A Haunting Picture of Poor Health

By David Parker, MD


Spinning Wool, India, by David Parker

Spinning Wool, India, by David Parker, MD. View the slideshow.

Why do we care about child labor? There is the frequent refrain, "I worked when I was young and it didn't hurt me." If we do care about child labor, do we care about all, most, or just some forms of work? The International Labour Organization (ILO) has tried to address this question in part through Convention 182, which defines four worst forms of work, including forced and bonded labor and prostitution. Carpet weaving is not explicitly mentioned in Convention 182, so is it a worst form of work? What makes work bad? These are a few of the many questions I have grappled with on my journey as a physician, photographer and child rights advocate.

During my first trip to Asia to photograph working children, I visited more than 15 carpet factories in Nepal’s Kathmandu Valley. Upon entering the first of many factories, I saw a large number of small children sitting in front of dimly lit looms in a small, musty and chilly room. The children were wheezing, many had rashes, and all were disheveled and dirty with their noses dripping and running down their faces. The exploitation of these children was obvious. Witnessing this scene, I felt the compelling global need to eliminate child labor, and remember it clearly nearly 20 years later.

However, many things were not immediately apparent in observing the children. For example, were the children bonded laborers or being held against their will? Did they have an opportunity for education? Were they sexually abused or beaten? Were meals adequate? Was potable water available? Were parents cognizant of their child's whereabouts? These questions and many others helped to frame my research and work over the next 20 years, leading to my work on the book Child Labour: A Public Health Perspective and numerous scientific manuscripts on the impact of early work on children’s health, education and status. There is no simple way to classify the effects of child labor on the health of children and communities.

Many people discuss job-related exposure to harmful chemical, biological and physical agents and their subsequent impact on health, while psychosocial hazards such as long work hours, abusive work practices, and bullying are not always recognized. Hazards may also be discussed in relationship to job tasks within specific industries, such as brick making, carpet weaving or steel polishing, in which children frequently work.

We can also look at health hazards in terms of acute (e.g., injury, pesticide poisoning) versus chronic illness, including developmental problems. However, there is no clear point when an outcome changes from acute to chronic. The nature of child labor is that several hazards almost always co-exist, and many exposures—for example fiber dust inhaled by child weavers—can result in both acute and chronic illness. Some occupational hazards may also result in health problems within the greater community, such as the aerial spraying of pesticides or the use of mercury in gold mining.

Both children and adults in the rug industry may be subject to an abusive work environment. This may include inadequate wages, bonded and forced labor, and generally poor working conditions. It is likely that none of the children who were sitting at the loom 20 years ago ever had any educational opportunities. Illiteracy itself leads to poor health outcomes for individuals as well as their future families. Child labor does not simply stop with the child being exploited today; it leads to a pattern of poor health for the generations to come.


—An occupational physician and epidemiologist from Minneapolis, Minn., David L. Parker, MD has photographed working children, labor conditions and public health problems around the world since 1992. His books include By These Hands: Portraits from the Factory Floor, Stolen Dreams: Portraits of Working Children, which received a Christopher Award, and Before Their Time: The World of Child Labor. He co-edited Child Labour: A Public Health Perspective (Oxford University Press, Editors: Fassa AC, Parker DL, Scanlon T).

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More articles on this subject:

Carpet Making and Occupational Hazards: A Photo Essay, by William S. Carter
Towards Health and Safety in the Carpet Industry, by Armand F. Pereira

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