Valuing Women’s Care Work in Pakistan: Lady Health Workers’ Struggle for Rights and Entitlements

This case study was conducted for the Pakistan Institute of Labour Education and Research (PILER), with the financial support of ActionAid France in 2017. It was published in both English and French. 

The Lady Health Workers (LHW) Programme, instituted in 1994, is considered one of the largest and successful community based primary healthcare initiatives in the world. The lady health workers’ role has received recognition by the global health bodies in improving Pakistan’s maternal and child health indicators. Currently more than 130,000 lady health workers reach out to 60 to 70 per cent of the country’s population residing in rural and low-income urban areas.

Perhaps if it was not a collective struggle for their rights, the lady health workers would have continued to suffer injustice in silence: a low wage, no benefits and insecure job. It was death of a health worker at child birth that compelled Bushra Arain, a Lady Health Supervisor, to rebel against the irony: health providers’ own deprivation of health facilities and lack of decent work conditions. She and several other lady health supervisors mobilised the workers and founded the union, the All Pakistan Lady Health Workers’ Welfare Association, in December 2008. By early 2009, each district had a Baji (elder sister), a dynamic activist health worker to prepare the cadre for struggle. The union took to legal intervention and street power to claim their due rights at work place. The phenomenon was unique: never before in Pakistan’s history had women workers exercised the right to ‘collective bargaining’ in any sector, much less in the low-paid care economy.

 The case study aims to document the LHWs’ struggle, review the constraints they faced as women workers in a public sector health programme and as caregivers, identify the union’s strategies and highlight the achievements of their eight-year long battle.

Click here to access the full report in English.

 

Moral Harassment

Published in Dawn on December 29 2019

The recent verdict by a French court on ‘moral harassment’ of employees has set a major precedent in an era of turbulent global economic liberalisation. While the criminal trial against the French telecom exposes tactics of corporate culture — merciless downsizing leading to workers’ suicides — the verdict reveals the strength and role of trade unions in holding corporations accountable.

Cynics might ask what a First World dispute between managerial staff and employers has to do with Pakistan, a country where managerial cadre is deprived of the basic right to form a union, where trade unionism is no more than a weak whimper and labour disputes take years to decide. Well, it gives us hope — an increasingly rare commodity these days — that the verdict might make corporations across the globe rethink ‘corporate social responsibility’.

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Auto Workers

Published in Dawn on November 26 2019

Our mutual value is for us the value of our mutual objects. Hence for us, man himself is mutually of no value. — Karl Marx

There’s quite a bit of information available if you wish to learn about the state of our country’s various industries. The origin, growth, material assets and level of technology, capital investment and revenue generation, production, sales and profit margin, constraints and challenges, vision and policies of each industry are documented, debated and analysed.

You may also find some academic research on a specific industry. What would elude you —almost entirely — is any clue about the workforce itself: those who manufacture the product and make the industry. The narrative of industrial growth, stagnation and decline seems to be without a human face.

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MNCs and Ports

Published in Dawn on July 3, 2019.

IN this age of globalisation, multinational corporations hold a vital place in the world’s port industry as 80 per cent of the global trade is handled by maritime transportation. Ports the world over are now increasingly being developed and operated by the MNCs for container terminal services in an environment of deregulation. With the privatisation of ports and globalisation of trade, a race to the bottom has come about in labour standards for workers.

So the union busting by the South Asia Port Terminal, Karachi, a subsidiary of the Hutchison Ports, is business as usual. Through the internet, the SAPT Democratic Workers’ Union does have supporters in the world hence the news of sacking of the union members four weeks ago was circulated and a signature campaign ‘Reinstate the Karachi 8’ was launched by the LabourStart, a global network of over 700 volunteers who devote their time and effort to support labour.

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Bangladesh Accord

Published in Dawn on June 11, 2019.

The textile industry the world over poses many hazards to workers, such as musculoskeletal disorders and exposure to chemicals, dust, fibres, noise, vibration, and dangerous machinery. In addition to mechanical and chemical hazards, fires pose the greatest risk, particularly in developing economies with substandard building structures. It is the state’s responsibility to ensure workplace safety through national safety regulations, along with inspection and compliance mechanisms. South Asian states, however, tend to abdicate this crucial responsibility — which may result in workers losing their lives and limbs.

