Life at the sharp end

Conditions for workers – among them children – in the smallest workshops are often appalling Photograph: BMA Medical Fair and Ethical Trade Group

The International Labour Organisation estimates that there are 5800 children working in the surgical instrument industry in Sialkot Photograph: BMA Medical Fair and Ethical Trade Group

Instruments are made without safety equipment such as gloves or protective clothes, leading to frequent injuries Photograph: BMA Medical Fair and Ethical Trade Group

Workers are paid as little as 170 rupees (£1.40) a day Photograph: BMA Medical Fair and Ethical Trade Group

Conditions are insanitary Photograph: BMA Medical Fair and Ethical Trade Group

Large companies typically sub-contract much of the early work on their products to small freelance workshops Photograph: BMA Medical Fair and Ethical Trade Group

Unfinished instruments Photograph: BMA Medical Fair and Ethical Trade Group

Work is undertaken without basics such as safety goggles and adequate ventilation Photograph: BMA Medical Fair and Ethical Trade Group

The NHS has now admitted that British hospitals are the destination for many of the products of Sialkot workshops Photograph: BMA Medical Fair and Ethical Trade Group