Pinky Munda, 25, is eight months pregnant with her second child. She lives at a tea plantation in India's northeastern state of Assam, where her husband is a laborer.
Six days a week, Assam's tea workers—more than 50 percent of whom are women—have to collect at least 48lb (22kg) of tea leaves to earn 137 rupees ($2.10) for a day's work, well below the 250 rupees ($3.80) minimum daily wage for unskilled labor in the region. Most plantations have no toilets, no drinking water and no running water. Workers are forced to defecate in the tea bushes and have no way to wash their hands before they go back to picking.
Of the approximately 1,000 laborers working at Ouphulia Tea Garden, Pinky's husband is one of the permanent laborers, which entitles his family to a house on the estate. But the Mundas' single-room brick house, plastered with an amalgam of mud and cow dung, doesn't have a toilet or bathroom.
The Assam region is known around the world for its tea, found in supermarkets and pricy tea boutiques. The tea grown across the state's 765-odd estates and 100,000 smaller gardens, mostly concentrated in the eastern part known as Upper Assam, contributes more than half of India's annual tea production of about 1.2 million tons, making it second only to the world's leading tea producer, China.
But the world's thirst for Assam tea has also earned the region a far more dismal reputation. Almost a fifth of the state's population of about 32 million is estimated to be living on tea estates, and most of them are in Upper Assam, the region with the worst maternal mortality ratio in the county. According to the latest national health survey, Upper Assam records 404 maternal deaths for every 100,000 live births—more than double the national average.
Health experts say the high maternal mortality rate among tea garden workers is due to a combination of poverty, malnourishment, and a lack of basic sanitation and healthcare facilities.
The Plantations Labor Act of 1951 mandates that certain basic provisions be offered to plantation workers, including drinking water, separate toilets for men, and women, housing and medical services. But the law does little to guarantee even these basic rights for most of Assam's tea pickers. Without action from plantation owners and the government, rights activists and tea workers worry nothing will improve.
Bare-bones Hospitals and Salted Tea
At home, Pinky Munda and her family often drink salted black tea, a vestige of the British colonial era. Colonizers in the 19th century would give laborers salted black tea to help replace the essential salts lost through dehydration. But as each generation born on the plantations produces the next batch of laborers, drinking salted tea has become an everyday habit, even for family members who don't work in the fields.
Dr. Khalekuz Zaman, a maternal mortality specialist with the Assam government, said consumption of copious amounts of salt by female tea workers is one of the reasons for the region's high rates of maternal death. "The nutritional intake of adolescent girls is poor on plantations. They suffer from anemia, and due to their regular intake of salted tea they develop hypertension," he said. "This then becomes pregnancy-induced hypertension or anemia."
Every week, Pinky gets a free ration of just 6.7 fluid oz (200ml) of milk, one banana and an egg that the plantation's management gives to pregnant women living on the estate. Every three weeks, she goes to the estate hospital for a free checkup.
The hospital, with its bare-bones facilities, has not had a doctor for the past year. A pharmacist prescribes medicines; nurses deliver the babies. Five to six babies are born at the hospital each month, one of the two nurses on staff told News Deeply. The nurse asked not to be identified because she didn't have her employer's permission to speak to the press.
"We look at the ultrasound results and if a pregnancy seems complicated, we take that woman to Assam Medical College for delivery," the nurse said, referring to the government-run teaching hospital about 35 miles (56km) away.
"Tea garden women come to the hospital at the last minute of delivery," Dr. Ratan Kumar Kotokey, the principal at Assam Medical College, said. "They come with severe anemia, high blood pressure, respiratory and abdominal infections."
Uttam Majumder, senior assistant manager at Ouphulia Tea Garden, acknowledges the estate is falling short on hygiene and medical facilities, but said his company is doing all it can. "The hospital here is not good. But all other tea garden hospitals have similar facilities," he said.
Majumder said drinking water is always available to laborers during their work hours, and every year the estate builds a few new toilets and repairs old ones in workers' homes. "But workers are habituated to defecating in the open. They don't use them," he said. When asked about the lack of toilets for workers out in the fields, Majumder said: "Putting toilets in the field is impossible. If we start doing that we will have to build 100-200 toilets. We are helpless."
No Place for Pregnant Women
About 30 miles (48km) from Ouphulia, the laborers at Singlijan Tea Estate have similar grievances about toilets and drinking water. Singlijan is owned by M.K. Shah Exports, which supplies its teas to leading international chains such as Starbucks, Twinings and Tetley, according to the company's website.
