Introduction
When occupational health and safety issues are discussed from the perspective of a working women, one tends to think of their status as workers and the nature of work for understanding the implications of the work on their health. These concerns are particularly evident in the case of female workers as compared to male workers, who also face occupational health hazards. For socio-cultural and economic reasons, among others, women's occupational health and safety issues call for specific attention in a country such as India, where a large majority of women workers are unorganized.
Gender complicates the situation because of the multiplicity of women's work, which begins with domestic responsibilities early in the morning at home, continues at the workplace, and ends late at night with the completion of domestic chores. Another facet of the multiplicity of women's work is the broad spectrum of tasks typically done by women. Many women work the family's field, labouring in agriculture to sustain the household. Others do home-based piecework. Often, women work at a construction site, employed as casual help or on a daily wage basis. Other women are migrants working in a city far away from the home (village), employed, perhaps, on an assembly line in the electronics industry, at a cloth mill or working behind a travel desk. Each of these occupations entails it own, specific health hazards.
At the same time, however, some health hazards are common to all women workers. As concerns the principle of a safe and secure work environment, for example, the issue of 'sexual harassment at the workplace' adds a social dimension, pertaining to a woman as a 'worker' outside the safe four walls of her home. In the light of the recent guidelines of the Supreme Court of India prohibiting sexual harassment at the workplace (1), this is rightly being seen as an occupational health and safety issue affecting all women and requiring independent attention.
A holistic definition of health as "a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity" (Karkal 1995), underlines the fact that a 'worker' whose health is neglected - whether because of some social norm or economic fallout - will not be a healthy worker. Also, if the conceptual base of such terms as 'work' and 'worksite' is expanded to include the less conventional, elusive, hidden structures of work - e.g. home-based work, housework, prostitution, informal sector activities, etc. - then the probable occurrence of occupational health hazards increases proportionately.
This article examines some aspects of the theme topic as entry-points to larger questions, exploring links between the following considerations: women's occupational, reproductive and general health; the division of labour by gender and women's specific roles in the world of work; their perceptions of self and perceptions of women's status and health in society; and other relevant considerations.
In India, issues of occupational health have been incorporated into the analysis of labour movement agendas and women's movement's agendas only recently, in the light of changes in the economy - especially the deregulation and liberalization processes comprising the New Economic Policy. This has been the case particularly with regard to the increasing numbers of women workers who are entering the vast unprotected and unorganized sectors of work in India. This article attempts to briefly weave these concerns into a cross-sectoral analysis of occupational health and safety issues (1).
Are women the only ones exposed to risks?
Why, one may ask, is it necessary to pay special attention to women's health, rather than looking at labour in general, and identifying problems encountered by both men and women?
The gender approach became a veritable bête noire among participants at a recent International Labour Organisation event, which dealt with women's working conditions at some length. Such questions as 'Why are only women being discussed?'' and `'Do men not suffer from occupational hazards as much as women do?'', highlighted the lacunae in the understanding of gender-related occupational health and safety. A direct and critical statement against such popular notions on gender (2) - which equate it with the feminist perspective (in spite of the very different political positions that these views take) - has investigated what are called the 'gender hierarchies of development thought' and has called for a general self-assessment by those who set out to do good unto others - a case of 'Doctor heal thyself', perhaps?
There is a need to compile an information base for a study on the relationships between gender and its various dimensions. A study of this kind should provide a better understanding of the distinct problems faced by women and men. However, this does not imply an inherent dichotomy between the approaches to be taken, nor does it necessitate competition between the sexes for aid or benefits.
The need to take into account the specific features of the 'female' situation is amplified in the context of issues pertaining to occupational health. This is not only because of women's biological requirements as child bearers and nurturers, but also because of the distinctly different nature of their roles on the labour market. The cases discussed below illustrate these interconnections and also introduce some basic issues of women's occupational health and safety in India.
Work in the informal sector
The complexity of variables which weave together to undermine women's health in every sphere of life is difficult to unravel without looking at specific examples and case studies. One such study analyses home-based work and attempts to discern the factors (at various levels of a woman's work within the household) which ultimately affect health.
Beedi (an indigenous cigarrette) rolling is a traditional industry employing women, children and men, who work mostly from the home (there are some exceptions to this) in certain parts of India. According to the Government of India, there were over 22,00,000 women making beedis in 1993-94, most of them working from the home. The work requires detailed skills and dexterity, and is highly labour-intensive, as each beedi is rolled individually, processed tobacco being wrapped into a Tendu leaf (a local leaf especially used to make beedis and also to make indigenous plates).
Most of the beedi workers belong to lower socioeconomic groups, and their immediate heath problems stem from the nature of this activity. The posture involves constant sitting and bending while working. There is exposure to tobacco and tobacco fumes and dust, while both physical working conditions and living conditions are poor. In most cases, the beedi workers live in extreme poverty, and the exploitative working contracts that this industry thrives on serve to keep these workers poor and dependent on the whims and fancies of middlemen who contract out the work for larger contractors or for industry. These workers have long working hours and limited or no alternative sources of livelihoods; they face exploitation at the hands of the middlemen or contractors, and legislative provisions that would be of assistance to them are not implemented. (Bhatty, 1984; Chawdhary,1980; Acharya and Saldanha, 1984; CSWI, 1974; Awachat, 1974; Morje, 1983).
