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Sanitation workers amid the pandemic

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Simi Mehta and Amita Bhaduri

Sanitation workers are out in full force tasked with disinfecting the public spaces as COVID-19 crisis continues to impact the country on top of other serious challenges faced by our WASH sector.  Sanitation workers are those who work in any part of the sanitation chain: cleaning toilets, emptying pits and septic tanks, cleaning sewers and manholes and operating pumping stations and treatment plants, and so on. The pandemic has further exacerbated their exclusion and vulnerabilities.

“Despite providing an essential public service, an uncounted number of sanitation workers around the world work in conditions that are hazardous and stigmatising – heavily compromising both their dignity and basic human rights. The recovery plan by governments to deal with the health and economic impacts of COVID-19 needs to foot on approaches that are sustainable, integrating protection of ecology and tackling of inequalities ,” said V R Raman, Head of Policy, WaterAid India.

Raman was delivering a talk on ‘Sanitation workers amid the pandemic: Woes of guarding public and environmental health, and ways forward’ co-organized by the Impact and Policy Research Institute and India Water Portal as a part of the #PlanetTalks series: The state of the environment.

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Sanitation workers are left behind

There has been a significant rise in waste generation over the years and more than a tenth of the world’s waste is generated in India. Those responsible for sanitation work, household collection and management, maintenance of toilets as well as sewer/ septic tank cleaners are faced with a host of challenges, ranging from health to monetary, but most importantly the stigma associated with their work. Despite calls and initiatives for recognizing and respecting them as covid ‘warriors’, such initiatives have not gone down beyond superficial or tokenistic levels across India, with few instances of exceptions.

In the absence of realistic and reliable data on numbers sanitation workers, Raman presented the numbers WaterAid India had arrived at based on projections by Dalberg and a general literature review. Sanitation workers are guardians of public health and their numbers exceed over 71.4 lakhs nationally, yet they lack visibility and barely receive the respect and dignity that they deserve. Being informal workers with no legal protections or rights, a vast majority of them continue to be marginalized and stigmatized. Caste system in India adds to this already complex and vulnerable intersection.

Raman started by discussing the vast amount of waste generated per day in the form of solid, plastic, biomedical and e-waste and then talked about the typologies of sanitation workers ranging from domestic cleaners to solid waste collectors. They work under vulnerable and unsafe conditions and provide a fundamental public service, yet they often face extreme health hazards and safety risks and receive a limited amount of rehabilitation support.

To explore the foundation of the problem, he threw light on the issue of the deep-rooted relationship between waste and caste and how that is guided by people’s idea of purity and pollution. He further discussed how the perceptions towards people who handle ‘waste’ and polluted water lead to further  marginalisation and discrimination of these workers.

“This manifests into coercion and thousands of lives are claimed every year with their families having access to little legal recourse. People who work on waste management often belong to the castes that have been historically involved in the work, in a scenario close to cent per cent reservation. Working as families involving young (and often child) members of the family, this involvement becomes inter-generational. The structural silence- lack of proper data on deaths and lives of sanitation workers showcases the treatment accorded to them by our system, institutions and individuals,” he said.

Moving on to the relationship between waste and pandemic, he discussed how traces of SARS-CoV-2 were detected in untreated wastewater in research in Australia as also in many parts of India. He drew a comparison between sanitation workers with health workers and discussed that despite sanitation workers having to deal with faecal matter and putting their lives at risk, they do not get an equal, or at least a fair amount of attention as health workers.

Not much is being done on protecting sanitation workers’ rights unlike that of health workers. Though a good number of sanitation workers got infected with the disease with a proportion of them losing lives, we don’t have data available on this. What does this reflect on us, as a society, and a state?

Study of  situation of sanitation workers during covid-19

A study by the Urban Management Centre and WaterAid India based on  telephonic and face-to-face interviews of 95 sanitation workers and 12 Urban Local Body (ULB) officials from 18 cities/towns across 9 states/UTs, combined with review of secondary data, held between May 26 to June 8, 2020, looked situation of sanitation workers during the pandemic.

The study shows how there was a high level of awareness of symptoms of COVID-19 among sanitation workers. However, adequate Personal Protective Equipment (PPE) was not available for sanitation workers. Additionally, around 40% lacked access to hand hygiene facilities in their workplaces, along with only 20% of sanitation workers being medically examined. Even high-risk groups, like medical waste workers and hospital cleaners, reported not having access to all types of PPE that is required to carry out their work safely. Yet, despite the risks and the dire conditions of their work, sanitation workers continued to do their job.

Discussing the livelihood issues and financial implications of the pandemic, the speaker discussed how 13% of workers were out of work since the lockdown due to a loss of parallel and part-time work opportunities, whereas others faced partial resumption of work, income reduction, payment delays, challenges in meeting day-to-day necessities which led to borrowing by some to deal with financial constraints. Some of them also reported a loss of income during the lockdown being compounded by a rise in food prices and additional expenditures such as for safety gears.

“Hunger is more dangerous than COVID-19. Our situation is very bad,” said a dry service latrine cleaner. Since the work performed by them constitutes an essential public service, their work continued even during the pandemic. There was, however, an uneven distribution of work with sanitation workers in hospitals reported having to work for longer shifts and increased working hours, which was usually uncompensated and domestic waste collectors, office cleaner and workers in trucks carrying wastes reporting a reduced workload.

The study also found that only 35% of the workers had insurance coverage and informal workers were fully excluded from such coverage or government provisions for sanitation workers, except for some general welfare measures. Even the government extended COVID-related support measures to general public in the form of cash assistance and ration support were received by very few of these workers, with around 77% of the sanitation workers enjoying no social welfare support whatsoever.

Looking through the gendered lens, the study also focused on the additional woes faced by women sanitation workers whose numbers were higher in the informal workforce over permanent staff or contractual staff. This led to greater implications on their livelihoods as a result of even lower-income security and limited social welfare coverage. They also faced additional difficulties during menstruation as many public toilets were closed during the pandemic. The faced additional workload and were forced to leave children home due to the absence of any child support or care arrangements.

If these tangible issues weren’t enough, many even faced discrimination and pressure from neighbours to not return home after work, or due to demands from landlords to vacate their homes- amid the fear and stigma created by the pandemic. However, some did receive recognition for their work from their employers and the public in general for providing essential services during the pandemic, in few instances reported during the study.

To acknowledge these issues, they demanded more targeted welfare measures in the form of bonuses or financial aid, rations or insurance coverage; and regularisation of the informal sector or at least their inclusion in the safety nets and welfare measures put in place.

Some other studies, such as the ones held by IIHS Chennai and other organisations, also showed similar situations and challenges across India, he said. WaterAid did a study in some of the other south Asian countries too- Pakistan, Bangladesh and Nepal, in addition to India. Situation of sanitation workers require a lot of similar improvements in these settings as well.

The way forward 

Raman suggested that national and state governments need to set up frameworks, plans, projects and investments to protect sanitation workers, along with the cooperation of municipal authorities, private employers, civil society organizations, research institutions, development partners to implement actions that can improve the conditions in which they operate.

Frameworks, protocols and guidelines are needed outlining measures for sanitation workers such as organised testing, medical check-ups and thermal testing along with measures of quarantine periods or isolation protocols for suspected cases. Additionally, access to water, sanitation and health facilities has to be ensured for the workers in their workplaces and communities.

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Picture Courtesy: Down To Earth

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