Shramshakti (1988): Report of the National Commission on self employed women and women in the informal sector||
To understand the occupational aspects of health, it is necessary to have a detailed examination of women's work in terms of the actual activity undertaken, the hours of work entailed, the remuneration, if any, and the effects of all these on their nutritional status and physical as well as mental health. To understand the issues pertaining to the nature of a woman's occupation, it is necessary to analyse them in terms of the types of physical stresses involved in the movements required, the postural positions, and their effects, and the noxious materials used. Long hours and inadequate wages further exacerbate the occupation related health problems of women and, hence, are also examined with respect to the occupation under discussion.
2. The effects of working environment on health include lack of adequate lighting, insanitary conditions, poor air flow, working in the open elements and such other factors likely to affect her physical condition. Mental stresses are also viewed with respect to the factors associated with their work. Lastly, it is essential to examine those benefits and protective legislation, which affect women's health such as minimum wages (as purchasing food and adequate, nutritional status are directly related to them), access to health services, maternity benefits and creches (which decrease her tension with respect to child care while at work).
3. All working class women work, whether they are wage-labourers or not Labour in the home is not only reproductive and social with regard to the upbringing of the family and care-taking functions, but also productive, as women's work replaces goods and services, which would, otherwise, be purchased in the market, such as fetching water, gathering fuel and fodder, grinding cereals, maintaining cattle, kitchen gardens, weeding, winnowing, harvesting, and a myriad other functions such as tailoring, maintaining the house structure and repairing it, and tutoring children. Hence, it can be said very confidently, that there are fewer women than men who do not work at all In fact, if women work outside the home, they are
consistently working a double (and when children etc. are ill, a triple shift, day after day Women, on an average, have much longer total hours of work than men. 1
4. One-third of women, at least, and in some instances, a higher proportion, are the sole supporters of their families. This has been brought out in many research reports. A recent study of two villages, sponsored by the Health Task Force of the Commission, in a chronically drought prone area in Maharashtra also very clearly brings out the contribution of the women workers in the economy of the area. The major source of income for women in this area was work in the Employment Guarantee Scheme. The men went in for work on private sites. For the same work, women received less than half of what the men received. Yet, in 20 per cent of the households women's income was 100 per cent of family income. In another 20 per cent of the households, women's income construed at least 50 per cent of the family income. This in effect meant that women worked at least twice as much as the men in economically productive work, and their income was the mainstay of the family's economy.
5. In addition, the women were also responsible for almost 100 per cent of the housework—"socially productive labour". They were also responsible for 100 per cent of the "reproductive labour"—the bearing and rearing of the children. 2
6. Thus, the contribution to society made by women's work is far greater then of men, though fewer women than men, have opportunities to work outside the home, the work which women do within the home—cooking, washing and cleaning, caring for children and the old, nursing the ill, fetching fuel and water, is work which is crucial to the survival of society. If women stop doing this work, and no one takes it up, all factories, transport, construction, food-production and so on will come to a standstill, disease and hunger will spread and very soon people will start dying. So if we look at the social usefulness of their work alone, it looks as if women ought to have more bargaining power than anyone else, because it is their work which produces, nurtures and sustains the people, who produce everything else. But this is not at all the case in fact, quite the opposite. 3
7. The fact that women are house-workers as well, affects their status within wage-work adversely. It confines them to badly paid work, marginal jobs, which are supposed to be 'women's work'. Though women-headed households constitute a large proportion of households in the country, yet the idea of the working women only "supplementing" the household economy has become a fixed notion of potential employers and, despite legislation women continue to be pushed into low-paying categories of jobs, which remain low-paying because women work in those jobs. Instead of enhancing women's status, each of the different roles women play, while performing the different aspects of social labour, works against the other roles. This is reflected, among other things, in the fact that many women have to work, up to the last day of pregnancy and return to work within a month, endangering their own health and that of their children. The vicious circle rather than being broken, is reinforced by other factors, thus depressing the situation of women further
8. The truth is that the contribution of women to the family, and to the economy, has not been evaluated, quantified, or even recognised. One has merely to shut one's eyes and visualise an all-women's strike for just a couple of weeks and see the massive chaos, destruction and havoc that would ensue—at least a couple of times greater that an all-men's strike. Hence, the statistics regarding the contribution of women's work is not even the tip of the iceberg. On the contrary, the figures indicate not the extent of women's labour, but only the extent to which it is even marginally recognised and paid. It indicates that a greater part of it is unpaid and that the burden and loss is women's alone of labouring, poor women—those who are unorganised, self-employed and remain unprotected. This section constitutes more
than 94 per cent of the female workforce of this country. It is increasing each year, as fewer and fewer women continue to be absorbed in the formal" sector.4 Besides, the few opportunities available to women especially those employed in the informal sector to participate in other areas of life, depend crucially on their access to the opportunity to be healthy. On the other hand, the obstacles to their achieving even the simple state of well-being are tremendous and emanate from almost every institution and structure with which they are in relationship, even remotely. Poor women have no access to education or training. In order to make both ends meet, they have to work, most often, in the unorganised industry, and health hazards are manifold. They cannot take time off from their work, either for illness or before and after delivery. Their access to health care is reduced considerably by the distances from health care facilities, lack of time to go there, the difficulty in making the other members of the household interested in their health needs and the costs. All these factors play against them and then particularly vulnerable to various chronic and acute illnesses, most of which, like anaemia, they carry along with them and suffer till they become severely handicapping or even fatal.
Some Common Problems Related to Occupations in the Informal Sector
9. In terms of the health problems women face specifically in their occupations, certain trends and tendencies about the nature of women's work and their health problems are discernible.
Problems related to the posture at work
10. The paper-bag makers in Delhi suffer constant stress and exhaustion, thus falling prey to a host of chronic illnesses. Their bodies ache from constantly sitting in one position, their backs.
She is concerned about her health provided she has the time and access to health care.
grow bent from constantly having to stoop. They suffer particularly from pain in the back, shoulders and waist, and stiffness in joints. Their eyes ache and water from hours of strain.
11. This is equally true of beedi workers, zardozi and zari workers, chikan workers, lace makers weavers, gunny bag stitchers, carpet-makers, tagai workers, in short the entire work force of women who are involved in strenuous work, usually working at home.
Problems of being in contact with hazardous material
12. Constant contact with woodsmoke, cashew oil, gases like carbon monoxide and formaldehyde, chemical fumes in the electronics industry, tobacco dust, oils: and silica dust, is an occupational hazard. The cashew workers in Kerala say, after working in this department for a month, our fingers start burning because of the extra oil coming out when we break the shell on the machine Boils and abscesses appear on our hands.
13. The fingers of the women look as though they have been afflicted with leprosy. Protective gloves are not given to the women.
14 The Bintoashale stone dust, which is thrown in the air while producing slate-pencils in the Mandsaur district in Madhya Pradesh, is in fact, silicosis, which is exacerbated by increase in the severity and duration of exposure. The mean age of the workers who were killed was 34.65 years.
Many of her occupations pose unavoidable health hazards
There have been 3, 000 deaths of slate-pencil workers in the last decade. The use of chemicals fertilisers creates skin reactions on hands and feet.
15. In all of the diverse occupations ranging from housework, domestic work, and laundering on the one hand, and photo-copying, electronics on the other, with mining, agriculture and construction somewhere in between that women are engaged in, there are numerous debilitating health hazards.
Problems related to their work environment
16. These include, lack of light, latrines, water, ventilation, space. Small, poorly-lit and ill-ventilated homes, in crowded mahallas and streets, serve as both the living space and workplace for almost all home-based workers.8 Inadequate lighting, long working hours spention doing in doing extremely fine, minute work tike chikan embroidery, lace-making, zari and zardozi embroidery, and tagai work cause severe problems like poor vision, eye-strain and headaches, and also accidents.
17. In all small-scale factories too, women work in cramped conditions in rooms which have extremely high temperatures—glass industry, garments etc. In the garment factories, women are often employed to iron the finished garments. Many women are known to have fainted due to the heat and humidity in the atmosphere. Most of these factories do not even provide women with toilet facilities. As a result, women try and eat and drink very little during the day. This results in constipation and other related health problems.
18. Women in the mining industry, in agriculture, women vendors10 have the opposite problems—having to work in the open all through the day, in the hot sun or rains. This. apart from other effects, causes them to sweat, losing very precious water and salts.
Problems related to their work actions
19. Tying, stitching, banging, lifting, bending all lead to health problems, than 3, 000 women in Jaipur are involved in the tying process of the tie and dye work. They spend almost the entire day tying extremely minute designs on yards and yards of cloth. They have deep cuts and dents on their fingers from the metal contraption they have to use and from the thread (personal conversations).
20. The block-printers in Ahmedabad manually print sarees and bed-sheets. The blocks are dipped in the semiliquid colour and placed carefully on the cloth and then the women have to strike the top of the block twice or thrice rapidly and hard, usually with both their hands in turn, sometimes with one. In one minute, they print about 12 times, i.e., 12 X 3 = 36 strokes with their hands and shoulders. Their fingers become rough due to the constant contact with the dye. The sides of the palm, which they strike on the block, are hard and have toughened. Their arms and shoulders too ache very badly (personal conversations).
Problems related to lifting weights
21. Lifting heavy weights is one of the "job descriptions" of women involved in construction, on employment guarantee schemes and brick-workers. These give rise to health problems like menstrual disorders, prolapse of the uterus, miscarriages, back problems, especially those relating to the spinal column, causing serious long-term repercussions.11 Accidents and injuries, to the children are also other serious health problems that women have to face, due to non-availability of creches at the worksite where the children play around.
Problems related to their long hours of work
22. Most of the serious health problems get aggravated due to the long hours of work the women have to put in.
23. The postural problems that women in beedi-making, chikan, zari, zardozi, paper-bag making, lace-making, and houseworkers face, get much worse as the women work for 8 to 14 hours a day, day after day. The chemicals, fumes, gases, dusts that women miners, women in slate-pencil making, in electronics, in fish-processing, and in the cashew industry, face, worsen the health problems and culminate in serious morbidity or even death due to the long period of exposure each day. Continuous actions like bending, crouching, banging, lifting, also aggragate the health problems.
24. Long and continuous exposure and lack of rest in order to recover from the health impairment due to continuous work, take a high toll of women's health.
Problems due to the repetitiousness of the movements
25. When women lift heavy weights, there are certain problems women face, prolapse of the uterus, miscarriages and back problems. But when they do the same work over and over again, the health problems are compounded many times more.
26. On the other hand, when women in the electronics industry spend day after day fitting in the circuits and use only one part of their bodies, hands and shoulders, in repetitive movements, they often suffer, from a condition termed tenosynovities. Also repetitive movements reduce the mind to a drugged state which not only causes extreme fatigue of the mind, but is also known to cause accidents which may be dangerous to limb or life.
