The spread of COVID-19 infection cases has accelerated with fervid intensity over the past few weeks, with the tally of infections reported by the Centre for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU) at a whopping 4,254,302 cases (as of May 12, 2020).
India itself, battling with an infection rate doubling every 10.2 days, is in for another two weeks’ partial lockdown starting from the 4th of May 2020. In such scenarios, one of the most essential services, classified by the World Health Organisation is waste collection and sanitation services.
It is a low income-generative sector largely comprising of low income, unprotected, informally employed workers, who in turn constitute one of the most vulnerable groups – economically, socially and politically in India during such pandemics.
Due to the mass spread of COVID-19, many workers in this sector are already on the verge of being deprived of their daily jobs, being ordered to stay in for their safety and the public’s, pushing them into significant economic risks. And those who in fact manage to retain their jobs, work in public spaces along with health workers and policemen, getting exposed to significant risks of infections. However, as the supplies of personal protective equipment (PPE) are already dwindling for health workers and policemen themselves, sanitation workers stand last in the priority line to be given protection (as their importance is often overlooked and overshadowed by the healthcare and police services), leaving them as the group of essential workers with the least access to health facilities, insurance and protective safety nets – social and otherwise.
Health and Economic Risks
Health Risks
Sanitation and waste disposal workers are one of the major forces that are preventing the spread of the infection through their work constantly cleaning and sanitizing. They are aggregating and disposing of tons of highly contagious marked/unmarked medical waste (like protective masks, gloves, tissues, tunics, gowns, caps, used syringes and IV bags) generated from isolation wards, hospitals, research facilities and homes where people have quarantined themselves along with segregating the contagious waste from general waste on a daily basis. However, the disconcerting truth is that while the privileged stay safe in their homes or protected under masks and gloves, these workers work often without adequate safety gear and equipment.
The Central Pollution Control Board (CPCB) of India, acknowledging the paramount importance of cleaners and waste disposal workers in such health crisis, had released elaborate guidelines to require workers to strictly follow safe and disciplined handling practices for COVID-related waste to avoid any secondary transmissions.
However, the intended effects of such guidelines and rules seem nowhere near and can be confirmed to be lacking by reported cases of negligent disposal of contaminated material leading to harmful exposure of unprotected health workers. Infected face masks are being dumped in huge quantities in household garbage and being collected by unprotected rag pickers reportedly in Pune. Individuals are drying thousands of washed masks in the open to resell them reportedly in Thane. Heaps of medical waste are reportedly lying in the open field in Delhi’s Sharan Vihar and Mumbai’s Bhiwandi area. And mounds of contaminated masks are reportedly lying around in the open near the Rohingya camps in Delhi’s Vasant Kunj. The reports keep coming in even as India’s COVID-19 infection graph continues to peak up.
While civic bodies in urban and rural areas across the country are working tirelessly to ensure hygiene in and around containment zones and hotspots, unprotected sanitation workers at the ground continue to take the brunt of the virus. Some frontline healthcare and sanitation workers are even being asked to take dosages of the anti-viral hydroxychloroquine (HCQ) which has shown mixed results as a potential treatment of Covid-19, but certainly has harmful effects on the body like anorexia, diarrhoea, gastrointestinal intolerance and hampered cardiovascular activities, as reported by Down To Earth.
Economic Risks
Economically, the workers are expected to face the brunt of the pandemic the harshest in slowed economies. Many workers are not able to report to their duties and are even banned from some societies and houses, eliminating all sources of their daily wages, on which their survival rests. This disproportionately affects women workers (who form a major chunk (over 50%) of the workforce in India) who are now forced to stay at home without any regular inflow of wages, expected to take care of the family and even falling prey to domestic issues.
Moreover, the workers who are asked to report to their duties aren’t able to. Apart from concerns of personal safety, issues like negligibly operational public transport facilities, harassment by policemen over the absence of required curfew passes are causing them to avoid reaching their workplaces.
Some health workers and sanitation staff on duty have even been brutally attacked by the locals, leading to which the Union Cabinet of India had to pass an ordinance amending the Epidemic Diseases Act, 1897 to make such an attack on health workers, a cognizable and non-bailable offence. However, the sanitation workers were again left out by the government from the protection of this law.
Probable Solution and Recommendations
Luckily, the conditions of waste pickers and the sanitation staff across other COVID-19 hot spots of the world is not as unpleasant as India’s. The tremendous threat to their health and economic conditions and its response by the government can be an important learning opportunity for the world.
A petition has already been brought in the Delhi High Court, seeking to have concerned authorities issue appropriate protective gear to the sanitation workers. While the Indian central government maintains that all guidelines issued by the World Health Organisation (WHO) for the safety of sanitation workers are being followed, the matter is slated for further hearing in front of a division bench of Justices D.N. Patel and Justice C. Harishankar on the 8th of May.
However, without immediate policy interventions, it might be too late to control the situation. For this reason, we offer the following recommendations:
- All sanitization and waste workers should be equipped as a priority with at least basic personal protective equipment (like masks, gloves, sanitizers) to avoid secondary transmission of infection.
Further, point-of-care diagnostic tests services should also be provided. This protective gear can be acquired from governmental funds. For example, the state of Maharashtra permitted civic bodies to use the Fourteenth Finance Commission funds to purchase PPE for sanitation workers, and even allowed them to work in shifts. The Ministry of Corporate Affairs, India has also permitted CSR funds to be utilized to make available preventive healthcare and sanitation to these workers. This protective gear could alternatively be purchased from local groups the way, the State of Telangana roped in the help of self-help groups (SHGs) to produce masks for sanitation workers or foreign countries.Further, those workers, reporting to duty must be provided with the means to reach their workplace safely – through adequate and safe transportation facilities and permits to move during curfews in hot spot/containment areas. - The pandemic has had a drastic effect over workforces and particularly the informal ones. Therefore, policy responses should majorly be aimed at increasing governmental spending.
Spending should specifically be increased to provide two fundamental needs. First, spending should be used to provide immediate relief to workers to help secure their existing livelihoods or engage them in alternative safe livelihood opportunities. Second, spending should be used to provide extended support through social welfare nets in the recovery periods when the economy slumps. - The systems of waste collection, segregation and disposal are currently under-equipped to deal with such unprecedented amounts of biomedical waste and as such they must be scaled up appropriately.
To alleviate their burden, it is required that the government upscale infected waste containment facilities to accept and treat the additional inflow of biomedical waste. The government must also incorporate preventive measures in the waste material chain itself like segregation at source, sanitization etc. - The guidelines issued by the Central Pollution Control Board (CPCB) for the handling of biowaste should be enforced right from the ground without fail along with systems of regular monitoring. They should also be incorporated within the frameworks of urban civic bodies.
The workers are already fighting a battle with the virus so that the communities and society do not have to. These poor people, already on the verge of losing their livelihood should not be left on their own to fight for their safety and health while they perform such an essential public function for the country to help curb the spreading of the pandemic.
For more on COVID-19, see our special coverage.
Oshin Malpani is a undergraduate student at Nalsar University of Law, Hyderabad. He frequently finds himself partaking in the areas of public policy and human rights law.
Suggested citation: Oshin Malpani, The Double-Edged Sword of Coronavirus: Lost Livelihood and Other Risks to Sanitation Workers, JURIST – Student Commentary, May 13, 2020, https://www.jurist.org/commentary/2020/05/oshin-malpani-sanitation-workers-covid19/
This article was prepared for publication by Tim Zubizarreta, JURIST’s Managing Editor. Please direct any questions or comments to him at commentary@jurist.org