"The limited drinking water we get has tea leaves and salt added to it. It stinks at times," Sangeeta, a tea picker who requested only her first name be used to protect her identity, said. "The groundwater here has high iron content. It changes color and even after boiling looks dirty."
With no water filters installed in their homes, most of the laborers use a crude contraption that funnels water through a piece of cloth holding sand and crushed bricks, which are supposed to absorb some of the iron. But it doesn't help much.
"That water is harmful," Dr. Kotokey at Assam Medical College said. "It can cause neurological as well as abdominal problems."
When asked to comment on the issues raised by Singlijan tea workers, the manager of the estate directed this reporter to the Indian Tea Association (ITA), an independent body representing the interests of tea producers in India. Madhurjya Barooah, a secretary with the Assam Branch of ITA, did not respond to several requests for an interview, only saying in a brief phone conversation: "MMRin tea gardens is not high."
But Dr. Zaman said that, "except for a few tea gardens, the management at most have done nothing for pregnant ladies."
He agrees the government needs to do more and pointed to the recent introduction of mobile medical vans in Assam as a step in the right direction.The vans are expected to travel around tea plantations conducting regular free health checks for tea garden workers.
But Sangeeta from Singlijan plantation said it will take more than new toilets and health checks to improve the lives of Assam's tea laborers.
"The real problem of tea garden workers is that we are not aware of our rights and entitlements," she said. "Until that changes, nothing will change for us."
This story has been updated to remove the description of salted tea as a medical treatment in the colonial era and to clarify that the mobile medical vans have not yet started giving free checkups to tea plantation workers. We have also specified that Dr. Kotokey is the only principal at Assam Medical College and corrected the spelling of Madhurjya Barooah's name.
Reposted with permission from our media associate Global Citizen.
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Since even moderate-intensity workouts offer a slew of benefits, walking is a good choice for people looking to stay healthy.
How to Rock Your Walk<p>Walking isn't just fun and healthy. It's accessible.</p><p>"Walking is cheap," says Dr. John Paul H. Rue, a sports medicine doctor at <a href="https://mdmercy.com/" target="_blank">Mercy Medical Center in Baltimore</a>. "You can do it anywhere at any time; [it] requires little to no special equipment and has many of the same cardio benefits as running or other more intense workouts."</p><p>Want to up your walking game? Try the tips below.</p>
Use Hand Weights<p>Cardio and strength training can go hand-in-hand when you add weights to your walk.</p><p>A <a href="https://journals.lww.com/acsm-msse/Fulltext/2019/03000/Associations_of_Resistance_Exercise_with.14.aspx" target="_blank">2019 study</a> found that weight training is good for your heart, and <a href="https://www.mayoclinicproceedings.org/article/S0025-6196(17)30167-2/abstract" target="_blank">research</a> shows it reduces the risk of developing a <a href="https://www.healthline.com/health/nutrition-metabolism-disorders" target="_blank">metabolic disorder</a> by 17 percent. People with metabolic disorders have a higher chance of being diagnosed with high cholesterol, high blood pressure, and diabetes.</p><p>Rue suggests not carrying weights for your entire walk.</p><p>"Hand weights can give you an added level of energy burning, but you have to be careful with these because carrying [them] over a long period of time or while walking could actually lead to some overuse injuries," he says.</p>
Make It a Circuit<p>As another option, consider doing a circuit. First, put a pair of dumbbells on your lawn or somewhere in your home. Walk around the block once, then stop and do some bicep curls and tricep lifts before walking around the block again.</p><p>Rue recommends <a href="https://www.healthline.com/health/exercise-fitness/running-with-weights" target="_blank">avoiding ankle weights</a> during cardio workouts, as they force you to use your quadriceps rather than hamstrings. They can also cause muscle imbalance, according to the <a href="https://www.health.harvard.edu/staying-healthy/wearable-weights-how-they-can-help-or-hurt" target="_blank">Harvard Health Letter</a>.</p>
Find a Fitness Trail<p>Strength training isn't limited to weights. You can get stronger by <a href="https://www.healthline.com/health/bodyweight-workout" target="_blank">simply using your body</a>.</p><p>Often found at parks, fitness trails are obstacle courses with equipment for pullups, pushups, rowing, and stretches to build upper and lower body strength.</p><p>Try searching "fitness trails near me" online, checking out your local parks and recreation website, or calling the municipal office to <a href="https://calisthenics-parks.com/" target="_blank">find one</a>.</p>
