PPE may protect us, but it harms the sweatshop workers who make it

One of the greatest controversies of the UK coronavirus crisis is the shortage of PPE for NHS workers. Yet most PPE is made in sweatshops, and its production endangers the health of those who make it. Ironically, workers who produce personal protective equipment for others invariably have inadequate protection themselves

Precarious bodies: occupational risk assemblages in Bolivia and Trinidad

This article develops a concept of “precarious bodies” to theorise the lived experience of labour precariousness in the 21st century and its implications for workers’ health, wellbeing and household reproduction. Drawing on ethnographic research with Bolivian miners and Trinidadian garment workers, we explore the relationship between workers’ exposure to global market forces and their everyday experiences of work, health and risk in these industries. “Precarious bodies” is a heuristic that takes into a single frame the macro-level economic and regulatory processes that create risks for workers, and the various ways in which workers negotiate these risks through their work practices and livelihood choices. We show precarious bodies to be both vulnerable and strategic. Positioned in situations of exploitation and risk, their choices to protect their livelihoods can harm their health and reinforce—rather than counteract—the precarious circumstances of their households

Strengthening cutaneous leishmaniasis control in Guatemala: policy recommendations

The country incidence rate of cutaneous leishmaniasis (CL) in Guatemala has increased from 3.14 per 100,000 inhabitants in 2011 to 6.24 per 100,000 inhabitants in 2019, (Fig.1) (1), probably due to a combination of improved active surveillance (2), climate changes (3,4), and occupational activities involving continued forest contact (5) among others. A national control program has been in place since 2003, but continued efforts are generating uneven results for the different endemic communities. Nationwide actions for CL control include active and passive surveillance, diagnosis and treatment offered free of cost by the Ministry of Health (MoH) and awareness-raising activities. We explored barriers and facilitators of CL control in Guatemala as experienced and perceived by service users and providers in order to inform evidence-based strategies to strengthen CL control in the country

'I should not feed such a weak woman'. Intimate partner violence among women living with podoconiosis: A qualitative study in northern Ethiopia

Background Intimate Partner Violence (IPV) is a serious, preventable public health problem that affects millions of people worldwide. Research indicates that adults suffering from long term, disabling conditions are more likely to be victims of IPV due to the intersection of disease-associated stigma and discrimination. IPV in turn is known to worsen the overall health and wellbeing of those affected by it. Little research however explores the relationship between neglected tropical diseases such as podoconiosis and IPV. This study explores the relationship between IPV and podoconiosis in northern Ethiopia with the aim of identifying new avenues for limiting disability and promoting the wellbeing of people affected by this neglected tropical disease. Methods The study was conducted in East and West Gojjam zones, located in the Amhara Regional State of Ethiopia. Research participants were first screened using the domestic violence screening tool Hurt-Insult-Threaten-Scream (HITS). Data were collected by native speakers of the local language (Amharic) in the form of semi-structured interviews during January and February 2016. Thematic and content data analysis was carried out, using the Open Code 3.4 qualitative data analysis software for coding. Results A total of 15 women living with podoconiosis and experiencing IPV were interviewed (aged 31 to 75). Women experienced different forms of IPV, including beatings (with or without an object), insults, name calling, undermining, denial of equal rights over common assets, movement monitoring, cheating, abandonment, forced divorce, obstruction of health care access, inhibition of decision-making and sexual coercion. Podoconiosis increases the frequency and severity of IPV and in occasions shapes a change from physical to psychological and financial violence. In turn, frequent episodes of IPV worsen disease outcomes and contribute to disease persistence in the region, in that these impede women’s ability to manage the disease and help perpetuate the conditions of poverty that influence disease onset. Conclusions Women living with podoconiosis are victims of various, overlapping forms of IPV that negatively impact their health and wellbeing. Poverty, scarce IPV prevention services in the area together with a social acceptance of IPV and these women’s decreased ability to work due to the debilitating effects of podoconiosis and childcare responsibilities frequently prompt these women to tolerate IPV and remain in abusive relationships. Tackling disease-associated taboo and stigma, developing accessible IPV interventions, working towards greater gender equality at the household and societal levels and developing sustainable strategies for improving the socio-economic assets of women affected by podoconiosis are all necessary to both prevent IPV and to improve disease outcome

