Extending Occupational Health and Safety to Urban Street Vendors

Introduction

The informal economy is a broad term encompassing both informal enterprises (those which are incorporated or unregistered) and informal employment (employment without labor and social protections), both of which are subject to varying degrees of regulation. The informally employed are very diverse, ranging from employees of both formal and informal enterprises to the owners of informal enterprises who employ others, to the self-employed who work on their own account and do not employ others, to those engaged in sub-contracting relationships, where the employment relationship is blurred or obscured. ¹ However, for most informal workers a defining feature of their working lives is that their employment is insecure, and there are no or few social or labor protections attached to it. There is also a higher chance of lower returns in the informal economy, meaning the informal workers are more likely to be poor. ¹

This article focuses on an action-research project which has attempted to extend a specific kind of labor protection, workplace health, and safety, to a specific group of informal workers—self-employed street traders who operate in urban public spaces. The project, called Phephanathi (“Be safe with us” in isiZulu), is located in the centre of Durban, South Africa in a transport hub and bustling informal market known as Warwick Junction. It was funded through the Rockefeller Foundation’s Centennial Innovation Challenge, and included a number of different modes of working, including training courses, policy engagements, health screenings, urban design work, and hazard mapping work.

This article is a critical reflection on the project after a year of work. It is not intended to be a comprehensive account of the project’s work nor is it fully inclusive of all the project actors. It is written from the perspective of key people who have played a role in conceptualizing, administering, and running certain aspects of the project. The article is intended to deepen the conversation about what it means to extend occupational health (OH) to the informal economy.

There exist several general models for Occupational Health and Safety (OHS) policy and provision in the informal economy, promoted for example by the International Labour Organization, the World Health Organization, and the US Institute of Medicine (part of the National Academy of Sciences).^2–5 The Phephanathi Project addresses more specific challenges: It has been designed for both the sector (street trade) and the place of work (urban public space). It follows Lund and Marriott ⁶ who argue that the “problem of regulating OHS in the informal economy” is too big to deal with on a general scale. Not only is the informal economy heterogeneous, meaning that different groups require different solutions, it is often not clear where responsibility for regulation lies. It is less daunting, they argue, to break the problem down “industry by industry, interest group by interest group … at levels ranging from the very local interventions which can be incrementally improved and institutionally integrated.”^{6(p. 30)}

Adopting a highly contextualized analysis has allowed the project to look outside of the traditional institutions involved in OHS, and to adopt a multidisciplinary, collaborative approach. To date this has included grassroots trader organization, nongovernmental organizations (NGOs), municipal officials, and OH professionals. This article, however, focuses largely on the engagement between traders, NGOs, and OHS professionals. To do so it draws on the experiences and the reflections of key project actors, including the director of Asiye eTafuleni, the local NGO involved in the project, the social facilitator attached to the local Asiye eTafuleni, the OH doctor who worked on aspects of the project, as well as traders (ranging in number from three hundred who participated in a health screening to twenty-eight who completed an OHS training course) who participated in various project activities. Asiye eTafuleni was set up to support the urban design needs of informal workers and has staff who have worked with traders in the area for over twenty years. These reflections were collected mainly through a series of interviews but were also supplemented by notes taken at various project meetings.

Institutions mould people, just as people mould institutions, argues Pierson. ⁷ Several commentators have argued that OHS as an institution—as a discipline and practice (in all its facets)—is in need of reform if it is to successfully engage with the world of informal work—a world that encompasses more than half of nonagricultural workers globally (and rises to 82 percent of nonagricultural workers in South Asia).^6,8–11 Indeed OHS has been undergoing significant reforms for some time as it grapples not only with the informal economy but also the rise of the service sector and the movement away from its original industrial setting.^5,12 Often lacking in the analyses of reform, however, are the experiences of the people involved in the work which is attempting to explore new forms of OHS practice (a notable exception here is Karen Messing’s book One Eyed Science: Occupational Health and Women Workers). ¹³ Their approach and viewpoints have been moulded by their institutional positions, and the difficulties and tensions that they encounter during the project may point not only to how individuals may need to adjust but also to how institutions—ideas, cultures, and what North calls “the rules of the game”—may need to change as well. ¹⁴ By examining the experiences of different actors involved in this project, we hope to produce specific insights that can inform the ongoing development of OHS in the informal economy.

