Rickshawpuller Rahmat Ali, in his late 40s, drops off his passenger to her destination. He sits down to take a breather, and takes his medication for joint pain.
Rahmat is in constant need of painkillers, which he carries around under his rickshaw seat. He suffers from chronic arthritis, and there is no escape from the pain.
Without the pills, he cannot take care of his family back in Kurigram, his home district.
Rahmat is not alone. Most rickshawpullers in the capital suffer from various diseases, particularly arthritis, thanks to faulty design of rickshaws and the way they pull the vehicles.
Besides, many suffer from abdominal pain and malnutrition, according to a government study. Physicians say arthritis puts rickshawpullers in the risk of becoming disabled.
The 50-year-old, who has been pulling rickshaw in Dhaka for the last 10 years, had to stop work for about two months recently as his pains soared.
He felt a little better after taking treatment and took to the streets with his three-wheeler – his lone source of income. But he has to take medicine regularly.
The National Institute of Preventive and Social Medicine (Nipsom) conducted a survey on health problems of rickshawpullers. The survey was done on 220 rickshawpullers at four rickshaw stands and two garages at Mirpur, Bhashantek, Ibrahimpur, Banani and Khilgaon between January and June of 2018.
The findings show the rate of arthritis is highest among rickshawpullers – 62.7 percent.
The survey using the Oswestry Disability Index – a method used by clinicians and researchers to quantify disability for low back pain – showed 75.4 percent suffer slight disability while 24.6 percent medium disability.
Apart from that, 14 percent suffer from abdominal pains, 14.3 percent general weakness and 9 percent malnutrition.
The rickshawpullers who have been in the profession for more than 10 years participated in the survey.
Most of them complained low back pain. Some 26.62 percent feel the pain while pulling rickshaws, 64.75 percent after finishing trips and 8.63 percent all the time.
Prof Dr Syed Shahidul Islam of the National Institute of Traumatology and Orthopaedic Rehabilitation (Nitor) said arthritis is a joint pain. The fluid between two bones of arthritis patients dry up and the bones come closer to each other. The bones become smaller and cause pain. Arthritis is a major cause of disability.
Experts say working for long hours, uncomfortable rickshaw seats, faulty way of sitting and unhealthy food habit are the main causes of various diseases suffered by rickshawpullers.
Dr Shafiur Rahman, assistant professor at Nipsom, told The Business Standard that rickshawpullers have to take a curvy posture sitting on rickshaws due to the faulty design of the vehicles. It causes trouble in the spinal nerve and results in pain.
Another survey showed 2 to 6 percent rickshawpullers become disabled due to arthritis, he added.
Dr Shafiur said rickshawpullers take pain killers without consulting a doctor. It causes gastric, abdominal pain and kidney problems. He said if their joint pains could be cured, other problems would disappear. They would not have suffered ulcer. They cannot eat properly due to ulcer and become weak. It increases lower back pain and kidney problem develops in them.
This correspondent spoke to more than 20 rickshawpullers in Green Road, Farmgate, Shahbagh and Bangla Motor areas and found that they seldom go to a physician. Most of the time they buy medicines from nearest drug stores and take those.
Shamsur Rahman of Gaibandha, who has been pulling rickshaw in the city for more than 20 years, said he faces problems in work due to pain. So, he always carries pills for painkillers and gastric.
Dr Shafiur Rahman said not only rickshawpullers and their families are affected by osteoarthritis, its burden is also borne by the state. He said if the government and non-government organisations took awareness programmes, this problem could be overcome.
He further said alongside reducing the rickshawpullers' work hour and providing counselling, if they are given oral saline three times a day, fluid secretion from their joints would come down.
The physician said it would improve their health condition. They should also be motivated to take foods rich in calcium and iron. If rickshaw makers have the sitting system straight and easy for rickshawpullers, their health problem would come down.