Warning: bad science can damage your health

Independent on Sunday, 21 April 2013

In the intensive care ward of a hospital in Sierra Leone, I once heard a young man moaning in agony. His body was going into spasms and I was shocked to discover that he was suffering from tetanus. On the same trip to West Africa, I met more than a dozen men with hugely developed shoulders and withered legs – polio survivors, who propelled themselves on hand-driven wooden carts. It made me realise how lucky I am to live in a country where successful vaccination programmes have all but eradicated such diseases.

Sadly, I also live in a nation where people believe all sorts of nonsense; I’m driven to distraction by individuals who talk about feng shui or go on about their star signs. I suppose it isn’t surprising when we have a future head of state who talks about Nature with a capital N (he thinks it’s female, by the way), and attacks science as “mechanistic thinking”. Prince Charles’s (now defunct) Foundation for Integrated Health even lobbied government ministers in support of offering homeopathy – an “alternative” therapy which has been condemned by MPs as “scientifically implausible” – on the NHS.

Nothing confirms the existence of this tragic credulity more dramatically than the current measles outbreak in Swansea. More than 800 cases have been reported in the city since November and on Friday, public health authorities confirmed that a 25-year-old man infected with the disease had died.

I had measles as a child and it was a very frightening experience; I have a vivid memory of having to lie in a darkened room for several days, while anxious adults drifted in and out. This was long before the MMR vaccine became available, but even at this late stage some parents in Wales seem to be reluctant to have their children vaccinated at
emergency clinics. It’s a fascinating fact that most European countries were unaffected by Dr Andrew Wakefield’s entirely discredited 1998 paper in The Lancet, which suggested a possible link between the MMR vaccine, inflammatory bowel disease, and autism. Wakefield was eventually struck off the medical register for serious professional misconduct, but by 2010 the UK had one of the lowest levels of MMR coverage in a survey of European countries.

What accounts for the difference is the way that sections of the British media, led by the Daily Mail, habitually push an anti-science agenda. British newspapers published  hundreds of MMR scare stories (more than 1,200 in the peak year of 2002) alongside claims about “cures” for cellulite and “sightings” of UFOs.

Experts warned that measles outbreaks would be the result, and that’s what we’re seeing now. There were more than 2,000 confirmed cases in England and Wales last year, almost double the figure for 2011, and the statistics are terrifying for parents of unvaccinated children. But they’re also a warning about the consequences of credulity in a country where hostility to science sometimes seems endemic.


Margaret Thatcher: the dogger climber who pulled up the ladder

Independent on Sunday, 14 April 2013

Baroness Thatcher did little to help less privileged women, believing the battle for women’s rights had been won. She was talking about herself

Thanks to Margaret Thatcher, every girl born in the 21st century knows that a woman can be prime minister. It’s an achievement, even if the party she led has stuck resolutely to male leaders since forcing her from power. No woman has even attempted to lead the Conservatives since Thatcher challenged Ted Heath in 1975, and this week’s ‘ceremonial’ funeral marks her official transition into history.

Last week her admirers preferred to dwell on what they saw as her achievements rather than the circumstances of her death. But just as the death-beds of saints were a popular subject in Renaissance art, there is something almost painfully expressive about the nature of Thatcher’s passing. Many elderly people are lonely, with family and friends dead or scattered to the winds, but few end their days in the sterile luxury of an expensive hotel.

The image of this frail woman dying in the Ritz, attended by a professional carer, is undeniably poignant. And it’s a curious end for a woman from a strict Methodist household who grew up without an indoor toilet – not because the family was poor, but because her father wouldn’t countenance such luxuries. In that sense, her death is a symbol of the contradiction at the heart of her character, which undermined the self-proclaimed simplicity of her politics.

As a girl, Margaret Roberts was clever but not intellectual. Her mother was a nonentity in Margaret’s eyes, omitted from her Who’s Who entry, while her father, a lay preacher and alderman, meant everything to her. “He taught me that you first sort out what you believe in. You then apply it. You don’t compromise on things that matter,” she once said. This identification with the dominant male in her family is the key to her personality, explaining why so many commentators have found it hard to recognise her as a woman.