According to findings of a study by the National Institute of Occupational Health (NIOH), Ahmedabad, the main hazard in the beedi industry is tobacco dust, which was found to cause, among others, burning of the eyes, conjunctivitis, rhinitis, mucosal dryness (including dryness of the genital tract), occupational dermatitis, bronchitis and emphysema. (NIOH, 1984) A study conducted specifically to investigate the gynaecological health problems experienced by the women beedi workers in Indore found that all but one woman worker reported some kind of problem. Exhaustion and dizziness were the most common problems, being reported by 91% and 90% respectively. Pain in the lower abdomen was reported by 62% of the women and 58% said that their menstrual periods began earlier than the due date. White discharge or leucorrhea was reported by 54% of the women, and anaemia seemed to be a condition common to almost all of the women (Chatterjee, 1987). In addition, an earlier study had reported frequent miscarriages among women beedi workers. (Patel, 1984).
Work in the formal sector
Experience over the years has shown that increasing 'feminization of the workforce' or the segregation of women into certain kinds of low-paid, dis-empowering jobs has adverse implications on their health. The 'reserving and stereotypingof certain jobs for women - whether in the nursing profession or as secretaries - serves effectively to exclude a large proportion of working women.
The obvious health risks associated with the profession of nursing, for instance, or with repetitive work actions such as those in the electronics industry are well-documented. The author, in a paper that dealt with health hazards in a hospital setting in Mumbai, observed certain effects on the predominantly female nursing staff: "They contracted certain viral infections like rubella while working in the infectious disease hospital. If the nurse is pregnant, the foetus can be deformed or have a hearing impairment, etc. Hepatitis B or HIV could be contracted easily especially in casualty wards where emergency cases were also handled. Exposure to radiation in the X-ray laboratory, during orthopaedic surgery etc., needle pricks in the blood bank or while giving injections, and autopsy rooms all come with their own set of health hazards." (Parhar, Maya 1997)
Similarly, in the electronics industry, assembly and the manufacture of certain electronic components are associated with several work-related illnesses. Work is broken down into a series of repetitive tasks that require intense concentration and precision and that are extremely stressful to carry out. The resulting health problems include weakening of eyesight, backache, headache, loss of weight, loss of hearing, extreme tiredness and fatigue. In addition, some of the chemicals used are toxic. Organic solvents and corrosive acids are commonly used and cause a range of problems, including nausea, dizziness, organ damage, cancer and burns. Lung diseases have also been reported (Gothoskar, Sujata 1999).
Apart from these immediate problems are the general issues, which are rooted in the roles played by women at work and at home. Mary K. Benet in Secretary: An Enquiry into the Female Ghetto, maintains how the secretary was also the 'wife, mother, mistress and maid'. Benet argued that office work is the 'business equivalent of housekeeping', since both jobs are custodial, concerned with tidying up, keeping away or restoring order, rather than with directly producing anything. She compared filing with washing dishes, arguing that both tasks produce the same sense of frustration. This analogy can also be extended to teaching at school, where women re-invent their child-rearing role (3).
The segregation of jobs on the basis of gender contributes to preventing equal payment and thereby impedes economic empowerment. The division of labour hampers women from entering professions or learning skills that would improve their economic conditions. Low economic stability means poor nutrition and poor health care for women. The increased flexibility of labour terms, a spin-off of the recent processes of liberalization, has ensured the presence of women in certain kinds of jobs offering the promise of flexible work routines enabling them to handle both housework and income-generating activities; but has also entrapped women in low paid, difficult and hazardous work.
Prevention is better than the cure
While these and many other studies spell out some of the problems inherent in the immediate working conditions, it is important to recognize that, to a great extent, the form of employment - largely informal and home-based - prevents women from getting balanced nutrition or good health care, which would help to combat diseases. The routine undermining of women's health, both in family life and in society in general, is a major factor contributing to this neglect. In the case of household work, which virtually every Indian woman has to do from a very young age onwards, the work done is not recognized as work at all. Therefore, the term 'occupational hazards' seems to have no relevance in the context of the home. In consequence, appropriate approaches for alleviating work pressures and hazards within the home are not sought. Moreover, for home-based workers, there is a tenuous line between housework and paid work that permits middlemen and factory owners to circumvent laws on working conditions in a large number of cases.
In the sphere of reproductive health, occupational hazards are endemic in prostitution and similar professions which capitalize on women's reproductive roles; these aspects have not been dealt with in this article. The situation is worsened, however, by the fact that these problems are considered 'women's problems' which women are expected to handle themselves in their own way - even though the lack of mobility, knowledge, resources or a certain moral framework may mean that they are not handled at all.
While legislation exists for monitoring working conditions and providing social security benefits, the lack of ability to understand legal text means that women do not have the information or skills needed to benefit in full from these laws. Most importantly, the low proportion of women in trade unions or the lack of awareness concerning labour-related issues amongst those who work at scattered worksites (e.g. home-based work) means that women workers cannot lobby for their basic rights, which would do much to ensure healthy working conditions and to minimize occupational health hazards.
Literature
- Kapur A. (ed.) Women Workers' Rights in India: Issues and Strategies - a reference guide, produced by the "Training and Information Dissemination on Women Workers' Rights" project of the International Labour Organization, New Delhi 1999.
- Kabeer N 'Reversed Realities', Kali for Women, New Delhi 1994.
- Benet, MK. Secretary: An Enquiry into the Female Ghetto. London: Sidgewick and Jackson, 1972.
- Lingam L. Report of workshop on 'Women's Occupational and Reproductive Health: research evidences and methodological issues, Mumbai: Tata Institute of Social Sciences, and New Delhi: International Labour Organisation 1999.
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Aanchal Kapur
Block III/78 (FF)
Sunshine Av.
Charmwood Village
New Delhi 44
India
E-mail: aanchal@sapta.com
Asian-Pacific Newsletter 2/1999 p.36-38