Health Impact of Occupational Risks in the Informal Sector in ZimbabweChapter 2Literature Review |
As indicated above, the larger share of employment is in the informal sector. A review of literature on the informal sector indicates that employment in the sector is generally characterised as semi- and unskilled employment, home based employment and low income employment. In some surveys, 90 % of informal sector workers have not undergone any training, gaining their knowledge and skills in service. Managerial and skilled workers are scarce as these are often drawn into formal sector firms. Informal sector employment is often a response to scarcity of formal wage employment, through small scale entrepreneurship, often capitalised from home savings and formal sector wages. It also includes small scale businesses avoiding the costs of government regulations and control. The terms and conditions of work are generally flexible, often below legal standards in terms of labour relations law and generally without formal written contracts. Informal sector employees are noted to be vulnerable to exploitation as they do not know or exercise their rights, and because they are either not covered by government labour law or are not monitored. Equally, however, due to relaxed regulatory and licensing framework and generally low incomes, most workers in the sector do not pay taxes or deductions out of their monthly earnings. The resilience of the informal sector lies in its relatively small size compared with the formal sector, its lower overheads and greater adaptability to changing environments, while fexibile labour regulation gives the sector relatively unfettered job entry and exit. Self employment is the main employment pattern in the sector, with small family-type businesses common, especially in the initial developmental phase of the enterprise.
'Homeworkers' form a major group of informal sector workers. Homeworkers perform their work in or about their home, processing materials, either in their own enterprises, or through a contract with another enterprise. In the latter case the work is furnished directly or indirectly by an entrepreneur, in some cases ith a written or verbal agreement on specifications on design and materials, and the final product is returned to the entrepreneur. Home Based Enteprise (HBE) is a further term used to describe the use of the home to generate income (Gilbert 1988). The operators of HBEs have been found to be both females and males depending on the nature and type of the enterprise.
Very few countries have tried to measure the extent of home work through their regular labour force surveys or population censuses. Among the seventy (70) countries and territories for which the ILO has information, only five (Federal Republic of Germany, Hong Kong, Italy, Japan, Morocco) have designed their labour force survey questionnaires so at to permit identification of homeworkers (or a group reasonably close to them' (De Vilegas 1990). 'Furthermore, official statistics and estimates usually underestimate the extent of home work because economic activities in the home are often invisible or clandestine in nature. In many cases homeworkers do not consider themselves to be workers and do not declare their activity for cultural reasons. In other cases the employment relation may be illegal: it might be that regulations forbid work at home in this or that industry, that the particular homeworker has no right to work, is not registered and is not declaring income, or that the employer is in violation of wage and benefit standards (Gilbert 1988).
Many large enterprises distribute their work among a chain of contractors, who in turn subcontract work to many middlemen, who distribute the work further still to hundreds and thousands of home workers. Home work in the service sector is gaining around. In many industrialised countries, where it had been stagnant or on the decline over the past decade or so, home work is again increasing because of its wide use in various services. It may involve simple tasks such as filling envelopes and preparing publicity mailings or more skilled tasks such as typing, word and data processing, invoicing, editing and translating. When a personal computer or terminal is used at home this type of work is usually referred to as telework' (De Villegas 1990).
Whatever the classification system, HBEs are generally small scale in nature, with low levels of capital investment and employing very few people. Strassman (1987) found an average of 1.4 workers employed in HBEs in Lima and Kalatura. In the surveys in Lima, Peru male household heads were more commonly involved in HBEs (Strassman 1986), as was the case in India (Raj and Mitra 1990), while studies in other countries have found women to be more commonly involved (Triple 1993). This probably reflects the nature of the economic situation and of the HBEs themselves: Strassman (1987) found that leather, wood and metal product production is dominated by men with women found more in food products, textiles and clothing. HBEs usually employ household members, with marginal use of non-household labour (Strassman 1987; Raj and Mitra 1990).