To be precise, the struggle is to identity her as a modern woman. Even the name by which she was known – “Mrs” Thatcher – belongs to an earlier age. This isn’t just a  matter of style, although her appearance drew on a formality already in decline by the 1960s. Yet at first glance she was a pioneer in many ways. In 1952, when she was looking for a safe seat, she made “trenchant demands” – the phrase comes from Hugo Young’s biography – in a newspaper article about the need for more women in Parliament. Of course, she did so from the standpoint of a graduate with a wealthy husband who bankrolled her ambitions. “The battle for women’s rights has largely been won,” she said in 1982. “I hate those strident tones we hear from some women’s libbers.”

She meant her own battle. Not for the first time, Thatcher was conflating her own experience with that of people whose circumstances were a great deal less privileged. Another species of cognitive dissonance surfaced after her election victory in 1979, when she talked about bringing harmony, faith and hope to the country. In no time at all she had plunged into fights to the death over the Falklands and with the miners, and it now seems that the truest thing she said that day was about faith. In an increasingly secular age, she had the single-minded certainty of the believer, expressed in a Manichean formula: “I am in politics because of the conflict between good and evil, and I believe that in the end good will triumph.”

In our complex world, it sounds like the blurb from a computer game, but Thatcher’s values were Edwardian; while two of the three current party leaders are atheists, it’s another measure of how distant the former prime minister appears from contemporary mores. Later, she returned to traditional language about the importance of marriage and motherhood, ignoring the fact that she had a live-in nanny and then sent her children to boarding school.

Like a lot of right-wing women, Thatcher preferred being with men but she appeared to them in different guises. “In her presence you pretty quickly forget that she’s a woman,” said Jimmy Carter’s national security adviser, Zbigniew Brzezinski. She may have toned down her version of refined middle-class femininity with Americans, but in a political party where maternal deprivation was common, she adopted the persona of the only powerful female figure in a boys’ school – matron. It made her not so much a mother as a mother substitute, which is why many of the anecdotes about her have an under- current of squirming adolescent eroticism. But it was fatal in other respects, setting her apart from other women and confirming her indifference to gender equality.

Almost a quarter of a century after she left office, her legacy to the Conservative Party has been five male leaders in a row. A different kind of politician could have done a great deal for other Tory women, mentoring them and helping them into safe seats, but Thatcher had neither the will nor the imagination.

The most serious charge against her is that she put her father’s stern principles into practice for other people, not herself. Perhaps she wondered, in the final weeks of her life, why other elderly widows didn’t just move into a suite at the Ritz. But the embrace  of traditional male values which made her palatable to Conservative grandees didn’t help her in the end. She was never “one of them” and they were ruthless when they decided to get rid of her. As her funeral approaches, the question that Britain’s first female prime minister leaves behind is not whether a woman can get to the top. It’s how she could do it and yet have so little positive effect on the lives of other women.


Sexual predator seeks needy young woman

Independent on Sunday, 7 April 2013

Just over two years ago, nine men from Derby were jailed in three separate trials for preying on teenage girls. The victims were aged between 12 and 18 and had been groomed by a gang led by 28-year-old Mohammed Liaqat and Abid Saddique, who was 27. Because all but one of the convicted men were Asian, the Derby trials were quickly subsumed in a controversial narrative about the role of ethnicity and culture in cases of systematic abuse of girls. But in the very same town, another man had been targeting vulnerable teenagers for decades.

In the mid-1970s, Mick Philpott began a relationship with a 15-year-old girl, Kim Hill. A couple of years later, when he was in his early twenties, he tried to kill her. He served time in prison, came out and married Pamela Lomax, with whom he had three children. He was 37 when he met 14-year-old Heather Kehoe, whom he began sleeping with a year later. She ran away with him just after her 16th birthday and they had two children together. When Heather left Philpott, his next victim was Mairead Duffy. She was 17 when he met her in a pub, a single mother who was “at rock bottom” after an abusive relationship.

