Chennai: On day one of the national lockdown, March 25, there were three deaths reported as a result of the novel coronavirus across India. On the same day, sanitation worker Jasbir (43) was admitted to the hospital in a critical condition and his colleague Suresh (40) lost his life at a sewage treatment plant. Subsequently, a case was registered at the Okhla Police Station, New Delhi but Suresh is not even a mere statistic in the larger picture of apathy regarding the hazardous conditions in which sanitation workers perform their duties.
“I used to work from 7 am to 2 pm earlier and earn a side income by cleaning septic tanks in my neighbourhood. Now I work full time from 7 am to 6 pm. Even in my dreams, I am spraying disinfectant,” says Manav (name changed), 26-year-old a sanitation worker with the Chennai Corporation.
Manav has an important job at hand, of disinfecting hotspots of the novel coronavirus. On some days, he sanitises the houses of infected persons, and on others, he sprays the disinfectant on buses and railway stations.
“One day, a young man from his top floor balcony suggested that I go a little closer to the infected site so that there is less wastage of water. I am terrified of this virus as I have to go home to my nine-month-old baby and my ever anxious wife. Who knows, one day I might just carry the virus along.”
Manav regularly cleans septic tanks and for him, hand wash with soap is a luxury. He gets a flimsy face mask to be reused for 15 days, which becomes redundant after a few hours of use, a fact that he is well-aware of. “But you know I am lucky, since my fellow-workers don’t even get this.”
After a pause, he adds, “I wish I could leave this job but this is what we have done for generations and for me it is an inevitable chain to secure my child’s education. If I refuse to work, there are ten others waiting to take my place.”
“We dread touching surfaces but sanitation workers are performing duties at the very site of infection. The government must ensure their wellbeing,” says Dr Amar Jesani, an independent researcher and editor of Indian Journal of Medical Ethics.
“Sanitation workers should be monitored as they are highly susceptible,” says Dr Dharun Prasad from the COVID-19 screening team and junior resident (community medicine) at the Government Medical College Hospital in Nagpur.
On March 27, a sanitation worker in Nagpur learnt that one of the residents whom he worked for had tested positive for COVID-19. He and a few other workers rushed to the government hospital to get screened. They were informed about the symptoms to look out for, and report back if they arise.
“Transmission through respiratory droplets and surfaces is well-proven, therefore anyone dealing with disposal of any kind, whether it is household or medical waste, should definitely keep themselves well-protected. In fact, they should be given a separate uniform at work so that the infection is not spread,” says Dr Pawan Kumar, head of COVID-19 team and respiratory specialist at RML Hospital, New Delhi.
“Right now, sanitation workers do not have any safety gear and the loss of their lives hardly matters to anyone,” says Bezwada Wilson, Ramon Magsaysay Awardee and National Convener of Safai Karamchari Aandolan (SKA), a non-profit organisation that works towards the eradication of manual scavenging.
According to a report by the National Commission for Safai Karamcharis, a statutory body set up by an Act of parliament for the welfare of sanitation workers, between 2015 and 2019, one person died every five days on an average while manually cleaning sewers and septic tanks across India. The 377 reported deaths during this period is an underestimation, as it is based mostly on newspaper reports and numbers published by a few state governments. Deaths resulting from entering toxic sewage areas have not been officially documented yet.
The issues faced by sanitary workers stretch from Tamil Nadu to Jammu and Kashmir. “We have a huge incoming expatriate population being tested for COVID-19 but protective equipment is not available for sanitation workers,” says Mahjabeen Bhat, convener of SKA, Jammu and Kashmir.
A little empathy will do everyone good. “The public should pack their refuse in strong disposal bags that don’t tear off and help reduce the risk of direct exposure for the trash collectors. Masks, gloves and boots are given to a select few and the rest don’t even protest. Who wants to lose out on the income, even if it comes at the cost of death?” says Vishal Shukla, convener of SKA, Maharashtra.
Velanganni Samuel, convener of SKA, Tamil Nadu says sanitation workers should be given immune-boosting injections, nutritional supplements and screened if they develop fever, cold or cough, as most workers continue to work through good and bad health. “The government has always focused on compensation post-death and rehabilitation of a handful who are officially identified to be doing this job whereas the main focus should be on prevention of loss of lives,” Samuel says.
If not now, when?
“India hasn’t batted an eyelid towards the welfare of sanitation workers. They are destined to suffer with or without work. When they work, sanitation workers are highly vulnerable to infection. If they don’t work, hunger and lack of livelihood will kill them. I can’t fathom why society doesn’t care about the people doing our most essential work,” says V.K. Madhavan, chief executive of WaterAid India, an international organisation that focuses on ensuring equitable access of water, sanitation and hygiene.
When Lav Agarwal, joint secretary, Department of Health and Family Welfare was approached about the issue, he said state governments have to be reached for questions on safety gears. “Whatever the Centre has to announce, it will, in due time.”
Lack of protection is common to all those involved in essential services. “I haven’t seen sanitation workers with masks around here. Well, I guess whether it is doctors, nurses or manual scavengers, we all lack adequate defence,” says Dr Tabassum Parveen, a medical officer at Kolkata Corporation.
Manual scavenging and cleaning of sewers and septic tanks continues even though the direct handling of human excreta was banned in India by the Employment of Manual Scavenging and Construction of Dry Latrines (Prohibition) Act, 1993. Manual scavenging was banned under the Prohibition of Employment as Manual Scavengers and their Rehabilitation Act, 2013.
In September 2019, the Supreme Court of India had raised serious concerns over people dying during manual scavenging and sewage cleaning in India. A bench headed by Justice Arun Mishra questioned attorney general K.K. Venugopal, “Why are you not providing them masks and oxygen cylinders? Four to five people are dying due to this every month. Nowhere in the world are people sent to gas chambers to die.”
Nalini Ravichandran is an independent journalist who has worked with The New Indian Express and Mail Today and reported extensively on health, education, child rights, environment and socio-economic issues of the marginalised.
#Grit is an initiative of The Wire dedicated to the coverage of manual scavenging and sanitation and their linkages with caste, gender, policy and apathy.