Millions supervision and management, whether under a written

Millions of workers die or are injured or fall ill every year as a result of workplace hazards. The suffering in terms of human life is enormous, while the economic costs of the failure to ensure occupational health and safety are so great that they may undermine national aspirations for sustainable economic and social development. Improving occupational health and safety is in the best interests of all government, employers and workers, and measures to make improvements should be discussed and agreed among the ILO constituents. Successful health and safety practice is based on collaboration and good will, as well as taking on board the opinions of the people concerned. As part of its efforts to promote occupational health and safety in its member states, the ILO has compiled comprehensive information of the subject. Much of this information is presented in detail in the ILO’s in Encyclopedia of occupational health and safety. The principles of occupational health and safety are set out in various conventions and recommendations adopted by the international labor conference, in particular the occupational safety and health conventions (NO. 155). A Worker is defined as ” any man or women over the age of sixteen working in return for any type of remuneration, for an employer and under his supervision and management, whether under a written or unwritten, explicit or implicit contract, or under training or probation period, or performing mental, technical, office, or administrative work”. Occupational diseases are defined as those diseases contracted as a result of an exposure to risk factors arising from work activities. An occupational disease is any chronic ailment that occurs as a result of work or occupational activity. It is an aspect of occupational safety and health. An occupational disease is typically identified when it is shown that it is more prevalent in a given body of workers than in the general population, or in other worker populations.Occupational health and safety in Sudan, roles of labor office and health ministry in improving the situationIn Sudan, occupational health and safety is an arising issue addressed by the government, labor unions, Health ministry and labor office. They are supposed to have the leading role in protecting the worker. Legislation is one of the key mechanisms to support policy and planning activities undertaken by the occupational health system. It is generally acknowledged that the target cannot be achieved without the existence of a modern, clear and realistic laws and regulations that clearly define the responsibility of the state and the employer and the employee { 1 }.There are significant variations in occupational health and safety performance between:Mai Ali/ 2351 wordsType text Page 3- Countries (construction workers in Guatemala are six times more likely to die at work than their counterparts in Switzerland {2}- Economic sectors: statistical data show that agriculture, forestry, mining and construction take the lead in the incidence of occupational deaths worldwide.- Sizes of enterprise: generally small workplaces ( defined as less than 50 workers) have a worse safety record than large ones ( defined as those with more than 200 employees).The means of action used by the International Labor Organization (ILO) to promote occupational health and safety include international labor standards, codes of practice, the provision of technical advice and the dissemination of information. Such actions aim to increase the capacity of member states to prevent occupational accidents and work-related diseases by improving working conditions. In Sudan, and despite of the worrying conditions, we find that the awareness of the magnitude of the problem remains surprisingly moderate. The inadequate dissemination of knowledge and information hampers action. It also limits the capacity to design and implement effective policies and programmes. The situation needs coordinated efforts from health and labor ministries as well as society organizations to operationalize the already-available legislations and to advocate for policy changes to ensure better, healthier working conditions for all workers. Sudan was among the Arabic countries that have just recently adopted a national occupational safety and health policy in 2007. Labor ministry, in coordination with other sectors, takes the main responsibility for policy implementation and execution. It should promote and protect safe and healthy workplaces through education, legislation, and enforcement. In Sudan we do have legislations but without a clear mechanism for implementation and enforcement.Labor office is cabinet body responsible for standards in occupational safety, wages and number of hours worked, unemployment insurance benefits, re-employment services and portion of the country’s economic statistics. The ministry of labor should provide a number of resources and tools to help employers and other workplace parties comply with the requirements of the occupational health and safety awareness and training regulation. The overall responsibility for ensuring the implementation of a policy regarding occupational health and safety rests with theMai Ali/ 2351 wordsType text Page 4ministry of health. The implementation should be in all sub-sectors of the health sector with the administrative structure being based on the currently existing arrangements within these various sub-sectors. Healthcare facilities are potentially hazardous workplaces that expose their workers to a wide range of hazards. Generally it is assumed among healthcare workers and the general public that the greatest occupational health and safety risk faced by healthcare workers is infection resulting from exposure to blood and body fluids as well as skin contacts, infectious fluids and droplets aerosols from patients exposes healthcare workers to infectious diseases such as hepatitis, HIV and TB among many others. Furthermore, the emergence of highly infectious diseases such as SARS has the tendency to increase the infection risk dramatically. In addition to these health workers are confronted with physical, chemical, ergonomic and psychological hazards. For instants, lifting and rolling immobilized or disabled patients exposes workers especially nurses to back injury. Besides, on a call duty, high work load, verbal abuse from disgruntled patients, poor remuneration among others, exposes healthcare workers to psychological hazards such as stress and depression. It is in view of the fact that the health workers are the most important resource in the process of rendering health care that the sector considers it prudent to provide a safe and healthy working environment as far as reasonably practicable. Providing and implementing occupational health services will largely depend on training in occupational health and on-going information provision for staff. The policy and guidelines available in Sudan on occupational health and safety for health workers should outline evidence – based measures for adoption by health service manager and staff of institutions in the health sector both within the public and private sub – sectors. Similarly, on – going monitoring of programs including regular audits is a must if performance of services is to improve progressively. The importance of ensuring the availability of financial resources to make the system function cannot be overemphasized. Whenever it is possible, all regional and district directors as well