Problems related to technology
27. Technology has been a double-edged sword, especially because in this society, the controllers of technology and the ultimate users of it are totally different sets of people, with different interests and concerns. Most technological developments are introduced with the aim of maximising profits. These often negatively affect the people involved in production, especially women workers. Thus on the one hand machines are being introduced to make bidis faster, or in the bead-piercing activity, or in weaving, or in the coal mines, but it results in the displacement and retrenchment of women workers, without offering them any alternatives, either in employment for the existing workforce or, alternative training facilities for the future workforce. With the already meagre sources of livelihood and survival diminishing, many women will be forced to do more strenuous work or be more malnourished.
28. On the other hand, work which is strenuous and hazardous, due to the primitiveness of the methods and tools, e g harvesting and weeding, is either left untouched by technology or it is beyond the means of most women e g LPG cylinders instead of the primus stove or the woodfuel.
29. The use of technology, through mechanisation of certain production processes, has not only increased, but qualitatively and quantitatively worsened, the health hazards for certain sectors of the workforce. The use of machines in the production of slate pencils as well as in mining, has rendered finer, and hence more easily inhalable, the silica and other dust flying in the air. However, there is no accompanying investment in measures to protect workers from the ill effects of this "technological advance". This dust is not obstructed in the nasal passage, but passes smoothly upto the lungs. The older workers in the Mandsaur slatepencil factories have noticed that both morbidity and death have increased since the advent of the machines in the slate factories.15
Problems related to mental health
30. The very unorganised nature of the "informal sector" women working in it are subject to
leads to various forms of oppression, including sexual oppression, they vary from rape, forced prostitution and sexual harassment to wife-beating, the unequal sexual division of labour at home and at work, and restrictions on the freedom to move about.
31. The constant tension and anxiety of this situation, results in continuous stress on the women. While men workers experience exploitation at the workplace, women workers experience both exploitation and oppression, not only at the workplace, but also in society and at home.
32. Sexual exploitation is regularly experienced by almost all sections of women in the informal sector, for example, nurses experience it from doctors and village politicians;16 women domestic workers, from the masters of the houses they work in; 17 women sweepers;18 and rag-pickers;19 from their male colleagues, prostitutes;20 from the police;21 the clients and the local goondas, the vendors;21 from male buyers and sellers, the gate-keepers of the buildings they go to sell their wares and from the police, for the workers in the processing industry and small-scale factories;22 from their supervisor, employers and male colleagues, for women working in agriculture;23 from the landlords, employers, and the forest guards etc.
Specific Health Problems Related to their Occupations
33. Following is a tabular representation of some of the known health hazards in various occupations in which women in the informal sector are involved, and some concrete recommendations to improve their health. Some points need to be kept in mind while noting the contents:
1. These are some of the known health problems. Considerable research needs to be undertaken to find out more about these occupations, as well as others which have not been researched at all.
2. Almost every woman in the informal sector performs a multiplicity of roles and activities. They are involved in activities like housework, child bearing, child-care, fuel and fodder gathering, carrying of water and many others, besides their economic activity. Thus, the hazards that women have to face are multiple.
3. Most women in the informal sector also face a number of health problems by virtue of being poor, labouring women-malnutrition, anaemia, discriminatory treatment, multiple pregnancies, severe deficiencies, the burden of contraception, sexual assault and harassment and mental trauma.
34. The occupation, some of the known health hazards and some of the concrete recommendations are as follows:
Occupation and some Causal Factors
(Postural problems exposure to dusts and chemicals, unguarded implements, working barefoot)
|Generalised body ache aches in calves hips. back legs and should ears, nasal catarrh irritating coughs irritation of the respiratory system respiratory allergies, respiratory tract||1) The hours of work should be regulated through the guarantee of a living wage and security of alternative employment in certain periods|
Occupation and some Causal Factors
|infections, tightness of chest, chest
capacities, pnumoconiosis, cutaneous allergies, skin irritation, rashes and pruntus,
mycosis, eye irritation, paddy keratitus,
schistosomiasis, ankylostomiasis, paronocia, fungal infections in feet, eczema, osteomyelitis of fingers
|2) Proper implementation of taws regarding guarding of machinery|
|3) Warning and training about the use of chemicals|
|4) Provision of protective equipment|
|5) Alternative work allocation during pregnancy, and in the post-natal period|
|Injuries||6) Education and dissemination of information about the possible health hazards|
|High rate of thresher accidents, especially while crushing sugarcane and ginning cotton, also serious physical injuries occur from the cutting edges of implements, such as sickles and machetes, for lack of first-aid facilities, small injuries become serious and often lead to tetanus|
|7) Research into the toxicology of the|
|8) Provision of health and medical facilities|
|Pesticide poisoning, intestinal|
|respiratory and neurological dis|
|orders, nausea, vomiting, abdominal|
|cramps, diarhoea, cough, head|
|aches, vertigo, blurred vision;|
|muscular twitching, convulsions,|
|loss of reflexes, loss of sphincter|
|control, disturbance of equilibrium,|
|jaundice, coma, and ultimately, death|
|may result by respiratory arrest|
|Abortions, premature deaths and still|
|births, high rate of neo-natal, infant|
|and maternal mortality|
|Cotton-pickers and Pod openers 34
(lack of personal protective equipment, heavy workload due to piece-rates)
|Bleeding of fingers||1) Provision of personal protective|
|2) Payment of daily wages|
|Plantation workers 35-37
(inhalation of dust, exhaustion due to heavy workloads, further increased by piece-rated wages and by high environmental temperatures and humidity, lack of health and medical services, working barefoot)
|Lung infections and bronchial problems, physical stress, malnutrition, Helminthic infestations, dysenteries, contact dermatitis and other contact diseases, heat stroke, high incidence of maternal and child morality.||1) Regulation of hours of work|
|through guaranteeing a living|
|wage and regular employment|
|2) Provision of personal protective|
|3) Provision of health and medical|
|4) Alternate work allocation during|
|and after pregnancy|
|5) Warning and training about the use|
Occupation and some Causal factors
|6) Proper food supplements|
|7) Education about the possible health hazards|
|(Working with unsafe chemicals, unsafe work terrain)||Insect and snake bites, allergies, occupational of bronchi, pesticide hazards, accidents and falls due to steep slopes, pain in back due to carrying heavy loads||1) Provision of personal protective equipment,|
|2) Reduction in workloads by providing a living wage on a daily or time basis|
|3) Provision of medical and health facilities|
(Continuous walking over rough terrain, lack of medical facilities).
|Pain in joints, cuts in feet, miscarriages, high rate of infant mortality (Personal Conversations)||1) Provision of sheds
2) Institute a scheme of trained mobile paramedics as exists for mobile teachers in Kashmir
|Mine workers 40-51
(exposure to mineral dusts, extremely hazardous working conditions, lack of timely diagnosis)
|Pneumoconiosis (a collective name of lung diseases caused by the continued inhalation of dust), increased respiratory ailments, cancer of the lungs, stomach, liver, kidneys and the central nervous system are affected by toxic dusts, deaths due to accidents|
|1) Reduction in dust levels,|
|2) Immediate implementation of existing laws|
|3) Proper diagnosis and treatment.|
|4) Workers should have to right to decide the safety of the mine and act on it|
|5) Regulation of working hours through guaranteeing a living wage|
|Quartz Crushers 52
and mine workers
|Silicosis, cough and expectoration, dyspnoea, chest pain high morality rates among young workers|
|6) Provision of comfortable personal protective equipment|
|7) Nutritional supplements|
|8) Provision of health and medical services|
(Exposure to high temperattures, lack of eye protection)
|Heat strokes, severe eye problems as chips of alloys fly into the eyes||1) Frequent rest periods,|
|2) Provision of sheds and rest rooms,|
|3) Provision of drinking water and mineral salts at the work-site.|
|4) Provision of personal protective equipment|
|Construction workers 53-62
(heavy work load, unsafe noise levels, exposure to dusts and chemicals, accident-prone working conditions contract labour)
|Physical stress and strain, skeletal defects, numbness of hands and fingers, loss of hearing, stress, high blood pressure, muscular pain, intestinal problems, gastroenteritis, respiratory problems, asthma, silicosis, asbestosis, skin diseases, heat cramps and sunburns, serious accident injuries, deaths, spontaneous miscarriages, high rate of infant mortality, a feeling of isolation and rootlessness||1) Regulation of employer-employee relations,|
|2) Strict provision of scaffolding|
|3) Reduction in noise levels,|
|4) Provision of personal protective equipment|
|5) Alternative work for women during and after pregnancy|
|6) Guarantee of a living wage|
|7) Reduction in working hours|
Occupation and some Causal Factors
|Employment Guarantee Scheme Workers 63
(postural problems unsafe implements, lack of sheds heavy workloads, lack of health and medical services)
|Backaches, abdominal pains, pains in hands, feet, knees, and shoulder-joints, increase in pain in the knees with age, splitting headaches, and migraines nausea, giddiness, vomiting, loss of appetite, leucorrhea, cramps in legs, dizziness and abortions||1) Proper wage rates to make possible frequent rest periods.|
|2) Provision of sheds and drinking water|
|3) Alternative work during and after pregnancy e g running creches at EGC work-sites|
(lack of personal protective equipment no precautions for work in hot atmosphere, contract and bonded labour, continuous heavy work loads, even during pregnancy)
|Heat exhaustion, burn blisters and wounds on hands, constant infections of the wounds, cracking, roughening and blistering of hands, aching of feet, pain in shoulders, back and neck, coughing, chest pains, premature aging, injuries due to accidents to the women and children, prolapse of the uterus, often resulting in hysterectomies, miscarriage, sexual exploitation|
|1) Regulation of employment|
|2) Frequent rest periods|
|3) Provision of sheds and water and|
|4) Alternate work during and after|
|5) Personal protective equipment|
|6) Provision of first aid facilities|
|Salt-kiln workers 66-67
(lack of personal protective equipment, working in the hot sun, unsafe working conditions)
|Heat strokes, constant bleeding in the feet, injuries due to accidents||1) Regulation of employment|
|2) Personal protective equipment|
|3) Provision of sheds and drinking water and mineral salts|
|Hand-cart Pullers 68-69
(heavy work, even during pregnancy)
|Heavy muscular exertion, thickening of the skin in the hypogastric region (lower part of abdomen), thickening of the palms, more calories spent than recovered every day, menstrual problems, repeated miscarriages||1) Provision of better-designed handcarts.|