Context: South Africa, Durban, and Warwick Junction

In contrast to other sub-Saharan African countries, South Africa has a relatively small informal economy. Only a third (33 percent) of all working people are classed as informal workers. ¹⁵ Reflecting the economic history of the country, where black South Africans were prohibited from many forms of self-employment, the labor market is also characterized by a higher proportion of wage employment than self-employment. Nevertheless, there are still a significant number of people who are self-employed informal workers. The two biggest sectors of the informal economy are work in private households and trade. ¹⁵ The Quarterly Labour Force Survey from the second quarter of 2010 identified more than half a million workers as street vendors. ¹⁵ Almost all of them were classed as informal, and 70 percent of them were women. Between 6000 and 8000 of Durban’s informal traders operate in an area called Warwick Junction, which sits on the edge of the Central Business District, and is one of the primary transport nodes of the city, mainly serving workers coming into town from the outlying townships.

Skinner ¹⁷ notes that the relationship between traders in Warwick and the municipal authorities who most directly control their place of work—the municipality, has changed a number of times over the years. ¹⁴ Apartheid policies were generally exclusionary and punitive, but after South Africa’s first democratic elections, a new spirit of inclusion allowed for the area’s development under the Warwick Junction Renewal Projects. Over 40 million Rand (approximately US $10 million at 1995 exchange rates) was invested in the area and the project has become well known as an example of how to successfully integrate street traders into urban plans. ¹⁶ As a result of these post-Apartheid developments, Warwick Junction is now made up of nine distinct markets, which display a vibrant mixture of Durban’s cultural heritage, and it remains an important economic hub. Despite the fact that individual incomes are low, it has been estimated that traders in the area generate an annual turnover of one billion Rand ($1 million). ¹⁷

In more recent years, however, the relationship between traders and the city has deteriorated with negative consequences for the traders. In 2010, there was a heated legal battle over the proposed development of a modern mall on the site of the century-old Early Morning Market. The courts eventually ruled against the city on a technicality. The area remains under constant threat from developers seeking to capture the lucrative market. ¹⁷ This is exacerbated by the modernizing discourses which surround city development and seek to “upgrade” urban spaces in ways which exclude street traders who are not considered part of the modern, urban landscape. ¹⁸ Basic services are increasingly neglected, and infrastructure is not well maintained.

The Phephanathi Project

It is in this context that the Phephanathi Project was initially developed by two NGOs (one local and one international), staffed by people with over twenty years of experience in working with traders in Warwick Junction. Both NGOs view themselves as support organizations to organizations of informal workers—they do not organize workers themselves, but are there to provide various forms of technical support to worker organizations. Traders who participated in the project were drawn from various worker organizations. The number involved varied from activity to activity, with nine key representatives sitting on the central health and safety committee, to over three hundred participating in the health assessment. Participants represented a variety of different trading sectors including bead makers, producers, and sellers of cooked food, traders in general goods, traders in traditional herbs, and sellers of fresh produce. The project operates on two levels. The first is very practical, seeking to produce objective improvements in the working conditions of traders through the development of a health and safety system designed specifically for an urban market situated in public space. The need for such a project exists because there are objective concerns about health and safety for traders who operate in the markets. The Informal Economy Monitoring Study, a ten-city study of the state of the informal economy around the world, led by Women in Informal Employment: Globalizing and Organizing, found that in Durban where a large proportion of the sample was drawn from Warwick Junction, 60 percent of women street traders and 88 percent of male street traders considered occupational hazards as a major problem. ¹⁹

