Rama is six months pregnant and worried about giving birth to her child. She’s just 22, earning a living by picking tea leaves on a plantation in Assam in northeast India.
Even if she feels pain during work, she does not take a break, and in the remote tea plantation, medical care is scarce.
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Workers like Rama earn just Rs 1000, or $14, a week, and are under intense pressure to meet daily quotas of 24 kilograms of tea leaves. If they cannot hit their quotas, their pay is cut.
Casual laborers often work throughout their pregnancy and rarely attend hospital appointments because they cannot afford to give up even a day’s wages.
“It is difficult, but work is work, I have to do it,” said Rama, adding that taking breaks is frowned upon and often results in a scolding from her supervisor.
She explained how she walks slowly to work these days, but with caution. “When they see us resting, they ask, ‘who will pay for your wages?'”
Rama admits she is largely unaware of the health care needed to keep her baby healthy. Women are often in need of supplements and blood transfusions, but are just too far away to get it, or to be informed.
One tea plantation owner admitted that medical problems facing pregnant employees, like excessive bleeding, are things the company cannot control, but “whatever we can do, we do.”
The Indian Tea Association pointed out that legally “workers are eligible for primary health care as per the Plantation Labour Act.” Under this, pregnant women can access maternity care including anemia treatment, immunization, institutional deliveries, and mother and child care projects.
But the claim that maternity care is accessible to all workers is debatable. Rama said the one ambulance on her tea plantation takes a long time to arrive and is always busy with patients. Sometimes, she says, “it even goes out of the town.”
“If you look at the infrastructure on the ground, it is not enough,” explained human rights lawyer Jayshree Satpute.
“There are not enough doctors, the hospitals do not have enough facilities, not enough beds, the primary health centers do not have enough infrastructure.”