article and picture by Djenabou Sow

Women market vendors in Guinea are pillars of the community sustenance. But their health struggles are systematically overlooked. Djenabout Sow, regional communicator for West Africa, has gathered some of their stories.

They are the queens of the stalls, the pillars of Guinea’s informal economy. Every day, from dawn to dusk, they sell smoked fish, condiments, rice or second-hand clothes. They are mothers, wives and breadwinners. Yet behind their smiles lies a reality that is reality that is all too often ignored: the steady deterioration in their health.

Suffering in silence

Mariam, 52, has been selling condiments at the Madina market in Conakry for over twenty years. Sitting on a small stool on the floor, she confides: “My back hurts all the time, but I can’t go to the hospital. It’s expensive and I lose a day’s sales”. Like her, more than 50% of vendors (according to the author’s own research) suffer from chronic back pain, but are reluctant to seek help. That is because a medical visit costs the equivalent of 2 to 3 days’ income. These thousands of women endure work-related pain associated with their work. Standing for hours on end, carrying heavy loads, working in dust or next to cooking stoves all leave their mark.

At KM36, Hawa sells smoked fish. She suffers from respiratory problems caused by the constant smoke from the stoves. She explains, “I’ve been doing this for 10 years. I stand next to the fire all day to smoke my fish. My eyes often hurt and I cough a lot. There’s no one to talk to us about health here”.

In Koloma, Aminata, a street vendor, talks about the difficulty of managing her menstruation in the middle of the day, with no suitable toilets.

“I go round the market with my tub of mangoes on my head. During my period, I have nowhere to go. The toilets here are not very clean, which is why some women use empty tomato cans to relieve themselves. We suffer in silence”.

Neglected health, increased risks

An informal survey conducted in some of Conakry’s markets revealed that over 65% of women vendors work even when they are ill. Many vendors have no health cover, which leads them to self-medicate. According to the ILO and WHO Africa, less than 30% of women in the informal economy in Guinea have access to health cover. According to a WHO and UNPD report on the adaptation of informal incomes, the average cost of a consultation in Conakry is equivalent to 2 to 3 days’ income for a small market vendor.For this reason, many make do with purchased painkillers, without ever consulting a health professional.Toilets, where they exist, are often unsanitary or closed.

Dr Mounthaga Diallo, a doctor at the Koloma health centre, confirms: “We often see women vendors with chronic pain, infections or advanced illnesses. They wait until the last moment to come”.

The demands of the women

These physical problems are compounded by psychological problems: financial stress, harassment and loneliness. The mental health of these women is an even more taboo subject. There are many recommendations: regular mobile clinics, a health fund for informal workers, clean toilets, awareness-raising campaigns tailored to the realities of the markets.

Integrating the markets into community health programmes would be a sustainable approach. Training the women themselves to become health promoters in their markets could also have a greater impact.

As a reminder, these women feed our families, they keep the markets running and support entire generations. And yet their health remains a blind spot in public policy. Looking after the health of women vendors is not only a question of social justice, but also of economic efficiency.

Guinea will not be able to develop fully if it continues to leave its most resilient economic players to fend for themselves in a climate of general indifference.