Reaching out to the workers and getting the messages on occupational safety and health (OSH) across can be quite challenging particularly for those working in the informal sector in the Bangladesh economy that employs largely and depends greatly on part-time, seasonal, casual, and daily labour. The large employment sectors including construction, transportation, agriculture, tannery, brickfields, re-rolling mills, ship-breaking, hotels and restaurants, retail and grocery shops rely mostly on informal work arrangements and in some of these sectors workers' risk of death, injury and illness related to their occupations or workplace is sadly quite high. OSH education and training programmes in Bangladesh may use a variety of these new and creative approaches when their target audiences include the underserved worker populations: social marketing campaigns, train-the-trainer programmes, community health worker model and direct worker training.
The selection of training approach is often based on real-world factors such as availability of funding, worker interest, employer support, experience and skills of resource persons (trainers), and access to the target worker populations. In the context of contemporary Bangladesh economy, many workers are exposed to high health and safety hazards at their workplaces as they have very poor understanding and cognizance about the risk factors and on ways how to protect themselves and their co-workers-- most have never received any OSH training. Some contemporary approaches are mentioned here to reach out to workers with OSH messages through their community and a variety of new media that have been practised and found effective in other countries or sectors and these may become gradually more important and useful in Bangladesh as well.
SOCIAL MARKETING PROGRAMMES: Some organisations and NGOs in Bangladesh have sought to reach workers and their family members for conveying broader public health messages including birth control or spacing, tuberculosis, leprosy, diabetes, vitamin deficiency and sexually transmitted diseases. They may develop and implement creative social marketing campaigns addressing major occupational health and safety issues such as fall risk for construction workers, sand and dust exposure for brickfield workers, burns from flame cutting among shipbreaking, poisonous gas exposure for septic tank cleaners, eye injury among re-rolling mill workers and welders, and chemical exposure among tannery workers. Bangladesh's learning on social marketing for use of contraceptives for population control and oral saline for diarrhea prevention can be expanded to incorporate OSH related lessons to workers. In fact, the roles of Bangladesh government, icddr,b and Social Marketing Company have been applauded globally and replicated in many other resource-poor countries. Most recently, Zinc supplementation in children with diarrhea campaign in Bangladesh has drawn a lot of attention and interest from a wide range of supporters and researchers.
Public health focused NGOs can collaborate with the government and international agencies to introduce OSH themes into their existing health promotion programmes and campaigns. A social marketing campaign supporting the importance of workplace health and safety initiatives would be beneficial for marginalised and vulnerable workers. Such a campaign would ideally involve mass-communication messages in a variety of media (e.g, TV, radio, movie theatres, posters, websites, newspaper ads) and focus and rely on media vehicles that can effectively reach these workers. South American countries have used this model for reaching out to construction and sugarcane workers.
TRAIN-THE-TRAINER PROGRAMMES: A new approach in OSH training has been the development of programmes designed to train trusted individuals in a community or workplace, who then receive continual support to provide training and education to their peers. Workers are most responsive to messages from workers. National workers unions may develop long-term programmes that can provide training to "worker-trainers," in each major sector mentioned above who may, in turn, train thousands of fellow workers. Documented impact assessments have shown that participants have more confidence and a willingness to make changes in the workplace following this kind of training; they also use training materials as resources more often and increase their interaction with supervisors. This author led an evaluation study in Canada on creating peer educators to prevent patient handling related musculoskeletal injuries among nurses and nursing aides.
Conducting a high-quality train-the-trainer programme is a difficult undertaking. To become effective trainers, trainees must receive intensive follow-up, coaching, and resources. For a recent example, the Alliance for Bangladesh Worker Safety- the North American retailers platform reports to have trained more than 1.6 million garment factory workers, security guards and factory managers in Bangladesh using this train-the-trainer approach.
COMMUNITY HEALTH WORKERS: Many community-based programmes have grown on the Community Health Workers model that have proven highly successful in promoting public health practice and advocacy. These Community Health Workers models have been used successfully in OSH training programmes for immigrant labourers, farm workers, and poultry processing workers in California, Nebraska and Texas. BRAC- the large Bangladeshi NGO 's health, nutrition and population programme has a network of 106,000 health workers?(shasthyashebikas and shasthyakormis) and they have made substantial impact in improving Bangladesh's key health indicators. Partnership with BRAC will certainly help in spreading OSH messages through its extensive activities and the OSH community may pursue this avenue.
DIRECT WORKER TRAINING: Many OSH education programmes include training workers directly, whether in the worksite, at a union office, or community. These training may range from brief interactions with workers at their worksites to highly coordinated, long-term educational programmes. However, this model may have questionable efficacy in Bangladesh for the part-time, seasonal, casual, and daily labour force in the informal sector and for small businesses.
Over the past few decades, the OSH training programmes have adapted a wide range of inventive, engaging training methods. Many of these emphasise active roles of worker participants in evaluating problems and creating practical solutions. This approach often begins with the need identification of the workers and then uncovers the assumptions and root-cause conditions within which OSH learning will take place. It targets to develop workers' critical thinking skills and confidence as actors in improving their working conditions. OSH training by unions and community organisations in the industrialised countries has adapted these methods and prefer small group learning to make it more participatory.
OSH training must be worker-engaging to be effective. A recent review of methods found that more engaging training methods such as simulations and hands-on exercises were more effective for knowledge acquisition and practical actions than less engaging, passive methods, such as delivering lectures.
All training programmes for underserved workers should include information about workers' rights under Bangladesh's employment law (2006 Labour Act) and 2015 Labour Rules (2015). The Act and Rules apply to those working in commercial and industrial enterprises and cover topics on working hours, vacations, leave, medical leave etc. The OSH sections of the Bangladesh Labour Act 2006 should be covered in these trainings in-depth; discussions should cover where to get help in addressing workplace safety and health problems, and where to find resources to seek more information. Training should encourage workers to take collective action to address safety and health problems, otherwise individual workers may become vulnerable and will face retaliation.
Training that provides leadership skills for organising and taking action is likely to be more effective in initiating positive changes in the workplace health and safety situation than training that only spreads knowledge or teaches skills.
Hasnat M. Alamgir is Professor, Department of Pharmacy, East West University, Dhaka, Bangladesh.