Review - Gender, Trade and Health
Gender, Trade and Health
Anit N. Mukherjee1
Trade is generally regarded as ‘gender-neutral’ in public policy debates on globalization. The focus on tariff and non-tariff barriers is at the macro end of the spectrum, while labour market consequences of trade liberalization is the micro-level impact of policies followed by respective countries. These policies are thought to affect men and women in equal measure, while very often this is not the case.Esther Boserup’s thesis on women in development challenged this notion of equity in the gender impact of development in general and trade liberalization in particular. Increase in trade during the 19th century led to very different labour market specializations, with women’s share in factory-based employment going up in certain goods such as textiles. This process has been repeated in the last couple of decades – first in east Asian countries such as Japan, and then across the world – most recently in South Asia.
Two countries where the classical process of trade liberalization has led to increase in establishment-based employment for women are Sri Lanka and Bangladesh – both in the garment sector. Although there are around 160 million occupational diseases each year, the health impact of women working in these sectors have not been well documented in academic literature. The long-term consequences of working with dyes, inhaling chemicals, and handling sharp instruments for long working hours can be harmful. However, economic considerations of foreign exchange earnings generate vested interests that put health issues on the backburner.
A related consequence of trade liberalization is the migration of workers, both domestic and international. While international movement of labour captures the headlines, it is sometimes the internal migration that is far more important from the gender perspective. Expansion in export-based labour intensive industries employing large numbers of women increase the opportunity cost of education – an adverse consequence being the use of child labour. Even if stringent laws can prevent the use of children, next in line are adolescent girls recruited by manpower brokers from impoverished villages in the countryside. Apart from the loss of family support leading to emotional stress, most employers have no provision for adolescent health services, which are essential considering the age profile of the recruited workers. Legal provisions in this respect are rarely adhered to, except when there is pressure from consumers in the destination countries, exemplified by recent cases in India.
Health impact of international migration of women is also complex, bringing with it issues of culture and disempowerment that arises from being in a foreign country. While the main driver of migration is the difference between local and international wages, information asymmetry related to actual conditions of work is extremely high. This is particularly so for employment in low-skill occupations where there is ample evidence of physical in addition to economic exploitation. Linguistic barriers and cost of accessing healthcare discourage migrants from seeking care, and often result in health problems in the long run.
One area where the health consequences of migration fall exclusively on women is the case of sex trade. Trafficking of young women and even girls across countries in South Asia and Southern Africa has been well documented. A recent study conducted in Nepal shows that 37 percent of women who returned after being involved in sex work in Indian cities are HIV-positive. This is a significant number, considering that the incidence of HIV in the general population in the region is below 1 percent. The link between trade and adverse health consequences for women is very clear.
The issue of trade and its impact on women’s health status, therefore, requires urgent attention. This is especially critical since the burden falls on public health systems in originating countries which, by definition, are less equipped to handle the complexity of the problem. The reality is that migration – both domestic and across international borders – in the Commonwealth countries is on the rise. Unfortunately, the solution is not simple, and it is still not in sight.
1 National Institute of Public Finance and Policy,