The Informal Economy Monitoring Study survey did not ask for details about specific occupational hazards, but complaints from traders about musculoskeletal disorders (lower back pain in particular) are frequent. There is also anecdotal evidence to suggest that respiratory health of those who work with poor quality and even toxic cooking fuel is compromised, and burns from the controlled use of fire and wounds from the use of sharp implements are all common problems. Poor sanitation and access to fresh water in the workplace is also an important issue; the lack of access to toilets whilst at work was often highlighted by traders in the Informal Economy Monitoring Study focus groups. ²⁰ Illness and injury can have a serious impact on the earnings of self-employed traders. In the Durban sample, 99 percent of women and 100 percent of men stated that if they could not work due to illness or injury, they would not be able to earn anything during that time. ¹⁹

The second level on which the project works is a more conceptual one. This is to embed the development of the health and safety system in processes which encourage traders, government officials, and OH professionals to start thinking about the Warwick markets in a different way—to begin understanding it as a workplace, with the rights and responsibilities that this entails, rather than as “just” a series of pavements and sidewalks. This has meant engaging in a less tangible process of what Paulo Freire called “conscientization,” by which he meant engendering the development of a critical consciousness of the world. ²¹

Following on from this, the vision for the Phephanathi Project was akin to an experiment in Freirian praxis. Freire ²¹ argued that conscientization was best achieved not through talking, but through people acting together on their environment and through doing so, critically reflecting on it and transforming it and themselves in the process. The vision for the project was that through the process of building a health and safety system in an informal workplace, this would not only lead to tangible improvements in the workplace but would also act as a conscientizing device for all involved in the work. This is, of course, an ambitious vision and after only one year of work, it would certainly be difficult to claim success. Nevertheless, as argued earlier, it is worthwhile to consider what has been learned through the process so far.

As mentioned in the “Introduction” section, the project has involved a number of activities and processes. Due to the scope of this article, not all of them will be discussed here. Those that are will provide the backdrop to the reflections on the project in the following section.

The first process which was put in place, and which will be discussed in this article, was the establishment of what is now called the Phephanathi Committee. This is a health and safety committee, on which representatives from each of the markets sit. The formation of the committee was encouraged through various activities which aimed to bring traders into contact with a number of different actors who could provide them with support in terms of improving health and safety in the markets. These activities included “joint hazard mapping sessions” where traders and local fire safety and sanitation officials came together to map hazards in the market, and to discuss ways in which they could be addressed. A second set of activities included a number of training courses in First Aid, Fire Safety (run through the municipal Fire Department), and an OHS course (run in collaboration with the local university’s medical school). The purpose of running the courses was to give the traders practical skills, as well as to enhance their knowledge about issues so that they could negotiate more effectively for workplace improvements. The OHS training course is the second activity (after the formation of the Phephanathi Committee) that will be discussed in the following section.

A third piece of work that will be discussed was a health assessment run in conjunction with the university’s Discipline of Occupational and Environmental Health. Over three hundred women traders participated in the assessment which was part of a study to look at basic health indicators (blood sugar, blood pressure, body mass index), as well as respiratory and reproductive health amongst the cooks in the market. The assessment was carried out as part of a research study, which aimed to look at the effects of different biofuels on the respiratory and reproductive health of female informal cooks. The data that emerge will be used to think further about health interventions in the market and be used for advocacy purposes.

Reflections On the Phephanathi Project Activities

The OHS Training Course

The OHS training for traders was a three-day course which aimed to introduce them to the basic concepts of health and safety in the workplace, including conducting hazard identification and implementing preventive measures to avoid acute injuries, ill-health, and other dangerous incidents (e.g., fires and explosions). The course was attended by twenty-eight traders, who were nominated by their organizations. It was run by a trainer from the local university, whose experience has been largely, although not wholly, in training workers on health and safety in formal employment. The trainer developed her own course materials (in book form) after spending several days in the Warwick markets and running an initial pilot course with the traders.

