Manifesto à la mode

Feature article

Aneka Larsen


Despite what your mother may have told you, it’s not just what’s on the inside that counts. As medical students, our external image matters greatly. We dress to impress, to show patients that we are capable and trustworthy. But how would our patients feel if they knew who made our clothes? Sustainable fashion is by no means a new idea, and most people I know support the idea, yet many of us still wear brands that are known to engage in unethical practices. Although we as medical students generally wish to improve others’ quality of life, too often we put ethics on the backburner as we convince ourselves that we are too busy, too tired, too whatever-it-happens-to-be that day, to think of the consequences of our actions. If we were truly compassionate, it would seem incongruent that we would not also express this in choosing which brands to support.

After becoming increasingly concerned, I discussed the issue with a friend who told me that given the opportunity, most people will choose to do good. That is, most people don’t want to benefit from the exploitation of others but will unthinkingly ignore the reality of how most clothes are made. Every day we are exposed to marketing on billboards, bus stops, shop windows, YouTube, Facebook, fashion blogs, and Instagram feeds. Our first thought is not ‘who made this?’, but ‘I want that’. It’s automatic, and that’s why it works. I choose to believe that my peers are not consciously deciding to fund a harmful industry, and that instead their choices simply reflect a lack of opportunity to consider their purchases. Here is said opportunity. Think carefully and buy ethically, so as to avoid a fashion faux-pas that’s more than just embarrassing— one that results in child slavery, abysmal wages and factory collapses causing thousands of deaths. If you would like to join me in protesting an industry that fuels the maltreatment and exploitation of others, then read on.

This is my manifesto to fashion, and all the illnesses, injuries and deaths that it can cause when not held accountable.

Do no harm

The famous, perhaps trite, Hippocratic oath often comes to mind when considering the part that many medical students have played in the illnesses inflicted on sweatshop workers. It is a turn of phrase strongly associated with the medical profession, and one that most doctors and medical students take very seriously. While much has changed since the oath was created 2,500 years ago, human nature is still very much the same. This oath is important because it sets clear boundaries for minimum decency. To paraphrase Hippocrates, —‘Guys, I know you’re busy and all, but at least don’t give Bangladeshi women gastric ulcers and deprive them of food and sleep for days on end.’ Bangladeshi sweatshop workers receive one of the lowest minimum wages in the world,[1] and women often feel obliged to prostitute themselves at work for extra money.[2] To help understand how severely impoverished they are, let’s take into account their average monthly wage, 3000 taka, which is approximately $50 Australian Dollars. Working 16 hours a day for 7 days a week, they have made the shirt on your back for 10 cents an hour. For an extra 7 cents an hour, they would have enough to meet the “living wage”,[3] defined as “the minimum required to provide a family with shelter, food and education”.[3] If you add on the other burdens associated with sweatshops; the cramped living, lack of maternity care, and risk of silicosis from all the sand blasting so your denim can have that worn aesthetic, Hippocrates would be turning in his grave.[4] No cause justifies the deaths of innocent people Averting the deaths of innocent civilians seems like another no-brainer, but in a globally reported disaster in April 2013, an eight-story sweatshop in Dhaka, Bangladesh, collapsed, killing over a thousand people and injuring over two thousand.[5] The sweatshop supplied clothes to international brands such as Primark and H&M. [5, 6] While this disaster was widely discussed, it is one of many examples of the deaths inflicted on Bangladeshi workers. Another 7 deadly accidents were reported to have occurred in Bangladesh between 2005 and 2015.[7] An example of the response from companies involved is the one provided by H&M after the Rana Plaza collapse. “It is important to remember that this disaster is an infrastructure problem in Bangladesh and not a problem specific to the textile industry”. [8] This response shifts the blame to a poverty-stricken country and should not absolve them from participating in the exploitation of Bangladeshi workers. Although these disasters may seem far away from our comparatively comfortable lives, the deplorable crimes committed by the fashion industry are being committed by the fashion industry in our names. Many of the clothing brands worn by my peers here in Australia have been remonstrated for their manufacture practices, including Tigerlily, UNIQLO, Gorman, Ralph Lauren, Lacoste, Boohoo, and Dotti.[9] Choosing which pretty dress or flash new suit to buy for the next ball can seem like a life or death situation, but instead of only stressing over which looks best, also ask yourself where and how it was made. There are actual lives at stake, not just social ones, and they are lives that you can help to save simply by asking the right questions.