Recruit a Friend<p>People who workout together stay healthy together.</p><p><a href="https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-017-0584-3" target="_blank">One study</a> showed that older adults who exercised with a group improved or maintained their functional health and enjoyed their lives more.</p><p>Enlist the help of a walking buddy with a regimen you aspire to have. If you don't know anyone in your area, apps like <a href="https://www.strava.com/" target="_blank">Strava</a> have social networking features so you can get support from fellow exercisers.</p>
Try Meditation<p>According to the <a href="https://www.nccih.nih.gov/research/statistics/nhis/2017" target="_blank">2017 National Health Interview Survey</a>, published by the National Institutes of Health, meditation is on the rise, and for good reason.</p><p>Researchers <a href="https://pubmed.ncbi.nlm.nih.gov/29616846/" target="_blank">found</a> that mind-body relaxation practices can regulate inflammation, <a href="https://www.healthline.com/health/biological-rhythms" target="_blank">circadian rhythms</a>, and <a href="https://www.healthline.com/health/glucose" target="_blank">glucose</a> metabolism, as well as lower <a href="https://www.healthline.com/health/high-blood-pressure-hypertension" target="_blank">blood pressure</a>.</p><p>"Any form of exercise can be turned into a meditation of some type, either by the surroundings you are walking in, like a park or trail, or by blocking out the outside world with music on your headphones," Rue says.</p><p>You can also play a podcast or download an app like <a href="https://www.headspace.com/headspace-meditation-app" target="_blank">Headspace</a> that has a library of guided meditations to practice while you walk.</p>
Do Fartlek Walks<p>Typically used in running, fartlek intervals alternate periods of increased and decreased speed. These are <a href="https://www.healthline.com/nutrition/benefits-of-hiit" target="_blank">high-intensity interval training (HIIT)</a> workouts, which allow exercisers to accomplish more in less time.</p><p><a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0154075" target="_blank">One study</a> showed that 10-minute interval training improved <a href="https://www.healthline.com/health/metabolic-syndrome" target="_blank">cardiometabolic</a> health, or lowered the risk of heart disease, stroke, and diabetes, just as well as working out at a continuous pace for 50 minutes.</p><p><a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0111489" target="_blank">Research</a> also shows that HIIT workouts increase muscle <a href="https://www.healthline.com/health/fast-twitch-muscles" target="_blank">oxidative</a> capacity, or the ability to use oxygen. To do a fartlek walk, try walking at an increased pace for 3 minutes, slow down for 2 minutes, and repeat.</p>
Gradually Increase Pace<p>A faster walking pace is associated with a lower risk of <a href="https://www.healthline.com/health/copd" target="_blank">chronic obstructive pulmonary disease (COPD)</a> and respiratory diseases, according to a <a href="https://pubmed.ncbi.nlm.nih.gov/30303933/" target="_blank">2019 study</a>.</p><p>Still, it's best not to go from a stroll to an Olympic-worthy power walk in a day. Instead, increase your pace gradually to prevent injury.</p><p>"Start by walking at a brisk pace for about 10 minutes per day, 3 to 5 days per week," Rue says. "Once you've done this for a few weeks, increase your time by 5 to 10 minutes per day until you get to 30 minutes."</p>
Add Stairs<p>You've likely heard that taking the stairs instead of an elevator is a way to add more movement into your daily routine. It's also a way to step up your walking. Stair climbing has been shown to <a href="https://www.sciencedirect.com/science/article/pii/S2211335519301123?via%3Dihub" target="_blank">decrease the risk of mortality</a> and can easily add a bit more challenge to your walk.</p><p>If you don't have stairs in your home, you can often find them outside a local municipal building, train station, or at a high school stadium.</p>
Is Your Walk a True Cardio Workout?<p>Not all walks are equal. A walk that's too leisurely may not provide enough burn to qualify as cardio. To see if you're getting a good workout, try to <a href="https://www.healthline.com/health/how-to-check-heart-rate" target="_blank">measure your heart rate</a> using a monitor.</p><p>"A target goal for a good walking workout heart rate is about 50 to 70 percent of your maximum heart rate," Rue says, adding that maximum heart rate is <a href="https://www.healthline.com/health/fitness-exercise/fat-burning-heart-rate" target="_blank">typically calculated</a> by 220 beats per minute minus your age.</p><p>You can also monitor how easily you can carry on a conversation while you walk to gauge your heart rate.</p><p>"If you can walk and carry on a normal conversation, that's probably a lower intensity walk," says Rue. "If you are slightly breathless but can still have a conversation, that's probably a moderate workout. If you are out of breath and can't talk normally, that's a vigorous workout."</p>
Takeaway<p>By shaking up your routine, you can add excitement to your workout and reap even more rewards than a basic walk provides. Increasing the pace and intensity of a workout will make it more effective.</p><p>Simply pick your favorite variation to add some spice to your next walk.</p>
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