Several positive outcomes emerged from the reflections on the training course which highlight the potential importance of OHS training for workers in the informal economy. Significantly, several of them extended beyond the practical concerns of improved workplace safety, toward the more intangible process of conscientization that is a central concern of the Phephanathi Project. One area that was particularly important for the local NGO was the fact that they felt that a course such as this one helps to reinforce the message to traders that they are workers, that the spaces in which they work are workplaces, and that they have certain rights and responsibilities in relation to that space.

As the NGO director stressed, street traders operating in public spaces are generally not seen as economic agents, but rather as somewhat unwelcome guests of the city who are allowed to operate on sufferance. This is a view that the NGO director felt had been internalized by traders themselves, meaning that they are less likely to see themselves as economic distributors, and in turn producing a lack of confidence in terms of challenging discriminatory practices and policies. It also, he felt, could lead to a lack of investment by the traders in maintaining their own workspaces. Being told, through the OHS course, that as a trader you are a worker and that this means that the place in which you work is a workplace, and that this means certain things in terms of the state’s responsibility toward you (and your responsibility toward it), certainly helps to challenge that view. As one trader put it: “The training has been beneficial … knowing about OHS gives us the courage to challenge city officials—to know that the condition of our workplaces are bad for us.”

The social facilitator was also impressed by the potential that the course had to impact on the organization of traders. The OHS trainer had used shop stewards from formal unions whom she had trained previously to run parts of the course. The shop stewards regularly impressed upon the traders the importance of worker organizations in terms of negotiating for better working conditions. The social facilitator felt that the exposure of the traders to shop stewards from formal unions in this way was a positive engagement between formal and informal workers, and it had encouraged some of the MBOs to become more active about recruiting members.

On an individual level, the course also elicited some important reactions according to the NGO staff who observed the training sessions. At the start of the first course, the trainer asked traders to talk about health problems that they had experienced as a result of their work. This resulted in silence in the room. Yet once the trainer had spent some time explaining how work processes can lead to ill-health, and giving examples based on her observations in Warwick (e.g., talking about the ways in which smoke, dust, and gases can affect respiratory health), the traders began to talk much more freely about the many health problems that they had experienced. As the NGO director noted about what he termed “the 180-degree flip” that he had noticed amongst the traders during this first training session:

It was almost as if two things were happening: a realisation that occupational ill-health was something to think about and then secondly that you have permission to complain about a sore back … now I have permission to think about it.

Yet allowing people the space to learn and engage with information about the long-term costs of using tools and processes which damage health is certainly an important aspect of this. If done in a way which promotes discussion, it can allow traders to make more informed decisions about their individual work practises. It should, as well, allow OH experts to gain a greater understanding of why workers work in the ways that they do and may create what Campbell and Jovchelovitch call “a constructive dialogue between what we [the scientists] know and what they [the traders] know.” ³⁰

The Health Assessment

… because we come from a formal background where everything is so organized and laid out in that way, I assumed it would be the same thing. You would get a register of traders and assign people per day, with a certain time limit … very organized. That’s what I thought it would be like.

The above extract came from the reflections of the OH doctor who ran the health assessment, which included a physical check-up and a questionnaire, together with a small team of nurses and field workers. Although she had run health assessments in the formal sector before, mainly in factories and with health workers, this was her first experience of working with informal workers, and, by her own admissions, it sent her “into shock.”

The large difference between running OH assessments in the formal sector and working with self-employed informal workers exists for a number of reasons. In South Africa, formal sector employees in listed (hazardous) occupations are required through law, and by the contracts that they have with their employers to, attend OH assessments. ³¹ These employees do not lose income because they are taking time off work—they are, in fact, fulfilling a work obligation. No such compulsion exists for self-employed traders, who need to be convinced of the relevance of such an exercise, particularly in relation to the loss of earnings they may suffer from the time they take off from work. Formal sector employees are easily contactable through their managers and can be organized into groups and sent for an assessment. Informal workers may be organized through their trader organizations, but even the authority of a leader cannot always trump considerations related to earnings. For example, on the day that the bovine head cooks were scheduled to have their health assessments, a consignment of bovine heads arrived. This meant that the cooks came into the assessment only once they had secured the heads, rather than at the allotted times, causing a breakdown in the assessment protocols.

