Of the first 100 patients to visit the clinic, a report released in 2002 revealed, 99 had one or more work-related conditions. Nearly half were diagnosed with back strain or pain, one-third with neck strains, one-fourth with shoulder strain or pain, and 9% with wrist and knee pain. More than half said pain kept them awake at night and impeded their housework. Nearly one-third had trouble dressing or bathing.
Just seven had filed workers' compensation claims, and four of them said they were fired or forced out of their jobs as a result. "It was a learning process for the garment workers to identify that pain wasn't normal," said Lashuay, who served as clinic director. " 'You work, you use up your body.' I heard that statement so many times."
Under the guidance of Chan, of the Department of Health Services, the women learned to relieve their symptoms by stretching, applying ice and taking ibuprofen. But when they were encouraged to confront their bosses about poor working conditions, most balked. Many were even reluctant to accept pieces of sturdy foam to use as lumbar support cushions or pad their hard-edged sewing tables, fearing that even slight changes to work equipment might rile their employers.
But slowly, the women began to speak up. One was teaching her colleagues stretching exercises at their sewing shop when her boss appeared. She feared she would be fired, but her supervisor was encouraging. The woman recounted her experience in a video testimonial, distributed to other workers. Maybe, they realized, they could change their workplace.
"Seeing doctors is not a long-term solution," said May Yeung, 50, a shy Hong Kong immigrant. "Prevention is better."
With the women's urging, the nonprofit organizers and clinic health practitioners decided to take the project one step further. Because there was no ergonomic equipment available for the garment industry, they would have to create some.
The final phase of the project convened in a makeshift lab in the nonprofit's offices. Chan and Lashuay recruited Ira Janowitz, a senior University of California ergonomics consultant.
Ergonomics improvement programs are generally initiated by management and conducted at the workplace, said Janowitz. Low-wage workers forming their own ergonomics committee was highly unusual, he said.
Industry conditions also startled him. Workers often sat on crates or stools to sew, factory visits and photos revealed. Those who had chairs adjusted them by jamming spent plastic thread spools under the rear legs.
The new equipment had to fit the factories' cramped conditions. And it had to be inexpensive if the group had any hope of promoting it to Oakland's immigrant-owned contracting shops.
Janowitz called on Carl Zdenek, a former architect and founder of Bay Area-based Soma Ergonomics. Much like musicians, sewing machine operators engage in what ergonomists call "forward sitting." Zdenek had already helped design a two-part chair that tilts forward to accommodate that posture in cellists. The garment workers' ideal chair, he decided, would look similar. An Oakland cabinetmaker and a sewing machine mechanic from San Francisco rounded out the team. Together, they devised a footrest that factory owners can make themselves for as little as $5, and a sewing table extension -- which sells for $40 -- that raises and lowers to accommodate heavy fabrics that tire the women's shoulders.
Finding factories to take the test designs -- even for free -- was not easy. "Nothing is free in the Chinese culture," said Ken Fong, a longtime AIWA organizer who with Chan visited the same factories repeatedly to persuade them to take the chairs. "They thought there must be some conditions we were hiding."
At last, three signed on. On regular visits to the factories, Chan brought dim sum, needles to replace ones that broke, and other offerings to signal goodwill. Then, two years ago, the first chairs arrived.
Although the Oakland group is too small to be scientifically significant, Chan said, the majority of women in follow-up surveys have reported a reduction in pain. The preliminary findings led to the study now underway with 300 workers in Los Angeles County.
At W&S, a small factory in an unmarked Oakland building, the industry's harsh realities and the ergonomics project's tentative hope are both in evidence. On a recent day, about two dozen women hunched over machines -- many sewing satin pink and black Jessica McClintock evening gowns.
One woman who identified herself only as Lisa said she had grown accustomed to constant lower back and leg pain. Because she has no medical insurance, she has never gone to a doctor.