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C5 Stress and Stress-Relief: Subprojects

Stress and Stress-Relief among Factory Workers in Dhaka, Bangladesh

Christian Strümpell

In his project ‘Stress and Stress-Relief among Steel Workers in Dhaka, Bangladesh’ Christian Strümpell investigates concepts workers in Dhaka’s steel factories employ to make sense of, contest and consent to the social, economic, political, and cultural transformation rapid industrialization entails. Strümpell conducts ethnographic research on the shop floors of two different factories, in a ‚classical’ rolling mill in Dhaka’s old town producing for the local market as well as in a ‚modern’ fabrication unit located at the fringes of the metropolis and aiming to attract foreign investment. Strümpell enquires into strategies Dhaka steel workers pursue to cope with ‘stress’ and social inequalities, both within factories and their urban surroundings. Strümpell gives particular weight to the social relationships workers maintain on and off their factory floors, how these relationships are negotiated and valued. In public health research ‘social support’ is considered among the most effective buffers against stress and Strümpell enquires what forms of sociability, in the socio-cultural contexts of Dhaka’s steel factories, are considered supportive or not. To contextualize his data on local discourse and practice Strümpell scrutinizes differences and commonalities between workers of different generations, between male and female, and skilled and unskilled workers, as well as between fully urbanized, proletarianized workers and those with more or less intensive links to ‘rural homes’ and access to land resources. As an anthropologist Strümpell’s research is based on participant observation, qualitative interviews as well as on the use of questionnaires developed by public health.

Transnational Industrialization and Formation of Stress amongst the Female Garment Factory Workers in Bangladesh

Hasan Ashraf

The neoliberal turn of Bangladesh’s economic policy resulted in a remarkable growth of garment exports from Bangladesh to ‘the West’. Bangladesh is now the second largest readymade garment (RMG) supplier in the global apparel production chain. It induced over 3.6 million workers in more than 5000 garment factories, about 80% of them are women. In 2010/11, the turnover of the industry (and variations thereof) was 17.91 billion US dollars under the influx of global economic recession, and constituted the main export earnings (78%) for the country in its third decade.  

In this context, the broader objective of the research is to understand how industrialization, understood as a transnational form that has been imported to Bangladesh from ‘the West’ along with the intrinsic conditionality of the neoliberal era, alters the ways of living of women working in the ready-made garment industries. The main objective of the research is to track a very specific aspect of the altered ways of living produced by the conditions of industrial labor, one that has been neglected so far, namely the production of ‘stress’ and discourses around stress in relation to industrial labor regimes and capitalistic discipline of labor in the wider socio-political context. The working hypothesis is that industrial workers have different stress hierarchies specific to occupation, gender, class and life experiences. 

The main questions are: How has a conception of stress arrived together with industrial labor and changing lifestyles in Bangladesh for these young women? Do social bonds or networks provide buffers against this? How is the changing and evolving process of the formation of stress as a socio-cultural construct interlinked with the political economy of transnational capitalistic production systems? This is a multi-sited ethno-historical research, primarily focusing on factory shop floor and the everyday lives of the workers, as well as the realms of policy domain, combining three academic perspectives: Anthropology, History and Public Health. 

Tibetan Buddhist tantric meditation of gcod as a practice and healing approach

Nike-Ann Schröder

The project of Nike-Ann Schröder will be based on situated ethnographies of encounters between healers and psychotherapists applying Tibetan meditation practices in India and Europe, and their patients / clients suffering from problems that can be related to mental distress. In particular, the meditation technique of gcod and its application as a healing technique will be focused. First, Schröder will research on gcod as a healing technique among Tibetan refugees in Ladakh, North India. Secondly, Schröder will research on the transfer and application of a Tibetan meditation technique practised within a different socio-cultural context in a psycho-therapist practise in London. By focussing on the Tibetan Buddhist healing technique in both settings, the different socio-cultural backgrounds of the respective agents and their practises will be examined as well as the patients’ interpretations of their problems, their ideas and their experience of the healing processes. This comparative study between two socio-cultural settings aims to gain insights into the transcultural ‘translatability’ of problems and illnesses related to ‘stress’, and to examine possibilities and boundaries of the transcultural transference of a Tibetan practise and healing technique as a coping strategy to Europe.  

Stress: The history of a western concept and its flow to South Asia

Saskia Rohmer

Nowadays Stress seems to be an omnipresent appearance in our daily life and is often perceived as a characteristic feature of our modern fast paced lifestyle. Stress related illnesses even became such an enormously health problem that it is often referred to as a western epidemic. But this raises the questions if this phenomenon which seems to pose such significant health risks is really a modern one and if it isn`t rather a transcultural problem than a pure western.

At the one hand this research focuses on the emergence of different historical conceptualizations of stress in Western scientific discourse since Hans Selye – the often so called “father of modern stress research” – published his first article about this topic in 1936. Within a review it will be also exanimated which theories and concepts laid the foundation for the modern stress research and it will be of interest if theories about stress existed before as well. At the other hand the second part focuses on the Asian context. Taking India as an example it will be investigated whether the Western concept of stress has gained prominence among medical professionals and scientists of other disciplines. A special focus will be set on the questions if the western concepts of stress are adopted or transformed by Indian scientists and it will be examined if similar concepts existed in Indian tradition before.

