The hidden slaves of medicine
Author: Sharon Sitters
Published online: 6 April 2020
To the Editor: Nearly all industries profit from today's 25 million slaves and 150 million child labourers.1 The results of their work, including medical disposables, are sold worldwide. Unfortunately, there is not a comprehensive analysis identifying exactly where slaves are involved in the medical products supply chain.
From the hazardous work forging surgical instruments in Pakistan to the manufacture of gloves in Malaysia,2 slavery permeates the manufacture and supply chains of medical products. Slaves are involved in the direct manufacture of medical products and in the generation of raw materials used to make medical devices, including cotton, rubber and metals.3 Some companies, have made a public effort to review their supply chains;4 however, many organisations are failing to monitor human rights abuses in their supply chains.5
As countries legislate Modern Day Slavery Acts, a few companies are moving to eliminate slavery. As an act of radical transparency in the long‐discussed issue of child labour in the cocoa industry, in 2017, Nestlé published the number of child labourers aged 5–17 years known to be working on cocoa farms that supply their cocoa.6 Nothing similar to Nestlé's effort has been done in the medical industry. However, notable efforts to regulate procurement have been demonstrated in the United Kingdom and Sweden.2
Few health professionals are responsible for the direct sourcing of medical products. Nonetheless, when speaking with managers, executives, and representatives of medical suppliers, we have the opportunity to share our concerns for the origins of the products we use. While a conversation with a medical representative on this topic may demonstrate scant knowledge of the manufacturing processes of the goods they are selling, that initial conversation is an important first step towards transparency, and we know that the influence of health professionals on industry is significant.7
Modern slaves are forced to work under threat of harm or by coercion or deception. Unable to refuse or leave, they earn little to no pay for extensive working hours in unsafe conditions, which may cause injury, sickness and, at times, death. Reports of harassment are common. In the medical industry, we must do all we can to address modern slavery because, above all, we should “first do no harm”.
Competing interests
No relevant disclosures.
References
- International Labour Organization. Modern slavery and child labour: 40 million in modern slavery and 152 million in child labour around the world. International Labour Organization, 2017. https://www.ilo.org/global/about-the-ilo/newsroom/news/WCMS_574717/lang-en/index.htm (viewed June 2019).
- Bhutta MF. Time for a global response to labour rights violations in the manufacture of health‐care goods. Bull World Health Organ 2017; 95: 314–314A.
- Bureau of International Labor Affairs. US Department of Labor's 2018 list of goods produced by child labor or forced labor. US Department of Labor, 2018. https://www.dol.gov/sites/dolgov/files/ILAB/ListofGoods.pdf (viewed June 2019).
- Khadem N. Ansell says worker rights abuse in its supply chain under investigation. ABC News 2019, 11 Mar. https://www.abc.net.au/news/2019-01-04/ansell-investigating-claims-worker-rights-abuse-in-supply-chain/10685124 (viewed June 2019).
- Boersma M. Do no harm? Procurement of medical goods by Australian companies and government. Australian Nursing and Midwifery Federation, Australia Institute, 2017. http://www.anmf.org.au/documents/Do_No_Harm_Report.pdf (viewed June 2019).
- Nestlé. Tackling child labour — 2017 report. Nestlé, 2017. https://www.nestle.com/asset-library/documents/creating-shared-value/responsible-sourcing/nestle-cocoa-plan-child-labour-2017-report.pdf (viewed June 2019).
- King B, Payne C, Melsom R. The tobacco free portfolios story [website]. Tobacco Free Portfolios, 2019. www.tobaccofreeportfolios.org/who-we-are/ (viewed Oct 2019).
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