Philpott married Mairead, but one young woman wasn’t enough to satisfy his massive ego. His next target was Lisa Willis, a 16-year-old single mother whose parents were both dead. The two women shared Philpott until last year, when Lisa took their four children and sought shelter in a refuge. That was when Philpott tried to frame her for a fire, killing the six children he’d had with Mairead.

Philpott is such a horrible man that it’s tempting to see him as a one-off. But his story is familiar, and it highlights a huge social problem: predatory older men who target vulnerable young women from chaotic backgrounds. Philpott forced Mairead and Lisa to pay their wages into his bank account and insisted on Mairead having sex with other men, including his co-accused Paul Mosley.

Passing girls around for sex was also a habit of Liaqat and Saddique, who roamed the streets of Derby looking for vulnerable teenagers. The modus operandi in these cases recalls that of the serial killer Fred West, who targeted his future wife Rose when she was 15.

Some of the girls involved are under the age of consent, but the chief attraction for sexual predators is a combination of youth, unstable backgrounds and a craving for affection. Many teenagers don’t get sensible advice about relationships from their families, which is why there’s an urgent need for the issue to be addressed in schools. Two months ago, a coalition of women’s groups called on the Education Secretary, Michael Gove, to make sex and relationships education compulsory. His department stonewalled, saying that schools “are encouraged” to provide it.

It was a feeble response even before the Philpott case. Now there is no excuse for the Government’s continued failure to protect teenage girls from dangerous men.


The Vogue Factor: Fashion really isn’t worth dying for

The Independent, Thursday 4 April 2013

The damage the industry inflicts on young women is paraded on the catwalk

Imagine a factory where the employees are regularly being starved. Some are so desperate with hunger that they pick up tissues from the floor and stuff them into their mouths, while a few become so weak that they have to be admitted to hospital and put on a drip. Any industry which treated workers so badly would be targeted by undercover reporters. Photographs of emaciated workers would cause an outcry, questions would be asked in parliament and the factory would be closed down. This would happen anywhere in the developed world with one glaring exception, and that’s the  fashion industry.

“You know how you read interviews where models insist that they eat a lot? Not true,” says Kirstie Clements, who edited Vogue Australia for 13 years. “The only way they can get that thin is to stop eating. They eat tissue paper to stave off the hunger pangs – literally ball it up and eat it.” It’s one of several startling claims in The Vogue Factor, a book that Clements has written about the industry she knows from the inside, and it’s  not even the most shocking.

Clements lifts the lid on the existence of “fit” models, the women used to check the fit of clothes who are expected to be even thinner than the catwalk variety. “Fit” in this instance means just the opposite, as Clements discovered when she asked a top model how she was getting on with her flatmate. “Oh, it’s fine,” was the insouciant reply, “she’s a fit model so she is mostly in hospital on a drip.”

By any normal standards, someone whose job puts them in hospital most of the time is: (a) deluded; and (b) abused. But the fashion industry departed from normal standards years ago, not even bothering to hide the damage it inflicts mostly (but not exclusively) on young women. It’s paraded on catwalks and in fashion spreads for anyone to see, evident in models whose jutting hipbones and stick limbs suggest they’re suffering from malnutrition. When flipping through a glossy magazine a couple of days ago, I was mesmerised by a perfume ad featuring two models whose naked bodies were as skinny as saplings.

Clements recalls a fashion shoot which lasted for three days yet she didn’t see the model eat once, even when the girl got so weak that she could hardly stand or open her eyes. Everyone involved in the fashion industry is expected to buy into a fantasy in which there’s nothing unusual about being five foot nine and weighing 45 kilos. But the death toll on the international modelling circuit – Ana Carolina Reston, Luisel Ramos and her sister Eliana, Isabelle Caro - tells a different story. Fashion isn’t worth dying for, so let’s start applying the normal health and safety standards to this sick industry.


Death – still with us, but further away than ever

It’s as if the Queen’s demise is so awful to contemplate that it can’t be mentioned

Independent on Sunday, 31 March 2013

When the death of the actor Richard Griffiths was announced last week, tributes from friends and colleagues were heartfelt. Griffiths was 65, which isn’t old in modern terms, and his death from complications after heart surgery was unexpected. That much was evident from the shocked reaction of actors who had worked with him, some of them on very recent projects as well as the cult film Withnail & I. With the retirement age for both sexes set to rise to 66, Griffiths hadn’t even reached the end of his working life, and the sense of loss was palpable.

