OCCUPATIONAL HEALTH AND INFORMAL SECTOR:THE WAY

FORWARDBy

Dr. O A Odukunle.MBBS.MSc.Occ.Med.DIH.AFOM.

FWACPConsultant Occupational Physician,Apapa.Lagos

• Occupational Health is a discipline in medicine which is concerned with the two-way relationship between work and health.

• Health========Work.

It is closely related to the effects of work environment on the employees’ health as well as to the effect of the employees’

health on his/her ability to carry out his/her duties for which he/she was employed.The discipline aims at preventing ill-health rather than to cure it.

‘Informal sector’ as a concept first appeared in 1972 when an ILO comprehensive employment mission to Kenya found out

that the main problem in the country was not unemployment per se but the existence of a large number of ‘working poor,’ many working hard indeed in goods and services sectors of the economy but whose activities were not recognised, recorded, protected,or regulated by the public authorities.

The mission recommended that if these group of people were given a modicum of support and legal protection, had the potential to offer and more secure appointment. In our own context, they include auto-mechanics,metal work/welding,hairdressing,fashion design/ cosmetology,.leatherwork,cooking/food

vending, foundry, tie and dye, steelwork, carpentry,tailoring etc to mention a few.

CHARACTERISTICS OF THE INFORMAL SECTOR OPERATORS, (ISOs)

They are small scale units or clusters producing, distributing goods and services,largely independent,self-employed,some also employ family labour,

and irregular incomes or apprentices but operate with little capital or none at all. They use low-level of technology and skill and those low level of productivity which provides low and irregular incomes and unstable employment. Education is usually non-formal and if formal, may be to primary school passed or failed or junior

secondary school passed or attempted.They operate invariably outside the framework of the law.They have little access to organised markets or credit institutions.Despite all these,it is estimated that 70% of labour force in Nigeria is engaged in the informal sector(IS).The IS

makes considerable contributions to the National economy and in Nigeria about 60% of GDP.

The ISOs are exposed to similar factors affecting the employees’ health like the organised private sector workers do and also develop occupational diseases and suffer from occupational accidents.The

occupational diseases are not easily recognised by them due to ignorance.

SOME WORKPLACE HAZARDS TO WHICH ISOs ARE EXPOSED TO:-

Poor housekeeping, inadequate ventilation, excessive heat or cold,inadequate working space,poorly designed tools,exposure to hazards such as chemicals and dusts,high noise level,lack of adequate personal

protective equipment(PPE) and long working hours.The unhealthy working environment leads to musculo-skeletal disorders and low back aches,allergic reactions,physical strain,fatigue and stress.The ISOs work for longer hours thus exceeding the statutory 40 hours/week since returns is directly proportional to production..They cannot

afford to employ adequate hands and so are overstretched.ISOs also engage in manual handling with such repetitive working movements,carrying heavy loads and even carrying loads exceeding their body weights!, awkward postures,twisting, bending,lifting,pushing and pulling.All these cause strain and fatigue leading

to work accidents which cause injuries and ill-health or occupational diseases.

In addition, welfare facilities like provision of potable water, adequate disposal of work and human wastes or sanitary facilities or washing facilities are not generally provided in the workplaces by the Authorities.

THE WAY FORWARD TO IMPROVE HEALTH AND SAFETY

IN THE ISOs.1. CAPACITY BUILDING PROGRAM.

It is essential to raise the awareness of occupational health and safety in the ISOs by imparting practical knowledge which will enable them to easily identify occupational hazards at workplaces and consequently, recognise, and voluntarily implement practical solutions to eliminate

or control workplace hazards. Those so trained are expected to disseminate the knowledge gained from such trainings to their other colleagues.

2. PROVISION OF OCCUPATIONAL HEALTH SERVICE.

i.This is non-existence per se, but the 774 Local Govt. Councils through their PHC departments health staff such as doctors,nurses, and environmental health officers should be trained or retrained in providing services on occupational health to the ISOs.

ii.The inclusion of occupational health as an integral part of Primary Health Care will ameliorate the current problems of its implementation at the grass root level.

iii.ISOs should be encouraged to have at least, pre-employment,and periodic medical examinations done in order to be fit for job at all times.

iv.Work accidents do occur and consequently first-aid facility should be available and supply of first aid boxes. Nigerian Red Cross Society and the Nigerian Red Crescent Society should be able to give first aid training practicals onto the respective ISOs’ associations.

v.The National Health Insurance through their health providers should in the near future

be able to offer occupational health services to the group.

3. REGULAR INSPECTION OF WORKPLACE

The various Governments, since health is in the concurrent list of 1999 Nigeria’s constitution, should intensify inspection of ISOs workplaces.This is an additional job though, under the present shortage of trained occupational health staff in the country.

Training and recruitment of appropriate staff is mandatory for its success.

4. DATA COLLECTION. Poor data collection on occupational

accidents and occupational diseases is the bane of our society. An effective means of collecting data use for planning purposes and also to enhance national profiles should be put in place.

5. PROVISION OF PERSONAL PROTECTIVE EQUIPMENT,(PPE).

The ISOs should be provided with and the use unfailingly whilst at their workplaces.

6. INFORMATION DISSEMINATION.i.Correct information to the ISOs by the

Governments should be intensified through the production of posters in the local languages of Hausa,Ibo,and Yoruba

ii.Publishing of relevant news sheets or leaflets and the formation of workplace health and safety committees whose function amongst others will include information dissemination to the ISOs.

iii.Regular meetings of the respective ISOs associations should include talks on occupational health and safety.

The mass media should help in disseminating correct information on occupational health and safety nationwide to the ISOs.

7. LEGISLATIONS.There is the urgent need to update relevant

legislations on occupational health and safety in the country,though the law as it is presently, seems to take care of the ISOs,

In terms of definition of workplace and expectations,the effective coverage of Nigeria workplaces is a problem as earlier enumerated, in terms of manpower requirements of the occupational health professionals.The speedy passage of the Labour,Safety, and Welfare bill in the National Assembly to replace the Factories Act of 2004 is long overdue.

The Employees’ Compensation Act 2010 has taken care of the issue of compensation payable at work for occupational diseases, or occupational accidents. The Act is contributory in nature by both the employers and the employees. To benefit from this Act, the ISOs have to meet the conditions listed in the Act.

8.DEVELOPMENT OF INSTITUTIONAL COLLABORATION BY MDAs.

There is the urgent need to build institutional collaboration by improving communication channels between the ISOs and the relevant Government institutions such the Federal Ministry of Labor and Employment, Federal Ministry of Health,

Federal Ministry of Environment,Federal Ministry of Housing and Urban Development, 36 States Ministry of Health,Federal Capital Territory(FCT) Health Department and the Health Departments of the present 774 Local Government Councils as stipulated in the Constitution

9. ACCESSIBILITY TO LAND.

This is a problem confronting the ISOs as it is difficult to access land including obtaining the Certificates of Occupancy.The present problem associated with owning land should be looked into dispassionately.

10. NATIONAL POLICY ON OCCUPATIONAL SAFETY AND HEALTH.

A national policy on occupational health and safety should be put in place as soon as possible.This policy when established, should be fully implemented by all sectors of the economy in order to promote safety, health and welfare.

ACKNOWLEDGEMENT.

I am grateful to the organising committee for the Society of Occupational and Environmental Health Physicians of Nigeria (SOEHPON) for the invitation given to attend and participate at the year 2014 Conference/Annual General Meeting.

I thank you for your rapt attention. God bless you all, Amen.

Dr O A Odukunle,10 Ashanti Close,Apapa.Lagos.Tel 08033247040.21st November 2014.