As the health assessments were part of her master's research study, the challenge for the doctor was to balance the realities of working on the ground—adjusting her thinking about “how things would work” and being more flexible with her protocols and her ideas, while needing to maintain the integrity of the science that she was trying to do, which included the need for specific sample size, with control and exposed groups. Performing this balancing act was not something that she had been exposed to in her prior training in OH, and she felt that the experience had given her a unique perspective over her peers, whose training had been largely in the formal sector.

It should be noted, however, that the need to maintain scientific integrity also placed a significant strain on the local NGO involved in facilitating the trader side of the assessment. The necessary sample size of three hundred may have been easy to gather if the assessments were open to anyone who was interested in attending a health screening. However, because the screening doubled up as a research study which required specific numbers of people from a defined population (females working with biofuels), this resulted in a great deal of additional work for the NGO’s social facilitator in terms of convincing the right people from the wider Warwick trading community to attend the assessments.

An additional concern for the NGO during the health assessment was what the data would show, and whether it would end up compromising the livelihoods of the workers involved in the study, rather than protecting them. Although the NGO staff were very aware of the importance of collecting data, and particularly the ways in which it could be used for advocacy, they argued that it could be a double-edged sword. The arguments used by the municipality to justify the building of a mall in Warwick, thereby evicting traders from the area, are laden with concerns about health, safety, and security, and this is a common justification worldwide for trader evictions.^18,32–34 This being the case, if the data show that the respiratory health of cooks in Warwick Junction is severely compromised by their work, and this information becomes widely available, it could be used by the municipality as another justification for evicting workers from the market. For this reason, the NGO argued, the findings of the study would need to be shared with caution and with consideration for the local politics of Warwick Junction.

Discussion and Conclusion

The above reflections reveal a number of different ways in which OHS can play a constructive role in the informal economy. This extends beyond the obvious practical need to improve workplace conditions in informal workplaces. These reflections show that gains can be made even in the process of moving toward that goal. These gains include the ways in which OHS can be used as a tool for conscientization and for catalysing a critical engagement with established ideas about workers and workplaces. In this way, it can be seen as part of what Samson, drawing on Judith Butler, refers to as the “ontological insurrection” needed to dignify traders as workers and the streets on which they operate as workplaces. ³⁵ However, the reflections on the Phephanathi Project have also brought up issues which have implications for the relevance of OHS to informal workers—and, in this case, specifically street traders working in urban public spaces. In this final section, the article turns to a discussion of these issues.

The first issue of importance, and one which has threaded itself through the reflections, is the central importance of urban policy in the working lives of informal workers. This is not a new point—it has been made before.^6,9,36,37 As it emerged so strongly out of the reflections, it is one worth re-emphasizing. It is municipal level policies and departments—from Fire to Sanitation and Public Works—which play a key role in determining the quality of the infrastructure in urban public workplaces, which in turn has an impact on the quality of the work environment. ³⁸ In South Africa, as in many countries, OHS is regulated at national level, falling under a number of different departments, including the Ministries of Labour and Health. ³⁹ Administratively this creates a disjuncture between OHS and local government—and it means that those in charge of regulating OHS may not recognize the importance of local-level policies in regulating workplaces. It may also mean that local level policies which contradict national-level laws (such as the right to a safe and healthy workplace) may go unchallenged.

As discussed earlier in the reflections on the OHS training session, this bureaucratic disjuncture is exacerbated by the individualized focus of OHS, which places much of the responsibility for workplace improvements on the individual self-employed worker, and views the context of the urban environment as somewhat of an afterthought.^6,26 National bureaucratic structures are not likely to change quickly. A step in the right direction, however, would be to inculcate—amongst OHS professionals interested in working with the informal economy (including doctors, trainers, and others), and those working in national government—an understanding of the importance of context outside of the formal workplace environment. In the case of workers working in urban public spaces, this would mean emphasizing the importance of urban policy. This understanding needs to be better integrated into OHS practice, so that training, interventions, and advocacy work take it into account not as an afterthought, but as a central defining feature of the work. It is very difficult, as the traders themselves pointed out, to give real consideration to the health and safety of your own individual work habits, when the environment in which you are situated is so unconducive to health and safety.

