Recognize the body of a ‘domestic worker’ as that of an
‘employed worker’

Jiyoon
Jung, MD, Specialist in Occupational and Environmental Medicine

Korea Institute of Labor Safety and Health

2021

Sixty-two-year-old at-home caregiver Lee
visits four houses a day: the home of a dementia patient living alone, the home
of an elderly couple in their 80s with limited mobility, and two homes of
elderly women in their 70s. One day, when she visited the house of an elderly
woman, she heard a popping sound from her shoulder as she was moving things she
had been shopping for. After several days of pain, she went to an orthopedic
surgeon and was diagnosed with a complete rupture of her right rotator cuff.
Eventually she had surgery. When she heard news from her fellow caregiver who
had gone through something similar, she decided to file her own occupational
injury claim as well. A month and a half after her operation, a doctor at the
Korean Workers’ Compensation and Welfare Service (KCOMWEL), who met her in the
treatment room while she was undergoing rehabilitation, asked what kind of work
she had been doing.

“I have been
an at-home caregiver for about a year and a half. Previously, I had been
helping other people with housework for about 10 years. Before that, my husband’s
business was good, so I had been a housewife. Back then
when I was working as a housekeeper, I was injured or sick many times, but I
just endured it because it was as difficult as when I was working at home.”

The expression for domestic service work as
‘helping’ by the worker herself implies a history of domestic workers not being
recognized as workers. She has been doing shoulder burden work as a worker who
provides care and housework services to people in need then and now, but the time
period of shoulder burden work experience recognized by workers’ compensation was
only 18 months.

Another woman, Jeong, in her 60s, slipped
while cleaning a customer’s bathroom last year and fractured her wrist bone.
She tried to ask the client for treatment, but the client did not have any
obligations, so she had to pay about 4 million won (~USD$3100 or €2,900) for the treatment herself. While undergoing two wrist bone
fixation surgeries, she was unable to engage in any “economic activities.” She
has never been a worker by law, and she has returned to the informal sector as
a domestic worker again, and she fears that her wrist will break again while
working.

The unseen sick body of a domestic
worker

In 2017, the Ministry of Employment and
Labor counted the number of domestic workers in Korea at 250,000, and in 2020,
the Korea Domestic Workers Association estimated that 300,000 to 500,000 people
worked as domestic workers. They are called by various names, including
housekeepers, postpartum caretakers, babysitters, and petsitters, but they have
never been referred to as workers, nor have their exact numbers been
identified.

Among the studies on the right to health of
domestic workers, the “Informal Sector Human Rights Situation Survey” conducted
by the National Human Rights Commission of Korea conducted a survey of 507
domestic housekeepers, caregivers, and childcare workers in 2015. As a result
of the study, ‘musculoskeletal symptoms’ (77.6% of care workers) and ‘working
despite being sick’ (74.3% of housekeepers, 57.2% of childcare assistants)
showed the highest frequency of health problems experienced in the past year in
each group. Lee and Jeong, whom we met earlier, also showed the musculoskeletal
risks experienced as domestic workers. It is not unfamiliar to talk about sick
workers who have to continue to work despite health inconveniences from
musculoskeletal burden work.

However, those are not the only health risks
that domestic workers face. In the same study, many housekeepers experienced
various health problems caused by strong detergents, and caregivers reported a
high rate of mental stress. Caregivers answered the most frequently that they
experienced being ignored and being overly monitored. Eleven percent of
housekeepers and caregivers experienced unreasonable suspicion regarding the
loss of items, and 28.2% of housekeepers, 31.4% of caregivers, and 17.9% of child
caretakers responded that they were excessively monitored while doing their
duties. For excessive surveillance, 16-32% of them knew that surveillance
cameras had been installed, and in only 26% of cases prior consent was obtained
from domestic workers. Considering that ‘excessive surveillance through
surveillance cameras’ is specified in the “Workplace Harassment Judgment,
Prevention and Response Manual” published by the Ministry of Employment and
Labor, it is obvious that domestic workers exist outside of the standard for
the workplace. It is also ironic that, despite such surveillance, exposure to
sexual harassment and sexual violence is high. Among caregivers, 30.8% said
they had experienced sexual harassment.

In 2015, the Korea Women’s Policy Research
Institute published “A Study on the Working Environment and Health Status of
Household Service Workers” and divided the categories of ‘Domestic Service
Workers’ and ‘Care Workers (nursery teachers, caregivers, and babysitters)’ in
the work environment survey. To identify the characteristics of care workers
and other domestic workers, data from 780 care workers and 165 domestic workers
were analyzed to examine the characteristics of domestic workers. The
self-rated health level was the lowest among the domestic workers, and the
diseases related to their work were also frequently reported in domestic
workers even after controlling the age of the participants. Psychological and
emotional health problems such as depression and anxiety disorders were also
found higher among domestic workers.

