EXCLUSIVE INTERVIEW
Dr Rüdiger Krech, Director, Office of the Assistant Director General, Health Systems and Innovation, World Health Organization
'Single Window Services' can boost safety situations in India
Dr Rüdiger Krech, Director, Office of the Assistant Director General, Health Systems and Innovation, World Health Organization speaks exclusively to Built Expressions that India should implement stronger accountability and enforcement mechanisms to ensure that the legal obligations are met. This would indeed improve the health and safety situation in India.
BE: How do you view the safety of construction workers around the world?
In the past 20 years, we are seeing a rapid urbanisation in some parts of India and with this goes a boosting of the construction business. At the same time, we are seeing this development in quite a few other countries, perhaps not as big as India but who still are what we call “emerging economies”. The boosting of the construction business has some great impact on its workforce. There is an increasing migration from poorer countries to these emerging economies. The work is, to a great extent, “informal”. This means that the workers do not have a work contract. As a consequence, there is often quite a bit of turn-over of workers as employers tend to send migrant construction workers back to their originating countries after three months.
All this has impacts on construction workers’ health and safety. Workers may experience elevated rates of violence. A great level of social insecurity might lead to nervous disorders. Higher levels of risk taking due to a lack of risk awareness may lead to increased accident rates on the construction site. Thus, the health of construction workers is determined not only by workplace hazards but also by their social environments.
BE: Your comments on WHO's initiatives towards construction safety….
WHO has developed a global plan of action on workers' health which is based on evidence: It deals with all aspects of workers' health, including primary prevention of occupational hazards, protection and promotion of health at work, employment conditions, and a better response from health systems to workers’ health. It is underpinned by certain common principles and values. All workers should be able to enjoy the highest attainable standard of physical and mental health and favourable working conditions. Primary prevention of occupational health hazards should be given priority. The workplace can, in addition, serve as a setting of other essential public health interventions, and for health promotion. Activities related to workers’ health should be planned, implemented and evaluated with a view of reducing inequities and workers and employers and their representatives should participate in such activities. While quoting from the global action plan, I must say that I have seen great projects in India. Construction can be safe, and health effects minimised. Needless to say that I have also seen construction sites which need to change urgently. There is still a lot to do.
BE: After your visit to India, what are your perceptions on construction safety here compared to the developed nations?
India is indeed "incredible" as in India, you can see pretty much everything that is going on in other parts of the world - developed or developing. You can find top nudge construction safety programmes as well as most hazardous environments. The issue is that those businesses that have implemented the objectives of the WHO Global Plan of Action on Workers’ Health see that it makes multiple sense. It makes sense as a responsible employer. It makes sense from a quality management perspective. And it makes sense economically. Last not least, it is an ethical obligation not to consciously harm people. This should not be forgotten.
For India as a whole, I believe that there could be stronger accountability and enforcement mechanisms to ensure that the legal obligations are met. This would indeed improve the health and safety situation in India.
BE: Heading a reputed organization like WHO, what your recommendations to socially protect construction workers?
There is indeed an important issue for governments to address, especially if there is a large “unorganised” workforce. The problem is that social security delivery systems are often fragmented. The emergence of these fragmented systems can be explained as over time, many governments have developed specific schemes and entrusted different functionally delineated government departments with its implementation. Typically, there is also legal and operational division of authority between national, regional and local governments. In some cases, the responsibility of public service delivery lies with private or semi-government agencies.
In countries such as India, the central and state governments have formulated several programmes and schemes on social security benefits for unorganized workers and their households, and these are administered and operated by a number of government departments and semi-government agencies such as banks. In Karnataka, for instance, there are more than 50 different such schemes. As a result, the unorganized workers, who typically are illiterate, isolated, powerless and socially excluded, are not even aware of their entitlements. Even if aware, they do not know which department is responsible for what social security benefit. In turn, unorganised workers face a series of problems: They often make frustrating experiences with government departments when seeking assistance, they experience delays in the access and spend long time in queues, and they depend on rent-seeking middlemen. In addition, they often are faced with high transaction costs.
A solution might be "single window services" to enable workers to gain access to one or more government social security services in one convenient location. These centres aim to improve accessibility to or actual delivery of government services to citizens or both. Improving convenience is usually a major driving force behind bringing government social security services together in one location. Construction sites could well serve as “Construction Worker’s Facilitation Centers” in order to guide construction workers to access social protection for which they rightfully are eligible.
Box item: About Dr. Rüdiger Krech
Dr Rüdiger Krech is the Director, Office of the Assistant Director-General, Health Systems and Innovation. Before that, Dr Krech was the Director of the Department of Ethics and Social Determinants of Health, and the Director of the Department of Ethics, Equity, Trade and Human Rights at the World Health Organization from 2009 to 2012. In this capacity, he was also responsible for WHO’s work on Social Determinants of Health. Before joining WHO, he was in charge of German International Cooperation's (GiZ) work on social protection from 2003-2009 both in its Headquarters in Eschborn near Frankfurt and in India. He has also held various management positions at the World Health Organization (WHO) Regional Office for Europe in Copenhagen in the fields of health systems, health policies, health promotion and ageing between 1992-2003. Dr Krech has studied educational sciences, medicine and public health and holds a doctoral degree in public health.