Hesperian Health Guides
Talk with workers about their concerns
Every day 20,000 people visit the HealthWiki for lifesaving health information. Ifwe could translate 50 more chapters.
Make a gift to support this essential health information people depend on.
Find ways to talk to workers about the work conditions that bother them and that they think are important. These discussions let you "take the temperature" of the factory and learn how people feel about organizing to change conditions. It also gives your co-workers a chance to know and trust you, and to begin to build power within the workforce.
Reach out to people in your factory in informal ways at first. It might be safer and easier to talk to people outside work. Be clear and open about why you are asking questions and what you plan to do with their answers. Do not force anyone to share information if they do not feel comfortable. Be discreet when approaching people, especially in public.
When you are ready to hold a meeting, identify a small group of interested and trustworthy people in your factory. Invite them to meet at a location outside work. Meeting in small groups is best at first. Small groups can be especially useful if workers come from different cultural, language, ethnic, or immigrant groups. It may also be useful to gather men and women separately at first, so women feel free to voice their concerns. Over time, groups can develop enough trust to include workers from all backgrounds.
During conversations with workers, create lots of space and time to let people talk about what bothers them and what issues they think are important. Be tolerant of people who do not want to talk or organize, and do not discriminate against them for not participating. Some people need more time to make up their minds.
Some issues people raise might make you feel uncomfortable. Try your best to be open to their concerns and look for others to help you think through how to respond. Remember, your role is not to help solve every problem, but to help people think and find tools to solve problems themselves.
Activity Talk in small groups
One or two people can lead several small groups, or you can have several people lead one or two small groups each. This allows more people to develop leadership and lets you gather more information in less time.
Meet: Call a few workers together in a place where you all feel comfortable talking about work problems. Find a safe space that is easy to get to.
Talk about concerns: Ask what bothers people at work or mention a concern you have. Find out what conditions they think harms or might harm them.
Listen for problems and proposed solutions: Listen carefully to each person’s concerns as well as for problems many workers share. Find out if different concerns affect different groups of workers. Pay special attention to the ideas of women and others from groups who are often discriminated against, such as migrant workers or people with disabilities.
Write what you learn: To help remember everything, take notes during the discussion or write your thoughts down immediately afterwards.
Summarize the results: After speaking with many workers, summarize what you have learned by answering questions such as: Which problems are common to many workers? Which problems do workers feel are the most important? Which ones have the easiest solutions?Do you need help? OSH professionals, unions, NGOs, and others may have helpful skills and experience. Ask the group who might approach them.
Ask questions through surveys
Carrying out a survey helps you gather similar information from many people, so the answers are easier to compare. A survey can also build a relationship among the team carrying out the survey, and between each team member and the co-workers they talk with.
Surveys are less useful for collecting complex information. Those issues may be best talked about in a group where everyone participates. Topics about feelings or issues people are uncomfortable with may be best collected with one-on-one survey questions.
Ask specific questions, for example, how many hours a person worked the past week, if people have skin rashes, or if a supervisor limits time at the toilet.
The simplest, easiest method of gathering information is always the best. If you have only a few, very simple questions, you might be able to just ask for a show of hands in the cafeteria and not need to do a survey.
Surveys with many complicated questions can be difficult to carry out and to analyze. People often want to talk about more issues than can be included in a survey. Plan to listen to people’s opinions about various things, note them down, and then invite them to meetings or discussions where they can follow up on their concerns.
Keeping information private is important when doing a survey. It will protect you and the people you are surveying.
Activity Do a survey
Meet: Ask several co-workers to help you. Meet in a place where you all feel comfortable talking about work problems.
Talk about concerns: Work with this team to make a list of questions to ask your co-workers. Start with the issues at work the group is most concerned about. From this list, choose a few common dangers or the issues you think are the most important to find out.
Breathing Problems: Yes/No
Write survey questions: Create a list of questions. When you ask about a specific problem at work, always ask how important that problem is to them and how much they care about improving it. If you have too many questions, think about which are most important. Questions with yes/no or multiple-choice answers are easier to summarize than open-ended questions. Do not make the options too limiting so you can find out what people really think. Try the survey first with a few co-workers who did not work on the questions. If they find the questions unclear or think there are too many, rewrite the questions and shorten the survey.