Mental Health and Stress in Asia: Epidemiological Perspectives


Part 1: The association of depressive symptoms with respiratory disease in Asian countries

Adrian Loerbroks



Many studies have linked stress and poor mental health (e.g. depressive symptoms) to respiratory disease. The majority of previous epidemiological studies were conducted in Western populations (e.g. Europe and North America) while data from Asia remains sparse. It is still elusive whether findings from Western populations can be generalized to Asian countries since the experience and expression of poor mental health differs considerably between cultures.


This subproject aimed to examine whether poor mental health (measured by depressive symptoms) is associated with the occurrence of respiratory disease in Asian countries.

Data and key findings

Two large data sets were used to address the research aim:

  • Data from 10,000 individuals who participated in the Chinese ”Guangzhou Biobank Cohort Study“ which is a collaborative study between the University of Birmingham, the University of Hong Kong and the Guangzhou No.12 People's Hospital in China. Respiratory diseases that were investigated included self-reported asthma and various indicators of chronic obstructive pulmonary disease (COPD). Key findings:
    • Asthma showed a positive association with depressive symptoms in China.Distinct patterns of association were observed for depressive symptoms and COPD:
    • Depressive symptoms were associated with self-reported COPD and with characteristic respiratory symptoms, but not with airway obstruction (determined by lung function assessments).
  • Data from the WHO World Health Survey were analyzed, which included approximately 250,000 men and women from 57 countries (including 14 Asian countries). This data set was used to explore associations between depression and self-reported asthma in various Western and nonwestern countries. Key findings:
    • Depression and asthma were found to co-occur in Western and Asian countries alike.
    • Associations tended to be stronger in Asia than in Europe.

Part 2: Work stress and health among workers in a Ready Made Garments factory in Bangladesh

Principal Investigator: Adrian Loerbroks
Doctoral Student: Maria Steinisch


Along with globalization and rising cross-national competition ”work stress” may be spreading across the globe, including Asian growth economies and settings such as Bangladesh’s Ready-Made Garment (RMG) industry. Adverse working conditions in RMG factories have increasingly been subject to discussion in Asian and Western media, but scientific research in this area is yet sparse. In this subproject, we aimed to develop a tool to assess work stress and to explore its associations with health outcomes among workers in a RMG factory in Bangladesh.


In earlier studies on work stress in an Asian context well established Western interviews have been used. These interviews have been developed to measure “work stress” among Western blue- and white-collar workers. Usually, these interviews were translated for use in Asia without any further adaptation to increase cultural sensitivity.

As “stress“ represents a subjectively felt and culturally determined entity there is reason to believe that the Western interviews are not able to fully capture work stress as it is experienced in work settings that are very different from Western work contexts, such as Ready-Made Garment (RMG) factories in Bangladesh.



The first aim of this study was to elucidate whether the validity of work stress interviews from the West may be improved by adding culture- and context-specific items, taking the cultural dimension of work stress into account.


The second aim was to investigate possible associations of work stress, as measured by our interview, with self-reported health outcomes.


The third aim was to explore whether work stress, as measured by our interview, translates into increased activity of the Hypothalamic–pituitary–adrenal (HPA) axis, a hormonal key pathway assumed to reflect a physiological manifestation of psychological stress. We aim to measure hair cortisol, a “stress hormone“ that is released as an endproduct if the HPA axis is activated.



In February and March 2012, we conducted a cross-sectional study among 531 women and men (response rate 98%) in a RMG factory in Gulshan, Dhaka together with the collaborating Centre for Health, Population and Development at the Independent University, Dhaka, Bangladesh. The work stress interview combined a 7-item version of the widely used Effort-Reward Imbalance model with seven setting- and culture-specific items derived from previous ethnographic research conducted by Hasan Ashraf. Hair samples were collected from 179 participants.


Preliminary results

Preliminary analyses of the interview data showed that high work related demands (e.g. physically demanding work and exposure to abusive language), and poor social interactions represent key components of work stress and are important determinants of poor health in RMG factories in Dhaka, Bangladesh. In contrast, work-related values like promotion prospects and job security as captured by well-established Western work stress scales, seemed to be of little relevance. These findings imply that the modification and cross-cultural adaptation of work stress measurement is warranted.

The associations of psychosocial work conditions with health, as measured in this study, underline the public health relevance of the current discussion about adverse working conditions in Asian RMG factories.

The hair samples are currently being transferred for laboratory analyses. Preliminary results related to the association between work stress and cortisol are expected in summer.

External cooperation partners: Dr. Rita Yusuf (Co-PI) and Prof. Omar Rahman, both from the Centre for Health, Population and Development, Independent University, Dhaka, Bangladesh
Internal cooperation partners: Dr. Christian Strümpell, Dr. Jian Li (Mannheim Institute of Public Health), Hasan Ashraf
Advisor:  Prof. Joachim Fischer