This points to the need for a multi-disciplinary approach. Incorporating an understanding of urban policy into interventions does not necessarily mean that OHS professionals themselves have to become experts in dealing with the urban environment. What it means is that they need to work in close collaboration with people who are. OHS as a discipline has long been considered multidisciplinary, but its multidisciplinarity has not so far extended to those concerned with the urban built environment–urban designers, architects, and engineers. The opposite is also true. Disciplinary and administrative boundaries mean that urban professionals are not likely to have had contact with OH professionals. Creating platforms where these two groups can come into contact with one another would be one way for these professional groups to interact with one another and perhaps result in more innovative work.

The second issue of importance arising out of the reflections is the difference in politics when engaging with informal workers. The practice of OHS in South Africa has always had a political aspect to it, but that politics has largely been one confined to worker-employer-state interactions.^40–43 Moving out of the world of formal employment takes OHS into a different politics—the politics of informality. Power relations play out here at several levels, as the reflections revealed. There is the politics of the trader organizations, which are far weaker and more fragmented than formal trade unions for many reasons, not least of all the fact that there is tough competition for resources at this end of the economy. ⁴³ There is also the politics of urban governance in the sphere of the informal, which is often highly exclusionary, and which continues to position street trade as an urban nuisance rather than a productive economic force. There is an important economic aspect to this—the influence of powerful urban developers trying to capture the gains of the productive urban spaces, play an important role in preventing spaces such as Warwick from being recognized as workplaces by local governments. There are many other reasons for the exclusionary nature of local politics in relations to informal workers—the point to emphasize here is that OHS interventions cannot remain separate from the politics into which they are inserted. For this reason, an understanding of the local politics is crucial to planning an intervention. Questions of how best to work with both trader organizations and local governments are crucial.

Informality does not mean a lack of regulation. There are indeed many policies and regulations which govern the lives of informal workers. Yet, these regulations exist in a sphere where the rules of engagement are more flexible, more open to interpretation, and more susceptible to the workings of power, than in the formal sector. In this case, a key concern needs to be how OHS interventions can be implemented in a way that enhances the power of the weak; not only in terms of having their voices heard but also in terms of enhancing the incomes which are so often more important to workers than their own health and safety.

A final issue to consider is the more systematic exposure of OHS professionals to the informal economy—something which is necessary if a new generation of OHS professionals is to be conscientized to the needs of informal workers. As the reflections of the OH doctor showed, there is limited scope for this exposure to happen. A large part of this problem is that there is no legislation, policies, or funding, which could support this work. In South Africa, it is the responsibility of employers to fund and provide OH services, and state resources are relatively limited. ³¹ Expensive health assessment work is paid for by big employers. Without a visible employment relationship, nobody is legally responsible to pay for this work in the informal economy. It was only possible to run health assessments for the Phephanathi Project because donor funds became available. There is a similar issue with OHS training: employers and large, well-established trade unions are able to pay for this, but small organizations of informal workers are generally not in the position to do so without assistance.

One answer to this would of course be to ask the state to take on the responsibility and even to advocate for legislation which would compel them to do so. Another option would be to appeal to large corporations to provide assistance (both financial and in terms of human resources) in developing the practice of OHS in the informal economy. ⁴⁴ The involvement of large corporations in this work of course poses its own set of challenges—convincing them that such investments are “good business” (as pointed out in the Institute of Medicine Workshop ⁴⁴ ), as well as the obvious political difficulties and ethical concerns that may arise. Nevertheless, considering the limits of state political will and resources for the informal economy in South Africa, this may certainly be one way to at least begin exposing OHS professionals to informal workers and their needs on a wider scale, which is a necessary condition if, in the long term, there is to be more systemic and systematic changes in the discipline, practice, and administration of OHS.