Getting attention to a much-neglected health agenda: occupational health and safety
Guest blogger Rangarirai Machemedze and David Satterthwaite report on the findings of their research on the occupational health and climate change risks facing informal residents and workers in Zimbabwe.
Most cities in low- and middle-income countries have most of their working population in the informal economy and most of their low-income populations living in informal settlements. Yet there are few studies of the occupational health and safety risks that they face.
This blog summarises findings of a research project entitled 'From surviving to thriving: learning from responses to the health effects of climate change in informal workers and informal settlements of Zimbabwe'. It explores the intersection of climate-related, environmental and occupational health risks facing informal sector workers and informal settlement dwellers in two cities in Zimbabwe: Harare and Masvingo.
The research included household surveys, focus group discussions and key informant interviews among those who do solid waste picking and recycling as well as those involved in urban agriculture.
Both residents and workers are exposed to and affected by a wide range of health risks and challenges by virtue of living in informal settlements and/or working in the informal economy. Local authorities in Harare and Masvingo face a very large backlog with regard to provision of services and infrastructure, exacerbated by poor economic performance in recent decades.
We chose four settlements. Hopley, one of Harare’s informal settlements, lacks piped water, refuse collection and grid electricity. Residents are involved in diverse informal activities, including collection of plastic waste.
Mabvuku-Tafara is a formal high-density suburb in Harare, with informal lodgings within formal house compounds. Piped water supplies are very irregular; residents are forced to rely on boreholes, wells and other sources. The residential areas are connected to grid electricity, and many residents engage in informal livelihoods such as farming and food vending.
Masvingo is on the main highway linking Zimbabwe and South Africa. Mucheke is one of Masvingo’s oldest high-density urban settlements, with both formal and informal lodgings. Residents are involved in farming, vending and trading in informal markets.
Rukejo is another high-density residential area. Some residents are involved in plastic waste recycling, and others in urban agriculture.
Workers and residents face a plethora of issues that affect their health on a day-to-day basis. These include:
Inadequate water, sanitation and hygiene (WASH):
The study found inadequate access to clean, safe water, adequate sanitation, and a functioning drainage system. This brings increasing risks from water- and vector-borne diseases.
In Hopley, water was primarily from boreholes and protected dug wells. In the other settlements, most residents have piped water infrastructure to their homes (but erratic supplies).
Where bulk water is supplied through tankers, it usually comes late in the evening. It is usually women and girls who face long queues in areas often without street lighting; tanker drivers may demand sex to supply them with water. One respondent reported: “We refused, and they are no longer supplying our section with water”.
For solid waste, most residents should receive waste disposal services from the local authority, but the service is erratic. In Mabvuku-Tafara, residents reported the last municipal refuse collection was three months prior to the survey. Hopley has almost no local authority waste collection.
Unclean energy and air pollution
Electricity supplies are unreliable and costly, and many residents are not connected to the grid. In Hopley, only 1% of respondents use electricity for lighting, with the majority relying on solar energy or candles.
Others must utilise unclean fuels that result in air pollution, as one urban farmer in Mabvuku-Tafara noted: “Our air is not clean. It has a lot of dust from roads, from the nearby cement factory and smoke from use of firewood, tyres and shoes for cooking. We have informal generator repair shops in residential areas, and the smoke from them is causing the air to be dirty. We used to have open spaces long ago to clean the air, but these spaces are no longer there.”
Unsafe working conditions
Waste pickers and recyclers work outdoors, often in harsh weather. In some dump sites, informal payment has to be made to council workers to get access.
Major physical hazards/risks included cuts from sharp objects (dump sites), vehicle accidents (as they walk long distances along roads) and burns from burning material. Chemical risks come from handling containers with hazardous substances. Fires in dump sites expose them to air pollution and other hazards. Few use gloves, masks, goggles or other protective clothes.
For those who reported work-related illnesses in the prior 12 months, the most reported conditions were bouts of diarrhoea, prolonged coughing, skin rashes, headaches and respiratory problems.
Many workers involved in urban agriculture have to travel long distances on foot. They reported exposure to pesticides and fertilisers, aggravated by poor storage, labelling, handling and use. Occupational injuries are mostly caused by snake bites and prolonged work in the fields (posture), lifting heavy loads and standing for too long.
Climate related risks to workers
Survey respondents, particularly those in urban agriculture, reported more periods of extreme heat over the past five years.
For those working in solid waste management in Hopley and Masvingo, more than half reported reduced work time and lost income. More than half also reported lower working efficiency due to heat: they can’t walk for too long, tiredness, dehydration, frequent headaches.
Urban agricultural workers reported water shortages/drought and extremes of heat as major factors affecting their work and living conditions. They mentioned health impacts from dehydration, health impacts on domesticated animals such as chickens and increased pests such as mosquitoes.
Priorities and next steps
Many recommendations have come of the research and follow-up feedback meetings with communities in Harare and Masvingo.
One clear way forward was to consolidate the recommendations and prioritise issues needing urgent attention from both central and local government authorities. The communities established a champions team that will work together with the local authorities. Masvingo Municipality supported the idea.
The following broad recommendations have been suggested from the research findings:
- Prioritise enhancing access to services and infrastructure, such as safe, regular water, health care, waste collection and affordable electricity. These can have multiple positive impacts on health and environments.
They also improve the ability to adapt to climate change impacts and create an array of co-benefits for climate resilience and urban health equity. Equitable provision is required for youth, women, people living with disabilities and other disadvantaged groups.
- Address key structural political issues at national and local levels to provide the governance framework needed to ensure such equitable access.
- Recognise the importance of collective action, building coalitions and associations that encourage those affected to act in solidarity to confront their challenges.
The research on which this blog draws was implemented by the Training and Research Support Centre (TARSC), in collaboration with the Zimbabwe Congress of Trade Unions (ZCTU) and the Zimbabwe Chamber of Informal Economy Associations (ZCIEA), with financial support from the National Institute for Health Research (NIHR), through IIED.
We gratefully acknowledge the contributions of Artwell Kadungure and Rene Loewenson (TARSC), Nathan Banda (ZCTU) and Wisborn Malaya (ZCIEA).