Sanitation Workers Amidst COVID-19: Indispensable Yet Disregarded
While the world is practicing social distancing and staying at home, there’s a section of the society that is going out every day to fight the COVID-19 pandemic. The Ministry of Home Affairs in their order dated 24th March, 2020 mandated various services and establishments, even government offices to remain shut with exceptions including, police forces, public utilities, hospitals, and related establishments, essential services like sanitation amongst many; thus, bringing Sanitation Workers (“SW”) under the ambit of essential workers.
During this pandemic, India has been at the forefront in celebrating its heroes- the policemen and the Health Care Workers(“HCW”). But another category of essential workers, i.e. the SW remain uncelebrated. These workers play a crucial role as they collect waste, even from containment zones, sanitise buildings, hospitals, every infrastructure there is and in addition, also deal with medical waste such as the discarded PPE kits.
The condition of SW has been historically deplorable due to the hazardous nature of their work. For instance, the National Commission for Safai Karamcharis (“NCSK”) in its (2017-18) report stated that between 2017 and late 2018, “one person has died every five days, on an average, while cleaning sewers and septic tanks across the country.”[i] With the ongoing pandemic, the condition of SW has only worsened as they lie at the threshold of increased danger. Through this article, the authors analyse the condition of SW, in light of the ongoing pandemic.
Even after taking up initiatives such as ‘Swachh Bharat Mission’, there is a continued persistence of manual scavenging and poor sanitation practices in India. Though the practice of manual scavenging is explicitly prohibited, it continues till date. The Central Government reported the existence of 54,130 manual scavengers(“MS”) in India until July, 2019. The deplorable condition of SW persists due to the notion of caste-designated occupation and; despite laws being in place, the agencies working at the grass-root level such as municipal corporations, panchayats, fail to implement them. A report by Dalberg Associates stated that there exist almost five million full-time SW, out of which 2 million work in high-risk conditions, exemplifying their dejected condition.
The Constitution by way of multifarious Articles including, Article 17 (Abolition of Untouchability), Article 21(Right to life and dignity), and Article 42 (Just and humane conditions of work) safeguards the rights of sanitation workers.
On the legislative front, the Prohibition of Employment as Manual Scavengers and their Rehabilitation Act, 2013[ii] aims to rehabilitate MS. The Act has widened the definition of MS to include those workers who engage in the cleaning/handling of human excreta in “insanitary latrines, ditches, pits, railway tracks, sewers, and septic tanks.”[iii] It also mandates the Government to implement schemes to provide alternate livelihood and assistance.[iv] However, the focus of this Act remains largely on MS. It briefly touches upon another type of SW, i.e. sewer workers.
The Act prohibits the manual cleaning of sewers and tanks without protective equipment.[v] Despite that, on various counts, the workers have been made to clean septic tanks and sewers, a clear violation of S. 7 of the Act. Also, though S. 9 penalizes violation of S.7 in the form of fine and imprisonment, yet, there has been no conviction under this Act until 2019. The current status is such that there is no Central legislation that addresses the different types of SW, it is only the local bodies that tend to this matter. Thus, not much has been achieved with respect to the rehabilitation of the SW as the authorities remain lax and the stigma continues.
The issue of safety of workers has also been deliberated by the Courts in the past. In Consumer Education and Research Centre v. UOI,[vi] various articles like Article 39 (to ensure that health of workers is not abused), Article 43 (securing a decent standard of living for workers), and Article 21 (in terms of right to health) were addressed. Additionally, in Delhi Jal Board v. National Campaign for Dignity and Rights of Sewerage and Allied Workers and Others[vii] the Apex Court safeguarded the rights of SW and mandated benefit of Provident Fund, Gratuity, and Bonus to all the sewer workers (including contract workers), free of cost treatment to those who suffered from occupational disease and much more.The landmark judgment of Safai Karamchari Andolan v. Union of India [viii] also held that manual scavenging is a gross violation of Article 21 and Article 17 of the Constitution.
The issue of the safety of SW is extremely pertinent during this pandemic as they remain one of the most vulnerable sectors of society. This can be substantiated by a recent study conducted by AIIMS which concluded that among the COVID-19 positive HCW, the largest population was of the SW and hospital attendees (35.3%).
Plight During the Pandemic
The pandemic has amplified the already existing burden of SW. Equipment such as medical masks, goggles, PPE kits, etc. which should be ordinarily provided to workers engaged in high-risk areas[ix]is now being made ‘mandatory’ during the pandemic. There have been various instances throughout the country, exemplifying the dejected conditions in which they are being made to work in the times of the pandemic. For instance, in Mumbai, about 6500 workers were put to work without any protective equipment or hazard pay. To ensure the safety of these workers, different guidelines have been released, but despite that, workers are being made to fight for their own basic human rights.
