Before even the Covid-19 pandemic brought in another layer of health hazard and employment insecurity for Bangladesh's garment workers, mounting social and public pressure and rising consumer expectations after a series of factory fires and building collapses had put the garment workers in Bangladesh at a crossroads and many factory owners were trying to go beyond meeting their legal requirements to protect their workers and act more proactively and responsibly. Creating workplaces that are safe for their workers and preventing injury, illness and disease, is one way in which factories can meet these growing expectations. Injuries, illnesses and disabilities at the workplace cause physical, economic and emotional hardship for individual workers and their families. These result in loss of business, reduced productivity and damaged reputation for the factory owners as well. In industrialised nations with strong protective policies and practices in the workplace, health and safety of workers have improved to a great extent and they are now incorporating a wide range of worksite wellness and health promotion programmes for their workers to live healthy. The vast majority of workers who are evaluated and treated for illness or injury return to work without unexpected delays there. However, this is not the case in resource poor countries like Bangladesh. Factory owners still need to see the connection between protecting and promoting workers' health and improving productivity and competitiveness. Unfortunately, the Covid-19 pandemic will hinder all progresses made by the factory owners as they are now in a struggle for survival.
Attention has focused on garment workers' physical safety arising from building conditions and fire hazards while their more ordinarily present chronic health conditions have largely been ignored by all stakeholders. One of such highly prevalent chronic health issue among these workers is pain in their body. Given the very tediousness of their job and remaining in a sitting position often awkwardly all day long, body pain is unsurprisingly a major health hazard in this population. However, pain in the body can be addressed with known, effective and inexpensive interventions.
According to one study commissioned by the Alliance for Bangladesh Worker Safety (the North American Retailers' group) garment workers reported on their knowledge and awareness on fire safety issues. This survey using a large sample size also had questions on chronic health issues like prevalence of body pain. About half of the workers surveyed reported to have neck pain and pain in legs and feet at the end of a typical work day. About 45 per cent reported bad headache and 38.6 per cent reported pain in arms and hands. Back pain was reported by 35.8 per cent and sore eyes by 21.7 per cent. Stomach pain was reported by 1/5 of the respondents and waist pain by 17 per cent. An additional question in this survey broke down body pain by jobs/departments and this shed additional light to identify high risk areas of occupation groups. Responding to the question: do you feel pain after a full day of work, workers from departments like Packing, Sewing, Finishing and Quality Control reported very high prevalence of pain (about 70 per cent or more). About 50 per cent workers in departments like Storage, Cutting, Washing, Embroidery, Ironing also reported suffering from pain.
These are very gloomy findings; millions of Bangladeshi garment workers who are making clothes for western retailers and consumers are going back home every evening with so much pain afflicting their malnourished body and not many studies have reported or investigated this issue before or tried to even address these pain stressors at the workplace.
Given the nature of that survey, it cannot be ascertained if these pain conditions were arising only from their work conditions as non-work stressors may also contribute to this pain. These findings are quite alarming and deserve immediate and considerable amount of attention from all stakeholders. Given the very nature of their jobs and working posture and positions of these workers, it is not surprising that neck, legs/feet, arms, hands and back and waist pain are so pervasive and attested. Sustained sitting or standing in often awkward positions, machines not adjusted to body height and positon, chairs not adjusted or aligned to body height or position could explain some of these findings. They work for very long hours in a day often extended further with overtime and they work almost every day in a week. Some of these pain may also arise from chronic stress that may develop from their work and non-work related life events and issues.
These health conditions may elucidate at least partially why the garment workers cannot have a full tenure career like most others; in general, they do not work for about 25 to 30 years like most other regular manufacturing type jobs in other sectors of the country. With so much pain afflicting them, it is quite likely that they run out of their stamina quite early in life and often quit garment factory job in their mid or late thirties.
With appropriate controls and active ergonomic interventions, many of these pain conditions can be made somewhat less burdensome for them. Letting the workers take frequent breaks, coaching them to stretch their body including neck, shoulder and legs at regular intervals, training them to change body positions more often during a work shift are quite simple and inexpensive interventions to implement. Some light body stretching exercises they can practise at home can be promoted as well. Eye pain can be attributed to their sustained and close attention to sewing, working with small objects and engaging with wearisome machine operations. The fact that one fifth of these workers are reporting about painful eyes is a grave finding for their long-term vision health. Maintaining correct and adequate light intensity at the factory floor and letting them take frequent and short breaks can reduce severe strain on their eyes.
These findings highlight many of the unmet needs of the garment workers who are making clothes for the Western market and driving our economic growth while they lack access to very basic worksite benefits, programmes, policies and facilities. Conducting pre-employment and then periodic or annual health screening can be a starting point to take good care of this workforce. Research should look into how regulatory enforcement, awareness of care providers and workplace-based interventions be effective in improving garment workers' health and wellbeing. Creating awareness domestically and internationally on garment workers' health should be a priority.
Once this pandemic subsides, it would be in the best interest of the western companies, Bangladesh government, donor countries, aid agencies, NGOs and consumer groups to re-channel resources and provide further technical support to the factory owners to keep on improving the health of garment workers. A healthy and productive garment workforce will benefit us all.
Dr. Hasnat M Alamgir is a Professor of Pharmacy at the East West University, Dhaka, Bangladesh
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