|2) Subsidised loan facilities for investing in the improved handcart|
|3) Provision of alternate work during and after pregnancy|
|Fuel and Fodder|
|Gathering 70-75||Great physical strain and distress, postural defects, like bent backs, long hours of walking and carrying loads, pain in legs, calf muscles, shoulders and arms, thorn pricks, falls from heights, sexual harassment||1) Provision of alternate, easily available fuel|
|(postural problems, long hours of walking and carrying loads).|
|2) State-owned fodder farms which are easily accesible, without harassment to the women|
|Carrying of Water 76-77
(heavy physical strain, even during pregnancy)
|Physical strain, intense pain in different parts of the body, especially the legs, waist, pin bones and shoulders, prolapse of the uterus, miscarriages||1) A well-researched and properly planned scheme for the provision of clean, drinking water to every house be worked out immediately on a war-footing|
(heavy work-loads, hazardous work terrain, work during pregnancy too, sexual harassment)
|Accident injuries, insect-bites, thorncuts and skin burns, tetanus, eye problems, lung congestion, respiratory problems, tuberculosis, high rate||1) Provision of personal protective equipment|
|2) Provision of alternate work during and after pregnancy|
Occupation and some Causal Factors
|of infant mortality and miscarriages, mental tension||3) Provision of medical facilities at work-sites|
|All workers involved in Manual labour|
|(lifting heavy weights, postural problems, heavy workload, continuous heavy work from childhood through illness, pregnancy and in the postpartum period to old age, nutritional deficiency)||Disturbances of blood circulation in the pelvic organs and lower limbs, menstrual disorders, prolapse of the uterus miscarriage or still birth, flat and narrow pelvic, if carrying weights from early age, risk of injury to spinal column and adjacent muscles, especially in the lumbar region, circulatory organs may be affected, deformities, callousites, neuntic pains, paralysis||1) Provision of compulsory and free education with stipend for girls|
|2) Research on ergonomics and working out good postures and training workers in these|
|3) Developing of safe and efficient implements|
|4) Training of doctors in Occupational Health|
|5) Legislating a comprehensive act on the working conditions of workers, to include maternity benefits, leave provision, health insurance, a living wage, security of employment, and old age pension|
|6) A nutritional supplements programme be introduced|
|7) Availability of first aid and other health and medical services|
|8) Regulation of hours of work through guaranteeing a living wage and security of regular employment|
|9) Easy accessibility to drinking water and fuel fodder|
|10) Education and awareness building of the women, the policy makers and the people, on the issue of women's occupation-related health problems should be initiated immediately through the mass media|
|Domestic Workers 82-90|
|(postural problems, working in water and with household chemical-based products)||Frequent colds, bruises, acid burns and other burns, chronic bodyache, postural problems, bursitis||1) Free personal protective devices should be provided to protect domestic workers against harm from chemical-based products|
|2) Protection in terms of wages, employment security, health provisions, paid sick leave and old age pensions should be given to them|
|3) Training facilities for alternate skills should be provided|
(working in water, continuous use of chemical-based products)
|Cancer, mainly of the kidneys and genitals, also of the bladder, skin and lymph tissues, irritation of the eyes||1) More research needed|
|2) Substitution of unsafe chemicals by safer ones|
Occupation and some Causal Factors
|and upper respiratory tract, acute chest pain, fatigue, drowsiness, memory impairment||3) Personal protective equipment should be provided, especially water proof foot and hand protection and aprons|
|4) Hexylresorcinols aerosols should be provided in order to disinfect clothes|
|5) Regular medical watch about skin disorders|
|Sweeper and Scavanger Women 92-93
(working in the open elements and with infectious rubbish heaps)
|Nausea, burns, rashes and sores on hands and feet, insect bites, viral infections, fever, headaches, body aches, exhaustion||1) Personal protective equipment must be provided against burns, rashes, sores and fumes|
|2) Alternative training facilities and alternate employment should be provided|
|(working in the open elements and infectious rubbish piles)||Dog-bites and glass cuts, skin diseases virus infections like flue, colds and coughs headache and fainting||1) Alternative income-generation schemes and training should be provided|
|2) Effective medical facilities and protective equipments to be provided|
|(transmission of infections from clients, treatment by quacks)
|Sexually transmitted diseases, ectopic pregnancies, back street abortions, miscarriages, constant pain in the abdomen, uterine and vaginal infections, leucorrhea, chronic pelvic infections, impaired fertility, sterility, irregular menstruation, possibility of giving birth to deformed and visually handicapped children, tuberculosis and other diseases like jaundice and typhoid, skin diseases like scabies, fevers, colds, coughs, asthma, anaemia, stomach ulcers, dizziness, guilt feelings, emotional deprivation, depression||1) Alternative income generation schemes must be initiated for those who would like to leave this occupation|
|2) Housing schemes for prostitute should be evolved to free them from the clutches of brothel keepers|
|3) Discriminalisation of prostitution, without legalising it should be legislated|
|4) Awareness building among the workers about the possibility of occupational diseases|
|Health Personnel 105
(transmission of infections from patients. Government coercion)
|Infections and contagious diseases, especially tuberculosis and jaundice, sexual harassment, mental tension (due to pressure for completing family planning targets from the Government)||1) Implementation of ILO Recommendations (Recommendation No 157, Convention No 149) Some of these are — regular medical examinations — more research on specific risks — personal protective equipment — longer annual holidays — compensation|
|2) Hours of work should be regulated|
|3) Provision of safe housing|
|Masala-pounding 106 Workers
(repeated lifting of arms inter- changeably while pounding, constant friction of the hand, skin irritation and irritation of mucous membranes due to the masala).
|Back pain, body ache, chest pain, headache, pain in arms and legs, pain in shoulder joints, coughing, sneezing, abdominal pain, burning sensations (especially in hands), blisters and callouses, eye problems, burning sensation while urinating, white vaginal discharge, dizziness and exhaustion||1) Regular free medical check-ups and treatment are necessary.|
|2) Training facilities for alternative employment should be provided|
|(working in the open, walking long distances, carrying weights, harassment by police and licensing authorities)||Coughs, colds, fever, eye complaints, constant headaches, pain in hands and shoulders stiffness in hands and hips, backaches, extreme fatigue, mental tension||1) Women vendors should be given protective devices for their hands, feet and head, including lighter load-carrying devices, like, folding wheel barrows|
|2) They should have the right to free movement in the country and licenses should be issued to any woman who wants to vend her wares|
|3) All necessary steps must be taken to stop harassment, intimidation, extortion by police and other officials and authorities.|
|4) Protected vending places should be built at locations convenient to both the consumers and the vendors.|
|All Women Workers in the
(Uncovered body parts in contact with water for long periods of time, contact with dirt infected by microbes, viruses, exposure to hazardous chemicals and the elements, transmission of infections from other people, due to close contact, lifting of heavy weights frequently, postural problems, accidents, low nutritional status, lack of facilities like toilets, drinking water, rest rooms, low wages and insecurity of employment)
|Chronic body aches, chills, cold, bursitis, cancer of kidneys, and skin, respiratory problems, insect bites, infectious and contagious diseases, skin diseases, burning sensations in hands, and abdomen, eye problems, injuries to feet hands and palms, sexual harassment and abuse, harassment by officials and the police||1) Regulation of hours of work through a living wage is necessary|
|2) Provision of personal protective equipment for work, where body parts in constant contact with water and where heavy loads are carried.|
|3) Unsafe chemicals to be substituted.|
|4) Provision of training and alternate employment.|
|5) Provision of powerful local exhausts.|
|6) Medical monitoring and free good medical treatment.|
|7) Doctors trained in Occupational Health to be provided in comprehensive medical scheme including maternity benefits.|
|8) Strict regulation of the powers of officials, stopping police harassment of prostitutes, rag pickers and vendors|
|9) Education and awareness-building of the women workers, the|
|Home Based 117-121 House-workers||policy-makers and the people, on the issue of women's occupation related health problems should be initiated immediately through the mass media.|
|(Exposure to dust, fumes, fuel smoke, chemicals in household products,, possibility of accidents, heavy work load, drudgery, postural, problems, mental tension)||Cough and expectoration, bronchitis, emphesema, irritation of eyes, nose and throat, skin wounds, skin reactions, eye diseases, physical pain, exhaustion, anaemia, hastening of tumour, carbon monoxide toxicity, impaired foetal development, severe depression, low self-esteem||1) Hours of work should be regulated|
|2) More research in and easy availability of safe cooking fuel e g LPG Cylinders|
|3) Availability of and education about better abrasive cleaners,|
|4) Provision of personal protective equipments,|
|5) Sharing of work by others including men in the household,|
|6) Provision of community kitchens, community child-care and launderies|
|Beedi-workers 122-134||Neck and low back pain, pain in hands and fingers, abdominal pain, burning sensation in the throat, cough, chronic bronchitis, asthma, palpitation, bodyache, eye problems giddiness, effect of nicotine on reproductive functions, amenorrhoea. leucorrhea, general fatigue, anaemia||1) Lessening of work loads through a regular fixation of wage-rates|
|(postural problems, exposure to tobacco dust and nicotine, cuts due to injury, repetitive movements constant friction on fingers)|
|2) Reduction in dust levels|
|3) Development of suitable implements to avoid postural problems|
|4) Regular medical check-ups and treatment|
|Chikan workers 135-137
(postural problems, allergies, low nutritional levels, continuous strain on eyes and working in ill- ventilated and badly lighted atmosphere)
|Back-aches, spondylitis, fatigue, failing eye-sight, tuberculosis, lung function disorders, allergic effects, Vitamin-D deficiency, goitre||1) Development of appropriate implements to avoid postural problems|
|2) Regular eye check-ups and provision of free spectacles|
|3) Programme to provide iodised salt and Vitamin-D|
|4) Provision of a living wage|
|5) Provision of alternate employment|
|(postural problems, repetitive||Headaches, low back pain, finger||1) Provision of frequent rest periods|
|movements continuous eye||aches, muscle-pain, eye problems||2) Provision of a living wage and|
|strain and working in ill-venti-||regular employment|
|lated and badly lighted rooms|
|(postural problems, reaction||Low back pain, pain in hands, palms,||1) Research on and provision of|
|to chemicals and non||and fingers, contact dermatitis, skin||substitute, safe work-materials|
|availability of personal protec||abrasions||2) Provision of personal protective|
|3) Provision of a living wage and|
|Paper-bag makers 143|
|(Postural factors and lack of||Bodyaches, constant pain in the back,||1) Training in good postures|
|Occupation and some Causal Factors||Health Problems||Recommendations|
