ESI on paper, not in practice: Jagdish Patel's silicosis struggle in Morbi’s ceramic industry, elsewhere

This is a follow-up to my news story in Counterview about why Morbi, India’s ceramic hub, has become a major cause of concern for health rights organisations. The other day, Jagdish Patel, who heads the People’s Training and Research Centre (PTRC) – an organisation that has been working with occupational hazard victims, especially those suffering from deadly silicosis, for the last few decades – called me.

The occasion was a message from Prof. Anil Gupta, a leading academic and well-known campaigner for grassroots innovations. He wondered whether silicosis victims – the subject of my story – were covered under the Government of India’s Ayushman Bharat scheme. Stating that the disease could be prevented through the use of “safety gear, proper exhaust systems and misting to reduce airborne particles,” he added that he would write to the Morbi ceramic industry association and also interact with Jagdish Patel, something he had done years earlier.

I forwarded Prof. Gupta’s concern to Patel, who said that there are virtually no facilities in Morbi to detect, let alone treat, silicosis victims. 

As a result, most of the nearly 4 lakh workers in Morbi’s sprawling ceramic units are unaware of the disease that is steadily damaging their health. This is despite the fact that nearly all the workers are covered under the Government of India’s Employees’ State Insurance (ESI) scheme, which requires industries with more than 10 workers to deduct 1% of employees’ salaries for the ESI fund, with industries contributing another 3%.

“Most of them earn less than ₹21,000, making them eligible for ESI benefits, which include free medical treatment and monetary compensation during treatment. However, no one is given a proper payslip. A worker told me he had one, but when I asked to see it, it turned out to be just a record of his daily work. Even after working for several years, they are not treated as formal employees of the ceramic units,” Patel told me.

Patel pointed out that while Morbi was brought under the ESI scheme back in 1967, it still does not have an ESI hospital. There is an ESI clinic, but hardly anyone knows of its existence. Instead, industry owners are found to be tied up with private doctors, to whom workers are sent in case of a health emergency. "Some workers, who were aware of the ESI scheme, told me they thought the private doctors were part of an ESI hospital. As for the ESI clinic, the less said about its condition, the better,” Patel remarked.

He linked the failure to provide proper ESI facilities to government indifference towards workers’ health, citing examples from industrial units around Vadodara, where his organisation, PTRC, is based. “We have been working with silicosis victims in Khambhat who are engaged in agate polishing units. These are very small, often home-based, units that may not be covered under ESI. But in the neighbouring areas off Vadodara town, where large industrial estates house small and medium enterprises, we have been fighting to get ESI facilities for years, without success. Even court orders have not helped,” he said.

According to Patel, the situation is no different in Morbi, where PTRC began working in the late 2010s. “These are small and medium-scale units employing large numbers of workers. Our aim is to fight for the health rights of Morbi’s ceramic industry workers, as almost all of them are eligible for ESI benefits,” he said.

Indeed, the study of Morbi’s ceramic workers – which formed the basis of my news report – appears to have been carried out precisely to understand how deep the problem really is.