Earlier in the week, in another continent, a much older man was admitted to hospital with a lung infection. The former South African president Nelson Mandela is 94 and clearly in the final phase of his life, which made the current president’s response all the more puzzling. Jacob Zuma asked South Africans to pray for Mandela, as though his death might be avoided through divine intercession, and added that they “must not panic”. Panic is usually a response to an unexpected event and it’s hard to see how anyone in South Africa, no matter how devoted to Mandela, could be unprepared for his demise.

If there is an element of denial in the public attitude to Mandela’s closeness to death, it is not exclusive to South Africa. Profiles of the Queen, 87 this year, stress her good health and the longevity of her ancestors, notably Queen Victoria. It’s as if her demise is so awful to contemplate that it can’t be mentioned, so we are treated to endless upbeat
announcements whenever she or her even older spouse needs hospital treatment. “Prince Philip joked with nurses last night” is how royal correspondents conceal anxiety about the fact that he is 91 and won’t be around for ever.

There’s probably never been a time when it’s so hard to talk about death. Better health and increased life expectancy mean we don’t grow up with the bereavements familiar in the 19th century; Queen Victoria’s husband, Prince Albert, died at the age of 42, leaving her a widow for almost 40 years. These days, most of us are too young to remember the Second World War, when whole areas of British cities were erased overnight, with thousands of civilian casualties. And while the Victorians’ belief in an afterlife doesn’t seem to have been much of a consolation to those who lost children or spouses, even fewer of us believe in it now.

So perhaps it isn’t so surprising that public discourse about death is characterised by avoidance. When Princess Diana died I was shocked to hear people telling their children that she was “in heaven” or “with the angels” – another example of how hard we find sudden death.

The subject is brought into focus by the British Museum’s exhibition of artefacts from Pompeii and Herculaneum, which opened last week. It includes everything from a baby’s cradle to plaster casts of men, women and children who died in the eruption of Vesuvius in AD79. The disaster preserved the cities in ash and pumice, allowing future generations to observe everyday life in minute detail once the sites began to be excavated in the 18th century. The juxtaposition is troubling: frescoes which could have been painted last week, election announcements, even sexually explicit graffiti, were all preserved at the very moment that the remaining inhabitants – many had been evacuated – lost their lives.

When the volcano erupted, the natural philosopher Pliny the Elder had just finished lunch in his villa and was working on his books. Pliny was commander of the Roman fleet stationed in the Bay of Naples and he set sail on a rescue mission, hoping to save a friend who lived close to the volcano. He reached his friend’s house but “the buildings were now shaking with violent shocks, and seemed to be swaying to and fro, as if they were torn from their foundations”, his nephew wrote later. Pliny returned to his ship, realised it was impossible to escape because the sea was too rough and sat down calmly, asking for water. When the flames and sulphurous fumes got closer, he tried to stand but collapsed and died, probably from a heart attack.

This is the horrifying reality behind those eerily well-preserved Roman cities. If we’re willing to hear it, it’s the story behind simple domestic objects from Pompeii, many of them in use almost as their owners perished, offering a vivid reminder of the closeness of life and death. That’s what we’re reluctant to acknowledge all these centuries later, despite our vastly greater scientific knowledge, unless we’re forced to by accident, illness or by having relatives in the armed forces. Every British casualty in Afghanistan is mentioned in news headlines, signalling a tragedy for the family concerned, but it’s only possible because so few soldiers die in combat compared with the conflicts of the first half of the 20th century.

Safety has made us squeamish and unrealistic. Death now happens in movies, computer games or faraway countries, while the reality is pushed out of sight and avoided in polite conversation. Life is much longer these days but it isn’t infinite, not even for heads of state.


