GLOBALISATION, OCCUPATIONAL HEALTH AND THE AGRICULTURAL SECTOR

Jonathan E. Myers

Professor and Director
Occupational and Environmental Health Research Unit
School of Public Health and Family Medicine
University of Cape Town
Anzio Road, Observatory 7925
SOUTH AFRICA
Tel: 021 4066898
Fax:  021 4066163
Email: myers@phfm.uct.ac.za

Word Count:  3975 including this title page

Introduction

This article is part of a series of three which examines the impact of globalisation on occupational health in the agricultural sector in the Southern African context.  The first   focused on understanding the globalisation  process1, while this deals with the impact of globalisation on occupational health in the agricultural sector.  Special characteristics of the agricultural sector in less developed countries  are examined in respect of  its overwhelming  size,  the overlap with other non-farming rural production sectors,  as well as absence of boundaries between work,  life and the general environment. This provides a framework for considering  vulnerable populations at occupational risk. The specific impact in Southern Africa will be taken up by a third and last article in this series2.

Work in the Agricultural Sector

Half of the world's labourers - or 1.3 billion people - are employed in agriculture3, and in less developed countries 60 percent or more of the workforce are in agriculture. About half of these are in waged labour. The agricultural sector has long been, and remains, critical to development. In the seventeenth, eighteenth, and nineteenth centuries, the agricultural sector facilitated industrialisation by providing surplus products and labour for the urban areas. Since the twentieth century, successfully industrializing societies in East Asia, like South Korea, managed to achieve relatively faster growth in the industrial sector and to absorb displaced rural workers. Their manufacturing exports have grown much faster than agricultural exports, and rural workers have taken advantage of better-paying urban wages to supplement their families' incomes. Over time, demand for rural labour has resulted in increased wages and the spread of development to all sectors. In this way, these countries have followed the historical development of today's developed countries in the current phase of globalisation. The African region as a whole has not fared well and has lagged behind the rest of the world with a stagnant industrial sector and  little development in the agricultural sector. Worldwide, the gross domestic product and employment contributions of the agricultural sector have declined relative to those of the urban industrial sector. 

Agricultural work takes place in mainly rural environments where working and living conditions are frequently poor and where boundaries are blurred between family and workforce, and between the domestic, work, and general environments. General conditions for rural and agricultural workers are typically poor in less developed countries. Basic public services such as water, sewerage, shelter, and electrification are frequently inadequate or absent, as are travel and communications infrastructure. Social services such as health, education, and welfare services are poorly represented and difficult to access from a rural base. A large proportion of rural dwellers, particularly in less developed countries, live in poverty with poor nutrition and general health status. Labour rights are difficult to obtain for agricultural workers due to geographical and social isolation. Labour organisation is typically weak, and working conditions are generally characterised by an unskilled labour force (often migrant or on contract), low wages, high unemployment, high rates of casual labour, and landlessness. Agricultural work is among the top three hazardous occupations, and labour inspection and social and health services are typically absent3.

Agricultural Work,  Women and Children

Distortions of the rural demographic structure are brought about by the migrant labour system when men leave rural areas to seek work in urban areas leaving behind women, children and the elderly. In addition to performing most of the agricultural and domestic work, women have to bear disproportionate responsibility for child and elder care given their access to limited resources. Consequently, the proportion of women and children in agricultural employment is increasing, and child labour is widespread in agriculture. The ILO has estimated that in a number of developing countries, the proportion of economically active children between the ages of five and fourteen may be as high as 30 percent of the agricultural workforce. It is estimated that about ninety million full-time child workers are to be found in the agricultural sector. A third of these child workers are in Africa, which has twice the proportion of children at work as does the rest of the world3. All occupational health risks are amplified for children, since, for example, tools and equipment designed for adults are not ergonomically appropriate for child workers. Child workers form part of the household workforce for subsistence farming, but they may also be found in commercial agriculture or be hired out as part of family labour as labour tenants or landless migrant farmworkers. The latter situation involving landless migrant farmworkers differs from that in which children work in the subsistence household context where coercion is less likely to be present when the employment relationship is tempered by familial relationships. There can, however, be substantial abuse of family members if household chores are made so onerous that they are no different from labour. This problem may be aggravated as the closeness of familial ties becomes more distant, so that a person is more likely to exploit a child relative such as a niece than to exploit his or her own child or younger sibling. Unpublished data from South Africa have shown children working up to thirty hours a week on domestic labour alone4.

