How are the surviving workers of the Rana Plaza factory collapse in Bangladesh doing: quality of life, participation restriction, income and occupation.

PURPOSE: On April 24, 2013 a building called "Rana Plaza" that housed several garment factories collapsed in Bangladesh. Around 1134 people died and more than 2500 sustained serious injuries. This study evaluates the change in income and occupation of the Rana Plaza survivors as well as their level of community participation and quality of life two years after the incident. It also aimed to gain insight into these survivors' success or failure in economic reintegration. METHODS: A cross-sectional survey collected data from the injured garment workers using convenience sampling method. The Short Form 36 Items Questionnaire measured their quality of life, and the Participation Scale measured their community participation restriction level. Poor economic reintegration was defined when a survivor was not working or had an income less than 3000 Taka [US$36]/month. RESULTS: Data were collected from 338 Rana Plaza survivors all of who were previously garment workers. Their income decreased substantially after the disaster. The majority were now engaged in earning livelihood from retail shop management and animal husbandry. A total of 124 survivors (36.6%) were found to be poorly economically reintegrated; females were found to be at greater odds (twice) of poor economic reintegration than males. Those with severe participation restriction scores had four times greater odds and who reported moderate restriction had two times greater odds of poor economic reintegration compared to those with no restriction. CONCLUSIONS: Survivors of Rana Plaza factory disaster were facing many health and economic challenges two years after the event. Implications for rehabilitation Rehabilitation service providers should document and describe the health status correctly to understand the burden and monitor the effectiveness of their intervention. Government needs to develop and strengthen rehabilitation capacity as more workers will be injured as the country rapidly industrializes. Factory owners should create light duty work opportunities and provide other workplace modification for injured workers to re-enter the workforce.

Urinary symptoms and infections among female garment factory workers in Bangladesh.

BACKGROUND: The prevalence of urinary symptoms and infections among female garment factory workers in Bangladesh - a large developing country - is largely unknown. Garment sector is this country's main economic growth engine. OBJECTIVES: This paper focuses on garment industry workers and compares the findings with another group of low socioeconomic status working women. METHODS: Urinary tract symptoms (UTS) were determined by self-reported survey including International Consultation on Incontinence Modular Questionnaire-Female Lower Urinary Tract Symptoms (ICIQ-FLUTS) and urinary tract infection (UTI) was determined among a subset population by urine dipstick tests. RESULTS: Data were collected from 310 garment workers and 297 comparison workers. About one third of garment workers (31.94%) and comparison workers (29.97%) could take up to 3 toilet breaks in a day. Garment workers reported to be more sexually active and menstruation was more common among them compared to comparison workers. They reported a significantly higher prevalence of malodorous urine and vaginal discharge. Garment workers were found to have a significantly higher ICIQ-FLUTS score of voiding than comparison workers (0.44 vs. 0.27; p-value = 0.0167).Among the study respondents, 148 garment workers and 134 other workers provided urine samples and 21 (7.45%) were found to have UTI. After considering all the risk factors in multivariate model, garment work had a significant impact on the probability of having UTI with Odds Ratio of 5.46 (p-value = 0.0374; 95% CI = 1.10, 26.97) compared to other workers. CONCLUSIONS: This study highlights the prevalence and burden of urinary symptoms and infections among female worker populations in Bangladesh.

Community integration and life satisfaction among individuals with spinal cord injury living in the community after receiving institutional care in Bangladesh.

PURPOSE: This study reports level of community integration and life satisfaction among individuals who sustained traumatic spinal cord injuries, received institutional rehabilitation care services, and went back to live in the community in Bangladesh. It examines the impact of type of injury, demographic characteristics, socio-economic profile, and secondary health conditions on community integration and life satisfaction and explores the association between these two measures. METHOD: Individuals with spinal cord injury were telephone interviewed by the Centre for the Rehabilitation of the Paralysed, Bangladesh from February to June of 2014. Data were collected from the subjects on type of injury, demographic and socio-economic profile, and secondary health conditions. The outcome measures were determined by using two validated tools - Community Integration Questionnaire and Life Satisfaction 9 Questionnaire. RESULTS: Total community integration and life satisfaction scores were 15.09 and 3.69, respectively. A significant positive relationship between community integration and life satisfaction was revealed. Type of injury, gender, and age were found to be significant predictors of both community integration and life satisfaction scores. Higher education was significantly related to community integration and life satisfaction scores. CONCLUSION: Participants scored low in total community integration and life satisfaction, suggesting there is a great need to develop interventions by governmental and non-governmental organizations to better integrate individuals with spinal cord injury in the community. Implications for Rehabilitation Government and non-government organizations should offer disability friendly public transportation facilities for individuals with spinal cord injury so that they can return to education, resume employment, and involve in social activities. Entrepreneurs and businesses should develop assistive devices featuring low technology, considering the rural structure and housing conditions in Bangladesh. Innovations being made in assistive technology should be supported by subsidies and grants. They should also plan to offer injury appropriate employment opportunities for individuals who suffer major injuries like spinal cord injury in Bangladesh. Housing facilities with accessible bathrooms, kitchens and stairs should be designed and offered for this population to improve their ability to self-care and decrease the dependence on caregivers for household tasks such as - cooking meals and taking care of children.

