Hesperian Health Guides

Worker health problems have many causes

In this chapter:

Workplace problems have many causes. By observing and discussing the problems, you can identify some immediate causes, but you may have to dig deeper to find the underlying causes.

Imagine a polluted river that carries waste into the ocean. You go upstream and find a person dumping plastic bottles and cans into the river. Maybe he is the cause of the pollution. After you show him how to recycle and compost, there is less waste but the river is still polluted. You go further upstream and you find a family piping their wash water and toilet waste into the river. Maybe they are the cause of the pollution. After you help them build a composting toilet and a leach field, there is less waste but the river is still polluted. You go further upstream and you find a factory discharging waste directly into the river. When they change to safe production methods, respect their neighbors and environment, and begin to value their workers’ health, the pollution stops.

Workplace problems are often like that river. Work dangers, like the man dumping his trash, are among the causes that are easier to see and to change. However, as you keep following the river upstream you find causes which are more complex. To solve workplace problems we must address the social, political, and economic issues that cause them: companies that favor profit more than people, social problems such as racism, discrimination and violence against women, and structures of power and government in our countries and communities.

illustration of the above: a woman trapped between a wall labeled "Poverty, Disability, Unemployment" and barking dogs with labels including "No education" and "Work dangers."

Juanita’s story

Juanita was a sewing machine operator for 5 years. In the factory, her hands moved lightning-fast as she repeatedly sewed seams about 800 times each day.

As she sewed, her fingers and hands grasped, pinched, twisted, pushed, and pulled clothing parts, bundles, bins, and tools. She worked 10 hours each day, 6 days each week, sometimes more. Although the pace of work was already fast, her supervisors constantly pushed her to do more.

Her wrists and forearms had been sore for several years, but since she could still work, she did not worry. She knew the pain came from her work because on holidays when she took time off to visit her family, her hands began to feel better. Eventually, the pain got so bad she could not sleep. As her hands grew weaker and more painful, it became harder for her to carry water, prepare food, and do other house chores.

She knew other workers had pain like hers. No one knew what to do other than hope it would go away. When she asked to see the doctor, her supervisor said, "No. Get back to work." She finally went to a doctor after work. He told her to rest and take pills for the pain. She could not afford the pills, but she bought them anyway. The pills helped her work for 2 more months. Then the pain slowed her down so much she could not make the quota and she was fired.

Juanita asking herself questions.
Why can our boss push us so hard?
Why must we work so fast?
Why do we keep getting hurt?
Why are there only bad jobs?

Juanita does not know how she will survive. She has no other job skills besides sewing. She only went to school for a few years because in her family, only the boys stayed in school and learned other work skills. She could clean houses, but that pays even less than sewing and is hard work too. She hopes rest will heal her hands so she can return to sewing soon.

Activity But why?

Asking "But why?" can help you see the causes of Juanita’s problems and choose solutions. Asking "But why?" again and again will give a group the opportunity think of more causes than when they first hear Juanita’s story.

  1. Why do Juanita’s hands hurt so much? Her job was designed to sew pieces of a garment as fast as possible. She had to bend, turn her hands constantly, and repeat tasks hundreds of times each day.
  2. But why was the work designed like this? The boss set up the factory quickly and cheaply. He did not think about protecting workers’ hands and bodies from injury. The boss paid Juanita based on how many shirts she sewed, not how many hours she worked. So Juanita worked as fast as she could for long hours to meet her quota and earn a living.
  3. But why was her pay based on how many shirts she made and not how many hours she worked? The boss wanted her to produce more shirts in less time so he would get more profit. The boss competes with other factories that pay workers the same way.
  4. Why did Juanita stay at this job if it caused so much pain? It was the only job she could get. She has no other training or skills. In her town, most jobs for women with little schooling are in factories.
  5. But why is this the best work Juanita can get? Her family was poor and her parents did not think girls needed to go to school. The factories hire women like Juanita who need the work and won’t complain because they don’t want to lose their jobs.
  6. But why does the boss get away with overworking and underpaying workers? He can treat workers however he wants because the government does not enforce labor laws and the workers do not have the power to stop him. Many workers want Juanita’s job. Garment workers in other factories face the same conditions.
  7. But why are there not better jobs for poor people like Juanita? Many poor countries try to attract foreign companies to build factories and create jobs for people like Juanita. The government builds Export Processing Zones or makes special deals to lower the taxes these businesses pay. To afford this, the government cuts spending for education, job training, and other programs that could fund better jobs and prepare Juanita for them.

Activity Analyze the causes of worker health problems

Talking about all the causes of a problem helps workers find more ways to solve the problem and prevent it from happening again. Workers can talk about which causes are the most important, which causes they can change, and who might be their allies to help them change other causes. Different workers will ask different questions and come up with different answers. The questions and answers for your situation will grow out of your own conditions.

Group the answers to the "But why?" activity to make it easier to see the causes of Juanita’s problem. For example, group causes into "work conditions," "social causes," and "political and economic causes." Create your own groups of causes.

a group of women using pieces of paper to put the causes of Juanita's problems in the groups listed below.

Dangerous work conditions include toxic chemicals, frayed electrical wires, repeating the same movements many times each day, and unsafe drinking water.

Juanita's work conditions.
long hours

Social causes of health problems for workers are attitudes, customs, and behaviors that deny workers’ rights and dignity, such as low pay, harassment, and discrimination. Women workers are especially affected by social causes.

social causes of Juanita's problems.
boss ignored problem
second shift
women not respected
no school for girls

Political and economic causes of health problems for workers are actions by those who own and control land, resources, and political power in the city, region, or country. Political and economic causes include: labor laws and policies that allow bosses to pay low wages for long work hours, the practice of firing workers who do not make quota, and the prohibition of unions. Political and economic causes also include governments that do not provide people with safe water, sanitation, education, and other services, and the kinds of policies and pressures that force small farmers to search for work in the city or in factories to survive.

political and economic causes of Juanita's problems.
no other jobs
poor countries compete
"free trade" not fair trade
laws not enforced
people need work