Plan the survey: Decide how many workers each of you will survey and from which parts of the factory. Set a date for the team to meet and check on progress. Use role playing and other activities to prepare the team for all the things that could happen during the survey. Also plan what you might do after the survey to see if the questions will generate the information you will need.
Do the survey: As some workers may not read well, you might decide to ask the questions in person and write down the answers.
Check in with each other: When the team meets again, have each person talk about the funniest or most interesting person they surveyed, and the most difficult ones. If some team members are having difficulties, ask other members to share some of the ways they found to make surveying easier.Summarize the results: When you have enough information, add up all the answers and categorize them. Then summarize what the team has learned by answering questions such as: What are the most common dangers people have observed or experienced? Which dangers are felt by only one group of workers? What health problems related to work are people experiencing? What do people seem to care about most? What are they willing to work to change?
Listen to what workers know
A group of us took a workshop on ergonomics. We learned how work can be designed in a way that hurts less. If we put things we need often closer to us, we reduce how much our bodies must move, which makes them hurt less later. We also learned to stretch, massage, and exercise our bodies to keep them healthy.
When the trainer talked about injuries caused by repeating the same movements over and over, we knew what she was talking about. Many of us have hand pain because of that! So when we went back to work and talked about "repetitive strain injuries," we thought people would be interested. Instead, people told us, "You are wrong! What we have is arthritis, not this repetitive strain nonsense. You get arthritis as you work more and get older, and nothing can fix that."
At the next workshop, we complained about our hard-headed co-workers in the factory. The trainer explained that every person has lots of ideas about health. Our role is to value people’s ideas and then introduce new ones. If we tell people they are wrong, they probably will just stop listening. We have to find ways to help people understand new ideas, and show how a new idea is related to what people already know.
Instead of saying they were wrong about arthritis, she suggested we ask questions, such as: Where does it hurt? Do you feel tingling, tiredness, and other sensations besides pain? Does it hurt more after work?
The questions let people bring themselves to an understanding of the differences between arthritis and strain injuries. And since they got there themselves, people were willing to accept the new information.
The trainer also said we could invite people to test the new ideas and see what happens. Ask some people to try to lessen their pain through small changes at their workstations, or to stretch with you during breaks, and you can show that the ideas work. After a week or so, ask them if they feel any better.
We followed her advice, and our co-workers started to learn how work was making their bodies hurt and that they could do something about it besides suffering the pain. But we learned a bigger lesson: when we help people understand instead of just telling them, we get better results and build a stronger, more active group.
Group activities that invite people to share their experiences and observations about their bodies, their work, and their communities are an opportunity to build upon people’s knowledge and to create a shared understanding of work problems. Mapping activities also let workers see how common many of their problems are. This helps a group more easily agree on solutions and priorities for taking action.
Map of the body: This map lets you ask, "Where does work hurt your body?" Everyone in the factory can contribute to this kind of map. A good way to start is for you to talk about where you feel body pain. That will help others feel comfortable talking about themselves and their problems at work. See an example of a map of the body.
Map of your factory: With workers comfortable talking about problems at work, make a workplace map. Label where the processes, jobs, or areas are that can harm workers, including harmful people, such as a rude supervisor. Also mark where accidents have happened. The workplace map focuses the group on specific problems in specific places in the factory. Then you can talk about specific solutions for them. See an example of a workplace map.
Map of the community: After doing the Pollution walk activity, bring together a group to map out the routes in which the problems inside the factory spill out into the community. You can map pollution by looking at where the waste goes after it leaves the factory and the health problems it causes. Showing the links between the factory and the community can help persuade neighbors and community groups to support workers’ campaigns to improve factory conditions and to convince unions to support environmental causes.
Activity Draw a map of the body
Meet: Gather a group of co-workers and have something to draw on that everyone can see. A large piece of paper and a marking pen, a chalkboard and chalk, or a smooth area of soft soil and pebbles or nuts would each work.
Draw an outline for the map: Draw the outline of a human body on the paper, chalkboard, or earth.
Mark and talk about pain: Ask people to mark the places on the drawing of the body where they feel pain from work. After people mark the map of the body, ask them to explain why they put the mark where they did. What pain do they have? What work tasks cause this pain? What dangers cause this pain? After each person does this, ask who else has the same pains.
