The findings represent a description of female workers’ health status and their understating about their health problems both individually and as a group. Quotes from the study participants present the female workers’ narratives. From the four sampled factories, cases are presented based on the in-depth interviews to represent all study participants. The cases show who the factory workers are, from where and why they migrated, their health problems, income, family expectations, job options, and future plans.
Gender division of labour, work environment and risks of health problems
The production room has both men and women working together. However, the women said that the production manager (PM), the floor-in-charge who works under the PM and the line supervisors on the production floor are all men. All the sewing machine operators and helpers are women. Operators and helpers are the two lowest positions on the production floor. The female workers reported that they cannot share their health problems with their supervisors comfortably as they are “men”. In this regard one woman said, “When we have our periods, some of us get sick from excessive discharge of blood, we need to go the toilet to change frequently but we cannot share our problems because we are embarrassed and they are all men around us.” Thus, they are unable to ask to adequately address their health needs.
The in-depth interviews with the female workers and the work site observations identified how the conditions of the work environment can affect their health. The female workers reported that the floor is overcrowded and they have difficulties breathing due to fabric dust. There is no air conditioning, although there are electric fans on the production floor and the workers suffer heat exhaustion during summer, as the number of fans is not sufficient. They suffer due to the smell of sweat, the noise from 500 machines in one large room, poor lighting, and having to climb up to 10 storeys of stairs twice a day, despite the presence of lifts. The lifts are reserved for the owners, managers, and their visitors.
This story describes a typical work day and its impact on the health and wellbeing of a female worker who works as a machine operator. She had finished primary education (five years), started her job at the factory as a healthy woman around four years before the interview. She explained how her work as a machine operator creates health problems. She sits on a small wooden tool without a backrest for 10 to 12 h each day. She sews the cuffs of shirts, one hundred per hour for the whole day, which puts constant pressure on her fingers and wrists. This sitting arrangement at work causes constant pain in her back. The work is monotonous and repetitive. The poor lighting, inhaling the fabric dust, and heat in the factory environment may contribute to the headaches and eye irritation. She indicates that the factory provides a face mask to protect workers from inhaling fabric dust, but she does not use it because it feels hot.
Despite there being doctors available, the workers do not have opportunity for regular medical examinations to check their health status. She added, “I was not as lean and thin as I am now. I lost weight after starting to work at the factory and lost my beauty. When I see myself in the mirror I cannot recognize myself. I do not get enough time to sleep and rest. Now I always have dark spots under my eyes.”
Physical illness and Panadol
The work hours are very long. The women reported that they are officially required to work for eight hours, but the production quotas are so high that they routinely work ten to twelve hours to meet the quota. The extra hours to meet the quota should be paid according to the regulations, but not all factories participating in this study fulfil this obligation. The female workers reported that they also do not refuse to do paid overtime (above the normal hours) as they can earn some extra money. However, these extra hours of work make them feel sick. Female workers reported that they suffer from headaches, eye complaints, body aches, and fatigue. They further reported that these physical illnesses have become ‘normal’ in their lives and they can live without treatment.
“I started working at this factory five years ago as a helper. Now, I work as a machine operator. I sew shirts.” says one respondent. Her monthly salary is 7000 taka (US$87) and with overtime, she earns 10,000 taka (US$125). She works 2–4 h overtime each working day, six days per week (total 28 days/month) to earn the extra money. She further added “I do overtime to earn some extra money to pay for food, house rent, and education for my children.” This work gives her the opportunity to earn extra money but she suffers from headaches, muscular pain, and back pain. She further added, “I have been working for last five years with these pains. Now I don’t think that they are pain, I even don’t go the doctor. As I work as a machine operator [operating with pedals], I always feel pain in my legs. I buy Panadol from the pharmacy and I take this tablet when I cannot endure the pain in my leg.”
Another woman explained, “Panadol becomes our main food to survive from all of our physical illness and pain. Every women who works at the factory they carry Panadol and eat it like rice because we all suffer from different pains in our body and Panadol helps to survive.”
“Tigers on the land and crocodiles in the water”
All of the women stated that meeting the demands of their job and taking care of their family members is a constant battle in their lives. The activities of women within the household include taking care of children and other family members, specially husbands, preparing and serving food to family members, washing and cleaning. All the female workers reported that the factory work gave them opportunity to earn money but their work load is doubled. They work at the factory but they also need to do all the household work. They further stated that they do not receive enough support and care from their husbands when they return home after work. Instead, they feel pressure to do all the household work to make their husbands happy.