|personal protective equipments for hands and fingers, repetitive uncreative work)||shoulders and waist, backs grow bent, stiffness in joints, hardening and cracking of skin, deep cracks along fingers, discolouring and itching of fingers, eyes pain and water tuberculosis, lack of Vitamin-D constant acidity, heart disease dulling of the mind||2) Provision of personal protective equipments for hands.|
|3) Provision of regular employment or alternate employment.|
|Zari and Zardosi Workers 144|
|(postural factors, long hours of work, fine, minute work in ill-lighted rooms)||Weakening of eye-sight, chronically hunched backs, aching in hands and fingers, legs ache, chronic head aches body aches.||1) Research into and development of ergonomically correct tools is necessary|
|2) Postural training should be initiated through worker's education boards|
|3) Reduction in workloads through better wage-rates|
|4) Facilities like proper lighting at the work place i e at home should be provided|
|Carpet weavers 145|
|(postural factors, long hours of minute work)||Eye problems, pain in joints||1) Postural training and facilities like proper lighting should be provided|
|2) Reduction in workloads through better wage-rates|
|(postural problems, and badly lighted rooms).||Backaches, eye problems.||1) Facilities like proper lighting and postural training. Also development of ergonomically correct tools.|
|2) Reduction in workloads through|
|Papad-workers||the guarantee of a living wage|
|(excessive workloads, postural problems, lack of facilities at home)||Pain in the chest, shoulders, legs and hands (personal communication||1) Reduction in workloads can be achieved through an increase in wage-rates, as well as regulation of hours of work.|
|2) Periodic rest intervals during work.|
|(repetitive movement of banging the block, constant contact with the chemical dye, postural aspects)||Tuberculosis, chest pain, difficulty in breathing, roughening of fingers, hardening of palms, aching and numbing of fingers, hurting of hands, skin irritation and itching, giddiness, miscarriages (Personal conversations).||1) Workloads should be reduced through guaranteeing a living wage.|
|2) Personal protective equipment should be provided.|
|3) Alternate employment should be provided.|
|4) Pregnant women should be given paid leave or provided with alternate employment.|
|(postural problems, minute stitching work, low nutritional level)||Aching of feet and low back pain, eye pains and weakening eye-sight, extreme fatigue and weakness (Personal conversations).||1) Regular and free medical checkups, especially eye check-ups should be undertaken.|
|Occupation and some Causal Factors||Health Problems||Recommendations|
|Spectacles should be provided free.|
|2) Facilities like proper lighting should be provided.|
|3) Workloads should be reduced by providing the women with a living wage.|
|4) Women workers should be pro-vided with postural training.|
|Gunny-bag Stitching Workers|
|(constant exposure to and inhalation of cement dust, postural problems, low nutritional level).||Weakening eye-sight, headaches, backaches, feet aches, fever, asthma, breathing problems, intermittent, shallow cough, tuberculosis, loss of appetite, extreme fatigue. (Personal conversations)||1) Powerful local exhausts|
|2) Regular medical check-ups and treatment, especially for respiratory problems.|
|3) Provision of nutritional supplements.|
|4) Provision of training and alternate employment.|
|(exposure to dust. heavy workload, low nutritional status).||Chronic cough, hurting and watering of eyes, headaches, giddiness, blanking out, severe pain in the lower abdomen, scanty periods with clots and other menstrual irregularities, exhaustion. (Personal communication).||1) Powerful local exhausts|
|2) Regular medical check-ups and treatment, especially for respiratory and gynecological problems.|
|3) Provision of nutritional supplements.|
|(Postural problems, cuts due to the metal contraption used, excessive workload)||Constant cuts and dents in fingers, paining of the fingers and arms, eye pain, back aches, especially low back pain, severe pains in the abdomen. (Personal communication).||1) Research on and development of tools and implements which are ergonomically more scientific.|
|2) Postural training should be given to the workers.|
|3) Personal protective equipment should be provided especially for the fingers.|
|4) Hours of work should be reduced through guaranteeing a living wage and security of employment.|
|(postural problems, minute eye-straining work)||Back-pain especially low back pain, eye problems, extreme fatigue. (Personal communication)||1) Postural training should be given to the workers.|
|2) Facilities like proper lighting of homes.|
|3) Hours of work should be reduced, through guaranteeing a living wage and security of employment.|
|4) Provision of personal protective equipment for palms and fingers.|
|Bead piercing workers and Bangle workers|
|(postural problems, minute work)||Back pain; weakening of eyesight. (Personal Communication).||1) Research and development of ergonomically better tools and implements.|
|Occupation and some Causal Factors||Health Problems||Recommendations|
|2) Postural training should be given to workers.|
|3) Facilities like proper lighting should be provided in their homes at subsidised rates.|
|4) Regular medical check-ups and treatment.|
|5) Provision of training and alternative employment.|
(Constant use of shoulders, arm and fingers for pulling the thread postural problems).
|Aches in shoulders and upper right arm, back aches, finger aches, respiratory problems. (Personal communication).||1) Levels of rotton dust and fibres in the atmosphere need to be monitored (monrtoved) and controlled.|
|2) Workloads should be reduced through a guarantee of a living wage, security of employment and facilities at the work-site i e, at home.|
|(postural problems, heavy work on the machines)||Low back pain, leg pains, eye problems. (Personal conversations).||1) Regular eye check-ups and development of machines heights to suit women's height.|
|Garments Workers (postural problems, heavy workload).||Postural problems-back, especially low back pain, eye problems, anaemia, leucorrhea, urinary tract infections||1) Necessity of reduction in work loads through guaranteeing a living wage.|
|2) Proper facilities like lighting, ventilation should be provided.|
|3) Research and development of machines to suit the height of women.|
|Brass-ware workers 149|
|(Hot atmosphere accident prone work)||Respiratory disease, eye problems, heat exhaustion, accidents||1) Regulating work on the guidelines given in the encyclopedia by the ILO for hot work.|
|2) Regular check-ups and treatment for respiratory problems.|
|(handling rough sharp edge surfaces).||Bleeding of hands, pain, in lower back||1) Provision of personal protective equipment.|
|2) Provision of a living wage as well as alternate employment.|
|(exposure to lead)||Lead poisoning||1) It is necessary to control exposure to lead and to substitute the presently used unsafe chemicals by safe ones.|
|(Postural problems)||Aching of hands and shoulders||1) Research on and development of alternate proper instruments.|
|2) Reduction in workloads through guaranteeing a living wage.|
|Occupation and some Causal Factors||Health Problems||Recommendations|
|Workers Ignoring Clothes 153|
|(Excessive workloads)||Pains in hands and shoulders. (Personal communication).||1) It is necessary to reduce the work loads through guaranteeing a living wage.|
|2) It is necessary to monitor work places for levels of allergens and control of allergens at workplaces.|
|Knitting workers||Asthma||1) It is necessary to monitor work places for levels of allergens and control of allergens at workplaces.|
|(Exposure to allergens)|
|Reed workers 154|
|(handling rough sharp edged material)||Cutting and bleeding of palms and fingers, back aches.||1) Personal protective equipment should be provided to the workers.|
|2) First aid facilities should be provided at the work-sites.|
|All women workers working in home-based occupations|
|(Exposure to dusts, such as tobacco, cement, house-dust, exposure to hazardous chemicals, carbon monoxide, lead, abrasive cleaners, fungi, drudgery, repeated movements of a few parts of the body, heavy workload, postural problems without respite, constant strain on eyes due to poor lighting, low nutritional status and work valued less in money terms as well as in terms of status).||Respiratory problems, hastening of tumours, digestive problems, adverse effect on reproductive systems, fatigue, skin problems, back, particularly low back pain, pain in limbs, body aches, stiff ness of joints, weakening of eye sight, heart diseases, acidity, ulcers, exhaustion and dizziness.||1) Research on and development of hazard free cooking facilities like smokeless chulhas. bio-gas or LPG gas stoves. These should be widely distributed.|
|2) Regulation of working hours of the workers through|
|(a) guaranteeing a living wage.|
|(b) security of employment.|
|(c) leave and holiday provisions.|
|3) The workers should be further protected by means of legislation and ensuring that they receive.|
|(a) maternity benefits and ante-natal care|
|(b) creche and anganwadi facilities.|
|(c) basic facilities like drinking water, electricity, toilets.|
|(d) old age pensions|
|4) Workers should be provided with work space near the home and credit facilities for production shelters. Housing norms should provide for work-space needs.|
|5) Personal protective equipment should be provided to the workers.|
|6) Postural training and other preventive health education should be initiated through the Workers Education Board.|
|7) Research on ergonomic aspect of home based production should be initiated immediately through National Research and Design.|
|Occupation and some Causal Factors||Health Problems||Recommendations|
|Institutes, with a view to suggest possible modifications in the work posture and process, and to develop simple, inexpensive preventive and protective equipment. This should be done in consultation with workers.|
|8) Women workers should be provided with nutritious food supplements.|
|9) Education and raising of awareness of the women workers, the policy-makers and the people, should be undertaken through the mass media. This should include (a) the sort of work women do;|
|(b) the health related and specific health problems they face.|
|(c) the reasons for these problems.|
|(d) the various possible solutions to reduce and stop these.|
(Working in ice-water, heavy seasonal work, fluctuations in work quantum, injuries due to handling fish)
|Extreme fatigue, backache, leg pain, chest congestion, peeling of skin. skin infections, numbing of fingers, scratching, blistering and bleeding of hands, burning and stinging pains in hands||1) It is necessary to provide the workers with the necessary personal protective equipment.|
|2) The workers should be able to take frequent rest periods during work.|
|3) Guarantee of a living wage, continuous employment and facilities at work-sites.|
|Cashew workers 159-161
(constant contact with corrosive, black fluid, hard nut splitting, postural problems)
|Burning and corroding of hands, allergy, dermatitis, hand-injuries, boils and abscesses on hands, severe respiratory problems, back pain due to crouching position.||1) Personal protective devices which do not hinder the free and fast movements of the hands and are comfortable e g gloves.|
|2) Timely treatment of skin problems.|
|3) Guarantee of a living wage, regular employment and facilities at work site.|
|(sitting on wet ground. unprotected hands, exposure to coir dust, lack of early detection of elephantitis).||Respiratory and cardiovascular complaints, asthma, cough, expectoration, dysnoea, precardial pain, palpitation, haemoptysis, skin diseases, elephantiasis, leprosy. hyperkeratosis, neurological disorders.||1) Local exhausts should be provided.|
|2) Regular medical check-ups and treatment, especially for respiratory problems, and diseases like elephantiasis are necessary.|
|3) Workloads should be reduced through a living wage, security of employment and facilities at work-site.|
|Occupation and some Causal Factors||Health Problems||Recommendations|
