Poverty, undernutrition and morbidity: The untold story of tea-garden workers of Alipurduar district, West Bengal

BACKGROUND: There is a paucity of information on health and nutritional status of tea-garden workers of West Bengal, which is crucial to meet their health needs by formulating appropriate public health interventions. OBJECTIVES/AIMS: The objective of this study is to assess the morbidity pattern and nutritional status of tea-garden workers of West Bengal, India. MATERIALS AND METHODS: The present cross-sectional study was conducted among 463 tea-garden workers of randomly selected three tea gardens of Alipurduar district of West Bengal, India, chosen by multi-stage sampling. Pre-designed and pre-tested questionnaire was used to collect information on socio-demographic and other variables by means of interview. Physical examination and anthropometric assessment were performed. The haemoglobin was estimated by the ‘filter paper cyanmethemoglobin method’. Morbidities were assessed on the basis of history, clinical examination, evaluation of medical records if any and relevant laboratory investigations and classified and coded as per the 10(th) revision of the international classification of the diseases. Morbidity profile and nutritional status were assessed through history taking, clinical examination, review of medical records if any, anthropometric assessment and laboratory investigations. STATISTICAL ANALYSIS: Simple proportion was used for interpretation of point prevalence. Chi-square test was applied as the test of significance wherever applicable. RESULTS: Out of total 463 tea-garden workers, majorities (76%) were female and from backward social class (81.2%). More than half (55.9%) were illiterate and three-fourth (67.2%) belonged to lower income quartile. Anaemia was found widespread (87.9%) and more than one-third (36.1%) of the tea-garden workers were found undernourished. Also 43.8% of the workers had airway obstruction as measured by peak expiratory flow rate. Majority (69.8%) of the garden workers had any form of morbidity. Non-communicable diseases (24.2%), musculoskeletal disorders (17.9%), skin disorders (17.7%), respiratory morbidities (16.2%), febrile illness (12.3%), gastro-intestinal disorders (8.6%), ocular problems (8.4%), vitamin and micronutrients deficiencies were found the common morbidities among tea-garden workers. Scheduled tribe caste, undernutrition and anaemia were found independent determinants of any morbidity among the tea-garden workers. CONCLUSIONS: Morbidities, anaemia and under-nutrition were found very much prevalent among tea-garden workers of West Bengal, which necessitates urgent public health interventions through multi-disciplinary approach in a focussed manner with an aim to improve the overall quality of life of the tea-garden workers.