Hesperian Health Guides

Women mobilize to meet their health needs

In this chapter:


Kamla, Ayesha and Leela are neighbors and mothers in Ahmedabad, India, who depend on the money they earn from occasional piece work to support their families. They are home-based workers, have no fixed employer, and have to pay for their own supplies. Cooking together at night, they realized they felt exhausted and in pain from their work. Ayesha, a garment worker, had constant back pain, while Kamla and Leela had trouble breathing after rolling incense sticks all day long. They decided to go to the clinic together. But the nurse and others at the health center did not offer the women any help for their problems. Although they were discouraged, the 3 women talked with other home-based workers and discovered they all had similar problems. Realizing they were not alone, the women agreed to work together to improve their situation.


2 women speaking while another listens.
Our bodies are all we have. We need to be healthy, so we can work and care for our families.
We must organize for better tools so our work does not make us sick, and for better attention from the doctors to get the care we need.


The women took their concerns to the state labor office, but no one there would listen. They decided to seek help from the Self-Employed Women’s Association (SEWA), a union led by poor working women, to organize for their rights. SEWA organizers helped them develop a plan and a list of demands. With an even larger group of women, they confidently returned to the state labor office. Facing the well-organized women carrying their tools in hand, the labor secretary was pressured to support their struggle. He helped the group organize a conference on occupational health, which brought together leaders in labor and public health services. Working women led the discussions, and the conference helped them build valuable connections with experts and other activists, most of whom were men. Working together, they designed new and safer tools for their jobs, and other ways to improve working conditions.

Armed with new information and the support of their new allies, the women returned to the local health center and persuaded the health workers to help them. Kamla, Ayesha, and Leela took the health workers to visit women doing piece work at home to show how harmful the work was. After seeing the women’s working conditions, the health workers agreed to help organize for better occupational health policies and for better services in their own clinic.

The women realized they faced another obstacle. Although they had won better health care, they could not afford the medicines they needed. Through SEWA, and building on the example of other groups, they discovered that if each woman contributed a small amount of her savings, they could build a cooperative to provide low-cost, generic medicines. After some planning, the women brought their proposal to the Cooperative Registrar in their state. But the official turned them down!

the registrar speaking to a group of women; 1 of them answers him.
What kind of a cooperative is this? A whole crowd of illiterate women and midwives?
We know our rights, and we won’t give up.


Even though they were not allowed to register as a cooperative, the women continued to write letters and speak out in public, and more and more women joined their efforts. The SEWA members worked together to learn about nutrition, reproductive health, tuberculosis, and other common health concerns. Friendly experts helped them grow plants to make more affordable traditional medicines.

After 2 years, the registrar granted the women a permit for their cooperative. Since then, they have been recognized as an outstanding cooperative with their own low-cost community pharmacy. The cooperative also produces some traditional medicines, and a team monitors local health services to ensure they meet the needs of women and their families. Over half of the 1,400 members serve as community health workers, educators, and midwives. This cooperative, created and run by poor working women, has improved the health of countless families in the community, and strengthened the economic and political power of women.

This page was updated:05 Jan 2024