Photo: © Lam Duc Hien

Monday 8th March 2010 marks International Womens Day, to mark this day Doctors of the World presents its investigation into the health of female textile and food processing workers in Guatemala.

In the 1990s, maquilas - factories that are sub-contracted for export industries - appeared on a massive scale in Guatemala and in the rest of Central America. After 36 years of civil war, the return of peace to Guatemala, its geographical proximity with the US, its wages below those of Mexico, and its tax incentives made it especially attractive for companies sub-contracting industrial and food processing.

As subsidiaries of foreign companies or factories financed by foreign capital, maquilas (textile mills) and food processing plants use low-cost, unskilled and overexploited labour to make textiles and to package fruit and vegetables for export to other countries, mainly in the Western world (US and Europe).

Today, 180 maquiladoras are registered in Guatemala and have created the most number of jobs in recent years. In 2002, the Guatemalan Clothing and Textile Industry Commission (VESTEX) estimated that 75,000 to 100,000 persons worked in the maquilas, as they are known for short, most of whom were women.

While these factories are considered drivers of development, the jobs they offer are still unstable and poorly paid. Job discrimination, unhealthy working conditions, psychological and sexual harassment, insults and physical abuse, wrongful dismissals, long working hours and non-payment of overtime are common practice.

Moreover, workers' rights are violated, particularly their healthcare rights, including obstacles to medical check-ups, failure to declare workers to the national health system, an almost total lack of proper on-site healthcare services, and so on.

And yet, labour regulations do exist. Guatemalan law and the international conventions that it has ratified prohibit discrimination in hiring, the obligation to register workers with the national health system and the availability and provision of healthcare. But these regulations are routinely violated and there is no political will to enforce them.

As a result, female workers are exploited and are regularly threatened with firing if they stand up for their rights.

Since 2005, Doctors of the World has worked with women employed at the maquilas and food processing plants in the Chimaltenango region, located about 50 kilometres from the capital, on the Pan-American Highway. Each Sunday, the Doctors of the World team offers free check-ups to female workers. It also holds medical check-up days inside the factories and trains some female workers to become healthcare promoters with their colleagues.

From 2006 to 2009, Doctors of the World carried out a survey of workers in 16 factories in the Chimaltenango and Sacatepéquez districts, to find out more about their working conditions, their health, and their difficulties in gaining their rightful access to healthcare. This survey was done of 589 women who had come to Doctors of the World for healthcare, including 530 working in factories (425 at textile mills and 105 at agro-food processing plants) and 59 healthcare promoters (i.e., MdM-trained workers).

1. Maquila-style exploitation

Context: 85% of the workers are women

85% of workers at textile mills and food processing plants are women. They need to work because they are vulnerable and because they have little other prospects for finding work, therefore these women are more likely to accept poor working conditions.

1.1 Who are they?

• Most of the women are young: 34% of female food processing workers are minors, and 56% are between 18 and 40 years old. At textile mills, 92% are younger than 40, and 4% are minors.  Since many of their families are economically disadvantaged, most of them (76.2%) had to go to work when they were still minors, and 35.1% before the age of 13. "They're like little girls who had to grow up too fast. To survive, they had no choice but to work in these factories," says Pilar Giraux, head of the Doctors of the World mission in Guatemala.

• Many are of indigenous descent: 56.2% of female food processing workers and 41% of female textile workers are of indigenous descent.

• Many are undereducated: Only one third of them know how to read and write. 43.9% went to elementary school and only 12.8% completed basic education (up to 15 years of age).

• Many are single mothers: 70% of female food processing workers and more than 50% of female maquilas workers are single. Many are mothers, and that increases their dependence on having a job.

A typical profile:

To work in these factories, women must meet criteria set arbitrarily by employers:

• Be young: 77% of the women are younger than 30.

• Not be pregnant: women must sometimes prove that they are not pregnant, by submitting to interrogations and examinations - urine analysis, signed statements, abdominal palpation, etc. - that invade personal privacy and violate international regulations.

