay with them for the rest of their lives.