The phrase “khat rahein hain” (“being worn down”) is how Suma Devi describes her 16 years of labouring at the brick kilns near the city of Mathura in Uttar Pradesh, more than 500 miles from her own state of Bihar.
Six years ago Devi had just given birth to her baby daughter when she was diagnosed with tuberculosis and put on a nine-month course of antibiotics. It is an effective way to treat TB but Devi had to abandon the course halfway through to find work at the Madhav brick kiln in Naujheel, far from her home in a village near the city of Gaya.
It has made the last few years the toughest of her 16 seasons working in kilns. “I don’t feel well. I have not got better in five to six years,” she says, coating clay in sand and moulding it into rectangular blocks on a wooden frame on a sweltering day.
Devi starts work at 8am, stopping at 1pm to avoid the worst of the heat. During her break she cooks for her husband and daughter and sweeps their temporary shelter, a brick hut.
After sunset she goes back to work, hoping to make at least 2,000 bricks by 1am. They earn 500 rupees (£4.70) for making 1,000 bricks.
Devi belongs to the marginalised Dalits – the people at the bottom of India’s caste system, who were formerly known as “untouchables”. She says her family has no choice but to take this work.
Last year they borrowed 80,000 rupees from the kiln owner and had hoped to clear it during the season – which starts in October and ends in early June, when kilns are shut down at the onset of the monsoon rains – but they still owe 30,000 rupees and have had to borrow more to make ends meet.
The lingering TB has left Devi stuck in a cycle of illness and visits to doctors. “We cannot repay the advance, because I keep falling ill,” says Devi. “We have spent up to 12,000 rupees on medicines and tests at a private clinic. We have to borrow more and more,” she says.
Every year, after the rains, millions of rural women – including pregnant women and mothers – travel long distances across northern India to work in the brick kilns.
Their wages are paid only to their male relatives. India’s public healthcare services for poorer workers – including free treatment for TB, vitamin supplements, vaccines, food rations for those who are breastfeeding and a freshly cooked meal if pregnant – are out of reach for these migrant workers.
Brick kilns are located outside villages and towns, and the women and children toiling in them are – like many seasonal workers in India – cut off from such healthcare.
“The women usually spend less than six months in their village – [so] their rights are curtailed,” says Lokesh (who goes by her first name only), the director of the Centre for Education and Communication (CEC), a campaign organisation that supports migrant workers and child labourers.
“In the kilns, the women are neither registered as a primary worker, nor even informally in registers. If they were registered as workers, they would get paid maternity leave and other assistance,” Lokesh adds.
Workers do not tend to carry documents – such as the Mamta card for pregnant women and new mothers to record antenatal care and vaccines, or the Aadhaar, a biometric identity card – for fear of losing them on their long journeys or in insecure temporary housing.
But without them they have no access to entitlements. For example, women cannot open a bank account to receive the maternity benefit of 5,000 rupees without showing the Aadhaar card.
Shrinking budgets for childcare mean clinics cannot include migrant workers in the antenatal or nutrition programmes. Asha Rawat, a rural health worker at a state-run childcare centre in Meerpur, says: “We get no additional provisions to include those from outside the state.
“We see that the women and children [at the kilns] are very, very poor. We want to serve them. But we can barely cover the local children and women who are supposed to get take-home rations.”
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Research on the children of migrant brick-kiln workers in Bihar published in 2022 found the cumulative effect of poor food and lack of healthcare left them vulnerable to chronic undernutrition and more likely to have stunted growth. Many of the children also work alongside their parents.
At the Madhav kiln, dozens of female workers queue in the shade of an acacia tree waiting to see a doctor conducting basic check-ups at a health camp organised by the CEC for the afternoon.
Nearly all of the women are underweight, and most of their babies have lightened hair colour – a clear indication of malnutrition.
Many do not have the ration card that entitles them to 5kg of free grain every month, or health insurance for those below the poverty line.
Heera Devi, 24, is worried that her baby, Kartik, is weak and cannot sit up. She says she usually lays him on a sheet on the ground while she works.
She weighs 37kg (82lb), and one-year-old Kartik is severely underweight at just 2.9kg – the average weight of a newborn in the west. “I feel he is not growing, but shrinking,” she says.
The health worker suggests getting Kartik to the malnutrition treatment centre for infants in Mathura, 25 miles away. For Devi, a week-long stay there is out of the question. As the family is struggling to pay off a loan of 70,000 rupees, she cannot miss work for that long.
Manisha, 10, has brought her 18-month-old brother to be seen by the health worker. The infant has been suffering with diarrhoea for three days. “He is going unconscious from the illness,” his sister says. His face is dotted with black soot, nazar teeka – the family’s effort to ward off evil eye.
Lalit Singh, who has coordinated the health camp for the CEC, phones the toddler’s parents and asks them to walk to the camp, a nearly a mile away, so the visiting doctor can give advice on their son’s treatment in person.
“The parents are very worried, but they cannot agree to come to the camp themselves,” one worker says. “The mother wishes to come and see the doctor. But the boy’s father is angry and says she cannot afford to miss their target of brick production for today.”
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This article was first published by the Migration Story, India’s first newsroom to focus on the country’s vast internal migrant population. The reporting was supported by Buniyaad movement which works with brick kiln sector workers in Uttar Pradesh.