“Who will stand up for us?” the social determinants of health of women tea plantation workers in India

Abstract

Introduction: The tea estate sector of India is one of the oldest and largest formal private employers. Workers are dependent on plantation estates for a range of basic services under the 1951 Plantation Labour Act and have been subject to human rights violations. Ad hoc reports related to poor health outcomes exist, yet their determinants have not been systematically studied. This study in Assam, situated in Northeast India, sought to understand the Social Determinants of Health (SDH) of women plantation workers with an aim to offer directions for policy action. Methods: As part of a larger qualitative study, 16 FGDs were carried out with women workers in three plantations of Jorhat district covering permanent and non-permanent workers. Informed consent procedures were carried out with all participants individually. Data were analyzed thematically using Ritchie and Spencer's framework based on an adapted conceptual framework drawing from existing global conceptual models and frameworks related to the SDH. Results: Determinants at structural, intermediary and individual levels were associated with health. Poverty and poor labour conditions, compounded by the low social position of women in their communities, precluded their ability to improve their economic situation. The poor quality of housing and sanitation, inadequate food and rations, all hampered daily living. Health services were found wanting and social networks were strained even as women were a critical support to each other. These factors impinged on use of health services, diet and nutrition as well as psychosocial stress at the individual level. Conclusion: Years of subjugation of workers have led to their deep distrust in the system of which they are part. Acting on SDH will take time, deeper understanding of their relative and/or synergistic contribution, and require the building of stakeholdership. Notwithstanding this, to have heard from women workers themselves has been an important step in visibilizing and building accountability for action on the health and SDH of women in plantation estates.

Water, Sanitation, and Women’s Empowerment: A systematic review and qualitative metasynthesis

“…Articles largely featured research from Asia (48%) and Africa (42%), and focused on adult participants (69%) (Table 2). The earliest paper was published in 1989; 82% (211) of articles were published since 2010 and 60% (153) since 2015 (Figure 4).…”

“…99,130,157,171,176,189,193,201,207,208,212,213,215,232,[238][239][240] Women used less preferred locations and sources for sanitation 116,156,159,183,205,211,215,221,226,234,241,242,256 and water due to cost, distance, or access limitations. 56,72,76,84,151,156,163,166,180,184,185,191,194,196,203,211,215,217…”

“…Women and girls' experiences of illness and infirmity related to water and sanitation conditions are well documented. 49,51,56,62,67,72,97,104,108,109,121,127,130,140,154,[158][159][160]163,164,170,172,[174][175][176][177]181,[183][184][185]188,194,200,206,209,211,212,217,[225][226][227]233,242,245,258,259,264,270,271,273,…”

“…258 Women qualitatively reported perceived linkages between various illnesses and their water and sanitation environments and experiences. Women reported experiencing or fearing diarrhea, vomiting, dysentery, cholera, hepatitis, schistosomiasis, and skin diseases due to polluted water, 51,56,72,97,130,163,164,183,185,200,206,211,217,234,245,259,274 and experiencing diarrhea due to limitations on hygiene in times of water scarcity. 56,109,188 Women in India worried about spreading disease if limited water constrained their ability to wash their hands during menstruation, 212 and were concerned about fungal diseases when using dirty water inside sanitation facilities.…”

Metagenomic outlooks of microbial dynamics influenced by organic manure in tea garden soils of North Bengal, India

“…in › project reports). Previous studies on tea garden workers showed the prevalence of neurological, gastrointestinal, renal and hepatic toxicity (Inglis and Sagripanti 2006;Frost 2001;Picard et al 2005;Bae et al 2002;Chenoll et al 2015) among them. Most of the tea garden workers are prone to respiratory ailments such as tuberculosis and skin disorders (Gayathri and Arjunan 2019).…”