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Dock Workers’ Rights

Published in Dawn on January 24, 2019.

The recent success of the Port Qasim dock workers’ union in claiming due rights after months of struggle is worthy of our attention for three reasons. Foremost is the fact that this is the first time workers took an open stand against rights violations committed by a Chinese company working for a CPEC project. Secondly, the way the dock workers’ union garnered solidarity of a larger representation of trade unions and civil society reflected positively on the unionised labour in Karachi ports and the trade union movement no matter how weak it stands in the current neoliberal environment. Thirdly, it provides an opportunity to take stock of labour legislation and international standards compliance in our ports.

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Bricks and Change

Published in Dawn on October 14, 2018.

The recent debate on brick kilns as a site of pollution, spurred by the Environment Protection Department (EPD) Punjab’s decision to close down the kilns during winter for 70 days, brings in to focus an aspect other than bonded labour generally associated with brick kilns. Based on a technology (Fixed Chimney Bull’s Trench Kiln, or FCBTK) as old as 1876, an estimated 11,500 brick kilns in Pakistan are run on coal and bonded labour. The pollution caused by their high emissions of black carbon from coal burning is linked with asthma, cancer, heart and lung ailments, posing risks for more than one million bonded labour involved in brick making. It is also leads to the smog impacting the cities. Considering the fact that we are a nation that hankers for ‘change’ yet resists it, it surprises no one that in this sector there is resistance to change in both technology and its exploitative labour relations.

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Dangerous Depths

Published in Dawn on August 17th 2018

While the country watched the induction of the newly elected parliamentarians and celebrated the 71st Independence Day, it was business as usual in the extractive sector in Pakistan, a business that claimed the lives of 15 coalminers in the dark alleys underground on Aug 13-14. The immediate cause, as reported, was methane gas explosion. Or, faulty blasting technique as asserted by the trade union federation.

Perhaps the cause or causes of the accident in the coalmine will never be known. Was it faulty ventilation and a flawed alarm system, inadequate illumination intensity, invisible hazard signage and the absence of an emergency and evacuation plan, or the lack of workers’ training, or a combination of all?

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Labour and Hope

Published in Dawn on August 3rd 2018

The miserable have no other medicine/ But only hope. — Shakespeare

New legislative bodies are about to be installed at the centre and in the provinces, and amid controversies and misgivings, the common citizens are heaving a sigh of relief that the democratic process continues. Meanwhile, civil society groups, professional associations and collective forums are engaging in closed-door consultations with their members on how to advocate policies that matter the most to them in a setup and that have gone from bad to worse.

Powerful bodies, like chambers of commerce and industries, the employers’ federations, would have their own projections of the future policy and institutional environment, but the trade union bodies — greatly shrunk in number and strength — have nothing but hope to hold on to in their struggles.

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Informal Economy

Published in Dawn on January 21 2018

THE 12th Five Year Plan (2018-23) — to be finalised soon — is based on a strategy that combines “inclusive growth with green development”. In recent years ‘inclusive growth’ — growth that benefits all segments of society — has replaced ‘poverty alleviation’ as a catchphrase in development planning. Everyone is talking about it, including the IMF, World Bank, ADB, ILO, national governments as well as those averse to the ‘growth’ paradigm. So let’s hope all players in the international and national arena mean it and are out to promote “equity, equality of opportunity, and protection in market and employment” as defined by the World Bank.

The time has come for Pakistan to address inequity and to tackle the informal economy, which is considered a barrier to inclusive growth as it excludes the majority of people from accessing opportunities of productive growth in the economic realm and deprives them of entitlements at work because of their informal status. In comparison, workers engaged in formal, registered, tax compliant businesses and units are legally covered for social protection.

The government cites its inability to bring thousands of small enterprises under the tax net, while the enterprises point to financial constraints as the main reason for remaining informal. However, both concede that formality is desirable for it benefits all stakeholders in the long run. Yet the goal remains elusive.

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