Even when workers bring their own lunches to their factories, the nutrition content is usually low (Photo by Stephen Uttom)
Ten years ago Mahinoor, her husband and two of their three children left their home in rural southern Bangladesh for the capital, Dhaka, with one goal in mind: to dig themselves out of poverty.
Before this, Mahinoor took care of the house and children while her husband worked as an irregular day laborer in Bhola, one of the country’s remotest and poorest areas. The family earned about 3,000 to 4,000 taka (US$39-$51) a month and was barely surviving.
“In the village we couldn’t manage three square meals per day, let alone anything else. So, we decided to move to Dhaka to try to end our poverty and misery,” said Mahinoor, 35.
In Dhaka, Mahinoor learned to sew and found a job in the country’s then-burgeoning garment industry; her husband became a cart puller. Each month, the couple earns about 12,000 taka but their life has changed little.
Today, the family lives in a tiny rented brick and tin-roofed room in the Moghbazar area of Dhaka. They can eat three meals a day, but nutritious food is still out of reach.
“After paying the rent and for daily essentials we cannot save anything. We cannot buy good food; we eat fish only two or three times a month and we eat meat occasionally,” Mahinoor said.
Tell-tale marks of extreme poverty and endemic malnourishment are clearly depicted in all the family members, especially on the children who have stunted bodies, unusually clear veins under their skin, low weight, and anemia.
“From time to time our children fall sick. Doctors advise us to feed them better food like fish, meat and milk, but we can’t manage,” she added.
Bangladesh’s $20-billion garment industry employs about four million workers, mostly rural women like Mahinoor, who struggle with high rates of malnourishment and enjoy few rights.
The industry is the second largest in the world after China, supplying clothes for major international brands like Walmart, Gap and H&M. But Bangladesh also has a notoriously poor record of labor practices and safety standards, which has resulted in tragic disasters like the 2013 Rana Plaza collapse which killed more than 1,100 workers. And, despite raising the minimum wage to $68 per month in December 2013, many garment workers still receive significantly less than that figure.
After the Rana Plaza collapse, European and American buyers — pushed by international labor groups — pledged to invest millions of dollars in safety checks and upgrades within five years time.
But moves to improve health and nutrition have been slower.
In late September, the Geneva-based Global Alliance for Improved Nutrition (GAIN), an international organization fighting malnutrition, launched a three-year initiative to help improve nutrition for more than 42,000 garment workers and their children.
According to GAIN, Bangladesh has one of the highest rates of malnutrition in the world. The problem disproportionally affects women, millions of whom suffer from one or more forms of malnutrition — from iodine deficiency disorders to anemia. Poorly nourished women often give birth to underweight children who are stunted, creating an intergenerational cycle of poor nutrition and unfulfilled potential.
An aerial view shows the corrugated tin roofs of housing for garment workers and their families in Dhaka (Photo by Stephen Uttom)
Over the next three years, GAIN aims to provide women workers with fortified foods and many of their under-five children with micronutrient supplements. The project will offer guidance to factory management to support breastfeeding and to upgrade and improve day-care centers and the women will be trained by experienced health workers on appropriate infant and young child feeding practices, as well as sexual and reproductive health.
“Malnutrition is one of the greatest global health challenges we face and Bangladesh has some of the highest rates in the world. There is an urgent need to address the intergenerational cycle that prevents mothers and their children in Bangladesh from enjoying a healthy life,” said Marc Van Ameringen, GAIN’s executive director.
Labor leaders blame factory owners for the malnourishment of garment workers and say there are endemic health and behavioral issues to be solved.
“Most garment workers are low-income people while their owners earn millions of dollars. They are not just low-paid but often victims of inhuman treatment,” said Nahidul Hasan, director of operations at the Awaj Foundation, a Dhaka-based labor advocacy group.
“Often, the management don’t provide pure drinking water for garment workers [and] restrict workers from going to [the] toilet during working hours,” Hasan added.
While factory owners promise necessary health benefits for workers, these often remain unrealized, alleged Khadija Akter, office secretary of the United Federation of Garment Workers, a Dhaka-based trade union
“Every factory is supposed to have a day-care center for children of workers, but in practice less than 10 percent of factories have them. So, female workers have to leave their children at home and cannot take proper care of them,” she said. “While the government has ordered six-month maternity leave for women workers, garment makers don’t allow more than three or four months.”
Akter added that garment workers could only benefit from GAIN’s initiatives if they can change the attitude of factory management toward workers.
Muhammad Jaglul Haider, additional secretary at the Bangladesh Garment Manufacturers and Exporters Association (BGMEA) insisted that garment makers are more concerned about the health of workers than ever.
“We have 10 health centers in Dhaka and two in Chittagong to offer health support to garment workers and two are under construction. Every month these centers serve 1,100 patients on average,” Haider said.
Haider claimed that all the factories affiliated with BGMEA have day-care centers.
This year BGMEA and the Bangladesh government launched an allowance program for poor pregnant garment workers, said Rafiqul Islam, a senior executive with the Skill Development Program unit of BGMEA.
“In 2014 to 2015, we aim to provide 500 taka to 7,400 pregnant female workers per month and it will continue for 24 months,” Islam said.
However, Khadija Akter said that these benefits are inadequate.
“There are more than 4,000 garment factories in the country, which means only two percent of workers can avail themselves [to benefits],” she added.
GAIN’s initiative is a positive way forward but the most striking issue around malnutrition among workers is a lack of awareness, early marriage, and lack of facilities, said Dr Moudud Hussain, National Nutrition Service program manager at the state-run Institute of Public Health Nutrition.
“Most women suffer from malnutrition because either they are ignorant or they are poor. There are state agencies offering free health and nutrition services to poor people but often people don’t come to get them,” said Dr Hussain.
“Because female garment workers are not granted six-month maternity leave, they are forced to go back to work early. While they are already malnourished, their children have the same problem as they can’t breastfeed and take proper care of them,” he said.
Mahinoor’s factory doesn’t have a day-care center nor does she know if it will be included in GAIN’s program.
“Our life is not going to change much because we are poor people. Although our struggle is far from over, we consider ourselves lucky that we are still alive and we can eat three times a day,” she said.