• Be single: Although Guatemala's labour code bans any discrimination between single and married women, factories prefer single women, in order to limit the costs incurred by pregnancies (pre- and post-natal check-ups) and motherhood (family responsibilities make them less available for work).

 

1.2 Quasi-exploitative working conditions

• Wages are among the lowest in the country

While these factories have many exemptions - customs duties, import duties and taxes for 10 years - maquilas and food processing industries pay the lowest working wages in Guatemala.

The legal minimum wage is 56 quetzals (£3.99) per day but just GTQ 51.75 (£3.97) for maquilas and food processing industries.

In Guatemala, the average basket for meeting a family's needs GTQ 3600 (£277) per month. But almost 65% of women working in textile mills are paid less than GTQ 1500 (£117) and 70.5% of women working in agro-food processing plants are paid less than GTQ 1000 per month (£76), including almost one third who are paid less than GTQ 500 (£38).

• Unstable contracts

While most workers are covered by written contracts, they usually don't have a copy of them. 18% have only a verbal contract to go by.

• Long working days

Context: 11 hours per day, 6 to 7 days per week

Article 116 of the Guatemala labour code states that working days may not exceed eight hours, or 48 hours per week. And yet, female employees of maquilas and food processing plants work an average of 11 hours per day, six days a week. 12.4% of female food processing workers even work  seven days a week.

M. works in a maquila: "The only thing that matters to them is that we meet their targets, that we fill orders. So they rush us and punish us so that we work faster, regardless of how many hours we work or if we are exhausted... If the working hours are not enough, we have to work overtime.

A TYPICAL DAY *

Before starting work: We get up at dawn. From 4 a.m. to 6 a.m. we wash the dishes, make breakfast and do the housework. We give baths to the children before they go to school, then we get dressed and get ready to go to the factory.

During the working: day From 7 a.m. to 6:30 p.m., or until whatever time we're allowed to leave, we stitch and unstitch, pack, brand, sew on buttons and make buttonholes, and inspect the quality of clothing, etc.

After work: From 8 p.m. to 10 p.m. we make dinner, help the children do their homework, iron their uniforms, do housework and wash dishes.

* Based on panel discussions of female maquilas employees

 

• Unsafe working conditions

Due to poverty, the lack of other working opportunities and the constant threats of being fired, women are more likely to accept unhealthy working conditions. They stand all day long in food processing jobs, even when they're pregnant; they sit all day on poorly designed chairs in textile mills. In both cases, they stay in the same position and repeat the same movements for hours.

"They work in cold storage rooms to pack fruits and vegetables for export with no safety conditions or protection," explains Aurélie Leroyer, coordinator of Doctors of the World's field programme. The same thing happens in maquilas: workers have no masks or protective gloves and inhale textile-treating chemicals all day long.

 

• Recurring abuse

Context: Almost 90% of female workers have been mistreated

Of the 530 workers who took part in our survey, only 56 said they had never been victims of abuse, e.g., verbal or physical abuse, threats of being fired, economic sanctions or even sexual harassment that they have to put up with, out of fear of losing their jobs.

Types of abuse:

Pressure to meet targets 205
Verbal abuse 112
Threats of being fired 102
Economic sanctions 80
Physical abuse 18
Sexual harassment by colleagues 18
Sexual harassment by bosses 4
Total 539*

* Some women reported several cases of abuse.

 

• Wrongful dismissals, unpunished abuses

Many companies deal with employees who stand up for their rights by forcing them to resign or firing them and even blacklisting them so they can't be hired elsewhere. Female employees have little recourse, and such violations still too often go unpunished. "The authorities are more concerned with enforcing laws that serve the interests of the maquilas, even when that hurts our rights," says M., a maquila worker.

S., 23 years old:

I used to work in a maquila, but after two years they forced me to resign, like other female workers. Some of them, who had more than five years' seniority, refused. They were fired and given redundancy pay, but were told that, neither here, nor in any other maquila, would they ever find work in the future. I had to knock on many doors, but I ultimately got a new job at a local maquila.

A., 42 years old:

I was laid off after eight years and is afraid that she will never find work again.