Prevalence and risk factors of depression among garment workers in Bangladesh.

BACKGROUND: Depression is a growing health issue in both developed and developing countries. General unawareness at the population level, lack of training among health care providers and scarcity of resources including treatment opportunities may conceal the real burden of depression in developing countries, and more epidemiological studies on its prevalence and risk factors are critically needed. AIM: This study reports the prevalence of depression and its associated risk factors among female garment factory workers in Bangladesh - a major supplier country of clothes for the Western market. This research should generate useful evidence for national and international stakeholders who have an interest in improving health, safety and well-being of outsourced factory workers. METHODS: A survey was conducted on a sample of 600 lower socio-economic status working women including garment workers. This survey collected data on demographic and health profile of these workers. The primary outcome was depression as measured by Patient Health Questionnaire 9. It also obtained data on traumatic life events and post-traumatic stress disorder. RESULTS: The prevalence of depression was 23.5%: 20.9% among garment workers and 26.4% among others. Part-time employment (odds ratio-OR): 2.36, 95% confidence interval (95% CI): 1.01-5.51), chronic pain (OR: 1.67, 95% CI: 1.01-2.78), two or more traumatic life events (OR: 6.43, 95% CI: 2.85-14.55) and dysuria (OR: 2.50, 95% CI: 1.02-6.15) were found to be significantly associated with depression among these workers in multivariate regression model. Depression prevalene lowered by 11% among these workers for every additional monthly earning of 1,000 taka (US$12). CONCLUSION: Depression is a multifaceted health issue with many personal, social, economic and health determinants and consequences. This study demonstrates that the prevalence of moderate-to-severe depression among working women in Bangladesh is quite high. Prevention and treatment of depression in developing countries and societies can reduce suffering, lower incidence of suicide, and prevent economic loss. Creating awareness on outsourced workers' poor mental health may help in developing initiatives to protect and preserve their well-being.

Self-efficacy, disability level and physical strength in the injured workers: findings from a major factory disaster in Bangladesh.

INTRODUCTION: In 24 April 2013, Rana Plaza - a high-rise building in Bangladesh where garments were being made for the Western markets collapsed. In this study, we report on the surviving workers' physical strength, self-efficacy, and disability level one year after the disaster. METHODS: This cross-sectional study took place at the Centre for the Rehabilitation of the Paralysed (CRP) which provided care for more than 600 victims. For this study, upper extremity strength among the survivors was assessed by dynamometer hand grip (HG) and lower extremity strength by five time sit to stand test (FTSST). The WHODAS tool measured level of disability and General Self-Efficacy questionnaire measured self-efficacy. Post-traumatic stress disorder (PTSD) prevalence was determined by the PCL-scale. RESULTS: The study recruited 181 injured workers. The mean disability score among them was 49.8 (SD 17.5) and mean self-efficacy score was 24.9 (SD 6.9). In multivariate models, after adjusting for age, gender, education, injury profile, employment, marital status and job category, self-efficacy was found to be higher among those who scored above median HG test score [ß= -2.32 (95% CI: -4.63, -0.01)] and FTSST performance score [ß= -2.69 (95% CI: -4.93, -0.46)]. The disability level was found to be significantly associated with PTSD score [ß = 0.84 (95% CI: 0.62, 1.06)] and self-efficacy score [ß= -0.45 (95% CI: -0.78, -0.13)]. CONCLUSIONS: There is an immense need to develop and deliver effective post-injury recovery, rehabilitation and return-to-work programs for injured workers in resource poor countries. Implications for Rehabilitation The study findings suggest that one year after the factory disaster in Bangladesh, the injured workers are suffering from a high degree of disability, low physical performance and reporting low self-efficacy. The national and international stakeholders including Western buyers, aid agencies, NGOs, worker advocacy groups, consumer associations and the government of Bangladesh can be updated on the progress made so far. There is an immense need to develop and deliver effective post-injury recovery, rehabilitation and return-to-work programs for injured workers in resource poor countries. International organizations like ILO, WHO, World Bank can help developing countries in building these capacities.