What’s behind mass fainting in Cambodia’s garment factories?

Cambodian garment workers protest outside their factory early this year. Photo from ILO

Chhim Saaim, 24, remembers the frightening week when she fainted three times at work.

The young woman had moved to Cambodia’s capital Phnom Penh nearly four years prior to work in a factory sewing clothes for sportswear brands such as Puma and New Balance. Saaim says the factory is usually very hot, with temperatures hovering close to 40°C, and she often skips breaks in order to meet the quotas – 170 pieces of clothing per hour – set by her managers. But she had never felt weak or dizzy at work before, and she certainly never expected to faint.

Then one day in March there was a power outage in the factory. In order to keep the seamstresses working, the managers switched on a power generator. But the generator wasn’t strong enough to provide electricity for the entire factory and it soon exploded. As the factory filled with smoke from the generator, the workers began to panic and started running for the exit. In the confusion, over 70 women passed out.

“Some of the women were just very weak and couldn’t walk,” Saaim explains. “But I collapsed completely.”

Saaim was taken to a local hospital with some other garment workers but she was sent home without any noticeable health problems. She returned to work a day later only to faint again.

“With the heat and the leftover smell from the smoke, I just didn’t feel good and I fainted,” she says.

Saaim and her colleagues fainted three times over the course of the week, with 50 workers fainting on the second day and 70 fainting a day later. On the third day, the company allowed a health inspector to review the building, but the workers were never informed about the inspector’s discoveries.

“I think it was the smoke, the heat and the chemicals from the factory that made us faint,” Saaim says, adding that she had to pay for her own medical treatment.

Saaim’s story isn’t uncommon in Cambodia, a country where the garment, textile and sports apparel industry makes up roughly 80 per cent of its export revenue. The industry generates over US$5 billion annually and employs up to 700,000 people, most of which are women.

Mass fainting in factories producing popular brands such as Nike, Puma, H&M and New Balance has plagued the industry for years. According to a 2013 report published by the University of Amsterdam, around 4,000 workers fainted in Cambodian garment factories in the two years prior to the study’s release. More recently, a report by Cambodia’s National Social Security Fund determined that 1,806 workers in 32 factories fainted in 2015.

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Complex reasons for mass faintings

But the cause of these incidents isn’t always as simple as an exploding generator filling the factory with smoke. In fact, many experts and officials are unable to agree on the cause of mass fainting or how to address it. Some people blame factory conditions, such as faulty cooling and ventilation systems, for a lack of oxygen in the buildings. They say smoke, pesticides from nearby farms and chemicals used to treat garments combine with Cambodia’s soaring temperatures to create the perfect conditions for spontaneous swooning.

Others, however, argue that it’s the workers themselves who are in bad shape, often exhausted, overworked and underfed. Many of the women working in Cambodia’s garment factories live in cramped barracks next to the factories. They usually work 10-hour days with few breaks and they are not able to eat or drink enough during working hours. Those who don’t live near the factories take long and dangerous rides to work crammed into the back of trucks like cattle. The stress of this lifestyle can take a toll on the workers and make them prone to fainting, experts say.

Meanwhile, some factory workers blame ghosts and possession by spirits for the incidents. A study released in April in the peer-reviewed journal Transcult Psychiatry noted that around 26 per cent of the incidents of mass fainting surveyed were believed to be triggered by spirit possession. Monks are sometimes called into factories to perform ritual ceremonies to appease the ghosts, and the study notes that fainting spells sometimes stop after such rituals.

The study’s authors blame the fainting episodes on the psychological fear and trauma caused by Cambodia’s bloody past, alleging that mass fainting tends to break out in factories “built on sites that were said to be blighted as killing fields.”

In March last year, officials even blamed mass fainting on the over-indulgence of partygoers during Cambodia’s wedding season.

Still, according to Ath Thorn, president of the Cambodian Labor Confederation, the most common reasons for mass fainting are the poor health of workers and the presence of pesticides and pollutants in the factories.

“[Garment workers] are working long and hard in bad conditions. They are working overtime and they eat less than they should,” Thorn says. “They are also working amidst many chemicals and lots of dust, so if the workers aren’t healthy it can cause problems. The factories sometimes don’t open the door so they can get enough oxygen.”

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Thorn argues that Cambodia’s government should enforce stricter regulations to ensure that factories are safe for workers. He also says garment workers should receive higher salaries so they aren’t tempted to exhaust themselves by working overtime. The minimum wage for garment workers is currently set at $153 a month, which forces many women to work extra hours to make ends meet.

Mass hysteria?

But Ken Loo, Secretary General of Cambodia’s Garment Manufacturer’s Association, argues that garment factory workers black out simultaneously in part due to the psychological phenomenon of mass hysteria.

In June this year, 27 garment workers fainted in a Taiwanese-owned factory in Phnom Penh after they heard the distressing news that one of their colleagues had died from inhaling toxic fumes. Mass fainting is usually sparked when one worker faints and many others follow suit, and often it is caused by stress or panic.

“When you read that 126 workers were affected, that doesn’t mean 126 workers fainted,” Loo says. “If anywhere near that number of workers actually fainted, I think all of the doctors in the world would be here in Cambodia studying this phenomenon. But usually it’s just a handful who actually lose consciousness and the others who say they don’t feel well.”

This explanation matches the experience of Phal Nen, a 28-year-old seamstress who works in the same factory as Saaim. Nen says she didn’t faint on the day the generator exploded because she was close enough to the door to escape from the smoke. But on the third day the stress from seeing her colleagues faint was too much for her.

“I saw some of the other workers collapse and I felt panicked. I became weak and suddenly I fainted,” she explains. “I fell down and I heard people calling my name, but I couldn’t respond, I couldn’t open my eyes.”

Nen says she regularly feels weak and dizzy at work. The factory’s cooling system does little to reduce the temperatures in the sweltering building, she says, and she is perpetually hungry, thirsty and stressed on the job.

“Everyday is more and more difficult. The managers say they are losing profits and they have given us higher quotas,” she says. “Sometimes I can’t sleep at night because I’m so frustrated about work.”

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