UVA-SEWA Partnership: Understanding Occupational Health among Informal Agricultural Workers in Gujarat, India

Mary Collins, Lina Hong, Patrick Robinson, and Elise Watt

This experience has instilled in me an appreciation for the paramount importance of personal relationships to successful grassroots public health work. Simple, informal conversations undertaken in a spirit of friendliness and open exchange often yielded some of our most valuable and rewarding insights. The sevikas, or community health workers, were our models; their inexhaustible commitment to the health and well-being of their families, friends and neighbors was unrivaled. – Patrick

Hello from Ahmedabad! We just finished our last day in the field working with the Self-Employed Women’s Association (SEWA). We visited four villages surrounding Ahmedabad city over the course of many weeks, and are excited to begin analyzing more deeply the information we have learned about occupational health in relation to agricultural work. We spoke in depth with women about their commonly experienced aches, pains, cuts, bruises, and work-related mental distress. SEWA will be using this information, along with the results of a similar study conducted with home-based workers in urban areas, to develop an occupational health training program that will strengthen their existing healthwork. We have been here for two months, and as daunting as it may be to lose half our body weight in sweat during the summer just to get drenched by rain during monsoon season, we can all agree that this has all been part of the learning experience.

Not all information that helped us in our research came from an academic source. Just being in India long enough to get familiarized with the culture proved to be immensely helpful in understanding the women that we met in the villages. In our first few days of fieldwork, it was difficult to understand why health was not a top priority. Some women seemed to brush off very concerning health problems so that they could continue working in the fields. We are used to health, both physical and mental, being almost always of utmost importance in American culture, so the difference was especially striking. Most people in the villages need to be able to work every day just to earn enough to feed their families, and are willing to exchange health for income.

Here we are with women from one village after our focus group activity, the final activity in our study. We are joined by the village’s Sevika, who coordinated and helped facilitate many of the research activities with us.

Additionally, we learned the importance of informal conversation beyond research activities. Every day, we went to the field with an agenda, in the hopes of completing at least one participatory action research activity, or at least one interview, but we realized that research is more than the activity itself. Some of our most enjoyable time with the women we worked with was before and after formal research activities, as women trickled in from their various homes after eating lunch or coming in directly from the field, with mud caked on their feet and sweaty saris. Almost all of our time in these villages was spent under a fan on the open porch or in the shady interior of a Sevika’s, or SEWA community health worker’s, home. These spaces were blessedly cool compared to the scorching fields, yet the women hardly complained about their work unless explicitly prompted, and even then with hesitation. As women arrived for our research activities, we chatted casually about their mornings and their plans for the afternoon–household work, a nap, an afternoon hour spent at the local mandir, or Hindu temple. Sometimes women or other onlookers, like the Sevika’s children or curious passerby, would venture a question to us–how old are you? Are you married? How do you like India?

My favorite part of doing field work is meeting women whom I know I would be good friends with in another setting. We only get a few hours with most of these laborers, but they are women of my own age, moms, daughters, and sisters; all people that I recognize. It’s amazing how well you can connect with people without a shared language, just through genuine curiosity, kindness, and shared senses of humor. I feel so lucky to get to know these women. – Elise

Following our interview with this landowner, she showed us her field of jasmine, cotton, and cucumbers. Although she employs laborers, she works with them side-by-side in the field despite being ninety years old. We observed how she carefully plucks jasmine each day.

We realized we could not do formal research activities without informally speaking with our participants. We needed to engage women to understand who they were outside of the research activities. Not every interaction we had needed to have an aim – drinking chai, laughing with the women, and trying buttermilk became the best parts of our research. These moments became opportunities for the women to get to know us as well. Some of our most engaging conversations usually followed our research activities, when we had spent enough time with women for all to be comfortable with one another. This was usually when participants would ask about America and American culture–what do you usually eat? What kind of crops do you grow in America? We weren’t sure what to expect as the typical curiosities about American life, but we were surprised and intrigued to get a peak at popular conceptions of American culture in India through hearing these questions.

One of the women that we worked with in the village told us that we made her feel like someone cared about her well-being. I’m excited to see where this project will go in coming years and hope we can help them with interventions, but if making them feel cared for is the only way that we can impact the women for now, I still consider that a huge success. – Lina

These simple exchanges proved extremely important. They allowed us to establish bonds of trust and goodwill that created opportunities for genuine relationships. This not only improved participants’ experience as well as our own, but markedly augmented the quality of our findings. These conversations always seemed to inform our understanding of village life in new and unexpected ways–something that bolstered the precision and nuance of later inquiries. We found our inspiration in the village sevikas. These women know their communities inside and out–from the fluid dynamics of the local economy to the difficulties women laborers face in harvesting jowar, or grass, to feed their buffalo. And their knowledge is entirely based on relationships–with the people, with the place, and now with us.

The women we talk to daily are inspiring in conversation when we learn that their rheumatism, feet infections, or headaches do not stop them from working in the paddy field and making an income. They are also inspiring beyond research activities. Research is so much more than conducting the activity itself; it is informally asking a participant how their day went and how they are feeling – this is so important to understanding their experience as a self-employed agricultural worker. – Mary

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