India's call-center workers pay health toll

NEW DELHI — The job came with a good salary and good perks.

But, 26-year-old Vaibhav Vats will tell you, it was doing him no good. His weight had grown to 265 pounds and he was missing out on social life as he worked long overnight hours at a call center. Eventually, he quit.

"You are making nice money. But the trade-off is also big," said Vats, who spent nearly two years at IBM's call-center arm in India, answering customer calls from the United States.

Call centers and other outsourced businesses such as software writing, medical transcription and back-office work employ more than 1.6 million young men and women in India, mostly in their 20s and 30s, who make much more than their contemporaries in most other professions.

They are, however, facing sleep disorders, heart disease, depression and family discord, according to doctors and several industry surveys.

Experts warn the brewing crisis could undermine the success of India's hugely profitable outsourcing industry that earns billions in dollars annually and has shaped much of the country's transformation into an emerging economic power.

Heart disease, strokes and diabetes cost India an estimated $9 billion in lost productivity in 2005. But the losses could grow to a staggering $200 billion over the next 10 years if corrective action is not taken quickly, said a study by the New Delhi-based Indian Council for Research on International Economic Relations. The outsourcing industry would be hardest hit, the study warned.

Reliable estimates on the number of people affected are hard to come by, but government officials and experts agree it is a growing problem. Health Minister Anbumani Ramadoss wants to enforce a special health policy for employees in the information-technology industry.

"After working, they party for the rest of the time ... [They] have bad diet, excessive smoking and drinking," he said last month. "We don't want these young people to burn out."

The minister's comments have infuriated the technology sector, which says it has been unfairly singled out for problems that also exist in other professions.

The outsourcing industry has come under fire because the sedentary lifestyle of its employees combined with often stressful working conditions makes them more vulnerable to heart disease, digestive problems and weight gain than others. Some complain of psychological distress.

Most call-center jobs involve responding to phone calls through the night from customers in the United States and Europe, some of whom can be angry and rude. It is monotonous and there is little meaningful personal interaction among co-workers. That can also be true of other jobs such as software writing and back-office work.

"There are times when the stress is so overwhelming that they fail to cope with it. Then they come to us," said Archana Bisht, who set up a counseling company, 1to1help.net, in Bangalore six years ago.

Her clientele has since grown to 25 companies, including Intel, IBM, Hewlett Packard and Mindtree Consulting.

Each day, about 60 to 70 employees at these companies seek counseling from 1to1help.net. The complaints are many, but marital incompatibility and relationship issues top the list, Bisht said, often because the long, odd working hours mean couples don't have much time together.

The outsourcing boom has created employment opportunities for Indian women, but there has been little change in social expectations. Adding workplace demands to responsibilities at home, which often include taking care of in-laws, leaves women workers with multiple stresses, Bisht said.

Loneliness can also take a toll.

"There is no social life," said Vats, who worked at night and either slept or watched television during the day. "You are not meeting new people."

The industry is getting sensitive to these problems.

The National Association of Software Services Companies (Nasscom), the main trade body of the outsourcing industry, said many of its member firms are already providing services such as advice on health, gyms and money for regular checkups.

Firms such as Infosys Technologies have set up 24-hour helplines for counseling by psychologists, while others have tied up with companies such as 1to1help.net. HCL Technologies and others have built day-care centers for children and routinely sponsor group outings by their employees.

But the industry insists it would do nothing to impose any lifestyle on its employees.

"We do not think it is for companies or for the government to interfere in the personal life of adult Indians," Nasscom said in a statement.

Also, there is little it can do to change the nighttime work hours of many outsourcing jobs.

"The odd hours can play havoc with your health," Vats said. "I never got good sleep because everyone was up and getting ready to go to work when I got home ... . Your diet goes for a toss. You get acidity, develop gastric problems."

Vats' weight has dropped to 214 pounds since he left IBM Daksh two years ago. He's still overweight for his 5-foot 9-inch frame but is much happier now working with a law firm for a much lower salary.

A recent survey by Dataquest magazine and technology consulting company IDC showed sleep disorders topped health complaints among outsourcing-industry workers.

About 32 percent of respondents complained of sleep disorders; 25 percent had digestive troubles; and 20 percent reported eyesight problems, said the survey, which covered 1,749 employees at 19 outsourcing companies.

Sleep and digestive disorders, doctors say, can grow into bigger problems: hypertension, diabetes and heart diseases.

Doctors say the rise in these diseases, alongside growing urbanization and rapid economic growth, is not surprising.

But India's case is alarming because of the number of people affected and the factors that make them vulnerable to these diseases, said Ravi Kasliwal, a cardiologist at New Delhi's Indraprastha Apollo Hospital. Those include India's fat-rich diet, genetic factors that make them highly vulnerable to diabetes, and abdominal obesity that gives rise to insulin resistance and heart disease.

Heart disease is projected to account for 35 percent of deaths among India's working-age population between 2000 and 2030, Kasliwal said, citing a World Health Organization study. That number is about 12 percent for the United States, 22 percent for China and 25 percent for Russia.

"This is a very serious issue for this country," Kasliwal said. "But nobody wants to talk about it."