|Coir Yarn spinners||Hand injuries—linear abrasions of the skin of the palm, pain and bleeding of injuries. (Personal communication).|
|(handling rough surfaces)||1) Personal protective equipment, especially for hands and palms should be provided.|
|2) Living wages regular employment, medical facilities and old-age pensions.|
|Wool workers 166|
|(exposure to dust and fibres)||Respiratory allergies like allergic rhinitis and allergic bronchitis, pulmonary tuberculosis.||1) Personal protective equipment should be provided.|
|2) Regular medical check-ups and treatment for respiratory problems should be provided.|
|3) Living wages and security of employment.|
|Glass workers 167|
|(extremely hot atmosphere, cuts due to glass splinters).||Extreme thermal stress, cuts and burn injures sometimes requiring stitches;||1) Workers should be provided with clean drinking water and mineral salts.|
|2) Frequent rest periods and personal protective equipment should be provided.|
|Pottery workers 168|
|(continuous exposure to silica dust).||Fibrosis of lungs, silicosis, tuberculosis.||1) Regulation of hours of work through a living wage and regular employment.|
|2) Powerful local exhausts should be provided.|
|3) There should be monitoring of the workplace for the extent of dust present and the size of dust.|
|4) Regular medical check-up and treatment for lung problems should be provided.|
|Garment workers 169|
|(Postural problems, eye-straining work, repetitive movements, lack of facilities, like toilets).||Pain in arms and legs, back pain, especially low back pain, swelling in limbs, pain in the neck and abdomen, persistent muscular pain, headaches, fever, eye problems, eye strain, visual fatigue, dizziness, exhaustion, insomnia finger injuries, leucorrhea.||1) Provision of the necessary facilities at the work place-toilets, drinking water, medical check-ups, holidays, regulation of work hours should be made compulsory.|
|2) Regular eye check-ups and providing free spectacles.|
|burning and itching sensation while||3) Proper lightinq and ventilation.|
|urinating||4) Development of appropriate instruments to avoid postural problems.|
|5) Living wages and regular employment.|
|Electronics workers 170-171|
|(handling small, numerous parts, exposure to hazardous chemicals, drudgery, postural problems).||Eye problems, tuberculosis, pneumonia, stomach problems like ulcers, fatigue, loss of appetite, skin diseases, frequent sore throats, cold, backaches, insomnia, depression, anxiety.||1) Rotation of work, proper lighting, regular medical check-ups, especially eye check-ups should be provided.|
|2) Security of employment and living wage.|
|Occupation and some Causal Factors||Health Problems||Recommendations|
|Slate-pencil workers 172-173|
|(Exposure to fine silica dust)||Dry cough, cough with expectoration, breathlessness, haemoptysis, chest pain, weight loss fibrosis of lungs, irritation of bronchial mucosa, silicosis, clubbing of fingers, diminished chest movements, crepitations, bronchi, early deaths||1) Powerful local exhaust should be provided.|
|2) Regular medical check-ups and treatment for respiratory problems should be provide.|
|3) Training for and employment in alternative jobs should be initiated.|
|4) Schemes for young children should be initiated whereby compulsory, free education with a substantial stipend be made available to them.|
|5) Regulation of hours of work through guaranteeing a living wage.|
|Matches and Fireworks workers 174-175|
|Chemical toxicity, explosive accidents, dermatitis, backaches.||1) It is necessary to monitor the work sites to avoid explosions.|
|2) Regular monitoring for levels of chemicals should be provided.|
|3) Safer chemicals should be substituted instead of the present unsafe ones.|
|4) Children should be given a substantial stipend to continue education and vocational training.|
|Workers in Beedi Tobacco Processing 176|
|(exposure to nicotine and tobacco dust).||Nausea, giddiness vomiting, headache. tiredness, loss of appetite, weaknesses.||1) It is necessary to monitor the levels of tobacco dust and use powerful exhausts to get rid of these.|
|2) The workers should be provided with personal protective equipment.|
|3) A living wage and regular employment are necessary.|
|4) For workers who are allergic to the fumes, alternate employment should be provided.|
|Small-scale pharmaceutical workers 178-180
(heavy workload, exposure to chemicals, postural problems)
|Extreme fatigue, weakness, backaches, aching of arms, feet and shoulders, eyestrain, low resistance to the effects of the chemicals they handle.||1) Workloads need to be reduced.|
|2) Work-systems like rotation of jobs, need to be worked out, to avoid eye strain.|
|Occupation and some Causal Factors||Health Problems||Recommendations|
|3) Postural training needs to be initiated.|
|4) Levels of chemicals in the air, need to be controlled.|
|Workers involved in Processing and other industries|
|(body exposed to ice-cold water, corrosive fluids, wet grounds, constant exposure to dusts, such as, silica, fibres, allergens, infections due to work, repetitive, monotonous work, drudgery, eye strain, injuries due to sharp-edged, rough surfaces, postural problems, contact with extremely hazardous and explosive chemicals, lack of facilities like toilets, drinking water, rest rooms, low wages and insecurity of employment, low nutritional status||Extreme fatigue, pain in body, corrosion of hands and feet, peeling of the skin, silicosis and other incurable and fatal respiratory problems such as fibrosis, clubbing of fingers, serious injuries, skin diseases like dermatitis, elephantiasis, backaches, allergies, weakening of eyesight.||1) Protective equipment should be provided to workers to protect them from hazardous chemicals constant exposure to water and dusts.|
|2) Dust and fibre levels at the work place should be mentioned.|
|3) Strict supervision to prevent accidents is necessary.|
|4) Workers should be given frequent rest periods. This should be made legally obligatory.|
|5) Proper facilities at the worksites should be made obligatory, e g, proper lighting.|
|6) A medical scheme should be evolved for workers which includes, among other things regular medical check-ups and treatment, training of especially women doctors in Occupational Health issues, maternity benefits, regular rest periods, leave and holidays.|
|7) Regulation of hours of work through a living wage, employment security and old age pensions.|
|8) Women workers should be provided with nutritious food supplements.|
|9) Education and raising of awareness of the women workers, the policy-makers and the people, should be undertaken, through the mass media. This should include;|
|(a) the type of work women do.|
|(b) the health-related and specific health problems they face.|
|(c) the reasons or causes for these problems.|
|(d) the various possible solutions to reduce and stop these.|
General Aspects of Physical Health
35. The most common occupational hazard for all women, is, probably overwork. Though it is generally thought that the man is responsible for farm work assisted by the woman, in most
cases, it is the woman who does the farm work assisted by the man.181
36. A study of labour in both homes and fields in Haryana, by Shanti Chakravorty, has for instance revealed that the average working day for women was between 15 1/2 to 16 hours. This was also found to be true in many other studies.
37. This is true for almost all women in India However, over-working tends to take place in a situation which has further grave implications for the health of women. The health status of women in India, as indicated by demographic statistics, is a matter of serious concern. The higher mortality rate is only one of the many indicators of her poor health status and poor access to health care facilities.
38. An important underlying reason for the poor health of women, especially among the poor, labouring women, is the malnutrition from which they suffer right from birth to death.
39. The nutritional status of women has shown no improvement and, if anything, seems to have deteriorated over the last few years, perhaps, at a faster pace than the rest of the population. The per capita calorie intake in the country as a whole declined from 2, 445 in 1961 to 2, 170 in 1971 (NSS estimates). The worst sufferers, paradoxically, are the agricultural labourers, people living in slums, in drought affected areas and in remote tribal areas, but among all these people, the axe has fallen mostly on women. 182
40. Malnutrition in women has further been aggravated by repeated pregnancies and lactation. It is stated that the average Indian woman becomes pregnant eight times and gives birth to 6-7 children of whom, 4-6 children survive. The infant is breast fed for at least 2 years or until the arrival of the next child. Therefore, out of 30 years of reproductive life, she spends 16 years in pregnancy and lactation. 183
41. Due to chronic malnutrition, women have no energy reserves for emergencies, and hence, fall ill, or at least feel ill, more often. Also their mortality rates are higher in the event of an epidemic. This could also result in early wearing out of cells and, hence, early ageing In India, about 60 to 80 per cent of women suffer from varied degrees of anaemia. In fact, it has been estimated that 10 to 20 per cent of all maternal deaths are due to nutritional anaemia. Women do not receive the additional nutritional requirement, so essential during pregnancy and lactation. For instance, during pregnancy, while it is recommended that she gets at least 2, 500 calories, in fact, she receives only 1, 440 calories. She needs 55 gms protein, but gets only 37 gms. She needs 40 mgm of iron but receives only 18 mgm 184. She needs 1 gm of calcium but receives a mere 0.2 gm The differences between what is needed and what she actually gets, are even more marked during the period of lactation.
42. Iron deficiency anaemia also results in constant tiredness, causing blackouts, general disinterest in work and lower resistance to infections. It is an entirely preventable problem. 185
43. The morbid effects of malnutrition are well documented, like toxaemia of pregnancy, post partum haemorrhage and now, malnutrition is suspected to cause psychiatric problems in women, lower resistance to fatigue, affecting working capacity under conditions of stress and increasing susceptibility to many other diseases. Maternal malnutrition also influences reproductive performance, affecting pelvic size, birth weight of child, lactation and breast feeding.
44. Besides these, there are a considerable number of problems that women, especially poor, labouring women, suffer from. These are menstrual and menopausal problems, dysmenorrhoea, white discharge, uterine bleeding, back pain and migraines.
45. There are also other social conditions which affect women's health which are reflected in statistics like the low sex-ratio in the country, high infant mortality, female infanticide and
female foeticide, neglect of and discrimination against girls, early marriage and child-bearing, high maternal mortality, hard work, low levels of education, problems relating to reproduction and contraception.
General Aspects of Mental Health and Social Exploitation
46. "Occupational health should aim at the promotion and maintenance of the highest degree of physical, mental and social well-being of workers in all Occupation... " Definition of occupational Health by the joint ILO WHO Committee.
47. An important aspect of a woman's mental health is the feeling of security or insecurity vis-a-vis her own being. The very unorganised nature of the "informal sector" and the women working in it, exposes them to various forms of oppression, including sexual oppression. The forms of sexual oppression experienced by the women are numerous they vary from rape, forced prostitution and sexual harassment to wife-beating, job insecurity, the sexual division of labour at home and at work and restrictions on the freedom to move around as they please. On the other hand, women face the cruel side of "freedom" contraceptives, which are dangerous and yet under experimentation, repeated abortions, all dumped on them.