It is predominantly women who are homeworkers. Women are less mobile and have fewer job opportunities; by doing homework they combine paid work with child care, care of the old and disabled, and other domestic responsibilities and are usually less educated and less skilled. Commenting on the employment patterns in HBE's, the ILO Review noted: 'Home work is women's work almost by definition. For this reason it is often wrongly confused with housework or domestic service. Women's predominance in home work is due not only to their family responsibilities, which tie them to the home, but also to their weaker position in the labour market. In developing countries, too, women predominate among home workers. Of the 2.5 million beedi (cigarette) workers in India, for instance, nearly 90 percent are women, most of whom work in their homes on a piece rate basis with the raw materials being supplied by a contractor. In industrial home work men often take on the role of sub-contractor or middleman or help with auxilliary tasks such as picking up and delivering materials and finished work. Rarely do they help women perform home work. However, in some countries there are some home work occupations in which men are active. For example, in handloom weaver families in India women and children do the preparatory work and men do the weaving. Child labour is also noted to be a problem associated with home work. (De Vilegas 1990).
HBEs have thus been criticised for their exploitation of family labour. Urban physical planners suppressed HBEs by separating residential, work and recreational areas in a separate development system enshrined in zoning regulations, bye-laws and prohibitions. This was not universally adopted, as for example, in Singapore and Hong Kong architects and planners blended living and working space (Strassmann 1988), allowing enterprises that do not generate excessive noise, fumes and or fire hazards to operate in apartment blocks.
In practice, HBEs have become a crucial part of the economic and social fabric of most if not all cities in developing countries. Data from Bogota, Mexico city and Valencia shows that one in every ten houses has a home based enterprise in or attached to its home. Strassman (1986) noted that from one-tenth to a quarter of the dwellings in the cities of developing countries have an enterprise at their home. HBEs are used for survival strategies, given the growth and persistently high levels of unemployment in large parts of the world and the growing difficulty of entering the regular labour market. One study on HBEs in two villages in Northeast Thailand (Ref E) indicated that homeworking has advantages and disadvantages. The system has flexible working hours and job entry and is not subject to employer control. The disadvantages are that homeworkers easily become victims of labour malpractice (e.g. delayed payment of income, breach of contract); work in poor working conditions (e.g unsanitary environment, poor lighting, inadequate ventilation etc.) and are easy prey to unscrupulous buyers or swindlers, as they do not have written agreements on terms and conditions of payment.
In a survey of HBEs in Harare, Zimbabwe, the Civic Groups Housing Project (CGHP/ TARSC 1995) found that on the 460 stands surveyed 308 home based enterprises were taking place, or 0.67 HBEs per stand. The most common activities were vending, making building materials, selling second hand clothes and hairdressing. Other reported HBEs included knitting, sewing, crocheting, vending, traditional healing, metal working, stone carving, brick moulding, coffin making, firewood selling, motor mechanics, selling second hand clothes, tuck-shops, welding, prophesying, craft work, weaving, braiding, cobra making, fence making, hairdressing, soap making, poultry, carpentry, shebeens, vim making, prostitution, selling food and gardening. Over a half of the HBEs (55%) were carried out outside and a further 38% in the main dwelling, the majority using less than five square meters (CGHP/TARSC 1995). Each enterprise had an average of 1.28 people involved. About two thirds (65%) of the 395 people involved were women, 47% of these doing this as their full time work. This was higher in one suburb, Mbare where 75% were women, 40% of these full time. This suburb is noted as it was also included in the occupational health survey, discussed in Section 3.
2.2.1 Occupational risks
The health problems reported in the literature on the informal sector are generally the same as in the formal sector, with a common presence of poor housekeeping, poor lighting, long work hours, poor work place design, unawareness of chemicals risks and increased use of drugs as home medication. Job-related risk factors are compounded by overcrowding, poor nutrition and other public health problems, inadequate sanitation, lack of adequate storage and the more general effects of poverty. In HBEs, the problems go beyond the worker and involve risks for the worker's family and home environment. The exposure of family members to poor working conditions can lead to their suffering from occupational diseases" even when they are not directly involved in the work.