Guidelines on Rational Use of Personal Protective Equipment
The Ministry of Health and Family Welfare (MoHFW) released a guideline on the rational use of Personal Protective Equipment (PPE). The guideline recognizes the sanitary staff to be on a moderate risk and suggests the usage of N-95 masks and gloves. In reality, the SW are made to work in areas containing disposed of medical waste of COVID-19 and in containment zones but are yet, categorized under moderate risk. This is in direct contravention to the WHO guidance for SW working in healthcare or otherwise, which states, "Sanitation workers should follow standard operating procedures which includes wearing appropriate PPE (protective outerwear, heavy-duty gloves, boots, medical mask, goggles and/or a face shield)."
Though the Centre in a plea[x] seeking to provide personal protective equipment (PPE) to sanitation workers stated that appropriate protective gears were being provided to SW and WHO guidelines were being followed, in the aforementioned guideline they mandated the usage of N-95 masks and gloves only and not PPE kits, contradicting their own submissions to the Supreme Court.
Guidelines for Handling, Treatment and Disposal of Waste Generated during Treatment/Diagnosis/ Quarantine of COVID-19 Patients
In addition to the already existing BMW Management Rules, 2016 the Central Pollution Control Board issued guidelines for handling the waste generated during COVID-19. The guideline released on 10 June, 2020 addresses the increasing concerns over biomedical waste generated and its handling by SW. The guidelines mandated “dedicated sanitation workers separately for biomedical waste and general solid waste”[xi] and instructed the Common Biomedical Waste Treatment Facility to ensure that the SW handling, and collecting biomedical waste are regularly sanitized.
The National Green Tribunal also advised the segregation of COVID-19 waste from others, as it would play an essential role in curbing the virus.[xii] The aforementioned guidelines, mandates the nodal officers for biomedical waste management in hospitals to train the SW in the handling of such waste. However, the problem ensues when this waste is sent to the common dumping ground, the workers employed there are neither aware of the potential risk of such waste nor are trained enough to deal with them.
The Delhi High Court also tended to the matter of bio-medical waste being dumped at the common dumping ground, highlighting the fact that “scavengers will be the first ones to be exposed to infection.”[xiii] Another problem is that there was no clear record of the number of SW on duty, their allotted area, and whether they received safety equipment or not. This further aggravates the situation of SW employed by the civic body as they have to deal with the waste of people who were home isolated and those residing in containment zones.
The Problem of Insurance
The SW apart from not getting proper safety equipment and hazard pay, face another problem. Though these workers are in their daily course of work exposed to excessively lethal environment, as per a recent survey conducted, almost “89.7% workers did not have any kind of health insurance or healthcare facility.”[xiv] Considering the situation, the Central Government announced a 50 lakh insurance scheme for healthcare workers including, doctors, nurses, paramedics, sanitation workers, working in the government and even private hospitals, but has conveniently ignored the SW working on streets, day and night, risking their lives to keep the community neighborhood clean.
Another problem that spews contemporaneously is the huge portion of the SW employed on a contractual basis, especially by private agencies. This has led to a quandary with respect to the number of SW employed, especially MS. Furthermore, the data available by different entities, including the state and central government has been contradictory. Up until 2017, the Ministry of Social Justice and Empowerment identified only 13,384 MS, whereas in 2018 the Niti Aayog reported an increased number of 38,785 workers, employed as MS (excluding the State of J&K).
Furthermore, there remains a dis-proportionality in the number of insanitary latrines and MS.As per the ‘House listing and Housing Census 2011’ there was 26 Lakh insanitary latrines in the country, and by 2016, only 11,861 MS had been identified by 11 States. A major reason why the numbers remain contradictory is that, because of the stigma attached to this profession, many SW work in an informal manner, because of which no documentation takes place. This unavailability of authentic data makes it even more cumbersome to urge the authorities to safeguard their rights, because the rehabilitation of SW is dependent on the identification of these workers, as only then can they be provided with the facilities mandated by the law.
Thus, though the Government has tried to lessen the burden of essential workers, SW still remain ignored. The guidelines released by the Government ignore the grass root realities and take a perfunctory approach in rehabilitating the SW even during the pandemic.
The International Perspective
The repercussions of the catastrophic COVID-19 have been felt worldwide. However, despite emphasizing their importance, the state of SW has been ignored globally. Death of a sanitation worker in Raleigh due to COVID-19, the unsafe working conditions of Pakistan’s sanitation workers during COVID-19, the apprehension of the scarcity of the protective masks for Hong Kong sanitation workers, all are indicative of the obliviousness of various governments towards this sector of the society. Though before the pandemic, the world had recognized the need for a safe working environment through the Sustainable Development Goals (Goal 8.8),less has been achieved in this sphere.
Furthermore, various other guidelines and action plans have addressed the issue of SW during COVID-19. The precautionary message published by UN Habitat focused on the issue of keeping SW safe as they play a vital role in protecting others from the virus. Even ILO urged countries to ensure maximum protection for all workers especially of the vulnerable sectors like the sanitation sector. UNICEF India COVID-19 Response Plan also mentions the training programs for various departments including the sanitation sector in order to improve their knowledge of risk communication and the spread of the infection.