In addition, an analysis examined the
impact of poor working conditions experienced by domestic workers (having to
work when sick, not being able to rest when they want, not being provided with
health and safety information) and the working environment (satisfaction with
working environment, job security, proper compensation, value of the work) on
health (subjective health, occupational musculoskeletal disorders, mental
health indicators). As a result, in almost all areas, these negative working
conditions and each item of the working environment were associated with each
item of health. In this study of 800 domestic workers, those who experienced
being demanded dangerous work from customers reported subjective unhealthiness 1.92
times, musculoskeletal disorders 1.99 times, and accidents 7.11 times higher
compared to those who did not. Also, the workers who experienced working while
sick reported 3.21 times more subjective unhealthiness, 3.52 times more
depression, 2.63 times more musculoskeletal disorders, and 3.49 times more
accidents than those who did not. In particular, it was found that those who
had been misunderstood about damage/theft and those who experienced unfair
treatment were more than twice as likely to experience depression than those
without these experiences.

However, outside the study, it is not known
how many domestic workers in the real world experienced work-related injuries
or had to work despite being sick. This is because domestic workers are not
covered by the Industrial Accident Compensation Insurance Act. No one knows the
number of domestic workers who are currently working, let alone the number of
domestic workers who were occupationally injured.

Recognize the body of a domestic worker
as that of a worker

Although housework is an essential labor
that maintains the foundation of society, domestic workers are not recognized
as employed workers, and they once again suffered as vulnerable workers in the COVID-19
era. In June 2020, the Korea Women’s Policy Institute and the Ministry of
Gender Equality and Family surveyed 290 domestic workers on the impact of
COVID-19 on the jobs of domestic workers. More than 7 out of 10 respondents
said that the number of home visits decreased during the pandemic. The average
monthly income of domestic workers who participated in the study was 1.12
million won (~USD$870 or €818), and the average monthly
income after COVID-19 was 639,000 won (~USD$500 or €466),
which was a decrease of 484,000 won compared to before COVID-19. For the
difficulties caused by COVID-19, 8 out of 10 domestic workers answered
‘reduction in income’ and 7 out of 10 answered ‘one-sided cancellation of
visits’. The “risk of corona infection” was answered by 5.6 out of 10 workers.
In the pandemic era, the threats that domestic workers felt more desperately than
COVID infection were reduced income and not being able to work.

Since they have to work in someone else’s
home, domestic workers experience challenges like never before. Even in 2015,
domestic workers had to work at individual customers’ homes without breaks.
They hoped that they could take 10 to 20 minutes of break in a four-hour
part-time job, but they had no choice but to work non-stop in order to complete
the task requested by their customers. As daycare centers and schools shifted
care work to the home in the pandemic era, the demands on work have increased,
but they are afraid that they will miss even that job.

Since the Labor Acts does not apply to
domestic workers, the employer is not legally liable for signing an employment
contract or compensating any injuries caused by work. Efforts to cover domestic
workers within the scope of the protection of the Labor Acts have not been
fruitful since the 18th National Assembly in 2012 until now. It is also
important to clarify the employer of domestic workers because it is a matter of
determining who will be held responsible for the actual labor contract and
consequent worker protection. Actually, the household receiving the worker’s
services looks like an employer, but in reality, there are various stakeholders
(job agencies, mediators, hospitals that instruct care services, etc.)
surrounding domestic work. However, in order to clarify the labor and health
rights of domestic workers, it should be based on who orders and supervises the
actual work.

It is quite familiar to see workers who are
not protected by universal labor laws because of the diversifying labor market
and employment relations. The problem of women’s labor will inevitably become
stagnant unless we bring the devalued labor of domestic workers back to the
surface and deal with their bodies as working bodies. As a female worker, and a
nonstandard and informal worker, the domestic worker is the most vulnerable worker.

Based on the phrase in clause 1 of Article
11 of the Labor Standards Act of 1953, ‘Does not apply to domestic workers’,
domestic workers have worked more than 60 years without being recognized as
workers. With the adoption of the ILO Convention on Domestic Workers in 2011,
strong demands to the government began for the recognition of the labor of
domestic workers. With COVID-19, workers’ right to rest when sick is a hot
topic, however, there are workers who are not even recognized as workers. Now, please,
guarantee the right of domestic workers to work and to work healthily.