48. Women workers suffer a peculiar form of oppression on the work-site, in the home, and in society at large—sexual harassment. Most women also experience active or passive discrimination at the work-site. They are given the least skilled, the most monotonous and often the more hazardous jobs, as well as, often being paid less than men for the same or similar work. Certain operations in agriculture like weeding are "reserved" for women. This operation involves constantly bending for all the eight hours that women work. They are also paid less. In the beedi industry, men often work in factories and women at home, doing the same work and getting very different wages and benefits. In the electronics industry, men often work in factories and women at home, doing the same work and getting very different wages and benefits. In the electronics industry, women do the assembly work and men do the supervision.
49. At home, women are kept in a subordinate position, denied any decisive say in family matters, and often beaten, or otherwise ill-treated. Women are the last priority even in the family, the last to eat and the last to get medical treatment. Even when they work outside and are economically productive, the work at home is her responsibility alone—from getting water from long distances to fodder gathering, to household chores. Besides this social productivity, the entire responsibility of reproduction and child-rearing is on women. This is also true about contraception.
50. Another aspect of harassment that almost all women talk about is the harassment at home due to drunkard husbands. As a pheriwali in Bombay said "When my husband died, I felt I was better off. Even if I eat dry bread, at least I eat it in peace. What did 1 get from marriage, but scolding and beatings?" Women vendors in Madras had a similar experience. A fruit vendor in Madras said, "At night, I bear the burnt of a different harassment".186
51. Other types of harassment that women workers in the informal sector have to put up with are the contradictory expectations from her different roles. They are often the major, if not the sole-supporters of the family. But their role as home-maker and a mother is expected to be fulfilled just as well. Besides, the strain of the entire workload and responsibility, is the constant feeling of guilt, generated by having to share herself between home and work demands, which gradually becomes a part of the personality of women. If a child is ill, if there's not enough food or money, or any child is hurt, it is somehow the woman's responsibility, her blame and her guilt.
52. Similarly, there is the idea of female seclusion in its various forms and degrees and there
is also the pressure on women to perform as workers, as housewives, as mothers. There is an implicit demand that women workers be superhuman beings, but not show it, because then it becomes threatening to the male ego. And that too is dealt with in this society, by punishing women. Even as late as 1982, there have been instances in Bihar and Maharashtra,187 where women have been branded as witches and killed, burnt or stoned publicly 53. The pressures that women workers have to live under, the stress and strain of the entire situation, have physical repercussions, as well as an impact on their entire emotional, psychological ability to cope with their lives.
Technology and Women's Health
54. The impact of technology on women has been in two basic ways
1) By displacing women's labour
2) By increasing women's burdens and socio-economic vulnerability
55. Technology has the potential to affect women's health both positively and negatively and both directly and indirectly. Studies in 'developed' or 'boom' areas of the country show that the health and nutritional status of a woman has actually deteriorated, and the incidence of low-birth-weight babies and neo-natal mortality has increased. This results in an undernourished, over-worked, and unhealthy woman, unprotected by any labour laws or social security.
56. There are also a number of cases where the introduction of new technological processes themselves harm women's health Industries like electronics, pharmaceutical, matches, slate-pencils, indicate these hazards which result in serious health problems respiratory, eye problems, postural complaints, skin irritations and premature deaths. Such direct effects on health are largely due to the fact that technologies have been developed for productivity and profit, with workers' safety, posture and overall health not entering the process of decision-making. And with avenues of employment being so limited for women, they are unable to organise or demand safety measures, even when they are well aware of the impact of their work on their health.
57. Ironically, several medical technologies, ostensibly evolved for improving the health of the people, and particularly of women, have created precisely the opposite effect. The best example of this, is in the area of contraceptive technology. With the Government obsession about population increase, the entire burden and responsibility of birth control has been placed on women, and specifically on poor women. However, the contraceptive techniques thrust upon the women have two invariable adjuncts.
1. They are technologies which are outside women's control, requiring trained professionals to install them or provide follow-up e.g. lUDs, tubal ligation, injectable contraceptives, laproscopic tubectomies.
2. They are technologies which can be hazardous to women's health at two levels, (a) either because the technology itself has side effects as is the case with injectables and intra-uterine devices like the loop and the copper-T or because (b) to be safe the technology has to be applied by highly-trained and experienced hands, and within an environment where sterile conditions and adequate aftercare are scrupulously maintained. Under the present conditions, where mass laproscopy camps, with inadequately trained doctors and unhygienic conditions are the order of the day, such technologies place women at an even greater risk.
58. Women suffer from serious health problems excessive bleeding, cramps, backaches, headaches, dizziness and swellings after IUD insertions, laproscopic sterilization and most of all, injectable contraceptives like Net-En and Depo-Provera.
59. Amniocentesis-cum-abortion clinics are proliferating all over our country, without let or
hindrance from either Government or Medical bodies Ill-equipped and poorly trained doctors and technicians are performing this test, which requires a high order or skill, on thousands of women, with disastrous results in many cases rupturing of the amniotic sac, and deaths from anaphylathic shock or haemorrhage are some of the known consequences. Preying on the socially-enforced desperation for a male child, these clinics also perform abortions on women at dangerously advanced stages of pregnancy, with inevitable results on their health, and sometimes on their lives.
60. These are only some of the most serious and widespread problems created by so-called health technologies. Far from improving or preserving the fragile health status of women, they often actively endanger it. Therefore, the whole question of technology and women's health, must be seriously re-examined in this context, particularly where the technology is not within women's control or where it facilitates the existing negative attitudes to women or promotes male-domination.
61. Another area for concern and action is related to the lack of technology and the consequences for women's health. Examples of this are numerous. The absence of simple technologies, for domestic fuel for cooking and heating, for implements and tools which will reduce the drudgery, energy-intensiveness and health hazards of women's work, is a major lacuna.
62. The problems here are of three kinds (i) Where technologies have been developed, but have not reached the majority of poor women for structural, administrative, or other reasons. The smokeless chula is an excellent illustration of this (ii) Where no technologies have been developed for easing or facilitating women's work because the latter is itself a low priority in research and development. For instance, simple tools, implements or protective devices can be developed and distributed to women working in coir-yarn spinning, rope-making, tie-and-dye, beedi-rolling, transplanting rice and shelling prawns. These could be cheap, simply designed, mass-produced by other women, and save them from untold miseries and illnesses. The fact that little or nothing is, in fact, available, in a nation capable of space satellites and nuclear power, speaks eloquently of the low value placed on women's labour and health. (iii) Where technologies have been developed but are inappropriate or unviable for poor women because they have not been consulted or involved in the planning, development, and prototype-testing phases. Several illustrations can be given, but the coiryarn spindle and solar cooker best symbolise the problem.
63. From the above, it is obvious that the basic concerns and, hence, the direction of technological changes and advances, needs to be reversed. Designing and development of basic tools for easing women's efforts, not dispensing with labour, and improving their health status, are an urgent priority—bio-gas installation, tools, implements and protective devices, together with subsidies and/or loan facilities for women to be able to avail themselves of these, is urgent.
Integrated Approach to Health
64. While making recommendations for the future relating to the health of women in the informal sector, it is necessary to outline the existing situation in terms of women, work and health very explicitly.
65. The larger situation is one of invisibility of women's labour, devaluation of women's labour, non-recognition of women as human beings, and of their role in social labour and social production. It is also a situation where the basic sexual division of labour is not merely an important aspect of the relationships within the family, but has become a structural aspect of
the labour-market and of the wage structure. It is a situation where even the most basic national priorities do not feature in women's health and work positively. If there has been any emphasis, it. is mainly on the reproductive and maternal roles in the usual Maternal and Child Health (MCH) programmes, but this too has been extremely minimal. It is an atmosphere which is both class biased as well as sex-biased, grinding down poor, labouring women in all aspects of their life. These aspects of the situation today have serious implications for women.
1. Women's work, unrecognised, devalued and constricted by the sexual division of labour, consists of economically productive labour, socially productive labour and reproductive labour. Even when women are not employed, they are involved in socially productive and reproductive labour, all of which is absolutely necessary for the continuation and reproduction of society.
Precisely due to this, most women are not, and cannot be involved in a single occupation all their lives. Very few women, as opposed to the majority of men, can be said to be employed or working in one sector of work all their working lives, except for housework and child-bearing and rearing.
2. Most of the problems, especially the health problems that women face, are related to their general life situation. These aggravate the problems women face in their work situation as workers. These general problems include nutrition, accessibility to health services, water, Housing, sanitation, maternity benefits, and child-care, control over their own bodies, opportunities for education and training, their status within the family, as well as situations that affect their mental and emotional health, that is, economic and job insecurity and helplessness due to harassment and discrimination.
It is necessary to tackle these together with the health problems women face directly related to their work. This is extremely important because it is not accidental that certain sections of women work in the informal sector of the economy. Working in the informal sector is a part of a self-perpetuating vicious circle, which requires much more than small-scale temporary palliatives to see that the women are able not only to survive, but to leave it once for all. This vicious circle consists of the following cycle women working in the informal sector, hence poor women, hence, living in unhealthy conditions in bastis, hence, less nutritious food leading to ill health, hence, also, less opportunities for education and training, and thus being compelled to work in the informal sector.
3. The work that women do, and the conditions in which women do it., constitute the lowest stratum of society. Women workers in the informal sector constitute a subproletariat. Thus, the nature of work, the security of employment, the wages, the conditions of work, are extremely exploitative and give rise to a number of health problems for the women workers. And because of the informal nature of their work, no mechanisms of redressing their grievances and health problems have been evolved.
66. Problems relating to the work of the women workers in the informal sector are low wages, insecurity of employment and seasonal employment, long hours of work, no provisions for leave or holidays, no maternity protection, no health provisions or schemes, no insurance or old age benefits.
67. Most of the health problems that the women workers in the informal sector face, relate to the complexities of their lives. and the deeper social mechanisms and structures underlying their situation. This complex situation, therefore, demands a multi-faceted approach. The basic aspects of this approach may be summed up broadly as:
68. It is not sufficient to provide health needs, without at the same time, attacking these underlying structural factors of exploitation and lopsided control of resources, which result in
the cycle of poverty, underemployment and unemployment, pushing large numbers of the rural and urban poor in the informal sector which, perforce, only permit very marginal levels of living. Health is no longer seen as a service without an integrated approach to the community and its problems. Similarly, packaging health services for women in the informal sector, without, at the same time, affecting their levels of living, including a living wage, improved conditions of work, a safe and hazard-free work place as well as protective equipment, controlled hours, benefits such as for health, maternity, creches and old-age pensions, sanitation, housing and potable water, near to their home in quantities necessary for family health, will be a purposeless exercise. Health must be understood in the context of this total scenario to affect the conditions of women in the informal sector.
69. We make the following suggestions with regard to women, health and work
General physical health needs
1. Nutritious and sufficient food is a crying need of the women workers in the informal sector. Specific nutritional programmes which include calcium, proteins iron and, Vitamin-D, could be initiated through the government health care system.