as facility managers should include specialist training in occupational health as well as occupational health services for their staff in their list of priorities and consequently make necessary budgetary allocations towards staff training, establishment of health and safety committees and securing tools necessary for efficient operationalisation of occupational health and safety services on an on-going basis. The integration of occupational health and safety functions into the existing health sector structure is generally advisable. In the light of the hazards posed by work enviroment, and based on the Labor Act 2003, ILO Convention 155 onMai Ali/ 2351 wordsType text Page 5″occupational health and safety and working enviroment” and convention 161 on occupational health services respectively, which spell out the components of comprehensive occupational health services, a group of strategies could be adopted by health sector in the provision of occupational health services to its staff:1/ Preventive activities aimed at preventing the occurrence of injury and disease.2/ Promotional activities including provision of information and education to employees to enhance their safety behaviors and adoption of habits that favor healthy lifestyles.3/ Curative activities that offer treatment and advice regarding injuries and diseases.4/ Rehabilitative activities in the event of disability following an injury or disease, essential to help the affected persons regain their skills or acquire new ones that will enable them return to work.5/ Research activities which entail investigations and studies on the work environment, and into diseases and injuries as they relate to work and conditions of work.Unfortunately this is not the typical situation in Sudan.Visitors to work place (such as delivery drivers, volunteers, trades people and those visiting patients or residents) should be made aware of and comply with the health and safety requirements for the facility. This should include:1/ Emergency procedures for the facility; (emergency plans shouldn’t only be prepared and shelved). There should be periodic emergency drills to pre-determine staff behaviors under emergency conditions and measures taken to address them.2/ the observance of all instructions and warning.3/the use of suitable safety warning signs in areas where there are hazards; and4/ the exclusions of visitors from certain work areas where they may be adversely affected.5/ Organization of periodic campaigns to create awareness on potential emergency situations that could arise and how to handle them.Mai Ali/ 2351 wordsType text Page 6Certain preparedness measures should be available. Telephone numbers of fire services, police and other emergency service agents should be posted at prominent places on walls of the facility. An alarm system with a unique sound for emergencies should be provided and maintained at the facility level. Workers on the premises should be trained to react appropriately to the alarm.Management of contract workManagers of health services are required to ensure that the health and safety standards of ministry of health are explained to contactors and that the contractors are held accountable for any safety breaches in their performance. Environmental management as well as work place safety plans should be required from contractors as part of their technical proposals before the award of contracts and their implementation should form a vital deliverable to be procured before payments are made. This may be integrated with the business plans submitted by the contractors. Where the gravity of environmental and safety risks so warrant, separate plans covering these should be developed and submitted by the contractors.Financing of occupational health servicesMedical surveillance and rendering of medical care for injuries and disease suffered by the worker should be under no cost for the worker. The cost should be borne by the employer through arrangements made in accordance with national conditions and practice. The ministry of health will ensure the availability of funds for occupational health and safety via a combination of funds from the following sources:1 national health insurance scheme to cover periodic medical examinations, medical care for ailments, rehabilitation and worker education.2 an endowment fund set up for the purpose which may involve contributions from both employer and employee. This will be drown upon to complement other sources for accident and injury cover, sickness pay and death as a result of work place and other hazards and to complement other sources for terminal illness rehabilitation.3 group insurance for workers.4 workmen’s compensation act: the above will complement the provision of this law.Mai Ali/ 2351 wordsType text Page 7The eventual configuration of funding sources may include all or some of the above as practicable.Risk assessmentRisk is known as a combination of the likelihood of an occurrence of a hazardous event or exposure and the severity of injury or ill health that can be caused by the event or exposure. In cases of occupational health and safety there should be risk assessment, that is the process of evaluating the risk rising from a hazard, taking in to account the adequacy of any existing controls and deciding whether or not the risk is acceptable.StepActionI.Look for the hazards.II.Decide who might be harmed and how.III.Evaluate the risks and decide whether the existing precautions are adequate or whether more should be done.IV.Apply control measures.V.Record your findings.VI.Review your assessment and revise it if necessary.Occupational regulations in Sudan cover industrial companies in private sector plus some of the public companies, Sudan provides an annual statistics about occupational accidents and diseases, but still not providing a clear statistics about indicators. There are some national occupational safety programs and activities such as safety on construction work, agricultural safety, elimination of silicosis, and elimination of dangerous child labor. These activities had been coordinated with the ILO. The country presents an estimated budget but declares that the finance allotments are still not enough. 90% of the occupational accidents have been reported to the concerned authorities while only 5% of the occupational diseases have been reported. TheMai Ali/ 2351 wordsType text Page 8government is responsible for the financial issues and the delay in ratification of some conventions. There is lack of co-ordination between ministry of health and labor office which delays any progress in improving working conditions. There should be an integrated surveillance system to detect and provide information about occupational diseases. There should be a proper use of data to assess the risk and plan for the suitable interventions. Awareness should be raised through well designed educational programs at the community base because, in Sudan, accidents happen a lot due to the worker misbehavior or inability to react appropriately to a risky situation. a strengthening of capacity in occupational safety and health management in Sudan is crucial if we are to get the desired outcomes. Sudan has ratified a number of ILO recommendations {3} namely:1/ convention NO.( 81) on the inspection work.2/ NO.( 105) on elimination of forced labor.3/ NO.( 111) on racial discrimination.4/ NO. (182) on the elimination of the worst forms of child labor.The current situation in Sudan is weak and needs refining policies and defining roles of different parties.