Hesperian Health Guides
Workers as health promoters
Factory workers can become health promoters in the factory. Forming or joining a safety committee can be a good place to start, since they often help prevent injuries at work. But worker health promoters can do even more by educating others about health dangers, and helping people find solutions and get care when they have a health problem. Worker health promoters develop a better understanding of the problems in the factory and can help others learn to treat the problems, to think about how to prevent them from happening again, and to organize for better and healthier work conditions. Workers often feel more comfortable getting advice from people who share their experiences than from "outsiders." See Chapter 2 and Chapter 3 for more on becoming a worker health promoter.
By finding out what workers believe are their most important health problems, you can create trainings and materials that they will be interested in and pay attention to. Use the information in this book to create health education materials that explain:
- how conditions in the factory threaten health.
- how to prevent health problems.
- how to recognize signs of problems caused by dangers at work.
- how to fight for workers’ right to health care.
Friendly health workers or community groups may be able to help produce booklets or posters, or organize discussion groups or workshops on different health problems. Make sure that talks and materials are in the languages that workers speak and reflect the conditions of their jobs and lives.
Workers’ health and safety trainings
The Asia Monitor Resource Center (AMRC) holds occupational health and safety workshops with organizers in Asia. Through training and activities such as mapping dangers, these organizers become health and safety promoters, sometimes even forming national occupational health and safety organizations. Although they do not have all the training or equipment a professional might have, they often have better local knowledge and practical workplace experience. This lets them have a real impact on workers’ lives. In Cambodia, Indonesia, and China they organize to remove dangers from the factory, train workers and employers on basic safety, and lobby for personal protective equipment.
Common health problems
Many of the health problems workers have are common in their communities. They may not be caused by factory work, but conditions in the factory make them worse by affecting:
- How they get sick and how often: Dangers at work, including bad ventilation, breathing in chemicals, bad food, and unhygienic toilets can weaken the body’s ability to fight illness and infection.
- How sick they get: Chemicals and dusts in the air can make respiratory problems worse. Bad food and unclean toilets spread germs.
- How quickly they get healthier: Not having time to rest or go to the doctor will prevent them from getting better quickly.
- How easily they spread contagious illnesses to others: Not having time or clean water to wash hands regularly, and ventilation that just moves dirty air around the workplace instead of replacing it with clean air contribute to the spread of germs in the factory.
Because workers spend most of their time at work, the factory is a good place to do health promotion. Improving workers’ health inside and outside the factory may be something the boss is willing to support. Healthy workers miss less work and are more efficient at work. Healthy workers are able to take better care of themselves and their families, and they participate more actively in the community. Involve workers from the start in the design and implementation of any health promotion program.
Health and hygiene trainings and workshops: Talk with workers or do a survey to find out which health problems are the most common. Bosses might make time for health trainings if they do not focus on how work affects health. Be creative in finding ways to incorporate work-related problems into your sessions. Hold separate trainings for women where women’s health can be discussed more openly.
Supply drives: Basic supplies can help prevent common health problems. Find sponsors and donors, such as a health post or a local store, and ask the boss to contribute towards soap, sanitary napkins, pain medications, and rehydration drinks, among other useful supplies.
Free cancer, HIV, and STI screenings: Health clinics or local non-profits often organize early cancer detection screenings, such as pap smears to check for cervical cancer. STI screenings are helpful when workers are guaranteed privacy, confidentiality, and free treatment.
Vaccination campaigns: Invite the health department to provide free vaccinations in the factory, before and after work, or during lunch.
Women workers organize through health promotion
Our organization, the Self-Employed Women’s Association (SEWA), is a trade union of 1.3 million women workers in India. We fight for better working conditions for women workers.
One of the biggest problems women workers were facing was that they did not have access to health care. So we organized many meetings with women where they talked about how expensive doctors were, how they didn’t have enough time or money to see a doctor, and what kind of health services they really wanted. We decided that we needed to bring health services closer to women for easy access. We first worked in a small, rural community to help build a community primary health care program.
At first the women saw us as just another organization that did family planning, because many organizations in the past were only interested in family planning. As we gained people’s trust and learned about some of the issues women were facing, we soon realized that the people who knew the issues the best were the women themselves. So we started training local women as health workers to respond to the community’s needs. We got help from the Center for Health Education, Training, and Nutrition Awareness (CHETNA), and they helped us begin training the first group of 10 women.
At the beginning, the women felt discouraged. They said, “But we have never been to school! How do you expect us to become health workers for the community? People will laugh at us.” But then the women realized that they already knew some traditional medicine, they knew the culture, and they knew what the problems were. We always started with what the women already knew and then we asked them what they wanted to learn and what was important to them and their communities. They have now formed a cooperative that helps other women become health promoters, provides low cost medicines, runs TB centers, and offers health insurance and other services.