People spend a significant portion of their life-time earning their livelihoods by working in various places in different forms. Therefore, health and safety are considered to be very important issues as these are intrinsically linked with overall well-being of the working people. Occupational safety and health have been repeatedly mentioned as a fundamental right of every worker, and are referred to in the Alma Ata Declaration on Primary Health Care (1978), the WHO Constitution, the UN Global Strategy on Health for All (2000), the ILO Convention (1919) and in many other multilateral conventions and documents along with the national labour law of Bangladesh. Hence, occupational health and safety is very important irrespective of the type of employment, or size or sector or location of the workplace.
As mentioned earlier, a safe and healthy workplace is considered to be a right of any worker/employee. Since people spend significant portion of their days in workplaces, the nature and scope of safety and security remain a major issue for discussion and debate. The question of a worker's safety is not only based on consideration of productivity but also on the ability of the employee to sustain and earn for his/her family. Where employment and income help us survive, unemployment on the other hand brings significant negative consequences for the family. Poor wages, long working hours, risky working environment with few safeguard mechanisms, unhygienic working environment with no or little air flow, no daylight, high temperature, excessive noise, and poor indoor air quality and both verbal and physical abuses are often cited as characteristics of the many 'sweatshops' which operate in developing countries. These sweatshop characteristics can result in death or mild, moderate and severe injuries, long or short-term work-related sickness/diseases of workers which can have significant economic consequences for the family and the society.
Workers in Bangladesh are expected to work overtime beyond the standard level, particularly in the manufacturing industry. There is evidence that workers working long hours show poorer performance and suffer an increased rate of accidents due to strong connection between working time and fatigue. Health and safety at work are strongly affected by overtime. Several studies have found a high correlation between excessive overtime and higher incidence of cardiovascular disease, high blood pressure, on-the-job injuries and repetitive strain injuries due to poor occupational health and safety condition.
Workplace/occupational injuries are increasingly becoming a public health concern in all developing countries. These cause insecurity, poverty, and sickness. Occupational injuries alone account for more than 10 million disability-adjusted life years (DALYs) each year globally. On the other hand, quantifying the global burden of disability due to occupational injury and illness is difficult because of the fragmented and often anecdotal nature of the data from developing countries.
Studies showed that less than 10 per cent of the working populations in these countries is covered by occupational safety and health standards at workplaces. The contribution of injuries to the global burden of disease is expected to rise from 15.2 per cent to 20.1 per cent in 2020.
Almost 50 per cent of the world's injury-related mortalities occur among the most economically productive cohorts of the global population, i.e. among those aged between 15 and 44 years. The intangible costs related to the mental trauma, pain and suffering experienced by injured persons and their families and friends are also equally important to consider. The other monetary and social losses including mental stress have a direct effect on their daily lives they live afterwards.
According to the labour force survey 2009 of the Bangladesh Bureau of Statistics, 51 million (which is now more than 72 million) people are employed in Bangladesh. Of them, 22.2 million are involved in agriculture, forestry and fisheries sector, 7.8 million in trade, hotel and restaurant, about 7 million in manufacturing, 2 million in construction sector, 4.2 million in transport, storage and communication sector etc. This picture of the labour force gives an impression of the vulnerability of the workers involved in it, as this huge number of labour is working under poor working conditions, where occupational health and safety are almost missing. Though there is no specific data on occupational safety, risk and vulnerability, we know that less than 10 per cent of the working population of developing countries is covered by occupational safety and health.
The real picture of occupational health in Bangladesh can be inferred if we take into account the regular media reports concerning workplace accidents. A media scan of safety and rights published in 2007 showed that almost half of all workers' deaths took place in the construction sector, with 164 separate incidents resulting in a combined total of 222 deaths. Another report from the same source revealed, at least 388 workers were killed in workplace accidents across the country in 2011. The reports excluded deaths of workers outside the workplaces or deaths of workers as a result of road traffic incidents. Electrocution at workplaces was the cause of the highest number of deaths followed by falling from height (e.g. scaffolds).
Statistics from the Bangladesh Occupational Safety, Health and Environment Foundation (OSHE) revealed that some 1,310 workers were killed and 899 others injured during the first six months of 2010. Some 622 workers were killed and 395 others injured in various work-related incidents across the country in the first six months of 2011. The statistics appear to show that as Bangladesh is on the path to industrialisation work- related injuries are increasing, which seems likely as occupational safety has not risen in line with industrial expansion.
The booming readymade garments industry, which employs about 3.6 million factory workers, is increasingly becoming unsafe in terms of working environment. With an absence of minimum safe standards, the factories are often housed in buildings that are poorly maintained and inadequately ventilated, cooled, heated or lit.
Unsuitable domestic premises, overcrowding and improper storage of flammable materials, frequently create serious fire hazards. Inadequate exit points, fire extinguishers and absence of proper training make the workplaces more dangerous. The incidents in factories in Savar highlight the extreme danger and immeasurable costs of a lack of workplace safety. In November 2012, a fire caused the death of 111 workers, and just five months later, in April 2013, a building collapse killed a further 1,143 workers while leaving thousands injured.
All the evidences portray the overall situation of occupation health and safety issues. Yet it is evident that the number of work-related injuries or illness in Bangladesh is higher than those reported or published. Employers in Bangladesh show little or no responsibility to protect workers. As long as a worker gives his/her consent to work, it is assumed that he/she is willing to risk his/her life without any compensation, an assertion supported by research.
Workplace injuries not only cause ill-health, disability and death, but also have several negative economic consequences. One study showed that irrespective of the severity of injuries, victims in rural Bangladesh spent an average of US $4 on each injury. This is in a country where 17.6 per cent of the population lives below the lower poverty line. Thus out-of-pocket expenses for treatment in developing countries often generate cataclysmic household expenditure, acute debt and a higher level of poverty among the poorer people. With a poor public health care system, insufficient health insurance and social safety nets, injured victims and their families are forced to cover the cost of treatment through their own means.
People with work-related long-term injuries and their families are often over-burdened by additional costs resulting from the accidents. Such costs include special medical care, rehabilitative and restorative equipment and services, and provision of special education needs, as well as costs incurred for or by care providers, including opportunity costs related to foregone income. Medical costs for disabled people can be up to four times greater than those incurred by people without disabilities.
Occupational hazards thus increase the risk of extreme poverty. These severely impact on the income capacity of the family through debilitating injury or even death of key earning members. The multiplicative effect can easily have long-term consequences, for example when children are taken out of school to provide care. In this way, a vicious circle starts marked by poverty and disability, which can be reproduced from one generation to another. Hence, the complex relationships between occupational hazards and its consequences need to be seen within the context of the dynamics of extreme poverty and disability.
The economic costs of occupational injuries and illnesses rival those of even cancer and heart disease. However, the individual picture and history of extreme poverty of each of the vulnerable workers and victim workers is wretched and needs immediate attention to minimise possible adverse consequences. The costs of occupational injuries have a high (social and economic) impact on the injured workers, their families, society and the country.
Better work environment can enhance productivity and profitability. On the other hand, lack of willingness of the employers to provide an environment in compliance with occupational health and safety is just a misunderstanding. This lacks comprehensive understanding about the benefit of having such environment. In a society which is not disability- sensitive, it is even more difficult to rehabilitate people who are victims of unsafe work environment. It is essential to invest on institutionalising occupational safety and health issues along with a substantial investment in establishing a national labour statistics management system. Further research and strong reporting mechanism are also instrumental to prevent such incidents.
The writer is a development researcher working for Oxfam in Bangladesh. akramir@gmail.com
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