A nation-wide programme for the distribution of nutritious, subsidised food supplements which includes calcium for women should be organised, on the lines of a similar program me of milk and egg powder in the 1950's. Coarse grains like ragi, as well as milk be made widely available at subsidised rates. Since all women in poverty work to eke out a living, they should be the major beneficiaries.
2. A very basic presupposition of health is the availability of and easy accessibility to clean. drinking water. Lack of it, especially in times of severe drought, is the cause not only of immense hardship to women, but the cause of morbidity and mortality of millions of children every year. After 40 years of independence, thousands of villages in our country do not have access to this basic human condition of life. It is of utmost importance that the Government takes up this issue on a warfooting and devises schemes to remedy this situation. While all women would benefit, those in the informal sector, who carry a heavy work-load would benefit particularly be such easy accessibility to safe water supply, which would reduce their drudgery.
3. As an increasing number of women move out into the job-market one of the important problems they face is the lack of housing facilities. From this point of view too, housing, including subsidized hostels for working women with and without children, is increasingly being felt as an important need by women workers. Housing is an important issue for women workers also in the context of a change in the man-woman relationship that our country is going through. An increasing number of women are becoming sole or major earners, and an increasing number of them, especially those who have jobs or occupations, are refusing to live a life of complete subordination and subjugation. An important obstacle in their being able to assert themselves is the fact that often houses and property are in the name of the man and inexpensive housing is difficult, if not impossible today. Schemes for giving housing to the poor, should allocate substantial quotas for single women, especially those with children. For the rest, they should allocate land pattas and housing jointly in the names of both husband and wife.
4. Most women in the unorganised sector live in slums, pavements, bastis and other makeshift shelters. It is necessary that, for a start, the people in bastis, slums and pavements be given adequate subsidised housing, with adequate drinking water and sanitation facilities. The houses need to be close to their place of work, and space provided for conducting home-based production activities. Credit should be provided for building production shelters.
Women's work-space needs should be incorporated in the housing norms of the housing schemes of the State and the area should be a minimum of 200 square feet.
5. Regular work and a living wage should be guaranteed to all women. It has been the experience of most women that after they start working for a wage, though their income is distributed in the family, there is a definite change in the family diet pattern in her favour. Very rarely do women receive an increase, proportional to their contribution, as many socio-political factors intervene. Yet, security of a regular wage would make a definite positive contribution to the health of the women workers.
6. In view of the fact, that children, especially small girls, in poor families have to stop education and begin work at an early age, and usually it is hazardous work, we make the following suggestion. Girls should be given a substantial stipend for completing their education which could be combined with training and production which is useful, but not hazardous.
Mental health needs
70. Mental health is an important element in the general well-being of women workers in the informal sector. Physical insecurity and the anxiety due to it, often lead to psychological ill-health. Besides, a feeling of helplessness and vulnerability paralyses women workers still further. Hence it is necessary that:
1. There should be stringent punishments for rape, sexual harassment, eve-teasing and other actions threatening women. The Government should legislate a Prevention of Violence Against Women Act to cover harassment at work-sites, homes, streets, police stations, and prisons.
Work-site harassment also be included in labour laws and be included in the Industrial Disputes Act, where the burden of proof should be on the man.
2. There is also the need for a Prevention of Domestic Violence Act to cover specifically wife-beating, child battering, molestation, marital and domestic rape and mental cruelty.
3. Since seclusion is a reason causing immense mental and physical problems for women workers, especially some sections of home-based workers, conditions should be created so that it is unprofitable to keep women secluded. This could be done by offering substantial stipends or financial assistance to women for training and education. These training centres should also have creche-facilities. The Government should also subsidise community centres with recreation, entertainment, sports and counselling services.
4. All necessary steps must be taken to stop harassment, intimidation and extortion of women in the informal sector, by the police and other officials and authorities.
5. The Law of Evidence must be changed, in view of the fact, that many of the most serious crimes against women, are committed in situations without witnesses e.g. g rape, dowry harassment, marital violence and sexual assault.
Availability of and accessibility to health care facilities
71. Increasing the availability of, and the accessibility to health care facilities, are important in order that the recent positive advances against diseases reach the mass of poor women. Statistics on health facilities and their use indicate that women go to hospitals and contact medical functionaries less often than men. Studies also indicate that, the amount of money spent by households for medical treatment is greater for men and boys than for women and girls. The result is higher morbidity and mortality among women, including a very high maternal mortality rate.
72. When women do go to seek medical help, they experience great discrimination at the
hands of the medical system due to a lack of understanding of the social situation of the women in poverty groups. It is necessary to tackle these problems at a social level as well as at the level of the medical system. It is necessary to critically evaluate this bias in the present health-care system and attempt to change it radically. In fact, the entire medical education in the country needs to be evaluated. There should be Refresher/Orientation courses for the doctors on subjects of women's work and health. It is necessary that the medical education should recognise occupational health hazards especially in the informal sector. These should be a part of the regular courses in the curriculum. It was especially evident as the Preventive and Social Medicine Departments had not even considered the possible problems of health of this sector in spite of letters to all the PSM Departments, hardly any response was received. A few visits to PSM Departments by the Task Force and by the National Commission also brought to the fore this neglected area which requires to be studied by both medical personnel, social scientists and professional social workers.
73. While ensuring better choices for women, including women's access to safe deliveries and safe and free abortions, it is necessary to stress the immeditate abolition of the oppression that comes directly from the Government—pressure on women both as promoters (ANM$ teachers, nurses) and as receptors of family planning methods, the target approach to family planning, and the promotion of dangerous methods like injectable contraceptives and amniocentesis. In fact, the entire emphasis on 'Family Planning, to the detriment of access to other health care facilities, needs to be strongly opposed, not only because it is oppressive in itself, and has caused misery to millions of poor women in the country, but also because it discredits the public health system and makes poor women workers dependent upon private. exploitative medical practitioners, or they have to do without any medical facilities, even when they desperately need these for abortions, deliveries and serious illnesses.
74. Besides, the primacy of free, effective health care for the poor and for rural areas needs to be emphasised, rather than the sophisticated medical facilities for a few which today consume a major share of health care finances. Certain concrete steps need to be immediately taken to facilitate the reaching of health-care to the poor, labouring women:
1. The timings of the dispensaries and hospitals should be fixed in a way which would be convenient to working women, who cannot forgo their income for medical care.
2. Necessary medicines should be adequately stocked and the hospitals and PHCs should be operated in such a way as to keep the number of visits of the women to the minimum necessary, if they are to avail of the treatment, otherwise, they get discouraged and do not continue.
3. There should be a 24 hour creche facility for women patients with children in every hospital and PHC.
4. Women should be allowed two free bus-rides to the nearest PHC every month.
5. Dais who are the only source of help for the majority of women, should be taken seriously, as a vital source of rural health care. Their skills should be enhanced via on-going training and their regular involvement in public health work should be encouraged.
6. Women should be involved at the village level as Community Health Guides if women's access to health care is to be improved. Teams comprising one literate and one experienced older woman, though not necessarily literate, may by the most desirable, both in terms of outreach and accessibility to women. Their training should include both preventive health education and curative care Mahila Mandals should support these women health workers and assist in the maintenance of linkages between the official health care system and village women.
Occupation Related Recommendations
74. Women workers are involved in the three crucial types of work, productive social and reproductive. These women workers need, as well as have a claim to certain facilities, by right. It is necessary that these rights be recognised through the following measures.
75. Living wage should be assured through legislation and the organisation of women to demand and protect their rights. Without assuring adequate wages, it is meaningless to discuss health or measures to ensure health. This needs to be given priority, especially because today women work hard for long hours for a miserable pittance.
2. Paid leave and holidays including two weekly offs.
In the formal sector, workers are entitled to a break after four hours of work as well as leave provisions and one or two days paid weekly off. These are provisions the workers have won after decades of struggle, because it is physically absolutely necessary, if one's health is not to break down completely. These provisions need to be extended to the workers in the informal sector too.
3. Regulation of working hours
This is particularly necessary in the informal service and production centres, where there is considerable exploitation of the poor with long hours and no over-time. Piece-rates should be converted into daily wages based on the normal quantum of work completed at a healthy pace. Only then, will women not have of work long hours to make a meagre living.
4. Maternity benefits
A majority of the women workers, in almost all the sectors, have to work till the last day of pregnancy and go back to work immediately after a few days. This affects the health as well as, the life expectancy of both the child and the woman it is absolutely necessary that women are entitled to paid maternity leave, as well as nutritious food, during pregnancy and after delivery.
5. Health insurance
Health insurance, including compensation for accidents, should be available to women workers. Health cards should be distributed to them, as is supposed to be done in the beedi-industry, but is not effectively implemented. Through this, they would be entitled to receive health care of their choice at any public health facility (Primary Health Centre, sub-centre, ESIS Hospitals, Municipal dispensaries, T B hospitals or general Government hospitals,) and/or recognised private facility upto a certain stipulated limit. The latter is necessary because workers are often located far from any Government facility, have no transport, or money for any transport that is available, and often find the timings of the Government facilities, unsuitable. In addition, in medical emergencies (complications during childbirth, accidents etc), the nearest facility may be a private one.
Accident insurance for both temporary and permanent disabilities, monetary and health benefits, should be available through both public health and private facilities as mentioned above.
6. Provision of a safe work-place and safety equipment,
(including personal protective equipment)
76. Ideally, it should be insisted that every workplace should assure safety to the workers.
This may imply mechanisation of processes which are hazardous. This, in turn, means loss of jobs/work for the women, which cannot be permitted until there is alternate safe work for women, and new training facilities for them. This is an important element in improving the health of women. Till then. however, it is necessary to provide safety equipment including powerful exhausts to remove harmful dust from the work environment and personal protective equipment like masks, feet protectors, eye glasses, ear muffs, gloves and other comfortable, strong contraptions for the safety of women workers.
7. Today, there is an appalling neglect of this sector by the various offices of the Commissioner of Labour in the states. They should be made more accountable for their work in the informal sector.
8. Preventive health education, both with respect to occupational and other health problems e.g. (anaemia, leucorrhea), should be initiated through the Workers' Education Board. Special training courses for women workers should be initiated through these boards.
Old-age benefits and pension schemes
9. Due to the very nature of work in the informal sector, as well as the conditions in which the women live and work, women age very early in life. During their working life, they live a hand-to-mouth existence and are not able to save anything for their old age. Hence, they are forced to continue to work or are reduced to beggary, if they find it physically impossible to work. Old-age security and pension is an absolute must for this section of the population. Every woman has added to society' benefit and should receive protection in old age from it. Hence, it should not be necessary to require absolute indigence to merit a pension. On visit to the states, the plight of widows and deserted women, with sons, who were alcoholic and did not care for their aged parents, was pathetically distressing. Because the women had sons, they were not entitled to a pension. These women had been self-respecting workers all their lives, but were now reduced to almost paupers.
