We have completed our report on the malnutrition of workers on six Indian tea gardens. This is the reason we came to West Bengal, answering the call of a local NGO which had been looking for volunteers with public health and writing expertise (my wife, Tay, is a nurse and has completed numerous health surveys in West Africa). Eventually, Iâ€˜ll make the full report available for download; in the meantime, I’ve posted the Abstract and a few excerpts below. If you would like to receive the complete report, let me know (firstname.lastname@example.org) and Iâ€™ll be happy to send it.
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NUTRITIONAL SURVEY OF TEA WORKERS ON CLOSED, RE-OPENED, AND OPEN TEA PLANTATIONS OF THE DOOARS REGION, WEST BENGAL, INDIA
Birpara, Jalpaiguri District, West Bengal
Sarmishtha Biswas, Debasish Chokraborty, Sutay Berman, R.N., and Joshua Berman, for Paschim Banga Khet Majoor Samity (West Bengal Agricultural Workersâ€™ Association), in association with the International Union of Foodworkers and the American Jewish World Service
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Objective: To determine the nutritional status of tea workers on closed, recently re-opened (â€œsickâ€), and normally functioning gardens. Setting: Six tea gardens in the Dooars Region, Jalpaiguri District, West Bengal, India. Methods: 120 families (609 individuals) were surveyed in their homes on the labor lines of six tea gardens. Results: Based on World Health Organization criteria for Body Mass Index, all four open gardens surveyed can be labeled as â€œstarving communitiesâ€ or â€œat critical risk for mortality from starvation.â€ Based on daily caloric intake, 42.5% of the closed garden populations classify as Below Poverty Line (BPL), followed by 40% BPL in sick gardens, both of which are significantly higher than the national average. Conclusion: Malnutrition exists on all six gardens surveyed. Even workers on sick and open gardens endure extreme lean periods due to decreased or delayed wage payments and food rations, as well as inconsistently provided benefits that are due by law. Legally mandated worker benefits (especially for pregnant and breastfeeding women) and government relief programs like Integrated Child Development Scheme (ICDS) and the Mid-Day Meal Scheme (MDMS) are irregular, inconsistent, and in some cases, inadequate or entirely absent. Garden managers and government aid suppliers need to (1) improve the quality and efficiency of their programs and (2) educate the workers as to the existence of these programs. This latter point is essential and urgent. Many workers have no idea as to the existence of relief or ration programs and, when they do, have no knowledge as to procedures. They are also uninformed as to their rights under existing labour laws.
Like most tea producing areas of Northeastern India, the Dooars Region tea industry suffered a critical period from 2002 to 2004; during this time 22 of the 548 registered tea gardens in Dooars closed their doors, effectively abandoning resident workers and their families. Nearly 100,000 people (workers and their dependants) were directly affected by the closures, deprived of food rations, wages, health care, electricity, drinking water, and transportation to and from schools for the children. This period was also marked by a surge of starvation deaths on closed gardens which led, in January 2004, to the filing of an IA (Interim Assessment) in Writ Petition 196/2001 in the Supreme Court (Right to Food and Work). This, in turn, led to limited government measures to provide rations and temporary work to tea workers in closed gardens. In addition, special efforts were made to find new employers or persuade the old employers to reopen their gardens.
All but two of the 22 closed gardens were subsequently reopened by the beginning of the monsoon season, 2005. However, at the time of this report, most remain insolvent, or â€œsick,â€ with worker conditions as poor as ever, and may soon shut their doors again. Despite efforts to ease the workersâ€™ suffering, reports of hunger, malnutrition, and starvation deaths persist on closed, sick, and open gardens. Such reports have been made in both the local and international media, in statements from trade union leaders, and in personal accounts from the workers themselves.
This survey of tea worker nutrition on open, sick, and closed gardens was undertaken in order to verifyâ€”or disproveâ€”the aforementioned reports of hunger and starvation deaths, and to collect statistically relevant evidence of malnutrition. It should be noted that managementâ€™s permission to survey on open gardens was granted on condition that theses gardensâ€™ names not be mentioned in the final report; for this reason, the authors will refer to the gardens simply by their status as â€œopen,â€ â€œsick,â€ and â€œclosed.â€
A. Body Mass Index (BMI)
1. Energy Consumption
2. How Often Families Eat and Hungry Periods
3. Drinking Water
C. Illness Past and Present
D. Deaths in the Last Three Years (since first closure events)
The total number of deaths were as follows: 38 families reported a total of 46 deaths in the last three years: 11 on open gardens, 19 on sick gardens, and 16 on closed gardens. Of these, 18 were children under 12 years old, and 28 were adults. Determining that death was caused by starvation or malnutrition, as opposed to natural causes, is a difficult task. What is â€œnaturalâ€ becomes unclear as undernourishment works its downward spiral on the health of a human being; immunity levels plummet, leaving the body vulnerable to all kinds of otherwise survivable infections, such as measles or malaria. For each of the 46 deaths encountered during the survey, families were asked basic questions about the deceasedâ€™s symptoms, treatment, and events leading up the death. Rather than ascertain the exact number of â€œstarvation deathsâ€ (a task beyond the scope of this survey), the research team recorded possible cases of malnutrition-related deaths on each garden, a few of which are presented below as case studies.