The best thing since Simenon

The Sunday Times, 31 March 2013
   After decades in which crime fiction in French was dominated by the Belgian author Georges Simenon, it has an indisputable new star in Fred Vargas (the pseudonym of the historian ­Frédérique Audoin-Rouzeau). Her novels have scooped the CWA International Dagger on three occasions. The Ghost Riders of Ordebec, translated by Sian Reynolds (Harvill Secker £12.99/ebook £13.56), is the eighth in her Commissaire Adamsberg series and an early contender for outstanding crime novel of the year.
   It opens in Paris, where Adamsberg is interviewing an elderly man whose wife has choked to death on breadcrumbs. It is a typically oblique opening, a domestic killing that has little to do with the spectacular murders that he is about to encounter in Normandy. Locals link the murders to a mythical troop of riders whose ghostly appearance always signals death. This piece of folklore fascinates Adamsberg, who understands that the apparitions are projections of the community’s desire for vengeance against people known for their cruelty to humans or animals.
   It is the kind of superstition that flourishes in a rural community, brilliantly drawn in the novel, where class distinctions have existed for centuries. Patient and humane as ever, Adamsberg realises he needs to disentangle the myth to prove that it has been exploited by a very ingenious criminal.
   Andrea Camilleri’s Inspector Montalbano novels reach a much wider audience these days, thanks to a popular television adaptation. The Dance of the Seagull, translated by Stephen Sartarelli (Mantle £16.99/ebook £16.99), begins with Montalbano brooding in his Sicilian seaside apartment. His mood hasn’t improved since the last book in the series, The Age of Doubt, in which the fiftysomething inspector started to dwell on mortality. Now he’s awaiting the arrival of his long-suffering girlfriend Livia when a colleague disappears, driving all thoughts of a holiday out of his head.
   Camilleri is a fine writer and the earlier Montalbano novels stand out in the ranks of modern crime fiction. Somehow the irascible inspector with a passion for food managed to avoid cliché even if there were elements that jarred, not least the ponderously stupid switchboard operator Catarella. But Montalbano’s preoccupations have begun to seem like those of a much older man and it’s hard to read the new novel without recalling that his creator is in his eighties.
   Donna Leon has been writing novels set in Venice for more than two decades. American by birth, she has lived there for a quarter of a century and her familiarity with the city is a feature of her Commissario Brunetti novels. The Golden Egg (Heinemann £17.99/ebook £18.77) is the 22nd in the series; a deaf mute who worked at the dry-cleaner used by the Brunettis has been found dead in an apparent suicide and ­- Brunetti’s wife is dismayed to realise she doesn’t even know his name. The novel proceeds at a gentle pace, but Leon’s ability to portray her adopted country has been overtaken by grittier Italian authors who write in their own language.

Amanda Knox’s retrial puts Italian justice in the dock

The Guardian, Tuesday 26 March 2013

Rudy Guede killed Meredith Kercher. The continued pursuit of Knox and
Rafaelle Sollecito implies incompetence and misogyny

The sexual assault and murder of Meredith Kercher in Perugia in 2007 was a dreadful crime. The perpetrator, Rudy Guede, left copious amounts of forensic evidence at the scene and is currently serving a prison sentence. In normal circumstances, Guede’s conviction would have been the end of the matter, but these are not normal circumstances. The announcement that Amanda Knox and her Italian ex-boyfriend, Raffaele Sollecito, are to face a retrial means a fourth set of proceedings, no doubt with worldwide publicity. It also confirms the reluctance of the Italian authorities to let go of a misogynist fantasy which has turned the case into a prolonged media circus.

To anyone familiar with the modus operandi of sex attackers, the identification of Guede as the killer is unproblematic. He knew Knox and Kercher by sight, he had visited the young men who lived in the apartment below theirs and it is entirely credible that he knocked on the door or broke into the upper flat in the hope of having sex with one of the women. He left a partial palm print on a pillow in Kercher’s room, a footprint matched the trainers he was wearing and his DNA was found on the body and at various locations in the apartment. He opted for a fast-track court procedure in 2008 and was sentenced to 30 years in prison, reduced to 16 on appeal.