Women account for 20 to 30 percent of total agricultural waged employment, but their overall contribution is much higher than is currently recorded. In sub-Saharan Africa women bear the brunt of agricultural production--particularly in the overwhelmingly dominant domestic, subsistence, and informal sectors--while also participating extensively in the formal agricultural sector 5. Despite the fact that women perform the largest proportion of farmwork, they are often seriously disadvantaged by gender inequalities concerning land tenure, control of income and expenditure, and poor access to finance, markets, and government assistance6.

The Impact of Globalisation on Agriculture

Globalisation as a creature of the modem urban industrial and financial sectors has had few direct effects on the agricultural sector. However, there have been indirect impacts having to do mostly with marginalisation of the agricultural sector, which is typically more backward and less productive than the industrial sector, particularly in less developed countries. Higher prices and productivity for traditional cash crops (whose production is increasing in sub-Saharan Africa) characterised earlier phases of globalisation but more recently have been static or declining3,7. This shift is both a result and a determinant of countries' unsuccessful globalisation efforts.

On the positive side, declines in transport and storage costs have been opening up new market potential for nontraditional exports. Some less developed countries, especially in the Latin American region, have been able to take advantage of these globalisation advances and diversify their exports into new crops that are in increasing demand, such as flowers, fruits, and vegetables. However, poor infrastructure in rural areas in the less developed countries has often slowed the adoption of new technologies and has deterred foreign direct investment to these countries' agricultural sectors, particularly in the African region3,7.

The Impact of Technological Developments

In less developed countries the impact of communications technology and the genetic modification of organisms and livestock has as yet been very limited, but this situation could change dramatically in the future. Currently, even developed countries have held the advance of these technologies in check because of their uncertain environmental and health effects. Nevertheless, genetically modified crops constitute one aspect of the new global technologies that have already penetrated the rural agricultural sector. While many prospective benefits have been cited by the purveyors of genetically modified crops, there has been considerable uneasiness at a global level about the subject. In 2000, this concern culminated in the Cartagena Protocol on Biosafety to the Convention on Biodiversity, under the auspices of the United Nations Convention on Biological Diversity. 130 countries were involved in its creation. The Cartagena Protocol regulated the use, handling, and cross-border transfers of genetically modified organisms, and it supported the moratorium, pending further research, on genetically modified organisms passed by the Eighth Session of the Commission on Sustainable Development in 20008. The Cartagena Protocol represents an advance in balancing environmental concerns with free trade, interests that are not easily reconciled. The key provision requires exporters to obtain prior permission from the importing country for the first shipment of a "living modified organism"  for release into the environment, but not for commodities intended for food, animal feed, or processing. The "precautionary principle" introduced in the treaty states that a nation can take action to protect itself--in this case, by barring importation of genetically modified organisms-even in the absence of scientific certainty about the danger. Some developed countries have successfully resisted the penetration of these new technologies by applying the precautionary principle, as related to the possibility of serious environmental harm, but less developed countries have not been able to press their case on the same grounds. An additional concern for all nations is the loss of biodiversity.

Since many less developed countries, especially in sub-Saharan Africa, have more than half the labour force in the agricultural sector, additional risks could arise if technological developments were to penetrate significantly. Poor farmers in those countries could become increasingly dependent economically on the multinationals for seeds and agrochemicals. Seed companies have introduced terminator genes into GM crops to prevent engineered seed spreading in the wild. But this also brings them obvious commercial benefits because farmers would have to buy fresh seed each year, which is viewed by many as being immoral because the world's poorest farmers will then be prevented from saving some of their harvest for planting the following year. The US transnational Monsanto makes the seed and several countries, like India, have banned the technology. Also, large numbers of agricultural workers could be displaced and the security of food supplies could be jeopardised if agricultural production stimulated by foreign direct investment and increased trade linkage were directed, instead, to nonfood products. Additionally, newer agricultural technologies are likely to reinforce a poor workforce's low levels of literacy and education while boosting the workforce participation rates of children and women, who would be at a disproportionately greater risk from the increasing use of hazardous chemicals and other mechanical inputs to production6.

Paradoxically, the greatest impact of globalisation on the rural agricultural sector in less developed countries has been from   increasing information flows accompanying increased global trade. Consumer groups and environmental groups in developed countries have become more aware of global implications of changes and have therefore increasingly pressed for standards to be met regarding occupational safety and health of workers, employment of children, gender equity, workers' rights, and environmentally sound practices. Voluntary initiatives in the form of labels and codes of conduct are intended to privilege goods and services produced under fair and equitable working conditions. The initiatives are "voluntary" in that producers or retailers who place a label on a product or service or adopt a code of conduct do so by choice, rather than in response to government legislation or import restrictions, and the consumer freely chooses to purchase the labeled or coded item9,10.

