While the Covid-19 pandemic has driven many of us into our homes to seek safety and shelter, sanitation workers remain an indispensable part of our frontline workforce. On World Day for Safety and Health at Work, it is important to recognise and address sanitation workers’ vital need to realise their right to a safe working environment.
Their pre-existing and routine vulnerability to infections and chronic health conditions, from unsafely managed waste and excreta, are now exacerbated by the risk of contracting the novel coronavirus through various pathways as they continue to maintain services we rely on.
In South Asia – particularly in India – sanitation workers collect garbage and solid waste, keep public spaces, sewers, septic tanks and toilets (community and public) clean and hygienic, and maintain wastewater and faecal sludge treatment and disposal sites. They are not a homogenous group – they have various roles and responsibilities that determine the extent of their risk, and their experiences are inherently gendered.
Vulnerability on the frontline
Sanitation workers who clean septic tanks, manholes, sewerage and toilets are exposed to direct contact with excreta-related pathogens and are consequently at risk of acute dermal, respiratory and gastric infections. In worst-case scenarios, manual scavengers (sanitation workers who manually remove excreta from septic tanks, other containment systems and latrines) inhale toxic fumes, asphyxiate and die because of working in dangerous conditions with no protective gear (masks, boots, gloves).
A report by WaterAid, World Health Organization and the International Labour Organization indicated that between 2017 and late 2018, a sanitation worker died every 5 days in India. Similar dangerous conditions and risks have also been recorded in Pakistan, Senegal, Haiti, Kenya and Burkina Faso.
In this context, the pandemic has magnified their vulnerability. Many workers already have health conditions such as skin, eye and respiratory infections, having developed them on the job. The presence of the novel coronavirus has been detected in RNA gene fragments in sewage and wastewater with a potential for faeces to be infectious – directly impacting manual scavengers.
In addition to their usual responsibilities, sanitation workers are often asked to disinfect and sanitise areas around the homes of those suffering from the virus, again without any protective gear and equipment. India has already recorded 2 workers who contracted the virus earlier this month.
Sanitation workers who clean public spaces and collect garbage also encounter biomedical and solid waste from homes and facilities where patients are quarantined and being treated. Waste like used syringes, masks, gloves, gowns and tissues are discarded in the open or in household bins, directly putting rag pickers and waste collectors at risk.
Inequalities at work
Most sanitation workers in India belong to the dalit caste. The stigma associated to this has major implications – they (along with their families) are subjected to various forms of social marginalisation, and their lives and contributions aren’t valued. Recently, several frontline sanitation workers were attacked while performing cleaning services in Karnataka (a state in Southern India).
They are part of the informal workforce and are therefore not safeguarded by basic labour rights. In many cases, they do not have the social and economic capital to access treatment and support in case they contract the virus. Furthermore, their work is mostly contractual and they cannot afford to lose their job.
Prior to the crisis sanitation workers already faced the choice of working under extremely dangerous conditions or earning no wages indefinitely. Now risks are even higher as they expose themselves and their families to the virus.
Vulnerability varies according to context, and this issue extends beyond India. New York City has recorded over 300 Covid-19 infections and one death amongst sanitation workers. Many workers around the United States have reported heightened levels of anxiety regarding fear of infection. In Hong Kong, sanitation workers also report feeling unsupported and anxious. Their workload has doubled with families staying indoors and generating more waste, and they do not have access to sufficient protective gear to cope with the increased workload.
The necessary support
So, how do we provide support to sanitation workers engaged in these essential services? Various articles and expert opinions indicate particular mechanisms to provide support to sanitation workers through various pathways.
These include structuring work in shifts, decentralising the provision of reusable protective equipment (like masks) and providing institutional support mechanisms. These can be salary protection and assurance, provision of safe accommodation and access to free meals in local canteens. Given the pace and development of COVID-19 it is crucial to ensure that support is adaptable, context specific and well informed by ground realities.
Providing support to sanitation workers at this critical time accords to them a recognition and acknowledgement that they have lacked. It is an opportunity to provide these frontline workers with the safety, dignity and respect they deserve, and pave the way for long-term improvements to their working conditions.
We can no longer ignore their crucial contributions towards ensuring hygienic environments and reducing disease prevalence. They are the backbone of our public health systems and we need them now more than ever.