Healthcare in tea gardens

Healthcare facilities in the 800-odd tea estates across Assam has always remained a major issue, with labour unions, NGOs and other organisations continuously complaining of lack of doctors, nurses, medicine, ambulances and various kinds of equipments and other facilities. While most of the health indicators in Assam only project a very poor picture of the overall scenario of the State, these have been the poorest – and alarming too – in those districts which have high concentration of tea estates and tea plantation workers. Infant Mortality Rate (IMR), Maternal Mortality Rate (MMR), malnutrition among children and women, anaemia in adolescent girls, pregnant women and young mothers – are all high among the tea plantation workers. While physical activities like picking tea leaves is definitely a back-breaking work that involves long and continuous hours under the open sky, the reality is that most of it is done primarily by women. Thus, in the absence of proper healthcare facilities, the children, adolescent girls and women in tea plantation communities are at high risk of poor overall growth and development. The situation has been further complicated by high levels of anaemia and malnutrition which have roots in poor food habits. Moreover, as has been pointed out by UNICEF, most children and women belonging to the tea plantation workers’ community thus suffer a high disease burden and high mortality. That their levels of education are low, and that there is high prevalence of superstitions due to the absence of a proper healthcare mechanism, the children of tea plantation workers’ families are also likely to marry at an early age. It is a fact that both boys and girls belonging to the tea plantation workers’ families get married at an early age, below the legally prescribed age. Moreover, they being totally dependent on the tea industry have become vulnerable to various kinds of exploitation. Though the Plantations Labour Act of 1951 has very specifically provided for tea garden managements to make provisions for basic services for their workers and their family members, the tragedy is that these provisions apply only to those who are on the permanent rolls of the gardens. It is common knowledge that about half of the tea plantation labour force in Assam comprise of seasonal or ‘casual’ workers, who are technically and legally not considered eligible for getting the various benefits from these services, which, according to the Act covers health and hospital services, crèches, primary education, water and sanitation, housing and rations for workers and their dependents. This makes the condition of a large segment of the tea plantation workers even more vulnerable. That the healthcare mechanism in tea estates is far from being satisfactory has been reflected in two recent incidents when two veteran doctors who had spent their entire career in tea estates, were physically assaulted. One of them even succumbed to the injuries he sustained due to the assault. Following these two incidents, the healthcare scenario of tea estates has further worsened, with many doctors quitting for fear of life. What has thus come as an alarming piece of information is that as many as 155 tea estates across the State at the moment do not have doctors. What has also come to the fore is that most of the tea garden managements, including some big companies, have started washing their hands off the responsibility of providing healthcare facilities to their workers on various excuses. The commonest excuse is that the tea industry is passing through a difficult phase. Tea companies have also begun taking advantage of the Assam government’s decision to extend free medicine supply scheme to the tea estates, apart from providing them with ambulances. It is unfortunate that most tea companies – big and small – have not taken steps to provide adequate healthcare to those same people who have been working with them to produce the world-famous Assam Tea for several generations now. It is time the Government of Assam takes steps to compel the tea garden managements to provide proper healthcare to their workers. At the same time, the government should also ensure that the big tea companies do not invest the profits they earn from the estates in Assam outside the State, but plough them back for attaining better productivity. The tea industry should also partner with UNICEF and other development agencies to find ways and means to bridge the gaps in the areas of healthcare.