. Aimed at consumers and potential business partners, social labels may be affixed to products, displayed at retail sites, or assigned to enterprises, while codes of conduct are written statements of principle intended to serve as the expression of a commitment to specific enterprise conduct. Such codes may be adopted unilaterally by enterprises, negotiated between management, workers and NGOs, or influenced in some way by shareholders. Following the success of campaigns against child labour in certain export industries, the first social labeling initiatives were introduced in the 1990s as a supplementary means of attempting to totally eliminate child labour from any role in the production of the labeled product and improving the situation of child workers. Later initiatives have encompassed other issues such as international labour standards on forced labour, freedom from discrimination, freedom of association and the right to collective bargaining, and issues relating to conditions of work with respect to wage levels, social benefits and working hours. Protection of the environment is an even more recent addition.

Voluntary initiatives are common for coffee, tea and bananas in the form of "fair trade initiatives." These initiatives purchase directly from small farmers at a guaranteed minimum price plus a premium for adherence. Fair trade labels attempt to shift the extra costs of labeling, such as the price premium, to the consumer. An example is the nongovernmental organisation the Fairtrade Labeling Organisation, which was founded in 1988 and covers international agricultural products produced in 20 African, Latin American and Asian countries for consumption in Western Europe, US, Canada and Japan. The United Nations has proposed a "Global Compact" between its various agencies and the world business community as an initiative to safeguard sustainable growth within the context of globalisation by promoting a core set of universal values which are fundamental to meeting the socio-economic needs of the world's people today and tomorrow. It is an effort to give a human face to the global market. The universal values include freedom of association and collective bargaining, elimination of forced labour and child labour and discrimination in employment3.

There may be a potential niche area, for instance, in organic farming for less developed countries, given the extreme difficulty of escaping ubiquitous chemical and increasingly genetically modified crop pollution in developed countries.

Impact of Globalisation on Occupational Health in the Agricultural Sector: General Considerations

Occupational Injury and Disease Indicators

According to the ILO and the WHO, poor occupational health and safety problems led globally, in 1999 to 250 million accidents and 335,000 fatalities, plus 60   to 150 million occupational diseases, which altogether resulted in 1.2 million work-related deaths that year7,11. Adverse and substandard work conditions result in substantial and unnecessary adverse health impacts, suffering, and economic losses amounting to as much as 4 to 5 percent of some countries' gross domestic product. All such problems are magnified in rural environments, and agricultural work worldwide constitutes one of the three most hazardous occupations, along with extractive industry labour (mining) and construction work7. This is the case even in the developed countries, where the preventive infrastructure is much more functional. For example, the U .S. fatality rate for farmworkers is five times that for workers in all other sectors. The main problems are occupational injuries (including fatalities) arising from machinery and transport equipment, and poisoning from agrichemicals. The WHO has estimated that between three and four million pesticide poisonings occur each year, with tens of thousands of fatalities 12. In addition, all the other generic occupational risks abound, whether physical, biological, ergonomic, or work-organisational.  These risks interact with general public health problems, as well as with poor basic conditions of life and work, to create a hazardous environment for vulnerable working populations, particularly women and children. Failure to communicate   hazards, inappropriate personal protective equipment, and poorly developed public policies provide the context for increased risk to poor and poorly educated farmers in less developed countries. Part of these poor conditions relate to less developed societies' hopelessly inadequate methods of recording problems, conducting relevant health-related surveillance, and inability to respond meaningfully with preventive, protective, curative, and rehabilitative measures that could ameliorate these risks and their consequences.

Validity and Coverage of Indicators

Poorly developed infrastructure make it difficult to record or process health-related data meaningfully. This problem is compounded by a characteristic feature of the agricultural sector, namely, the blurring of boundaries that makes it difficult to distinguish occupational from non-occupational determinants for injuries and disease, and therefore to easily obtain valid indicators of the extent of risks. Furthermore, recognition of the occupational determinants of morbidity and mortality is a major problem  in less developed countries. Atypical but common occupational causes of mortality such as drownings of farmworkers who have never learned to swim may not be recognised as occupationally related, while obvious instances of direct occupational causation, such as deaths of children of farmworkers from farm machinery injuries, are poorly recognised in the mortality statistics as being occupationally related13. More indirect, complicated, and subtle determinants of less traditional occupational health outcomes, such as the drowning of farm workers and their family members in farm dams and ponds, are typically missed altogether, and the true burden of disease in agriculture can only be guessed at.  For instance, pesticide-related morbidity and mortality exemplify under-ascertainment of the scope and extent of health problems, especially underreporting for women due to a  generalised gender bias 13,14,15.

