BUDGAM DISTRICT, Kashmir – On the outskirts of Srinagar, in Indian-administered Kashmir, most of the residents owe their livelihoods directly or indirectly to one thing: traditional Kashmiri garments. For many of them, producing or selling items such as shawls, namda (mats) and pheran (cloaks) is the only way they can make a living.

But for the women who embroider the garments, the craft that pays their way has its own dire cost. Days spent hunched over delicate needlework, some of which can take months to complete, is taking a toll on their health. For some, it is even causing serious vision loss.

In one Budgam workshop, the sound of clicking looms mixes with the songs playing on the radio. Zahida Akhter, 18, sits in a corner near the windowsill to get more light as she puts the final touches on the cloak she is working on.

Every day, she starts work at 9 a.m. and goes home at 6 p.m. After finishing her daily chores around 10 p.m., she sits down to continue working, usually by candlelight, until 3 a.m. After two hours’ sleep, she wakes up before her family to do more embroidery until it’s time for her to go back to the workshop. There are around 30 girls working with her, most of them under the age of 18.

As a result of sitting hunched over her work for so many hours a day, she suffers from a slipped disc, swollen joints and deteriorating vision. “I was given glasses last year, but I never wore them,” she says. She felt they interfered with her ability to get up close to the cloth as she works. “I have severe headaches and backache after working throughout the day. But, well, one has to work to pay for life’s expenses,” she says.

Doctors have recommended that she give up the work, but Akhter, who can barely read or write, says embroidery is the only way she can help provide for her family, which includes six younger siblings, all of them too young to work.

“How can I give it up as it is the only means for me to keep my family going?” she asks. “So, I don’t pay any attention to the doctor’s recommendations.”

There is no data available on the rates of visual impairment in Budgam district, but Dr. Mariyum Rubiya, an ophthalmologist who has been posted at the Budgam district hospital for over a year, says the number of patients she sees coming from the embroidery industry is on the rise.

“Working intricate designs and keeping the piece very close to the eye for hours at a time eventually puts stress on the retina, and if this kind of thing continues, it has the tendency to affect the person’s eyesight,” she says. “I see two or three such patients per day, which amounts to about 720 a year. It’s a huge number.”

Rubiya says the women usually come in with headaches, for which she prescribes medication. She also recommends that the women start wearing glasses or take a break from their work. But they rarely listen, she says.

“Most of the patients never follow up with their treatment, so it’s difficult to know how their condition [evolves] later on,” Rubiya says. Most of her patients, she says, are between the ages of 14 and 30, and come from lower socioeconomic groups.

“For these young girls, protecting their eyesight is the most important thing, which we keep on telling them. But unfortunately, they stop coming to us as soon as we suggest they give up their work,” she says.

Most of the embroiderers in Budgam are under Kashmir’s legal working age of 14, and some workshop owners openly admit they use girls as young as 12 because they are easier to train.

“We prefer to take young and fresh minds to teach them about this art,” says Ramzan Mir, who owns three workshops employing more than 60 young girls, most of them minors. “As they are sharp enough at that age, they pick it up very fast.”

But when a girl’s eyesight gets so bad she can no longer do the intricate needlework or her back hurts so much she can’t work for long stretches of time, she loses her job and often will struggle to find another.

“This is unfortunate, but we tend to earn from others’ misery. First [the workshops] lure young girls with money, but then when their health starts to deteriorate, they declare them useless,” says local sociologist Dr. Bashir Aadil.

“It’s like blinding the coming generation, and we are doing absolutely nothing to prevent it.”

Sakeena Bano, 26, works alongside Akhter. “It’s my fifth year in the business and each day, my strength decreases, owing to sitting at one place for hours,” she says. “My shoulders are cursing me; even my eyesight is diminishing with each passing day.”

Bano does much of her work at night, and the electricity supply to her home is unpredictable, so she often ends up using candles for light. Over the years, her eyesight has become so bad, it has started to affect her work.

“Before, I could work throughout the night and the piece would come out very nicely. But now, I can see irregularities that are the outcome of my blurred vision,” she says. “I don’t get too many orders nowadays.”

But, like Akhter, Bano sees no other option than to keep doing the work. Like most of the garment-makers in Budgam, Bano comes from an impoverished background and can’t read or write.

“For people like us, surviving is the main task,” she says. “We can afford to take our chances with health and eyesight, but not with empty bellies.”