When Neang Sokly woke up under a tree outside the Conpress garment factory where she has worked for the last two years, she screamed for help. The last thing she remembered was seeing factory security guards directing workers to get out of the building and going to investigate. “I went to see what the problem was and I passed a pile of jeans being dyed. The smell was horrible. I realized it must be from chemicals so I started to run out of the factory, but I fainted,” remembers Neang.

She is just one of hundreds employed in Cambodia’s garment manufacturing industry, producing clothing for the world’s biggest brands, such as Puma, H&M and Nike, who have fainted on the job this year alone. During a single week in July over two hundred workers were admitted to the Prek Anhchanh Health Center, a small rural clinic on the outskirts of Phnom Penh, after collapsing at work.

“I don’t remember what happened,” says Sao Nari, a 22-year-old seamstress employed at the Chinese-owned Sixplus factory, where she sews the elastic waistbands into Adidas sports shorts. “I was working in the back of the factory and I saw people running out, but I didn’t know what was happening. I started to run out as well, but there was a strange odour I had never smelled before. Then I fainted outside.” Hooked up to an IV drip in Prek Anchanch, she complained of lingering chest pains nearly three hours later.

Yet fainting workers could be considered lucky. At the New Archid and Sangwoo garment factories, located in Kandal and Kampong Speu provinces respectively, Sokny Say of the Free Trade Union of Workers of the Kingdom of Cambodia (FTUWKC) reported that two workers died last month from factory-related ailments. Thirty-five year-old seamstress Nov Pas, who spent nearly four years making clothes for brands like Gap and Old Navy, passed out at her post in the Sangwoo factory at 8am on 24 July 2014. By 9am she had been admitted to the nearest provincial hospital, and around 6pm she was pronounced dead. 

When contacted for comment, Chea Sok Thong of the Korean-owned Sangwoo factory denied corporate responsibility for Ms. Nov’s death, claiming medical carelessness from the hospital where she was receiving treatment. When questioned about the reason for her presence in the hospital in the first place, Chea stated only that “she seemed sick and weak,” but was adamant that it was unrelated to working conditions.

Sithyneth Ry, a labour resolution officer from FTUWKC, while agreeing that there is room for improvement in how garment workers are treated in hospitals, offers sharp criticism of Sangwoo’s official position. “Excuses about illnesses not being related to work are very common. [The factories] will always try to avoid being responsible.” Ultimately, he asserts, it is the responsibility of the factory to provide a safe working environment.

Though proving culpability for such episodes of mass fainting and death is a complex issue mired in the notoriously corrupt context of Cambodian bureaucracy, Mr. Sithyneth says everything is centred around one fundamental fact: garment workers are not provided with a livable wage. “In my opinion US$200 a month is the minimum amount required to live in modern Cambodia,” says Sithyneth, “but garment workers make half of that unless they work a lot of overtime hours.”

According to Sithyneth, overwork and poor workplace conditions are two of the reccurring factors responsible for the majority of fainting incidents – and both of these issues are a direct result of the financial burdens shouldered by garment workers.

Neang Sokly has worked in the garment industry for eighteen years. Currently she is employed in the quality control department of Conpress Factory Holdings Ltd., where she checks over a thousand pairs of jeans each day to make sure they meet customer standards before being shipped to international retail outlets. Her basic salary is US$124 per month, with which she has to support herself, her aging parents, and her three unemployed siblings. Even with their extremely modest lifestyle, her wages are simply not enough to cover basic expenses – leading her to actively seek as many overtime hours as are available.

“I always try to work eleven hours if possible. I want to help my family, and if I work less I cannot help them,” says Neang. “Next month there are no extra orders [at Conpress] so I will not earn any extra money. Without overtime our lives become very difficult.”

During one such overtime shift, Neang recalls when one of her co-workers collapsed at work, but they were unable to help. “She called me from the hospital [after she fainted] asking for help, but we had an urgent order so we were not allowed to leave.”

Though union intervention has largely stopped the practice of forced overtime, the financial realities faced by garment workers – the majority of whom come from impoverished families – make extra work essential, if not officially obligatory.

These long hours expose workers to the often inadequate conditions inside garment factories for far longer than is healthy. Sao Nari, who has fainted twice in her four months of employment at Conpress, remembers the same chemical smell in the air each time she collapsed. “I felt like I was suffocating,” she recalls, “I couldn’t breathe. I don’t know what the smell was, and the managers wouldn’t tell us.”

Yet the thought of quitting her job at the factory, despite her family’s concern for her wellbeing is not a plausible option. “I’m the only person in my family with a job, and we have a lot of debt from building our house. Without this job and overtime hours, I don’t know what we would do.”

In the opinion of Mr. Sithyneth of FTUWKC, the effects of poverty on the home life of garment workers could be as responsible for fainting as the long hours. A study from the British National Health Service recommends that an average woman consume roughly two thousand calories per day in order to maintain a healthy weight. Yet because of their low salaries, many garment workers are malnourished.

Twenty-four year-old Chang Savy, who has fainted twice at work in the Conpress factory, says she and her husband have just US$30 per month to spend on food. “I often feel dizzy at work and I don’t know why,” reports Chang. “Maybe I fainted because I don’t eat enough. My husband and I eat just half a cup of rice each per meal, and maybe a little bit of soup. We rarely can eat meat.” With the United States Department of Agriculture estimating that half a cup of cooked white rice contains just one hundred and twenty calories, Chang falls well below the caloric requirements necessary to maintain energy for a full workday.

Neang Sokly, who also reports not having enough disposable income to eat properly, recognizes that her poverty means she has little choice but to keep working in garment factories. Yet she credits the arrival of worker’s unions in Cambodia as improving their situation drastically. “Before the unions conditions were horrible. [The unions] have improved both the conditions and our pay. With all of us standing together, the owners must treat us better,” Neang states.

In an effort to improve the lot of her fellow garment workers, Neang volunteers as a representative for various union groups that give her funding to purchase medical supplies which she distributes to those in need. Furthermore, the presence of unions allows her to report worker abuse and exploitation. “Without the unions, things would be very bad. The unions make our voices heard.”