10. Facilities like latrines, drinking water, ventilation, should be made available at women's workplaces and living places, as lack of these seriously undermines the health of women workers.
Electricity should be made available on a priority basis to workers, particularly those whose trade adversely affects their eye-sight they includes chikan and ready-made garment workers, zardozi workers, weavers and others . Electricity should be supplied to women workers at non-industrial-non-commercial rates.
11. Creche and anganwadi facilities should be made available at women's workplaces and/or living areas.
Subsidized tools of trade
12. Subsidized tools of trade e.g. (carts, tools, etc.) and/or machinery e.g. sewing machines, charkhas,). Tools, machines and protective, which reduce occupational health problems, should be given priority.
13. The State should provide credit to women, and small consumption loans, for investing in bettering their working conditions.
14. A comprehensive Health and Safety Act should be evolved and enacted This Act should give the workers.
(1) right to information about chemicals and work process at the work-site.
(2) right to inspect work-sites.
(3) right to demand guards for machinery, monitoring and controlling levels of dusts, fumes and fibres in the work atmosphere.
(4) right to demand personal protective equipment, and
(5) right to stop work if the conditions are found unsafe.
This Act should be evolved in consultation with workers, trade unions and concerned voluntary agencies.
Introduction of new technology
15. Before introducing any new machinery, equipment or process, these should be screened and approved by representatives of women workers involved in that particular occupation where these are to be introduced. The women workers should have statutory rights to screen and approve new machinery, equipment or process, or any changes in the existing ones.
Priorities in research
16. The Indian Council of Medical Research, National Institute of Occupational Health. National Institute of Design, and such other organisations, should undertake occupational health studies of women's. These should be done with a view to developing simple preventive and protective mechanisms and machines acceptable to workers which would reduce health problems.
Special emphasis must be placed on the ergonomic aspect of women's work, including postural problems Innovation in the production processes which could reduce health problems should be examined, with workers guiding and advising throughout, and such innovation be recognised and rewarded.
Technology Related Recommendations
77. We can summarise here some criteria for scrutinising the potential negative and positive effects of technology on women and their health.
1. All technologies which are labour-displacing must be rejected a priori.
2. All technologies which are likely to take over tasks currently performed by women (for wages or self-employment) and, therefore, likely to displace them, must be placed under women's control by:
a) Training women in its operation and maintenance;
b) Providing credit facilities to women only for its acquisition;
c) Being designed for women, with their participation.
Back breaking work leads to postural problem
3. All technologies which are likely to directly and indirectly increase women's workload must be accompanied by other technologies or measures to ease or eliminate these side effects in other words, systems approach should be used to develop packages, rather than the current unidimensional approach. These multi-faceted packages must be gender-sensitive and women-biased.
4. The development of new technologies for traditional, or even modern occupation, must be prioritised, beginning with women's occupations. In other words, technology development must be selective, designed to impact positively on women's work, whether wage-work or non-wage work.
5. Development of simple or appropriate technology in the form of tools, implements, and protective devices, to remove or reduce the work-related hazards faced by women, must be given top priority and taken up on a war-footing. Mechanisms must be created for involving the women themselves in the research and development process, so that the results are appropriate and useful to women.
6. In the specific area of health technology—particularly contraceptives and sex-determination techniques—strong and immediate steps must be taken to withdraw or ban such technologies where they are actually damaging the health of already vulnerable poor women. Measures for women's education and health promotion must be strengthened.
7. Priority must be given to the selective or preferential training of women in new areas of technological development Schemes like TRYSEML and DWCRA—can readily be utilised for this purpose.
8. An advisory committee, with some power of veto, must be set up at Central Government level to monitor the impact of technology on women. The Committee should also actively identify and promote the areas for research and development of pro-women technologies.
9. Existing technologies, which are not appropriate to women, though they are almost exclusively utilised by women (sewing machines, table heights, cashew nut sifters, etc), should be redesigned on a priority basis. The redesigning should be based on women's anthropometric measurements.
10. Thirty-five per cent of all the research and development funds of national research and design institutes should be reserved for occupational health studies of women's work and working out changes in these for the convenience of women workers.
Recommendations Related to Future Research Areas
1. Multi-centred studies of health problems of women workers in specific occupational groups should be undertaken by the Indian Council of Medical Research (ICMR) on a priority basis. These studies should cover
(a) the occupation related health problem—direct and indirect,
(b) the general health problems of women workers,
(c) special stress should be on the effects of the triple burden on women.
2. National institutes like the ICMR, ICSSR and other bodies should give priority to research on health problems of the unorganised labouring women. It is a pity that a leading institute like the ICMR does not even have a women's cell to look into the health problems of half the country's population. However the present tendency of thrusting research related to women to a small cell is also questionable. This has implied in practice that the small cell conducts studies specifically on women, while the major portion of the personnel, research projects and finances of the institutes focus on men. In fact, what should happen is that while the entire institute, say, the ICMR or the National Institute of Occupational Health (NIOH).
should focus on workers, both, women and men, the women's cell should try to take up issues related more specifically to women.
3. The ICMR, NIOH, (NID), and such other organisations, should undertake occupational health studies of women's work. These should be done with a view to developing simple preventive and protective mechanisms and machines acceptable to workers, which would reduce their health problems.
Strategies for Implementing these Recommendations
79. Respecting the complexity of the situation of women workers, it is necessary to adopt a multi-pronged approach for women workers in different occupations and regions. An important aspect of this is the actual implementation of the present legislation where some of the provisions have already been legislated for some sections, as in the Bidi and Cigar Workers Act, the Contract Workers' Act, the Minimum Wages Act. These legal provisions have largely remained on paper. It is also necessary to devise mechanisms for the implementation of these and other provisions to women workers in other occupations in the informal sector.
80. While it would be ideal to make a list of the various occupations women work in, and work out a whole set of legislations for these, incorporating the above mentioned provisions, the complexity of women's work in the informal sector would make such a simple approach meaningless, though it would be necessary to do so in certain occupations. But, by and large, women workers are compelled to change their occupations, depending upon the availability of work. For example, agricultural women workers, in certain seasons and during period of drought, would have to work at the employment guarantee schemes, as bidi workers, as domestic workers.
81. When there is little work available women workers may work as rag-pickers, as prostitutes. After a certain age, prostitutes may work as domestic workers.
82. Secondly, whichever occupation women workers may be economically active in, their socially productive and reproductive work does not cease. Hence, the social security and health schemes that need to be worked out should apply to all women, irrespective of their particular occupation. This is also necessary because this society has created certain specific occupations for women and yet continues to victimise the women for it it is difficult for women prostitutes to want to claim health care facilities, if they are compelled to reveal their profession, because they know they would be victimised in other ways for doing so Women work day after day, producing future generations of workers as well as daily replenishing the existing labour force, working for social capital, gratis. Thus, every employer, private or public, should be made to pay for the facilities to women workers, irrespective of whether women are employed in the particular occupation or industry. This could be in the form of a common cess or levy.
83. In order to implement the above mentioned schemes and measures, some alternative mechanisms have to be worked out. Some of the possible alternatives are sketched below.
84. Occupations which are potentially, by the nature of their work, 'formalisable', like most of the occupations in the manual sector, should be so formalised in the form of Women Workers Boards, which take up the responsibility, financially and structurally, to ensure the facilities outlined above. The finances may be collected through a specific cess or levy on every employer depending on the number of days the women have worked there and on the number of days the women have worked there and on the profit and turnover of the employer. These Boards would have the legal authority of ensuring that employers employ workers who are the members of the Board. This would take care of employers making some workers under-cut others and weakening the bargaining power of all the workers in the process.
85. These Boards would necessarily have to be, not huge centralised giants, but decentralised bodies, so that women workers would have some say and control in these. There could be say, one Board in one ward of a city and some similar area grouping at the town and village level. It would be possible for voluntary and other agencies and trade unions to act as watch-dogs and facilitate the smooth functioning of the Boards. To begin with, it is possible to start a Board in one or two occupations e.g. construction by involving different agencies and trade unions. Through the experience of the working of these Boards, a better fool-proof scheme could be evolved for the other occupations in the country.
86. At the same time, training courses for women should be organised—training for skill upgradation e.g. learning masonry in the occupation of construction work, rather than the 'unskilled' nature of women's work today. Skill training should also be made available to women who do not want to do the work they are doing at present, but would like to change their occupation e.g. rag-pickers. It is also necessary that the Government establishes Women's Industrial Training Institutes, which train women in more marketable skills, with less health hazards.
87. In occupations, difficult to formalise, one could visualise a community-based structure, in which women could produce, exchange for the community and get paid for their labour eliminating the middlemen.
88. These general provisions for ensuring better health care, ensuring long-term betterment like education, and skill training, are important and can be concretised and initiated immediately. Those, however, which pertain to particular occupations like registration of women workers in the occupations, providing them with identify cards have to be worked out in the particular context of the different occupations. Identity cards for home based workers are important in order that they can avail themselves of the legislative provisions like, the Beedi and Cigar Workers, Act; However, no such move for prostitutes can even be considered as it would make them more vulnerable to exploitation and biased social prejudices. Hence, it is necessary to have greater in depth consultations with women workers in different sectors to work out a detailed concrete plan of action and/or legislation.
89. The condition of women workers covered by legislation like the Minimum Wages Act, the Contract Labour Act, and other protective legislation, is a strong testimony to the fact that today legislation has no teeth and the question of implementation of these laws leads to a vicious circle of the unorganised sections not being able to enforce legislations and remaining unorganised. This is especially true of poor women living and working in remote rural areas. A completely new mechanism for the enforcement of legislation needs to be worked out. One possibility is that trade unions and women's organisations may be given the authority of supervising the implementation of legislation.
90. Today, the executing authorities, like the Factory Inspectorate are not accountable to the workers of the occupations and industries, where they are supposed to be executing the laws. It is necessary that a public accounting system be initiated, whereby the workers, and concerned organisations have access to the functioning of these authorities and are able to monitor these closely.
91. The sections of the Factories Act, 1984, dealing with occupational health and safety, have a number of loopholes and flaws, which Tender them ineffectual. To begin with, the Act itself covers a very small section of the workforce. Workers who are within the purview of the Act too, find it difficult to benefit from it because 1) the doctors are the only people who are supposed to report the notifiable diseases; 2) the managements are the only agencies to report the reportable accidents; 3) the workers or unions have no role to play in the enquiries of the accidents.