Amidst the Covid-19 pandemic, multiple news reports revealed the dangerous conditions in which sanitation workers did their jobs. They worked extra hours under high-risk conditions, without adequate protection, training, hazard pay or even job security.
- 89.7% of the workers did not have any health insurance or healthcare facility.
- The MoHFW guideline classified them only under moderate risk, even though they worked in containment zones and handled infectious COVID-19 waste. The guideline suggesting protection by just gloves and an N-95 mask.
- The guideline was in stark contrast to the WHO guideline — “Sanitation workers should follow standard operating procedures, which include wearing appropriate PPE (protective outerwear, heavy-duty gloves, boots, medical mask, goggles and/or a face shield).”
These facts are distressing but unsurprising in a society where one person dies every five days while cleaning sewers and septic tanks across the country.
The average life expectancy of a sanitation worker is less than 50 years.
But the average age of deceased sewer workers was only around 32 years (data obtained by Safai Karamchari Andolan for 2017-2018).
Quoting Dr BR Ambedkar here,
“Caste has killed the public spirit. Caste has destroyed the sense of public charity. Caste has made public opinion impossible. Virtue has become caste-ridden, and morality has become caste-bound.”
What else explains the apathy that allows us to accept such deplorable conditions of our fellow human beings, without a second thought, as just another data. Sanitation workers work amidst extreme physical and mental constraints. They often come in direct contact with human waste and face risk of Asthma, Cholera, Typhoid, Hepatitis, Polio, eye infections, skin burns, blunt trauma, gastroenteritis, and others, a seemingly endless list.
Toxic gases such as ammonia, carbon monoxide and sulphur dioxide in septic tanks and sewers can cause workers to lose consciousness or even die. Usually, workers have no form of protective or safety equipment despite the hazards at their work. They are prone to injuries and infections caused by sharp objects such as razors, syringes or broken glass.
Somappa, 52, says, “Injuries are common in our work. Sludge sometimes has broken glass, blades and needles. Moving heavy granite slabs or climbing up and down the pits can also cut our hands and feet. I work with bare hands and feet. When I have a cut, I tie a plastic bag around my hands or feet and continue to work.
“On January 5, 2017, Kathiravan died by suicide by hanging himself at his home in Pulianthope. He was 25. He had been employed by the Slum Clearance Board for eight years as a manual scavenger. His family says he put up a uniformly sunny exterior, but underneath, Kathiravan was in agony. His work was a nightmare he couldn’t shake off.”
The mental health of sanitation workers is a completely overlooked area. Even studies in this aspect are inadequate. Many manual scavengers resort to alcohol or drugs to escape the harsh realities of their atrocious work and caste stigmas. Even their families have to face the physical and mental suffering that accompany alcohol and substance abuse.
Women comprise 95% of over 1.3 million manual scavengers in India (International Dalit Solidarity Network). But their particular health requirements are neglected. Most of them work are in the informal sector and work without any sick leaves or maternity benefits. Additionally, they also have to carry out household responsibilities.
Despite all these health hazards, in most cases, the employer is not held liable.
According to a report by Dalberg Associates, the cost of workplace-related injuries and illnesses is internalised and not perceived to be the liability of the employer. Recently, the government extended Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) to manual scavengers. PM-JAY assures a health cover of ₹5 lakh per eligible family per year to avail cashless inpatient secondary and tertiary healthcare.
Is this a revolutionary step or just another new scheme with the same old problems?
Who Is A Manual Scavenger?
The government only recognises railway cleaners, sewer cleaners, latrine cleaners and faecal sludge handlers as manual scavengers. The Dalberg Report identifies nine types of sanitation workers in India with their separate safety and work profiles.
“Sanitation workers involved in waste-treatment plant cleaning, drain-cleaning, community and public toilet cleaning, domestic work and school toilet cleaning are not recognised by the government, though they work with human faecal matter and other dangerous waste too.” says this report.
With such a narrow definition under the act, it is no wonder that sanitation workers have borne the brunt of the pandemic. Even amongst those recognised by the government, names of a vast majority of manual scavengers are not included in government surveys meant for their rehabilitation, employment and children’s education schemes (WaterAid report).
Denial is sometimes highly ridiculous. For instance, the Delhi authorities claimed that manual scavenging has already been eradicated under its jurisdiction, while the National Commission for Safai Karamcharis (NCSK) said that 38 such deaths had taken place over the last two years in Delhi itself.
The Dalberg Report also points out that workers often operate without formal contracts, lack a unified voice for collective bargaining and have low awareness of rehabilitation schemes. Besides, there are large incentives for authorities to not acknowledge and address the problem of unsafe sanitation work. The processes to avail schemes are difficult and come at a significant cost to workers. Thus, they are discouraged from claiming their rights.
Without solving the fundamental problems of data collection and rehabilitation, new schemes might just prove to be eyewash. Various committees and reports have suggested actionable measures to help eradicate manual scavenging and provide dignity of labour to sanitation workers. The existing schemes need to be put in order instead of introducing new schemes with the same flaws.
It’s high time we recognise that public health invariably depends on sanitation work. Sanitation workers should be acknowledged as frontline preventive healthcare workers who play an important role in keeping all of us healthy. Steps to ensure their health, safety and dignity will determine our health as a society.