Discuss dangers and solutions: After everyone has spoken, discuss which dangers affect the most people, which dangers are the most serious, which might be easiest to fix, and then which the group thinks should be fixed first. Ask for ideas on how to fix these problems.
Write what you learn: Take notes about the pains people describe, the dangers that cause the pain, and the solutions they propose. Write them in a place where others can see them and add to or change them.Options: If you have several colors of marking pens, use different colors for different kinds of problems. For example, you might decide that ergonomic problems will be red and problems caused by chemicals will be blue. Or, have the workers from each work area use the same color to see if they share problems. Using colors might also let you see if one kind of problem is more common than another. You could also use "ouch" stickers on the map to show where there is pain.
Activity Draw a map of your factory
Meet: Gather in a place where all feel comfortable talking about dangers at work. Lay a large piece of paper and marking pens in several colors on a table (or use a chalkboard and chalk).
Divide large groups: Divide into small groups so each can create and discuss their own map. Each group can explain their map to the others as a way to share different views of the same workplace.
Draw an outline of your factory: Ask the group to draw it as if they were looking down through the roof of the building from the sky. Each floor of the factory will need its own map. Include the walls, doors, windows, and exits. Draw in the work areas, workstations, machines, people (supervisors and coworkers), or anything else the group wants to include.
Mark and talk about dangers: Ask the group to mark the areas on this map where they have experienced or seen dangers. Use different colors. For example, use red to mark physical dangers such as fire, electrical wires, slippery floors, bad stairs, and so forth. Use blue to mark where chemicals are used or dust is created. Use orange where jobs cause strain, sprain or overuse of workers’ bodies. Use yellow for biological dangers such as contaminated food and water, or dirty bathrooms. Use green where workers feel stress from threats, harassment, and unfair treatment.
Take one more look: Have the group look over the map and ask if any important dangers are missing. Add them to the map with words, colors, or a drawing. Also ask if anyone has lost their job or gone on sick leave because of work problems, and add them to the map where they used to work.Summarize the dangers: Help summarize the dangers with questions: Which dangers are common to many workers? Which dangers are felt by only one group of workers? Which dangers cause the most serious problems?
Activity Draw a map of your community
Bring paper and pencils, pens, or markers to draw the map. Or use stones, sticks, and other materials to make a map on the ground.
Meet: Invite workers and community members to do the Community pollution survey where people survey community members, walk through the community, and take photographs. All of this can be used to make a map.
Draw a map: Ask people to draw a map of the community that shows the factories and the areas where people live, go to school, buy their food, and spend time. Be sure to include community water sources, bodies of water, food growing areas, and waste dumps. The size of the area represented by the map can be as large or as small as makes sense for your situation.
Mark causes and effects of pollution: Use a different color (or material) to show each kind of pollution. Show where it starts, how it moves through the community, and how it affects people’s health.
- Where pollution starts: Are the factories in your community polluting the air, water, and land? Which ones are polluting? What does pollution look like? Mark where and how it comes out of the factory. Some kinds of pollution are not as visible as others.
- Signs of pollution: Where does the waste go? Are waste and chemicals dumped into the water? Can you see or smell smoke or chemicals in the air? Do people and animals in the community come in contact with factory waste? Ask people to talk about all kinds of pollution and the ways we interact with it. Be sure to include the people in your community who collect, clean up, or recycle waste.
- People who are sick: Mark areas where people complained about health problems such as rashes, asthma, reproductive health problems, children born with birth defects, and cancers, because these are some of the health problems caused by pollution that your survey might uncover. Look to see if a problem "clusters" in a specific area. Often you will find clusters in the communities closest to the factory. But if the factories dump chemicals or other wastes into a river, communities downstream are likely to have similar clusters.
Take one more look: Have the group look over the map and ask if any important information is missing. For example, people might want to add areas where materials get recycled in your community and talk about pollution there, too. Or talk about other important polluters in your community.Document and summarize what you learned: If your map is on paper, take it with you. If it is drawn on the ground, take photos of it. Discuss how you will share it and its information with other workers, people in your community, government officials responsible for environmental and public health, and with social media or other kinds of media. Getting people to pay attention to the problems outside of the factory that are caused by the factory can help you bring their attention to the problems inside the factory and get support to improve them.