The story of a quality inspector
“I started working at the garment factory three years ago. Now, I work as a quality inspector. I check the quality of every sewn trouser. I need to do the work constantly by standing in front of a table. I always feel pain in my feet for standing for a minimum of 10 hours per day. Now it is the holy month of Ramadan. We fast from very early in the morning to evening. We get one hour break during the evening to break our fast. We get a long vacation (10days) during our Eid [the biggest Muslim religious festival at the end of Ramadan]. We are working 7 days in this holy month of Ramadan to compensate for the days we will get as vacation during Eid. In fact we need more rest during Ramadan as we are fasting. Instead we work more this month to compensate for the days off.” She added, “When I return home after work I need to do household work. My work at home as a woman remains the same despite working at the factory. Last week I fasted, I worked the whole week and after I returned home I felt so tired that I couldn’t cook. I lay down and fell asleep. When I sleep sometimes I cannot move from one side to another side. I feel that I am paralysed as I work standing up. My husband became angry with me as I couldn’t cook for him. I need to make happy every day two of my supervisors, one at work and one at home. No one wants to listen to your pain of tiredness. Both of them want us to work.” She further lamented, “I am working hard at the factory and at home but most of the time I cannot make happy either my supervisor or my husband.”
Paid work choices, longevity and future plans
All of our study participants reported that working in the garment factory is better than working as a domestic servant, a sector where unskilled woman are generally employed. They further stated that they had no choice except to work as a domestic servant or as a factory worker. Factory work is like a profession, it gives them social identity. They can do extra work to earn extra money but in domestic work they cannot earn extra money. Though they work most of the weekends in the factory, they do get some holidays.
The story of a helper
She came to Dhaka with her husband and children for work. She can only write and read her name. She used to work as a housemaid in Dhaka. But the employer did not behave well towards her and did not give her food. The salary was very low. She was thinking about changing her job. She talked with one of her neighbours who worked at a garment factory. Her neighbour took her to the factory to meet her supervisor. The supervisor told her to go to the factory with her national ID card and there she got a job working as a helper. She folds the finished shirts to pack, standing all day. After starting to work in the factory as a helper, she always feels pain in her waist. The doctor said she needs to take breaks during work but running to meet the production quota provides little opportunity to take a rest during working hours.
All of our study participants shared their future plans. Every female worker said that they would work ten years in the garment industry. Many of them had already spent five years and would work five more years. After this time they will return to their own village. They are trying to save some money to buy some land in their village and to build a house. Some of the women reported that they establish a tailoring business in their own village after they leave the job. All of the women said that after working ten years in the garment factory, they will not do any factory work. They want to rest and spend time with their family.
The story of a machine operator
She completed her education up to grade five. She says,“We sew shirts with our tears and injure our fingers due to needle punctures. If you work at the garment factory it will give you some money but it will take your health. Every day my fingers get injured due to needle punctures. I wear a needle guard to save my finger but I can work faster if I do not put the needle guard on my finger, but that causes finger punctures. Now I do not care about needle injury. I just think I need to work hard to earn more money to save some money for the future of my family. No one can work in a factory more than ten years because you will lose your physical strength, energy and health after ten years due to the nature of hard work in this industry.”
The factory doctors’ perspectives
The key informant interviews focused on the health services provided by the factory clinics and the health problems facing the factory workers. One of the key informants described how the factory clinics run, “The factory provides health services to the workers through factory clinic. The clinic has a sick room and nurses. We [Doctors] are available in the afternoon but the nurses are available the whole day. If you [pointing to the researcher] visit the factory floor you will see first aid boxes are available on each floor to treat them for small injuries, fever, and headache. We have paramedics on each floor to treat the workers. When the paramedics cannot treat the problems they refer the workers to the factory doctor for further treatment.”
A factory doctor explained the health problems associated with the work of the factory workers, “The female workers suffer from mainly headache, eye pain, back and joint pain and weight loss. The first three health problems occur due to the repetitive nature of the work. The weight loss is very common among the female workers. The reason for weight loss is not getting opportunity to take enough rest and not eating enough food, On the contrary they work hard to earn money to run their family. We can only advise them to take enough food and to have enough rest.”
Another doctor identified health problems related to the job position: “The women who work as machine operator they come to the factory clinic with a complaint of suffering from dry cough. The machine operators inhale dust of fabric for continuously sewing clothes. The machine operators also suffer from injury due to needle punctures. The factories provide needle guards and masks but they do not use them. Sewing machine operators also suffer from the back, neck, and shoulder pain. The women who work as a quality control inspector and ironers suffer mostly from musculoskeletal pain in the knees and thighs due to working for long hours standing. Some women complain about losing hearing. They do not lose hearing power but noises of machine make them feel headache.”
The doctor further reported that the factory clinics provide limited health services. They mostly prescribe pain killers to treat the illness of the workers, along with some health advice. The doctors were asked about the longevity of the workers working tenure. In response to this question the doctors reported that the female workers cannot work more than ten years because they get physically exhausted and unfit to work.