A survey of automotive and machinery repair and metalworking urban informal sector in the Philippines found a range of hazards, including long working hours, poor housekeeping, inadequate welfare facilities, ventilation and lighting, poor work postures and work methods, chemical exposure and inadequate provision of personel protective equipment (PPE). Piece-rate systems were also found to make working hours irregular and work habits of the workers unsafe (Ref A). Long hours without regular breaks, repetitive movement, fixed working position and prolonged visual concentration were commonplace for simple one-step outsourced work tasks such as gem cutting, net repair, garment gluing and ribbon making. At peak seasons the workers rush work with lack of regard for safe working methods.
Work performed in poor residential areas or informal sector worksites have inadequate washing facilities, lockers or separate eating areas for workers, no first aid kits and an inadequate supply of clean water. Few informal enterprises have fire extinguishers. Work spaces are often limited, with emergency exits blocked by cluttered passageways and obstructed by wires and cables. Tools, raw materials, scrap and empty containers are scattered over the shopfloor and worksites with earth floors have both rubbish and dust on the floors. Awkward work positions (e.g. bending, squatting and lying underneath cars in auto repair shops) are common, with poorly designed stools and benches leading to musculoskeletal problems due to constant neck and low back flexion.
The use of complex machinery is not common among informal sector workers and high noise levels have not been commonly reported, mainly because of the low degree of mechanization. Where old, unguarded machinery is used, hazards present relate to moving parts such as drive belts. More commonly experienced mechanical hazards arise due to pulling threads, knives, scissors and needles and other sharp hand tools.
Indoor workplaces have been reported to be hot during summer months, and although few report poor lighting, more experience problems of poor task lighting for work tasks requiring concentrated vision.
Depending on the type of process, informal sector workers are exposed to common chemicals as in the formal sector. Problems arise of exposure in all family members when production takes place in the home, such as due to drying products and open containers left in the living area. Chemicals with acute effects are more commonly recognised than those with chronic effects. For example, loss of eye sight is reported in jewelery homeworkers from splashes of acid solutions (e.g. boric, muriatic, nitric acids and caustic soda) and gold dusts and powder chemicals (e.g. borax or potassium nitrate) that accidentally make contact with the eyes. Chemicals used by homeworkers in jewelery HBEs in the Philippines (e.g. boric, sulfuric, nitric acid, cyanide and caustic soda) led to eye and respiratory disorders. Similar problems werew reported in the handicraft sectors due to organic dusts.
In the survey of HBEs in Harare in 1995 (CGHP 1995), field workers noted a range of health and environmental hazards associated with the HBEs: Vegetables sold in the open, put on a sack on the ground or put near sanitay facilities are exposed to dust and other pollutants, while banana and orange peels thrown in the open create a problem of hygienic waste disposal. Some vendors were selling meat without adequate storage facilities. Working areas were often found to be dirty and inadequately ventilated. Using fire to cook maize led to a risk of burning of log cabins in close proximity to the cooking place. Some people made floor wax using plastic and paraffin creating a risk of burning the workers and their home, particularly if the home is made of wood. Where carpentry is taking place there are sharp objects lying around (eg: wood and nails) which could also hurt children. These hazards not only posed a risk to the workers but to the environment and community. Food markets near toilets led to flies and fly borne disease, including diarrhoea. Air pollution from smoke occured at fire places where green mealies are cooked and sold, production wastes were poorly disposed of and in the absence of litter bins, people burnt their wastes, polluting the neighbourhood.
Small-scale farmers are exposed to agrochemicals, owing particularly to increased pressure for fertiliser and pesticide use with shifts in crop production, use of hybrid seeds and the need to increase yields to match input costs. Small-scale farmers commonly apply chemicals manually using old, poorly maintained equipment. Thus, not only are exposures to chemicals increased, but ergonomic hazards are involved, owing to use of primitive handtools, hoes and ploughs, lifting heavy loads and sustained physical work.
