Many garment factory workers count among the urban poor. They live in nearby slum colonies with high population densities and unhygienic conditions. These conditions are grounds for the rapid spread of illnesses. Despite knowledge about the importance of vaccination to protect against serious illness, and a willingness to be vaccinated, many vulnerable communities found challenges in accessing the jab.
Many workers can engage for services during work hours in a factory setting. An integrated workspace safety strategy that looks at protecting workers from COVID-19 through awareness generation, myth-busting, and vaccination and provides other health information, health services, and counselling is a win-win. The workers - who remain safe and healthy - and the management can keep the shop floor operational for more extended periods and have lower absenteeism. Such an approach also builds the capacity of a cadre of women who get trained on essential health. This boosts their confidence among their peers. It further erases the stigma around women's health issues like menstruation, making for open dialogue and access to services. Finally, it promotes resilience by creating grassroots service providers and leaders.
Workers across the nation felt the debilitating effects of the lockdown as their lives and livelihoods went into a tailspin. Millions of daily wage workers and factory workers were stranded without a livelihood to meet their basic needs. One such vulnerable person was Vijayashanthi, a tailor at a garment factory in Bengaluru. Having worked at the same factory for the past ten years, Vijayashanthi had come to rely on this job to support her household. Despite the high labour turnover rate in this industry, it still serves as a steady income source for many migrant workers like herself.
Thus, the nationwide lockdown imposed on 24 March 2020 was a huge shock for her. The factory would be closed for two months, putting a full stop on her only reliable source of income. Furthermore, she recalls, “It was challenging to get travel permits during the lockdown. The government officials had placed very stringent rules for travelling; I could not even freely go back to my native village!”
The reopening of factories post-lockdown did not immediately resolve her woes; public transport was still closed for use. The daily 10-km commute between her home and the factory added a significant burden on her household budget. As television kept Vijayashanthi updated on the COVID-19 situation back in her home state, she felt apprehensive about her and her family’s safety, considering the high population density and unhygienic conditions of the locality. Her overcrowded two-room home could not have provided quarantining isolation. Being at increased risk of getting infected due to the nature of her job, she was constantly worried about how they would manage if even one of them got infected. Vijayashanthi recalls, “Online learning mode was becoming a serious challenge for my children. I want them to secure a good education, but what use is online learning if my kids are not healthy enough to study?”
One of the main issues Vijayashanthi faced on returning to work was the compulsion placed by her factory to get vaccinated. In Bengaluru, it was challenging to get vaccination slots immediately at government hospitals. People had to shell out a fair bit of money to book a space and get vaccinated in other places. Further, while people did have information to prevent COVID-19, there was a lot of misconception about COVID-19-like symptoms. The side effects of vaccination, including fever, body aches, and sore throat, had planted a staunch hesitancy against vaccines. She also mentions that the hesitation and mistrust for vaccines is not something new; it is the same for all medical interventions such as health check-ups.
A community-based organisation of women in sex work, Swathi Mahila Sagha (SMS), saw the opportunity to support vulnerable women in Bengaluru’s nooks and crannies through its health and vaccination camps. These camps proved to be a very reasonable boon for Vijayashanthi and many others in her position. SMS’s vaccination camps were organised in localities with distressed populations and garment factories. The health facilitators imparted awareness and education to dispel myths and misinformation, leading to vaccine hesitancy. They organised free vaccination drives for factory workers and their family members. When she attended these COVID-19 awareness sessions on protecting herself and her family from being infected, she gradually felt confident in going to work. The factory also had made an effort to create a COVID-19-safe working environment. She says, “the factory provided workers with masks and hand sanitisers. They had ensured social distancing at each workstation. When one’s employers make such efforts, I’m sure every worker will feel valued by their company.”
The SMS health camp volunteers were also ready to offer technical support for workers who did not have access to their mobile phones, where the OTP for vaccine registration would be received. “We have young children and our ageing parents and other adults in our homes. Even if we continued coming to factories, it would have been tough if they became COVID-19 positive because of us,” another factory worker noted. Vijayashanthi and others expressed their relief at getting such easy access to the vaccine, “Calling all the workers to the factory to SMS’s vaccination camps is greatly appreciated. We are now confident about the safety of our family”.
Vijayashanthi’s association with SMS did not just end at this vaccine camp. SMS established many such interventions associated with the factory, including regular health check-up camps. In one such centre, she was diagnosed with acute anaemia. The SMS health facilitators gave her ample information about this health condition, explaining the importance of nutritious and wholesome food and basic hygiene. The counselling and appropriate guidance of SMS is helping her recover quickly.
The experience with SMS has instilled courage in Vijayashanthi. She wants to empower and educate migrant women like her, who have faced various forms of social and economic barriers in accessing healthcare facilities. She has converted the relationship between herself and SMS from a provider-beneficiary form into a partnership; “I was very impressed with SMS volunteers’ work in the camps and thought of how I could give back to the community. With the support of SMS and CAC, I underwent basic training in healthcare practices and first aid. Today I am one of SMS’s facilitators at my workplace”, she concludes with a bright smile.
SMS, supported by Swasti and CAC, has created such grassroots leaders through its extensive network and outreach programs. These “Social Sahelis'' have proactively disseminated good healthcare practices to underserved communities. Rekha is one such Saheli who is proud of being able to help other women through this role. Rekha underwent a three-day Foundational and Advanced training to improve communication and build leadership skills. This training led her to be selected as ToT (Trainer of Trainers); she had to teach her coworkers everything she had learned at the training. Her coworkers, who would earlier liken her to a strict “army officer,” were now pleasantly surprised at her openness, friendliness, and approachable nature. These attributes have helped her break through the thick hesitancy and discomfort in publicly discussing reproductive and menstrual health topics. How does she deal with this hush-hush attitude? Rekha says, “Our trainers explained that we should not be ashamed as it was essential for us to be trained on this topic and train other workers. They told us that whenever we go to a doctor, we need to openly discuss reproductive and menstrual health concerns to prevent any health risks and fatalities''. Identifying such dynamic community leaders and equipping them with the sensitivity and right set of informational guidelines is the heart of the CAC mandate.
Vijayalakshmi and Rekha’s stories are a testament to how people’s institutions can respond to crises, expand the scale of their work, and reach out to non-community members, gaining confidence and acceptance in the process.