Much of what is presumed to be true about less developed countries' general and occupational health, particularly in the agricultural sector, is speculative due to the absence of primary research data. It can be assumed, however, that traditionally well documented and well recognised agricultural sector hazards seen in countries with well-developed information systems are generally present, as well, in less developed settings. Moreover, acute and chronic conditions involving musculoskeletal, allergic, respiratory, and nervous and mental health systems are bound to be exaggerated, as poor general conditions for rural dwellers in less developed countries interact with work-related hazards.

Globalisation has brought increasing movement of goods and people across the borders of many countries. In the case of sub-Saharan Africa, this is reflected in a rise in the incidence of diseases that are usually considered to be non-occupational--such as sexually transmitted diseases,  malaria, cholera, and HIV/AIDS-- but that, on closer inspection, can be recognised not only as occupationally related but also as bound up with working conditions and the relationships between the rural agricultural and urban industrial sectors. The movement of migrant workers to urban centers where there is employment or to mining or extractive industries in rural settings results in the transfer of infectious agents and the development of social conditions that cater to needs of men away from their families (such as sexual services) 16. The much-touted need to integrate occupational health services with the primary health-care infrastructure is double-edged, as such integration often results in obscuring occupational determinants of morbidity and mortality. At the first point of contact with agricultural workers and their families, health-care personnel unskilled in occupational health tend to see general health problems (such as asthma) when they are presented with  work-related ones (such as occupational asthma). This problem is aggravated by the high levels of morbidity in less developed countries17,18.  Occupational health personnel employed by agribusiness or the commercial extractive sector have tended traditionally to emphasize general primary care-related concerns, often at the expense of occupational health determinants.  Even when these latter are recognised, they are often  downplayed in relation to more general health determinants (e.g. lifestyle factors), which have generally been used to “blame” the victims,  thus directing attention away from the workplace risks.

The health effects of general environmental determinants such as pesticides and genetically modified organisms are as yet unspecified and difficult, if not impossible, to ascertain. In the case of pesticides, however, a generally increased awareness worldwide of the risks to health and the environment has led to the development over time of integrated pest management practices and of programs to limit chemical use involving producers, manufacturers, and regulators. IPM is an approach to the management of pest problems in agriculture which relies primarily on biological and ecological interventions such as using pests' natural enemies, which is sounder and safer than chemical dependent pest control 19.  Farm owners, governments, and policy makers have become increasingly aware of the high social costs of occupational health risks20.

Access to Key Services

In the rural agricultural sector, occupational health services are generally absent, except through agribusinesses and large scale-plantations21.  The form that these services take is often similar, albeit inferior, to those occupational health services provided by the extractive industry, which are oriented to providing general health services to migrant worker populations. For populations living near factories or commercial farms there is little in the way of available health care.. Public sector health services are relatively inaccessible particularly in peri-urban and rural areas. Uneven and skewed development in less developed countries has led to concentrations of health services in urban areas and to a marked predominance of specialised referral hospital-based services. Such a high proportion of health-care resources are tied up in these patterns that, even in the era of primary health care, very limited health-care resources are available for primary care. The generally poor provision of physical infrastructure, such as piped water into homes, and of social services interacts with occupational health risks to exacerbate communicable and vector-borne diseases, such as diarrhoea, and poor nutrition. 

This articles has  examined the impact of globalisation on occupational health in the agricultural sector in general terms.    The third and last2 article will examine the impact on Southern Africa as well as  opportunities stemming from positive aspects,  while working to ameliorate the negative effects,  of globalisation on occupational health risks in the agricultural sector.

 References

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3.  International Labour Organisation (ILO).  2000. Sustainable agriculture in a globalised economy. Report for discussion at the Tripartite Meeting. Geneva: ILO

4. London, L 2001. Personal Communication.
 
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12.	Jeyaratnam 1990. Acute pesticide poisoning: a major global health problem. World Health Stat Q. 1990;43(3):139-44.

13. Schierhout, G. H., A. Midgley, and J. E. Myers. 1997. Occupational fatality under-reporting in rural areas ofthe Western Cape Province, South Africa. Safety Science 25 (1-3): 113-22.

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