The plan builds a Multi-Sectoral Response Strategy that aims at protecting the rights of the most vulnerable section of the society during COVID-19 with the help of various Ministries of the country. It aims to cover 100 districts across 23 states in 13 field offices of India. It also seeks to implement IPC (Improve Infection Prevention and Control) framework, however, this is mostly restricted to healthcare and doesn’t specifically mention other sectors. Furthermore, UNICEF concluded that it has been successful in training around 100,000 people from the sanitation workforce, Swachhagrahis, women’s groups, etc.
To reduce the risk of COVID-19, due attention should also be paid to the issue of waste generation as India produces around 100-500g/person of Municipal solid waste (MSW) which directly affects these workers. India can adopt an action plan like the Zero Waste and Litter Action Plan of Philadelphia. This comprehensive plan aims to achieve zero waste goals by 2035 through short-term goals.
Firstly, it emphasizes on the importance of systematized data collection. This can be an effective step as India lacks proper data collection of the SW.Secondly, it seeks the proper implementation of regulations and policies. This step can help India ensure that the various guidelines issued during COVID-19 are implemented, including provisions of fines if infringed. Thirdly, the policy seeks implementation through community participation.
Therefore, only through a balance between government regulations and public participation, one can create a sustainable environment for these SW. Therefore, it is high time that we give due attention to the issues faced by SW because whether it was the Memphis SW Strike of 1968, or it is the prevalent miserable condition of SW, the narrative remains the same globally.
They are denoted as front-line warriors, but are not even ensured minimal medical facilities. They function under the most vulnerable and unsafe conditions during the pandemic. Therefore, to improve their condition, concerned governments and local citizens need to adopt certain practices.
Firstly, to reduce the percentage of waste production, as conscious citizens we should use reusable or washable cloth made masks.
Secondly, there should be strict implementation of Infection Prevention and Control (IPC) guidelines which were issued during the Ebola outbreak, in the current scenario. These are comprehensive measures that provide proper instructions for workers who are in direct or indirect contact with the patients suffering from such infections.
Thirdly, governments should invest in wastewater management system to ensure proper monitoring and effective use of it. This is essential as many countries have reported the presence of COVID-19 in wastewater.Suggestions can also be taken from measures listed by WHO to reduce the spread of antimicrobial resistance, which focuses on proper research and the economic aspect of the challenge.
Furthermore, we must recognize the work of these sanitation workers globally. In these catastrophic times, the healthcare workers are getting due respect and attention but the equally deserving community of SW is still being neglected. Concerted efforts need to be made to enforce the implementation of existing law and formulate policies to cover and recognize all kinds of sanitation workers throughout India and introduce technological alternatives to free them from years of plight. Sanitation workers have already faced various forms of discrimination and human rights violation for ages; therefore, it is imperative that we discuss and deliberate upon this issue before it is too late.
[i] One manual scavenging death every five days: Official data, The Indian Express, available athttps://indianexpress.com/article/india/official-data-shows-one-manual-scavenging-death-every-five-days-5361531/ last seen on 11/08/20.
[ii] The Prohibition of Employment as Manual Scavengers and Their Rehabilitation Act, 2013.
[iii] S. 2(g), The Prohibition of Employment as Manual Scavengers and their Rehabilitation Act 2013.
[iv] S. 13, The Prohibition of Employment as Manual Scavengers and their Rehabilitation Act 2013.
[v] S. 7, The Prohibition of Employment as Manual Scavengers and their Rehabilitation Act 2013.
[vi] Consumer Education and Research Centre v. UOI (2010) 15 SCC 699.
[vii] Delhi Jal Board v. National Campaign for Dignity and Rights of Sewerage and Allied Workers and Others, (2011) 8 SCC 568
[viii] Safai Karmachari Andolan. And Ors. v. Union of India And Ors. (2011) 11 SCC 224
[ix] Ss. 4 & 5, The Prohibition of Employment as Manual Scavengers and their Rehabilitation Rules, 2013.
[x] Harnam Singh v. UOI, 2020 SCC OnLine SC 449.
[xi] Guidelines for Handling, Treatment and Disposal of Waste Generated during Treatment/Diagnosis/ Quarantine of COVID-19 Patients, Telangana State Pollution Control Board , available at https://tspcb.cgg.gov.in/COVID19/Rev3%20Guidelines%20for%20disposal%20of%20COVID%2019%20Waste_10_06_2020.pdf, last seen on 11/08/20.
[xii] In re: Scientific Disposal of Bio-Medical Waste arising out of Covid-19 treatment – Compliance of BMWM Rules, 2016.
[xiii] Harnam Singh v. UOI, W.P.(C) 2989/2020.
[xiv] Condition of Sanitation Workers in India: A Survey During Covid-19 and Lockdown, June 2020, available at https://www.academia.edu/43470203/Condition_of_sanitation_workers_in_India_A_survey_during_COVID_19_and_lockdown, last seen 12/08/2020.
By Anjuri Saxena, Online Content Editor and Chahat Gautam, Associate Editor at RSRR.