Practice what you preach

Do what your favourite soul singer tells you to do and “Practice What You Preach” (Barry White, 1994). How could you resist that deep baritone anyway? Sustainable fashion is generally seen as an ethical “thumbs up”, and yet so many people don’t practice it. There are a range of reasons that beliefs may not necessarily transfer to action, but the difficulty in keeping track of which brands treat their workers fairly seems to be a key one. One way to combat this challenge is to refer to an organisation that conveniently does it for you, such as Ethical Clothing Australia (ECA), which maps the local supply chain of brands to ensure the fair treatment of clothing workers. It provides a list of those brands which provide fair wages and decent living conditions, and its website lists these brands for your perusal. Some included brands are Cue, Manning Cartell, Thurley, Scanlan Theodore and Nobody.[10] As a general rule, however, it helps to ask if the price tag on an item really reflects the amount of work that went into making it.[11] A Kmart t-shirt‘s $3 price tag may be appealing to some, but their supply chain is untraceable and the workers receive a “minimum wage”, less than a “living wage”, the amount required to meet basic costs of living.[11] When considering price, it is obviously very important to acknowledge that not everyone can afford to pay for organic, handmade clothes. Some ways to overcome this include participating in the events run by charities like Fashion Revolution that work at raising awareness, shopping secondhand so that your money does not go directly to exploitative companies, learning to make your own clothes and writing to companies to put pressure on them to subscribe to ethical practice. [12] Go on, make Barry proud.

There are alternatives to supporting exploitative fashion labels. Protesting the unethical choices of the fashion industry doesn’t mean you have to look like a hessian sack. Fashion is about making you feel like your best self, which is hard to accomplish when your new look endorses an industry that is directly responsible for the illnesses, injuries and deaths of women and children from third world countries. Next time you’re worried about committing a fashion fauxpas at Med Ball, remember your commitment to improving the lives of others. That commitment shouldn’t just remain within the confines of the hospital.


Photo credit
Ricardo Gomez Angel, accessed from https://

Conflict of interest
None declared


1. International Labour Organisation, Characteristics of minimum wage setting system and minimum wage levels, [Internet]. Available from: wcmsp5/groups/public/—asia/—ro-bangkok/documents/ genericdocument/wcms_223988.pdf, (accessed 2 September 2018)

2. Inter Press Service News Agency, Women Suffer Most in Garment Sweatshops in Bangladesh, [Internet], 1998. Available from:, (accessed 25 August 2018).

3. War on Want, Sweatshops in Bangladesh [Internet]. Available from: (accessed 20 March 2017).

4. Akgun M, Araz O, Ucar EY, Karaman A, Alper F, Gorguner M, et al. Silicosis Appears Inevitable Among Former Denim Sandblasters: A 4-Year Follow-up Study. Chest. 2015;148(3):647-54.

5. The Independent, Bangladesh factory collapse: 41 charged over deadly Rana Plaza tragedy, [Internet], 2015. Available from: asia/bangladesh-factory-collapse-41-charged-over-deadlyrana-plaza-tragedy-a6781876.html, (accessed 22 March 2016).

6. Clean Clothes Campaign, Evaluation of H&M Compliance with Safety Action Plans for Strategic Suppliers in Bangladesh, [Internet], 2015. Available from: https://, (accessed 25 August 2018).

7. CBC, Timeline: Deadly factory accidents in Bangladesh, [Internet]. Available from: interactives/timeline-bangladesh/, (accessed 22 March 2016).

8. Business and Human Rights Resource Centre, Response by H&M: Rana Plaza factory collapse in Bangladesh; over 1100 dead, [Internet], 2013. Available from: https://business-humanrights. org/sites/default/files/media/documents/company_responses/ h&m-response-re-bangladesh-building-collapse.pdf, (accessed 20 March 2017)

9. Baptist World Aid, The 2018 Ethical Fashion Report, [Internet]. Available from: resources/2018-ethical-fashion-report, (accessed 25 August 2018)

10. Ethical Clothing Australia, Brands, [Internet], 2016, http://, (accessed 20 March 2017)

11. Choice, Ethical clothing, [Internet], 2014. Available from: clothing/articles/ethical-clothing#ethically, (accessed 22 March 2016).

12. Independent, Katharine Hamnett interview: How to shop ethically on a student budget, [Internet], 2014. Available from: html, (accessed 22 March 2016).

Tags: No tags