CARE OF VULNERABLE GROUPS - Department of Community Medicine

ILO records shows that women in the world’s labour force were
                                31.3% in 1950
                                35%    in 1975
                                44.5% in 2000
Employers of women
                                Civil service
                                Health sector
Female occupations
Teachers, cleaners, cooks and agricultural work
Women have multiple roles
                                paid work
                                house work
                                child bearing, child rearing
Work about 80 hours / week
In Africa, women work about 16-18 hours a day.

                                last to retire
                                first to rise
Work condition of women
          Low pay – a problem for female breadwinner
          Low status
          Respond to others with little decision making component. i.e high job demands and low work control.
          Sexual discrimination. Need to work twice as hard to prove themselves
          Ergonomic hazards
    - Most tools in the workplace are designed for the average man.
    - Women do repititive work such as typing, cashier (using cash register) telephone exchange e.t.c
                - Wear and tear on the joints
                 risk of tenosynovitis
                PIPE in men’s sizes. E.g gloves, boots, respirators
Pregnancy and work
1st trimester - Increase in
 -blood volume
- H.R
-BMR
-G.F.R - freq of micturition
Sensitivity to heat and humid places
Fatigue
2nd trimester
-          Excessive standing can predispose to varicose veins
-          Prolonged standing  foetal loss and premature delivery
3rd trimester
                pedal oedema
                weight gain
Reproductive hazard in the workplace
Genotoxic – can cause mutation, benzeme, ionizing radiation, vinyl chloride
Harmful during pregnancy
Chemical
                 - halothene
                 - CO
                 - Organic solvents
                 - Hg
Biological
- viruses – Hep B, Herpes, CMV, Rabella, Varicella, HIV
- Bacteria - toxoplasmosis
Physical
- ionizing radiation
Solutions
ILO resolution on equal opportunities and treatment for man and women 1985.
Right of pregnant worker
- same salary during maternity leave
- should not lose her job because of pregnancy and delivery. 
Flexible work arrangements for female workers
Restriction from jobs with reproductive hazards
MIGRANTS
          Article 10 ILO 143 – 1975 deals with the rights of a legitimate migrant to have equal opportunity for employment within the host territory.
Who are migrants
          Persons who move from their home base to other location seeking greener pastures
          Others seek political asylum
          The migrant drift is from Africa, Asia and Latin America to Europe, USA and Australia. It si difficult to obtain data on migrants because many are illegal.
PROBLEMS
          Desperation to work
      Migrants take the least attractive and poorest paid jobs
      They fill in jobs where labour is lacking
      They are keen to work and even break law to do so.
      They face new hazards especially with new technologies
      This results in accidents at work
          Nutritional Status
      Nutritional status may be poor
      Infections like TB may come to light during stressful periods
          Health Care
      Health problems are mainly communicable diseases and STDs.
      Migrant does not know how to survive health-wise in the new country
PSYCHOLOGICAL PROBLEMS
          May not speak host’s language fluently
          Cultural confusion and shock
          Racial discrimination
          Harsh social factors may lead to depression, mental breakdown, psychosomatic problems and even suicide
REMEDIES
          Equal opportunity for minority groups
          Provision of Occupational Health and safety services
Ideally, migrants should have:
          Information, Counselling and Language training before travelling
          Medical and psychological screening
          Families should not be separated
          Prepare local population to avoid hostility
          Information and advice on accommodation
          Rights to social benefits
          Safety instructions in migrant’s language
          Encourage them to preserve their culture
          Encourage children to speak parent’s language
THE DISABLED - Care of the disabled
          Identify cause of disability
          Work related e.g. occupational injury
          Non work related e.g. polio, RTA, stroke
          Make a medical diagnosis
          Determine severity of disability
          Determine the impact of the impairment on person’s ability to work
          Job description
          Assess physical and psychological demands of the job
          Assess work station
Plan return to work
             Reorganization of work station
             Installation of facilities e.g for wheelchair access
             Return to alternate jobs
             Psychological rehabilitation
             Fear of re- occurrence of injury
             Loss of self esteem


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