Global Health Watch 1 in one file

Health and globalization | A1
number of people who fell into poverty by exhausting their income and savings
to pay for medical treatment – Qingming’s grandfather was just one of 27 million
rural Chinese in 1998 to whom this happened (Liu et al. 2003). There was
also a dramatic slowdown in China’s population health improvements (Deaton
2004), particularly infant mortality and life expectancy (Akin et al. 2004).
Similar trends are found in India, where rural poverty has deepened in many
states. Women in the poorer states have shorter life expectancies and lower
literacy rates (Abbasi 1999). Government expenditure on health care accounted
for just 18% of health care spending, with the rest financed by users – making
it one of the world’s most privatized health care systems (WHO 2004). Predictably,
the quality of public health services is low and deteriorating: the infant
mortality rate for the poorest fifth of the population is 2.5 times higher than the
richest fifth, and poorer children are almost four times as likely to die in childhood
(International Institute for Population Sciences & ORC Macro 2004).
What if Qingming had completed his education and found employment in
one of the many export processing zones (EPZs) to which 10–20 million rural
Box A1 Women and export processing zones
Had Qingming found work in an export processing zone (EPZ), his sex
would have placed him in the minority. EPZ employers favour young, often
single women, particularly in textile, garment manufacturing and electronics
assembly: their fingers are thought to be more nimble than men’s, and
they receive only 50–80% of the wages paid to men (ICFTU 2003). Eighty
per cent of China’s EPZ employees are women (Durano 2002); the global
average is 70–90% (Athreya 2003). EPZ employment for women is credited
with increasing gender empowerment by providing them with income.
This may sometimes be true, but women’s earnings are often channelled
back to the control of male family members, and many women’s domestic
responsibilities remain unchanged, creating a double burden of work (Durano
2002). To reduce costs, EPZs frequently employ women on part-time,
casual or subcontracting arrangements that involve working at home. This
gives women flexibility between their domestic and paid duties, but denies
them the social protections that might come with regular forms of employment
(Durano 2002).
Because they are located in countries with a large supply of cheap
labour, EPZs rarely improve wage conditions for either women or men
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