Introduction
Haushala Prasad Mishra is spearheading a workers' movement in India for occupational safety from his position as a textile worker. He has also been instrumental in uncovering and disseminating information about byssinosis ("brown lung disease"), a major cause of death among textile workers.
The New Idea
Haushala Prasad Mishra has mounted one of India's first citizen-sector-led occupational health campaigns. Starting among Ahmedabad's textile mills, Prasad has elaborated a multi-faceted campaign by organizing and educating workers, corralling medical practitioners and institutions, providing factory managers with cost-effective solutions, guiding public safety inspectors and policy makers and, when necessary, dramatizing the hazards workers face through the media. His initiative has made the killer lung disease byssinosis–whose presence was once hidden in medical textbooks and surveys–a priority issue for workers in the textile industry, one of India's largest.
Prasad uses different "sales pitches" and even different vehicles to get his messages about the disease across.
As the founder of a shop floor workers' movement for occupational safety, he teaches textile workers about the cause, symptoms and effects of byssinosis and demonstrates ways of making their workplaces safer. This knowledge helps workers to recognize and stand up for their rights by pursuing concrete ways to develop a safer workplace.He has also created an independent public interest organization, Mill Kamdar Swasthya Suraksha Mandal, whose goal is to improve the conditions in which textile workers are currently forced to work. Prasad says, "Our focus on byssinosis was prompted by the trade union movement's inability to prioritize workers' health and safety." Mill Kamdar is represented by five volunteers from every textile mill of Ahmedabad, formerly known as the Manchester of India because of its large number of textile mills.
Prasad convinced the Employees' State Insurance Scheme of the validity of textile worker ill health, resulting in nine workers receiving compensation for the first time in 1991. The process of obtaining compensation is becoming regularized. He also convinced Employees' State Insurance officials to provide medicine to byssinotic patients for as long as they have the need.
A major result of his negotiations with the government is the creation of a public occupational health center that is the first of its kind in Ahmedabad. In addition, Prasad has persuaded the government to introduce a Byssinosis Control Program and has sought the help of the National Institute of Occupational Health to adequately train doctors to recognize and provide treatment for the disease.
The Problem
In India, workplace safety and occupational health are virtually neglected. Byssinosis, in particular, is not a well-known disease. In 1987, Dr. J. R. Parikh, Director of the National Institute of Occupational Health, discovered in his pioneering study that 50 percent of the workers of the spinning section of textile mills suffered from byssinosis, or "brown lungs," shattering the belief that byssinosis was not prevalent among textile workers in India. Even today, because the textile mills still operate on vintage technology, workers in the card and blow room are continuously exposed to high levels of cotton dust. Recently, it was learned that people who live near the textile factories also face the risk of contracting the disease.
Worker and management ignorance is reinforced by doctors who are also largely unaware of the disease, which can easily be misdiagnosed as tuberculosis or bronchitis. In the past, medical checkups were not designed to detect byssinosis at an early stage, resulting in inaccuracies in the surveys that were performed to define the relationship of byssinosis to textile workers.
Furthermore, the new high-speed production machines that yield greater quantities of sub-standard cotton and cotton dust increase the workers' risk for byssinosis. If they seek medical care, workers are often forced to go to more expensive private practitioners to avoid losing a day's salary by traveling to a distant Employees' State Insurance hospital. Those workers who do take time to go to the Employees' State Insurance hospitals often do not find their needs met since the hospitals have a shortage of paramedical staff (both part-time and full-time), specialists and drugs.
The Strategy
Prasad is using the media as an ally to draw attention to this "new" issue. His advocacy has resulted in the appearance of weekly news items on byssinosis in regional newspapers and frequent updates in national daily papers. Media publicity was facilitated by Prasad's invitation to three prominent journalists from Delhi to visit textile mills in Ahmedabad in 1992. The increased attention helps lobbying at the policy level and has brought a new agenda to the state legislature to initiate procedures for a dust-free environment in textile mills.
Prasad has carefully designed a network that provides periodic training and information to workers. The network typically includes the Chief Inspector of Factories, Employees' State Insurance officials, a mill manager, medical professionals and lawyers. To increase general awareness, Prasad organizes exhibitions on occupational safety using posters, brochures and pamphlets. He amplifies the reach of his occupational safety education efforts through other nongovernmental organizations in Ahmedabad.
First working with 32 mills in Ahmedabad, Prasad is now spreading the message of occupational safety and extending that impact in other important textile centers in India, such as the states of Maharashtra and Uttar Pradesh. To tackle his growing agenda, Prasad's organization has mobilized over 40 volunteers.
Prasad also establishes positive relationships with managers of the textile industries. Instead of confronting the industry in a hostile manner, he chooses to recommend solutions that are cost-effective and do not cause health hazards. For example he suggests hand picking the cotton flowers and improving the ginning process in mills as a cost-effective option to meet basic health standards. He also suggests the use of a monitoring plan to help factory inspectors trace the onset of byssinosis among the workers by requiring workers to undergo a medical check-up twice a day, before work and at the end of their shift. The checkup includes a lung function test by a vitalograph spirometer that measures the lung capacity, which diminishes with the inhalation of cotton dust. Prasad's other suggestions directly affect the well-being of byssinotic workers, such as transferring workers with the disease to other sections and requiring workers to wear cloth masks. At least five mills have followed his lead and have become dust-free.
The Person
Prasad was born in a small village in the state of Uttar Pradesh. He went to the village school and through "shramdaan" (charity) initiated a project for the blind. An outstanding student, he took part in various activities, including sports and plays. After graduation in 1970, Prasad took the initiative to start a Sanskrit village school that earned recognition, and eventually financial aid, from the state. After completing his own education in 1975, Prasad further consolidated the organizational structure of the school and expanded its enrollment.
His association with the religious leader Baba Jai Gurudev Acharya brought him to Ahmedabad in 1978. Obtaining a training of "eiremanship" to secure work, he joined a textile mill as an apprentice in spinning. After six years of work in the card room of the spinning department, he developed breathing difficulties. A private physician diagnosed his complaint as "normal" among textile workers. Prasad had noticed that many of his colleagues in the spinning department had wheezing problems for which medication brought them only temporary relief. He also observed that many workers sought relief by consuming alcohol.
In 1989, Prasad attended a meeting called to discuss the problem of byssinosis, where he heard of the disease for the first time and learned about the survey performed by Dr. Parikh two years prior in the National Institute of Occupational Health, which irrefutably proved that workers in the spinning department were victims of an occupational lung disease. Dr. Parikh supplied Prasad with a list of byssinotic workers and helped him learn about the disease. Armed with the unofficial list he had obtained from the National Institute of Occupational Health, Prasad met the labor officer in his factory. They told him that the workers must sign a particular form to claim the compensation, but the form was unavailable. Obtaining one through a personal contact, he printed more copies and submitted multiple claims, nine of which were compensated. Thus, years of inaction were dramatically overturned and a dangerous disease finally revealed to the public. Despite the dramatic growth of his movement, before his election as an Ashoka Fellow Prasad continued to work in the mill by day and as an electrician at night to support his family of five and to raise the funds for his organization.