Hariom Sharma, is a diligent quality checker in a garment factory in India who migrated from the scenic landscapes of the state of Uttarakhand to the city of Jaipur in the state of Rajasthan back in 2008. Hariom, an army veteran, has been diligently serving in the workforce since 1992. He has been working in the garment industry for 15 years; little did he know that a silent adversary, diabetes, was lurking within.

In January 2023, during a routine health screening conducted by Swasti’s Health@Work, Hariom’s world took an unexpected turn. With blood pressure soaring at 177/107 and diabetes

levels at a staggering 378, he suddenly found himself facing a situation he never expected. He mentions that his ancestors were knowledgeable about Ayurveda, and despite having a good

understanding himself, he was surprised to realize that he was not aware of his health condition.

This made him think about the thousands of workers in factories who may not even have basic education. He realized that if he, with his background, was unaware, how could they be expected to know about their health?

Chronic noncommunicable diseases (NCDs) are the number one cause of death and disability in the world. 

The term NCDs refers to a group of conditions that are not mainly caused by an acute infection - often indicated by very subtle symptoms in its early days that are frequently overlooked - such as persistent fatigue or tiredness even after getting enough sleep, unexplained weight loss or gain, frequent headaches, feeling constantly thirsty or having to urinate more often, blurred vision, difficulty concentrating or brain fog. NCDs result in long-term health consequences and often create a need for long-term treatment and care. 

When diagnosed early, NCDs can be managed and the individual can lead a long healthy life. However most of us are unaware that we may be living with an NCD - like mentioned before - signs and symptoms often go unnoticed - and by the time they are so obvious that it cannot be missed - the management of the same and attempted treatment may cause significant out of pocket expenditure and reduced quality of life. 

Modifiable behaviours, such as tobacco use, physical inactivity, unhealthy diet and the harmful use of alcohol, all increase the risk of NCDs. Coupled with stress, shirking of preventive and promotive health care, workers find themselves unknowingly struggling with a range of non communicable diseases that reduce their number of healthy days and affect their quality of life. 

Early screening for NCDs becomes even more critical in the face of climate change. Rising temperatures and extreme weather events can exacerbate existing health conditions. For example, heatwaves can put additional strain on the heart and lungs, worsening cardiovascular and respiratory diseases. Air pollution, often worsened by climate-related factors, can trigger asthma attacks and might increase the risk of lung cancer. Early detection of NCDs allows individuals to take preventive measures and manage their health more effectively, potentially mitigating the additional burden imposed by climate change. This can include adopting heat-protective measures during work hours,  adjusting exercise routines for extreme weather, or seeking dietary advice to improve overall health. By identifying NCDs early, workers can build resilience against the added challenges posed by a changing climate.

It needs to be remembered that, at the absolute frontlines of climate change are workers. 

The Health@Work program at a workplace begins by risk assessment and screening of workers for non communicable diseases - Since the year 2018 - 4 out of 10 women workers screened for anemia in garment factories were found to be anemic; 2 out of 10 workers screened were found to be hypertensive, 1 out of 10 workers screened were found to have diabetes and 3 out of 10 workers screened had vision issues. 

Since 2018, the Health@Work program has partnered with brands, factories, healthcare providers, workers and their families with a mission of adding healthy days to the lives of workers by – helping set up wellness centers in the factory; running health screening and management camps; anchoring a TeleCare program to suit workers for access both within and outside work hours - Call4Svasth including a dedicated mental wellbeing line; facilitating health insurance and other social protection schemes; tying up with a womens’ collective to provide a nutritional supplement - Swathi Savi and more. 

The Health@Work team played an important role in Hariom’s newfound awareness. The team’s comprehensive follow- ups and telecare - Call4Svasth - outreach not only provided a diagnosis but also offered a personalized roadmap to recovery. 

Initially shocked by the news, Hariom became determined and decided to make changes in his life. He started eating less sugar and included regular exercise in his routine.

The Health@Work program invests in ensuring that the legacy of ensuring health and wellbeing services for workers remains in the workplace for good - Health@Work has trained factory workers to become community wellness facilitators / health workers across all 189 factories ensuring that workers have their own peer and a dedicated partner on their journey towards healthy days. In addition, 128 of these189 factories now have menstrual product vending machines. 

With his family’s support, Hariom began a complete transformation. Observing the Wellness and Fitness (WF) training organized by Health@Work made Hariom even more aware of how closely physical and mental health are connected. He adds, “Recently, we had a special training called Wellness Facilitator training (WF Training) organized by the Health@Work team. They talked about various illnesses like Anemia, Diabetes, and Blood pressure, explaining how we can get help and take care of ourselves. I found the hygiene and mental health lessons very helpful. Now I know that my physical health is connected to my mental health and how much stress I experience.”

With Health@Work since 2018 we have directly trained 140,000 apparel workers from 189 factories across India, Bangladesh, and Lesotho on preventive health. Our TeleCare services - Call4Svasth - has reached their families and communities too. For us, this is a tiny way we give back to the community of global workforce who work diligently to keep our world and our economy running. Our key partners in change have been LSF, VF, Kontoor, Auchan Foundation, Landmark Group, Amazon, UMF, Tufts Labour Lab. 

Here is to International Labour Day. 

Here is to Healthy Workers and Everyday Wellbeing for Everyone.

Author Bio:

Shrirupa Sengupta (Shri) spent the first few years of her life (yes you read that right) growing up in tea estates nestled above the Himalayan foothills and playing in her fathers’ office and in the tea plantation factory - while supervised by caring and nurturing tea plantation workers and ambling in and out of their homes, the schools, the creche and the health sub center at will. Spoilt within an inch of her being, Shri dreamed of being a tea planter one day and learnt everything she could about a job she had decided was ideal for her - also learning the hard lessons of workers functioning in harsh weather, fragile ecosystem, hits and misses when it came to access to health care and wellbeing and other challenges.

Despite a career so far away that her childhood seems like a different life - Shri strongly believes in the ethos of the Health@Work program and celebrates how it contributes to the spirit of International Labour Day, fostering a healthier, happier workforce. 

Says Shri, 

“Programs like Health@Work ensure workers have access to on-site healthcare screenings and resources and their families have access to TeleCare like Call4Svasth and not to forget; a lasting legacy of Health@Work through - 1. preventive care training and 2. workers becoming wellness facilitators for the factories and in their communities. With each worker trained and twinned with a Call4Svasth, the program is able to reach worker families and community spaces too! By prioritizing preventive health care and worker well-being in partnership with employers, the program creates a thriving work environment for all and more importantly builds health resilience in the face of climate change.”  #InternationalLabourDay #HealthAtWork

Author - Shrirupa Sengupta