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Despite laws and regulations being in place in India, the practice of manual scavenging has not been curtailed but has been forced underground, a report released by World Health Organisation (WHO) on November 14, 2019, said.
The most undesirable and high-risk jobs are typically subcontracted to temporary, informal workers despite a substantial formal and permanent sanitation workforce now being present in India, with basic working conditions protected by law, the report highlighted.
“Challenges remain regarding the systemic discrimination of groups perceived as being of a lower caste and the multiple layers of subcontracting the high-risk jobs to temporary and informal workers, for which oversight and enforcement of laws by local authorities are weak,” the report titled, Health, Safety and Dignity of Sanitation Workers — An Initial Assessment, said.
Many workers most likely do not have fixed wages and are often victims of extortion. Some workers report getting paid in leftover or basic food items, it said, adding that those “perceived” to be of a lower caste suffer discrimination in healthcare, education, employment, access to land, employment and wages.
The report, which has been jointly authored by the International Labour Organization, WaterAid, World Bank, and WHO, features the plight and dehumanising working conditions of sanitation workers across nine lower and middle-income group countries — India, Bangladesh, Bolivia, Burkina Faso, Haiti, Kenya, Senegal, South Africa, and Uganda.
Sanitation workers across the developing world often suffer because of weak legal protection and lack of enforcement of existing rules. The numerous operational activities along the sanitation chain — emptying and conveyance of faecal sludge, sewer maintenance, treatment, and end use/disposal have often been invisible or at least disregarded in regulatory frameworks, it emphasised.
“Many countries either lack laws and regulations that protect sanitation workers, or the laws in place are not enforced or are not enforceable in practical terms. Manual emptying, often the riskiest sanitation work, is often characterised by informality,” it said.
It also talks about how sanitation workers who are not protected by adequate health and safety measures risk injury, infection, disease, mental health issues, and death.
The reported physical and medical conditions directly associated with sanitation work include headaches, dizziness, fever, fatigue, asthma, gastroenteritis, cholera, typhoid, hepatitis, polio, cryptosporidiosis, schistosomiasis, eye and skin burn and other skin irritation, musculoskeletal disorders (including back pain), puncture wounds and cuts, blunt force, and trauma.
Common accidents reported included losing consciousness and death by asphyxiation resulting from the noxious gases in septic tanks and sewers, pit collapse or falling masonry, and wounds from sharp detritus.
Several manual pit emptiers report working at night to avoid neighbour objections and sanctions, as well as being under the influence of alcohol and drugs, factors that further exacerbate the risk of accidents.
Poor sanitation causes up to 4, 32,000 diarrhoeal deaths annually and is linked to the transmission of other diseases like cholera, dysentery, typhoid, hepatitis A and polio.
The report observed that the number of existing sanitation workers overall is unclear, and estimates are often contested.
“Numbers are typically not disaggregated to specify the type of work. For example, municipal workers may also be grouped with solid waste management workers, which can obscure accurate quantification of the workforce,” it pointed out.
“Also, existing data sources tend to be incomplete, covering only part of a city or parts of a year. The most vulnerable sanitation workers, those working informally or temporarily in the lowest grade positions, are difficult to quantify for multiple reasons,” the report added.
The report has covered toilet cleaners and caretakers in domestic, public and institutional settings, those who work at faecal waste treatment and disposal sites, those who empty pits and septic tanks and other faecal sludge handlers who clean sewer and manholes — called manual scavengers in the Indian context.