The common factors that undermine workplace safety in MSEs are:
- low levels of capital, use of primitive tools and techniques and a tendency to innovate or take short-cuts in production that, while necessary for economic survival, may pose serious hazards to the worker;
- poor working conditions, poorly regulated by labour or health and safety laws and poorly monitored by unions, employer's organisations and the state, as workers such as those working for their families are not always under formal contracts of employment. These problems are particularly acute in the categories of labour common in informal and small-scale enterprises, such as child, casual, family and female labour; the majority of small holders and a large proportion of informal sector workers are female, while many small rural and urban enterprises also employ children; and
- poor access to information, lack of knowledge, about hazards, their effects and controls and pressure to generate an income `at whatever cost'.
Detection and control of occupational exposures depends on a system of monitoring and management at the level of the workplace and at the national level. In Africa, factory inspectorate systems have inadequate staff and resources to implement laws relating to the work environment, which are themselves often neither specific nor comprehensive. Countries such as Kenya, Mauritius, the Seychelles and Zimbabwe are now establishing laws and practices for workplace safety committees in order to localise monitoring and to promote legislative obligation for the dissemination of hazard information to manufacturers and employers.
A small-scale enterprise may not fulfil the definition of a `factory' in the law governing inspections (such as Zimbabwe) or may not de facto be monitored owing to shortages of inspectors, time and transport (Sitas et al , 1988). A small-scale enterprise may have too few workers to be required legally to have a safety committee (such as in Namibia and Mauritius). Workers and employers in such enterprises are less well organised and thus less well informed of their rights to health and safety, of advances in work environment practices and of workplace hazards, greatly inhibiting effective monitoring of exposures. As shown in the previous chapter, few good assessments are therefore available of the pattern of occupational exposures and particularly of the chemicals used in this sector, and we are forced to rely on anecdotal evidence and cross-sectional studies.
2.2.2 Occupational injury and illness
Despite the heterogeneity of informal sector workers, a common pattern of occupational health problems is reported from many parts of the world, including musculoskeletal disorders (shoulder pains, backaches, numbness of hands and feet and rheumatism/arthritis); eye strain and injury, skin irritation and respiratory disorders.
Assessment of visual acuity in a study indicated that only half of the workers had normal vision in both eyes. Although many workers were aware of eyesight problems, eye testing and the purchase of glasses were considered expensive and beyond their financial means (Reference). Foreign bodies in eyes were commonly reported by workers such as gem cutters and grinders, yet few were wearing eye protection. Hazardous chemicals use has been associated with respiratory problems, while exposure to organic dusts have been associated with frequent headaches, respiratory disorders, skin irritation, and burns from bleaching and dyeing. The rate of accidents for informal work was been found lower than might be expected in an unregulated work environment. were recorded. Common work-related accidents were burns from the spillage of acids or from fire and splashes of melted metals and minor cuts from sharp hand tools.
Informal sector workers living in low income areas already suffer poor health attributable to poor diet, substandard housing, overcrowding and adverse environmental conditions. Their overall vulnerability to ill health increases the possibility of developing long-term illness resulting from working conditions. Equally, hazardous and adverse working conditions compound and combine with poor health and living conditions. Many informal sector workers were reported to self-treat illness using over the counter drugs, including caffeine and analgesics. Such drugs were taken for work-related problems such as back, neck, limb and joint pain as well as eye strain and headache.
Detection of the health effects of occupational exposures depends on the accessibility of health services in general and particularly of screening for occupational illness, which are generally still underdeveloped in African countries. Workers in the small-scale sector often represent the poorer section of the population, who do not have care by geographical and cost factors. They may rely more heavily on self-help, traditional health sectors and primary health care services, where knowledge of occupational health may be poor.
It is however evident that there is a significant level of reported risks and ill health in the informal sector. Despite this, given that there is no comprehensive monitoring of injury and illness rates in urban informal sectors(Endnote 4) , these rates would need to be estimated through surveys of the sector.
How does the work related burden of ill health in the informal sector contribute to the national burden of ill health and to the overall health impact of work related risks? What can be done to reduce such occupational risk and the ill health it produces? These questions wil be further explored in the ensuing sections.
Endnote 4:
Reports on surveys of small scale enterprises in Tanzania and Zimbabwe provide qualitative data on hazard exposure and injuries but do not provide quantitative rates or exposure levels.
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