Abstract

Organised cultivation of tea in India dates back to the 19th century. Traditionally, tea is grown at higher elevations in large estates after “opening up” what used to be verdant rain forests. Even today employees of these estates are not indigenous people but those who were forced to migrate generations ago to these unknown lands due to drought conditions in their native villages. They continue to live in closed communities – a feature that lends itself to unique epidemiological interventions and investigations.

South India contributes 18.94% of the total land used for tea cultivation in the country, which produces 20.16% of the tea grown in India and employs 28.70% of the total workforce in tea. For more than 15 years now, a systematic annual audit of the health and welfare services of one of the larger producers of tea in South India, followed by recommendations for altered intervention strategies has resulted in improved health conditions in the company.

Working with a population of less than 15000, primary health care indicators consistently match those of developed countries: a Crude Birth Rate of 3.87/1000, Couple Protection Rates of about 90% and the absence of severe under-nutrition are examples of these. There is a resultant fall in infectious diseases and other preventable morbidities. Concomitant interventions to combat non-communicable diseases have resulted in good control of diabetes, hypertension and cardio-vascular problems. Admissions to the estate hospitals for complications of non-communicable diseases have been dropping. Absenteeism due to sickness has consistently remained less than 2% of the available working days.

The management’s confidence in its primary health care systems has now resulted in a greater focus on occupational health interventions, such as the prevention of poisoning and noise induced hearing loss. Indeed ensuring basic health is a step towards providing basic occupational health services.