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Iman A. Nuwayhid, MD, DrPH

Correspondence: Requests for reprints should be sent to Iman Nuwayhid, MD, DrPH, Department of Environmental Health, Faculty of Health Sciences, American University of Beirut, Bliss St, Beirut, Lebanon (e-mail: nuwayhid{at}aub.edu.lb).

Poudel and colleagues report that the number of published articles on occupational health in Nepal is very limited, and they call for occupational health research in Nepal that addresses the "internal domain" (workplace hazards, work organization, exposure-disease spectrum, and occupational health services and programs) as well as the "external-contextual domain" (social, political, and economic context) of work and health.

I agree that research on the external-contextual domain should not displace research on the internal domain, and I concur that Poudel et al. may be more equipped and better placed to define the occupational research agenda in Nepal. In my article, however, I did not call for a research preference. Instead, I argued that for research findings to translate into policy, occupational health researchers should link their projects to the wider public and environmental health concerns of the country.

In a recent publication, Singh reported that Nepal is one of the poorest countries in the world, with 90% of its 25 million people living in rural areas, and that health services in Nepal are inadequate, hurting the poor and most vulnerable, especially women and children. The political conflict is further worsening the situation.¹ Under such conditions, one would expect that workplaces are not being inspected, that child labor is commonplace, and that workers are being exposed to severe work hazards. Of course, this can and should be documented. The challenge remains in the "what next."

Documenting the miserable working conditions in most developing countries is necessary but not sufficient to put occupational health in the limelight. Occupational health researchers should step out of their technical/disciplinary isolation and integrate their research within a wider social justice agenda. Hence, examining the impact of working in hazardous conditions on the health of working children, women, and men is not an aim in itself but rather a means to improve these workers’ livelihood and quality of life. This cannot be achieved unless we join hands with researchers from other disciplines, labor unions, and community organizations who share the same objective.

Reference

1. Singh S. Impact of long-term political conflict on population health in Nepal. CMAJ. 2004;171: 1499–1501.[Free Full Text]

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