The neglected health problem of female garment workers

You'll likely have heard constant mentions of lower back pain, especially from women. And some of the stories we have heard, particularly about women working in garments factories, are absolutely harrowing. The silence as she performed her daily tasks was like an oppressive veil.

This is the story of 32-year-old woman who we shall call Saleha. She was married at the age of 19. Her husband used to work as a messenger in a private organisation. Then, after having a child, she began working at a garment factory as a sewing machine operator to help her husband with family expenditures. She worked in the same sector for eight years before quitting due to her chronic Low Back Pain (LBP) for the five months.

It started, at first, in the lower back region and was worsening day by day, eventually compelling her to quit. Even now maintaining a sitting or standing position for a lengthy period of time makes the pain so excruciating that she cannot return to work and has troubles doing regular household chores.

Due to her economic condition she has not been able to undergo the proper treatment. As a result her condition and that of her family has deteriorated gradually.

Saleha and her family are not fictional characters. They are instead, a common scenario for the female garment workers of Bangladesh.

The ready-made garment industry is one of Bangladesh's most noteworthy catalysts for economic development. According to the BGMEA, there are approximately 4,300 garment factories, employing more than 1.2 million workers, 85 per cent of whom are women.

A large portion of the workers in many of these factories fall outside the protection of international safety-improvement initiatives, and are vulnerable to unsafe working conditions. Part of the reason the diagnosis and treatment of women's lower back pain is lacking are simple work-related factors like overtime, lifting heavy items etc. In addition, physician often have inadequate training in diagnosing and treating lower back pain which affects women.

Recently, the North South University — Department of Public Health conducted a study of 1,000 female garment workers from three garment factories in the Gazipur area to understand the epidemiology of LBP. The study found that 38 per cent women were suffering from moderate to severe chronic low back pain. It also found that about 67 per cent of female garments workers with chronic or intense LBP were not seeking any medical care. It appears that lack of effective treatment and cultural stereotypes of women combine insidiously, leaving women at greater risk pf inadequate low back pain relief and continued suffering.

It is evident that there exists high prevalence of LBP among female garment workers in Bangladesh. This problem is not only detrimental to the workers, but can also negatively impact their ability to support their family, impede their productivity in the garment sector and impose an economic burden on a national level. Also most of the affected workers cannot take proper treatment due to their financial condition or for their lack of knowledge. So, to handle this problem, annual screening for LBP for the garment workers is necessary, especially for the elder age groups and long-term employees.

Furthermore, creating awareness and implanting knowledge among garment workers about LBP can also be helpful. Finally, the authority can organise the roster in terms of regular shifts of duty for the garment workers, rather than making them work overtime. With these changes to the health-care system and healthcare providers in the garments factories, we may be able to mount a better response to women who experience persistent LBP.

Dr. Ahmed Hossain is an Associate Professor at the Department of Public Health, North South University.

Fazle Rabbi is an MPH student at the Department of Public Health, North South University.