I was happy at the maquila. It was like my second home, but one day a new boss arrived and made life impossible for me and many others... One morning, we met him at the maquila, and when he saw me he told me that he was about to send me on vacation. I told him that was great because I had not had a break in eight years. The next week, I was on vacation. When I got back, the bosses called in everyone who, like me, had been on vacation and told us that we were being fired, without saying why, and gave us each a cheque.

At the bank, we were told that the cheques were no good. We went back to the factory and the manager told us that he would pay us later, that we would just have to be patient. We came back again and again, but he wouldn't pay us. I recalled that I had once attended a seminar on our rights, and so we all went to the Labour Inspection Office of the Labour Ministry. The maquila manager was very angry and tried to give us cheques again.

I then said in a loud voice and without fear that we didn't want cheques, but cash and after a short while, I heard my colleagues ask for cash, too, and I felt that I had some support.
Now I'm scared and very stressed because they said they would write to all the maquilas telling them not to give us any work. They also accuse me of taking part in a demonstration against the company, which I never did.

I have never felt so bitter as I did then. Now I just want to get back the GTQ 300 (£22) on my savings account at the maquila. The manager says "all this fuss for GTQ 300!" 300 quetzals may be nothing to him, but it lets me feed my children for a few days.

2. Poor health, healthcare rights violated

From December 2006 to July 2009, 1565 female workers came to Médecins du Monde for check-ups: 1314 were from textile maquilas and 251 from food processing plants.
"Many are tired of the heavy overtime, depressed, stressed by machine noise, by abuse and the constant threat of being fired, irritated by dust and chemicals," explains Aurélie Leroyer, coordinator of the programme in Guatemala.

 

2.1- Pathologies linked to working conditions

Food-processing plant workers come in mainly for respiratory ailments, skin rashes and allergies, headaches, lumbar pain, urinary pain, intestinal disorders, menstrual cycle and gynaecological problems, pregnancy exams and vitamin deficiency, as well as illnesses due to lack of sleep, stress and nervousness.
Maquila workers come in for leg and back pain, dizziness and nausea, nervousness and headaches, gastrointestinal disorders, vaginal infections, anaemia, abdominal pain, pregnancy exams, family planning and uterus cancer screening tests.

These illnesses may be linked to working conditions. The women themselves identify the risk factors incurred by their working conditions and state that they have a negative impact on their health:

Risks cited by female maquila workers:

Uncomfortable working positions 41.5%
Pressures to meet production targets 35.3%
Lack of ventilation 26.8%
Too short meal breaks 26.2 %
Noise 22.6%
Exposure to chemicals 20.0%
Lack of rest time between two shifts 17.2%
Long working days 17.0%
Not allowed to drink water 4.0%
Harassment/abuse/threats 3.6%
Not allowed toilet breaks 3.0%

 

Food processing workers also cite exposure to chemicals used in processing vegetables or being exposed to sudden changes in temperatures (cold-storage rooms) and other problems.

 

2.2 - No healthcare coverage

Context:

50% of female workers have no healthcare protection

All employers are required to register their employees with the Guatemalan national health service (the IGSS). Many of them don't do so, while continuing to withhold dues from wages. For example, 86.4% of female maquiladora workers pay into the healthcare system (dues are withheld directly by employers), but only 56.5% have a membership card that allows them to truly benefit from healthcare services. The same situation exists at food processing plants, where almost half (43.8%) of women employees pay into the system but where only 29.5% are affiliated with IGSS.
This is illegal and subject to a fine or even the closing of the factory, but in practice, most factories are not punished at all.

Lupe, 15 years old:

I had to go to work when I was very young. I wanted to help my mother and brothers after my father abandoned us, and my mother didn't earn enough money to support us. One day I cut off the fingers on my right hand with a paper-cutter at the factory where I worked, and they sent me to the hospital since I did not have an IGSS card. I lost four fingers. Then my boss sent me to an IGSS facility but didn't pay any workers' compensation. When I went back to work, they assigned me to custodial work, but my hand hurt too much when I did that, and I had to stop working.

