Workers, Staff, Faculty and… Healthcare?

Since we arrived at Shahi Exports, we’ve witnessed the stark differentiation between “staff” and “non-staff.” The staff includes the company’s management, the HR team that we work under, us, and all of the other marketing and design groups that help a garment company function. The people who do the actual labor – cutting fabric, washing it, sewing pieces together, adding buttons, dying jeans, etc.—they are non-staff or workers. While everyone works within the same building at unit 7, the staff and non-staff are mostly segregated by floor. There are also separate cafeterias and restrooms for the two groups. Often, these separations make sense because of the structure of the factory floor, but the distinction and the salary gap are both very real.

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A worker sanding jeans — one of the most physically taxing processes involved in garment production

Back in my hometown (Kutztown, PA), the same phenomena is easy to see. My dad is a professor at Kutztown University, where a very similar “faculty” and “staff” division exists. The two groups differ in education, salary, and benefits. When I asked my dad if he knew any specifics on the differences in faculty and staff health care, he said he wasn’t sure since they operated under separate unions. Back at Penn, race, dialect, and local West Philadelphia residents vs. non-locals often (but not always) enforce the faculty/staff division even more. While I’m curious to return to both Kutztown and Penn to better understand more about similarities or differences in benefits and healthcare, I was lucky enough to experience both worker and faculty heath facilities in the Shahi context.

Shahi provides all of its workers with a health insurance program called the Employees’ State Insurance Corporation, or ESI. ESI is a government-run program for individuals who earn less than 15,000 rupees, or $250, per month. The health insurance is immediately effective as soon as the worker is on payroll, and is paid for in part by the government, worker, and employer. This service is enormously important to many workers, as it covers both them and their families and services are usually free of cost.

ESI covers over 75,800,000 individuals across India, which puts tremendous strain on the facilities. We got to visit one of the nearest ESI hospitals, and found it packed with people. People were sitting on the floor and on windowsills, and there were lines to see general physicians that snaked outside in the hot sun. Many people would stand for hours just to be turned away after closing hours. The hospital was also over an hour away from the factory unit where we work. The hospital is not open outside of normal working hours, so workers have to take off full workdays in order to go. If workers are sent due to severe anemia, they will likely have to go first to an ESI dispensary (small, but more numerous pharmacies) in order to get recommended to the hospital, then travel to the hospital, stand in line to see the doctor, and be recommended for blood tests. However, the blood tests are only available until one o’clock. So, in almost all cases, the individual will have to return the next day to wait yet again for the blood tests. The results can take time to obtain as well.


A worker getting her blood pressure taken before her blood is drawn for a hemoglobin (anemia) test. This is part of the initiative that Chan and I have been working on.

When I later needed to see a doctor for my own stomach troubles, my supervisor, a member of the “staff” of Shahi, recommended the doctors’ office that she and her family used. It was a private hospital that was about 10 minutes away from the factory unit where I work, and I was able to sit down in an air-conditioned waiting room as soon as I arrived. After my appointment, I inquired about hemoglobin tests, and was told that I could get one right then and there if I visited the labs downstairs.

These discrepancies in services and care are difficult to witness from afar, but becoming part of the system myself was much more impactful. It also forces me to recognize that I am part of such systems of inequality back home, but their familiarity renders them much less visible. I know that broadening my understanding of the intersection of class, education, and health will not stop when I hop on my plane to Newark.

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About amysindiabound

My name is Amy Summer and I'm a cultural anthropology major at the University of Pennsylvania concentrating in medical anthropology and global health and minoring in international development. I'll be a rising senior this coming year, and I'm hoping to work in the non-profit field for a few years once I graduate. I love to travel, cook (and eat, of course), and write. Over the summer I'm working on the Shahi experts internship team in India. I'm hoping to experience what it might be like to work in international development or the corporate social responsibility division, all while gorging myself on naan, dosas, butter chicken, and biryani.