The central mystery of this case is not the identity of the murderer but the steely determination of the Italian authorities to drag in two other suspects, Knox and Sollecito. At their original trial in 2009, the prosecution was able to produce neither witnesses nor a credible motive. Knox’s “confession” was obtained when she was sleep-deprived, had no access to lawyers and was unable to speak fluent Italian; she retracted it as soon as she was allowed to sleep and get legal advice. The two students’ eventual conviction rested on minute traces of forensic evidence, and even that was comprehensively discredited during their successful appeal in 2011.

There’s no doubt that their release infuriated prosecutors in Perugia, who had convinced themselves that Knox was a villainous character who could easily have walked out of a medieval witch trial. It’s impossible to overstate the influence on Knox’s trials of Perugia’s dark history, which has earned it a reputation as an “epicentre” of medieval witch burnings. It’s left a residue of superstition and fear of female sexuality which emerged time after time in court, with one lawyer actually accusing Knox of being ‘diabolic’.

In a country where Catholicism still informs conservative attitudes towards female sexuality, and Silvio Berlusconi’s TV channels present young women as writhing sex objects, there is little space for independent modern women. Knox was transformed from a typical American student into a sex-crazed hedonist who arrived with from the US with a vibrator in her luggage. Within weeks, she supposedly conceived such a hatred of her British flatmate that she persuaded two men she barely knew to take part in a murderous attack.

Improbable as all this is, Knox’s supposed role as the instigator was reflected in the sentences in the case. After Guede’s sentence was reduced, she was left to serve the longest sentence for Kercher’s murder – 26 years in prison, compared to 25 for Sollecito. This was an extraordinary outcome, bearing in mind the lack of evidence against her, and one of its lasting effects has been to put Knox at the centre of the case. This must be unbearably painful for Kercher’s family, who have seen their daughter relegated to little more than a footnote.

The resurrection of the tabloid caricature ‘”Foxy Knoxy” cannot be far off, but it’s hard to see how justice is served by what looks like the prosecution’s idée fixe. Knox and Sollecito face the ordeal of another trial but the Italian criminal justice system is also in the dock, arraigned for incompetence and rank misogyny.

Why the game’s up for Sweden’s sex trade

Sweden’s innovative sex-trade laws criminalise clients, not prostitutes. The result: a huge per cent drop in business. Joan Smith jumps in a squad car with local police to find out how it works – and whether Britain could follow suit

The Independent, Tuesday 26 March 2013

I am sitting in the back of an unmarked police car on the small island of Skeppsholmen, to the east of Stockholm’s picturesque old town. Above us is the city’s modern art museum but it’s a dark February night and we’re not here to appreciate culture. “They park up there,” says the detective in the front passenger seat, pointing to a car park at the top of the hill. “We wait a few minutes and then we leap out, run up the hill and pull open the doors.”

What happens next is a textbook example of the way Sweden’s law banning the purchase of sex works in practice. The driver of the car, who’s brought a prostituted woman to the island to have sex, is arrested on the spot. He’s given a choice: admit the offence and pay a fine, based on income, or go to court and risk publicity. The woman, who hasn’t broken any law, is offered help from social services if she wants to leave prostitution. Otherwise, she’s allowed to go.

“Buying sex is one of the most shameful crimes you can be arrested for,” explains the detective, Simon Haggstrom. He’s young, black, and his appearance – shaved head, baggy jeans – suggests a music industry executive rather than a cop. But he’s in charge of the prostitution unit of Stockholm county police and he’s proud of the fact that he’s arrested more than 600 men under the Swedish law: “We’ve arrested everyone from drug addicts to politicians. Once I arrested a priest and he told me I’d ruined his life. I told him, ‘I haven’t ruined your life, you have.’”

Sweden’s decision to reverse centuries of assumptions about prostitution and criminalise buyers of sex caused astonishment when the law came into force in 1999. As arguments raged elsewhere about whether prostitution should be legalised, the Swedish government’s simple idea – that the wrong people were being arrested – was new and controversial. Detective Superintendent Kajsa Wahlberg is Sweden’s national rapporteur on trafficking in human beings. When I meet her at her office in Stockholm, she recalls that one police officer from another country actually accused the Swedes of “Nazi methods”. Wahlberg acknowledges that many Swedish officers were sceptical as well. “There was frustration and anger within the police. People were chewing on lemons,” she says with a wry laugh.