2.3 - Healthcare when and how employers decide

Even when workers are affiliated with the national health system, many don't have access to healthcare. The reason for this is that to be treated in an IGSS facility, an employee must provide a series of documents, including an identity card, an IGSS membership card and proof of employment issued by their boss (except in an emergency). In practice, each worker must therefore ask her boss for permission to go for a medical check-up. The boss grants such permission arbitrarily, often refusing to do so, so that employees won't be away during working hours.

Only 25% of the women surveyed had been treated at IGSS facilities and had received the prescribed drugs.

M., a maquila worker: "One day I really didn't feel well and the maquila wouldn't let me go to IGSS. They didn't give me the proof of employment until my situation had gotten worse. I had an emergency gall bladder operation at an IGSS clinic."

Testimony of S:

One day, so that I wouldn't miss the last bus home, I was running to the bus stop when, at the entrance of the maquila, I was hit by a car. The driver didn't stop. My colleagues called the paramedics, who took me to the hospital, but I wasn't covered for all of the healthcare that I needed. My parents then undertook the formalities to obtain my proof of employment, so that I could be taken care of by IGSS. At first they wouldn't give it to me, saying that I was not yet entitled to IGSS, since I hadn't yet worked for them for three months, but they ultimately gave in. But then they refused to fill in the IGSS form, so that I would be paid during my recovery. I finally got physiotherapy at IGSS. They took good care of me and gave me good treatment. They also gave me some advice for taking care of myself afterwards. Now that I have returned to work, the hardest part is staying seated for a long time and actually doing the sewing.

 

3. Our requests

While laws exist, healthcare rights of workers in textile maquilas and agro-food processing plants are routinely trampled upon. It is the government that must lead the fight against such violations and to ensure that the guilty companies are punished. That's why Doctors of the World requests the following from the Guatemalan authorities:

1 - that companies be made to stop violating national laws and the international standards ratified by the Guatemalan government that guarantee and protect workers' rights.

2 - that the government exercises its right to inspect companies to ensure that labour laws are enforced, notably in terms of healthcare, and that urgent measures be taken to ensure that workers' rights are respected.

3- that monitoring task forces be created that include experts on this issue, in order to follow up on commitments made to workers' health.

We ask that European and US companies who buy from, or are supplied by, Guatemala factories, ensure that their sub-contractors comply with internationally recognised labour rights and workers' rights to healthcare, so that they will no longer be accomplices in this situation.

Doctors of the World with Guatemalan female workers

As the third mission set up by Doctors of the World, in 1983, Guatemala is a symbolic country in the association's history.

Since 2005,  Doctors of the World has worked closely with local organisations to stand up for the rights of women employees of textile mills and agro-food processing plants in the Chimaltenango region. Doctors of the World offers free medical check-ups, trains healthcare promoters and holds medical check-up days at factories.

Since 2005, 5000 free medical check-ups have been given. Seven check-up days have been held in factories, and 150 healthcare promoters will have been trained by the end of September.

Doctors of the World will conclude its activities next September but has already found a partner to take over. "The local association EMES, which works with female workers at Guatemala City factories, has agreed to come to Chimaltenango and continue our activities," says Aurélie Leroyer, coordinator of the Doctors of the World programme.

With a goal of getting political officials to enforce the laws, the first international conference on "Healthcare law for female workers at Maquilas and food processing plants" will be held in April 2010, in order to discuss this issue with political leaders, NGOs and factory managers.

 

Violence against women: a cross-disciplinary programme in 29 countries

In addition to its programme in Guatemala, Doctors of the World, backed by the Agence Française de Développement (AFD, or the French Development Agency), is committed to fighting violence against women. A three-year convention programme between Doctors of the World and the French Ministry of Foreign and European Affairs, which is currently being monitored by the AFD, takes cross-disciplinary initiatives in 29 countries. The aim is to share skills, promote and strengthen total healthcare coverage and prevent violence against women. The Convention Programme is based on three pillars: strengthening local skills, increasing community awareness, and sharing and publicising know-how.