Case Study No. 1
R. Baraik, 23, received no pre-natal care after becoming pregnant in 2003, not long after her tea garden, closed its doors. But, late in her pregnancy, she fell ill, and made the trip to the Government Hospital in Birpara. She returned home with a diagnosis of tuberculosis. Soon after, with the help of the three elderly midwives from her labor line, R. gave birth to a small, extremely weak baby boy who remained listless, barely able to feed. R. died a few weeks after giving birth, followed three months later by her son.
The Baraik familyâ€™s struggles continue, two years after R. and her babyâ€™s deaths. Their garden remains closed. The household of six adults and three children usually manages to eat three times day (roti, rice, potato, and tea), but say they have gone completely without food more than three times during the last year.
Help from the government is dismal, at best. The two Baraik school-age children (Sidhanto, 7, and Sidhan, 4) receive midday meals two or three times per week. It is not enough food, they say, only a spoonful of hodge-podge, often with rancid oil. Meanwhile, the government-supplied water pump down the block is not potable, so, like the rest of their neighbors, the Baraiks travel to the neighboring tea garden for drinking water, a round-trip of 5 kilometers.
The mobile medical van, which arrives on Mondays, provides extremely limited treatment and medicine. The Baraiks learned this all too well when Budhain Baraik, 45, began to have irregular urination, a condition that quickly worsened until she could not relieve herself at all. The hospital in Birpara offered no diagnosis and no treatment, only a referral to the University Hospital in Siliguri. This was a trip they could not afford to make, so Baraik was brought back home, where she lays hidden in the house, paralyzed from the waist down and in extreme pain, and most likely, waiting to die.
Case Study No. 2
On one open garden, both Charoa B., 65, and Charotoa B., 85 (from different households) suffered from tuberculosis for one year before being admitted to Birpara Hospital; both were given medications and sent back to their homes where they died one month later. In the hospital of this same open garden, a 12-year-old girl named Chandni B. lay for eight days, suffering from â€œfever and anemia,â€ before she was finally referred by the doctor to Birpara Hospital, where she died soon after.
E. Mother-Baby and Pregnancy
F. Government Relief Programs (ICDS and MDMS)
Malnutrition exists on all six gardens surveyed. Even workers on open gardens endure lean periods due to decreased or delayed wage payments and food rations, as well as inconsistently provided benefits that they are due by law. Based on World Health Organization criteria for Body Mass Index, all four open gardens surveyed can be labeled as â€œstarving communitiesâ€ or â€œat critical risk for mortality from starvation.â€ Based on daily caloric intake, 42.5% of the closed garden populations classified as Below Poverty Line (BPL), followed by 40% BPL in sick gardens and 30% BPL in open gardens. All six gardens together, averaged 37% BPL, which is higher than the national average.
It is encouraging that pregnant and breastfeeding mothers appear to have some knowledge of the importance of taking additional nutrition, but in general, more pre- and post-natal care and education is needed. Few of the garden hospitals had delivery facilities, making the prospect of complications during home delivery extremely dangerous. If local doctors or hospitals (or mobile medical vans) are to give meds and immunization to pregnant women, they should do so on a more consistent basis, and should educate their patients, at the very least, about what they are administering and why.
Legally mandated worker benefits (especially for pregnant and breastfeeding women) and government relief programs (ICDS and MDMS) are irregular, inconsistent, and in some cases, inadequate or entirely absent. Garden managers and government aid suppliers and need to (1) improve the quality and efficiency of their programs and (2) educate the workers as to the existence of said programs. This latter point is essential and urgent. Many workers have no idea as to the existence of relief or ration programs and, when they do, have no knowledge as to procedures. The same is often true regarding workersâ€™ knowledge of their rights under existing labour laws.