Mary H. Ross

The reproductive and occupational health of women street vendors in Johannesburg, South Africa

While the informal sector is rapidly emerging as the major source of employment in poor countries, little attention has been paid to the health hazards encountered by workers in this sector. Women, the majority of informal sector workers in most parts of the world, are particularly at risk. This paper reports on 422 women street vendors trading in 323 city blocks in Johannesburg, South Africa. The median age was 29 years, 66% were single, 29% had primary education and 58% had secondary schooling. Foreign-born women accounted for 15% of the sample and a further 59% of the women were not born in Johannesburg. More than a third of the women did not work for themselves and 48% earned <115 US dollars per month. Fertility was positively related to age and inversely related to education, while reported infertility was related to gynaecological disease. More than half the women used, mainly injectable, contraceptives and only 5% reportedly had PAP smears taken. Most of the women sold food and clothing, 51% lifted heavy weights and a small proportion of the women worked with fire. Over half of the women (54%), mainly those over 40 years and the self-employed, complained of a work-related illness or injury, mainly burns, cuts, headaches and musculoskeletal problems. The type of health problem was related to age and 32% had received treatment. More than half (52%) of the respondents reported that they were not comfortable with the working environment, for reasons ranging from lack of shelter and dirt (34%), noise (26%) and having to clean the area themselves (24%). While only 2% reported that they felt unsafe, violence and abuse was ever present. Approximately one in four women reported some form of abuse, either verbal or physical, while 7% reported that they had been sexually harassed. A substantial proportion (29%) of the women reported that they had been robbed of money or goods while trading in the streets. The implications of these findings are discussed.

Preventing Infectious Diseases in Long-Term Travelers to Rural Africa

[Extract] The traveler to, or expatriate residing in, rural areas of developing countries for prolonged periods is at greater risk of illness than the short-term traveler.1 This is a result of increased and more intense exposure to pathogens and their vectors or reservoirs, poorly developed infrastructure for water supply and sewerage disposal, limited environmental hygiene, extreme climates, potentially greater risk-taking behavior, and limited availability of medical facilities. Risk may be reduced by appropriate counseling, and vaccination and prophylactic medication based on the best available epidemiological data. This paper aims to provide travelers and practitioners with guidelines for reducing the risk of acquiring important infectious diseases associated with long-term travel or placement in rural Africa, a topic that is generally neglected.2 The diseases discussed were chosen on the basis of their frequency or potential severity and include yellow fever, malaria, tick-borne infections, food and waterborne disease, schitosomiasis, rabies, and tuberculosis.

1589 Infections in the workplace: identifying problems and applying research to prevention

Introduction Infections are the only occupational diseases that can be transmitted from one worker to another. Although workplace and community-acquired infections have a long history of affecting health and productivity, from miners’ ‘consumption’ and seafarers’ plague to influenza and Ebola, occupational infections have been under-recognised, under-reported and under-researched. In most workplace settings, infectious diseases have not received the same attention as physical, chemical and psychosocial challenges. Similarly, workplaces have generally been underutilised in the prevention and control of infections. However, epidemics in the 21 st century have evoked attention not only from the occupational health fraternity, but also from employers, workers and the media seeking policies and procedures to prevent and manage infection in the workplace. Methods Selected infections and their impact in various occupational settings are explored to illustrate the challenges of their identification and management, as is the interface between public health and occupational health surveillance, research and interventions. The unique nature of infectious agents as an occupational hazard is considered, while longstanding and new public health research and strategies for prevention are evaluated in an occupational context. Discussion A major challenge for research and prevention is measuring occurrence, morbidity or mortality from occupationally-acquired infections, especially when exposure in the workplace is not always recognised. Primary prevention interrupting the transmission cycle of micro- organisms comprises a variety of interventions that are implemented concurrently rather than in a hierarchy of control, while secondary prevention for affected individuals, becomes effective primary prevention for others. To date, even for health care workers, who dominate global research and interventions related to occupational infections, success has been somewhat limited to better resourced workplaces. It is vital for the focus to extend beyond the workplace in collaboration with public health care to promote research, recognition, prevention and management of infectious diseases for all workers.