Synergistic state governance of labour standards in global value chains: Forced labour in the Malaysia–Nepal–UK medical gloves supply chain

Drawing on research into medical gloves global value chains (GVCs), this article examines the interacting roles that states differently positioned in GVCs have played in preventing and eliminating forced labour. Our case study, based on a worker survey and semi-structured interviews across GVC actors, focuses on forced labour in the Malaysian medical gloves sector during the COVID-19 pandemic, linking production in Malaysia, end markets in the UK (primarily through procurement for the National Health Service) and migrant-sending countries, especially Nepal. We analyze the intermeshing effects of the different roles of states, operating at either the horizontal or vertical level of GVC governance, in terms of contributing to issues of forced labour. We identify three state roles in the Malaysia–UK medical gloves chain: producer state (Malaysia), migrant-sending state (Nepal) and regulator-buyer state (UK). We also identify some of the most persistent barriers to resolving forced labour in the value chain. Our research illustrates that Malaysia’s complex regulatory, political and institutional dynamics most directly influence forced labour in gloves production, but Nepal’s migration policies and the UK’s healthcare procurement practices also create forced labour risk in Malaysia. Advancing Gereffi and Lee’s (2016: 25) notion of “synergistc governance” and Jessop’s (2016) strategic-relational approach (SRA) to the state, we thus argue that the creation of sustained and positive regulatory synergies among states differently positioned in GVCs is necessary for the prevention and elimination of forced labour

Forced labour in the Malaysian medical gloves supply chain before and during the COVID-19 pandemic: evidence, scale and solutions

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Forced labour in the Malaysian medical gloves supply chain during the Covid-19 pandemic: research summary

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Global epidemiology of podoconiosis: a systematic review

Background Podoconiosis is one of the few diseases that could potentially be eliminated within one generation. Nonetheless, the global distribution of the disease remains largely unknown. The global atlas of podoconiosis was conceived to define the epidemiology and distribution of podoconiosis through dedicated surveys and assembling the available epidemiological data. Methods We have synthesized the published literature on the epidemiology of podoconiosis. Through systematic searches in SCOPUS and MEDLINE from inception to February 14, 2018, we identified observational and population-based studies reporting podoconiosis. To establish existence of podoconiosis, we used case reports and presence data. For a study to be included in the prevalence synthesis, it needed to be a population-based survey that involved all residents within a specific area. Studies that did not report original data were excluded. We undertook descriptive analyses of the extracted data. This study is registered with PROSPERO, number CRD42018084959. Results We identified 3,260 records, of which 27 studies met the inclusion criteria. Podoconiosis was described to exist or be endemic in 32 countries, 18 from the African Region, 3 from Asia and 11 from Latin America. Overall, podoconiosis prevalence ranged from 0·10% to 8.08%, was highest in the African region, and was substantially higher in adults than in children and adolescents. The highest reported prevalence values were in Africa (8.08% in Cameroon, 7.45% in Ethiopia, 4.52% in Uganda, 3.87% in Kenya and 2.51% in Tanzania). In India, a single prevalence of 0.21% was recorded from Manipur, Mizoram and Rajasthan states. None of the Latin American countries reported prevalence data. Conclusion Our data suggest that podoconiosis is more widespread in the African Region than in the rest of the regions, although this could be related to the fact that most podoconiosis epidemiological research has been focused in the African continent. The assembled dataset confirms that comprehensive podoconiosis control strategies such as promotion of footwear and personal hygiene are urgently needed in endemic parts of Africa. Mapping, active surveillance and a systematic approach to the monitoring of disease burden must accompany the implementation of podoconiosis control activities

Occupational Health management in precarious and uncertain environments; lessons learned from Bolivia’s cooperative mining industry

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‘Looking at health risks with two eyes’: plural and changing rationalities of risk and occupational risk management amongst Bolivian cooperative miners

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