All of that’s changed dramatically since the law came into effect. “The main change I can see when I look back is we got the men on board,” says Wahlberg. “The problem is gender-specific. Men buy women. One of the keys is to train police officers. When they have understood the background, they get the picture.” She talks about why women end up in prostitution, citing research that shows a history of childhood sexual abuse, compounded by problems with drugs and alcohol.

“They have no confidence in themselves. They’ve been left out and neglected and try to get all kinds of attention. This is not about an adult woman’s choice.” In the 1990s, the Swedish government accepted the arguments of women’s groups that prostitution is a barrier to gender equality and a form of violence against women. What’s remarkable is that public opinion, which was initially hostile, has swung round to this view; these days, 70 per cent of the public support the law. “We’ve changed the mindset of the Swedish population,” Haggstrom tells me. The change is visible among the older members of his unit.

One undercover cop, who’s been a police officer for 37 years, reveals a lingering sense of surprise when he remembers what happened 14 years ago. “When the law came into force, the streets were empty for six months,” he says. These days he’s one of its most enthusiastic supporters, having seen for himself how the number of women in street prostitution in Stockholm has declined. Where 70 or 80 women used to sell sex outdoors, these days it’s between five and 10 in winter, 25 in summer. A small number of women work on the streets of Malmö and Gothenburg but the Swedish figures are nothing like those for Denmark, where prostitution has been decriminalised. Denmark has just over half the population of Sweden but one study suggested there were more than 1,400 women selling sex on Danish streets.

The law has brought about other changes as well. Before 1999, most women in street prostitution in Stockholm were Swedish. Now they’re from the Baltic states or Africa, and have sold sex in other countries as well. They tell Haggstrom’s officers they’re much more likely to be subjected to violence in countries where prostitution has been legalised. “Swedish men want oral sex and intercourse, nothing more than that,” the undercover cop tells me. “They know they have to behave or they may be arrested. They don’t want to use violence.”

It’s a fascinating observation because one of the criticisms of the law was that it would make prostitution more dangerous. All the Swedish police officers I spoke to insisted this was a myth, along with the notion that prostitution would go underground. “If a sex buyer can find a prostituted woman in a hotel or apartment, the police can do it,” Haggstrom observes sardonically. “Pimps have to advertise.”

Specialist officers have been trained to monitor the internet and the police also have access to telephone intercepts, which suggest that traffickers no longer regard Sweden as a worthwhile market. “We’ve had wiretapping cases where pimps say they don’t findsSweden attractive,” Haggstrom continues. “Even if they don’t get arrested, we arrest the clients. They’re in it for the money. For me, this is not an advanced equation to understand.”

Swedish crime statistics seem to support his argument. In 2011, only two people were convicted of sex trafficking and another 11 for pimping connected to trafficking. (At the same time, 450 men were convicted and fined for buying sex, including a number of foreign tourists). Last year the figures were slightly higher: three convictions for sex trafficking and 32 for the related offence. But 40 women, mostly from Romania, had sufficient confidence in the Swedish criminal justice system to testify against the men exploiting them.

Could the Swedish law work in other countries? Norway and Iceland have brought in laws banning the purchase of sex and the UK has taken tentative steps towards criminalising clients; it’s already a criminal offence to buy sex from anyone under the age of 18 or an adult who’s being exploited by pimps or traffickers. But there have been few convictions, suggesting that British police officers don’t share the robust attitudes of their Swedish counterparts. Haggstrom agrees with Wahlberg that legislation on its own isn’t enough: “You have to have enforcement resources. You have to have police officers who go out and make arrests.”

In the police car, something happens which reveals the full extent of the philosophical shift that has affected men and women in Sweden. In a brightly lit street, Haggstrom points out a couple of Romanian women who work as prostitutes. As I think about them making the journey over the bridge with a total stranger to the desolate car park on Skeppsholmen, Haggstrom turns to me. “Having sex is not a human right,” he says quietly.