The report, “Safety and wellbeing of sanitation workers during COVID-19 in South Asia”, explored how the ongoing Covid-19 pandemic was impacting the lives and work of sanitation workers in South Asia.

Sanitation workers provide an essential public service that does not stop even during lockdowns. But despite this, they often work in terrible conditions with low pay, job insecurity and face social stigma and discrimination.

The research was carried out in Bangladesh, India, Nepal and Pakistan over a period of approximately six weeks from the end of April until mid-June.

Various types of sanitation worker were interviewed, including sweepers, latrine cleaners and hospital cleaners, said a press release on Wednesday. 

The report found that fear of infection and concern for family members was a common concern across all four of the  countries under study.

Eight in ten workers interviewed in Bangladesh thought their job would put them at high risk of infection.

Despite a high level of awareness amongst workers about the need for personal protective equipment (PPE) to reduce the risk of infection, supply and use of equipment was mixed. Where PPE was provided by employers, it was rarely sufficient in terms of fit, quality, and regularity of supply.

While use of masks and gloves was relatively higher, supply and use of more specialised equipment such as aprons or goggles was much lower, even amongst high-risk groups such as hospital cleaners.

In Nepal, a third of workers had received no PPE from their employers at all. Workers across India, Pakistan and Bangladesh also complained of suffocation when using PPE in hot weather.

Sanitation workers are exposed to multiple hazards and suffer debilitating infections, injuries and even death whilst carrying out their work. The Covid-19 pandemic magnified the considerable occupational and health hazards these workers already faced, leaving many of them to continue working with limited protection and almost no formal guidance or support structures.

A sanitation worker in Khulna said “I and other sanitation workers are the reason people can live at home during the lockdown without worrying about their waste disposal. If we don’t work during this pandemic, people do not know what to do with this waste. We are continuing our job under great risk only to give the public some level of comfort. But it is very unfortunate that people do not value our sacrifice.”

Practice of frequent handwashing also varied largely due to worker access to facilities with soap and water. In India, most workers reported washing or sanitising hands at least twice during a workday.

However, 40 percent of workers reported lack of any handwashing stations at work, and handwashing was not consistently carried out at times most relevant for COVID-19 prevention.

Many sanitation workers across the four countries worried about the possible loss of livelihood. Around half of the respondents in all countries reported challenges in meeting their daily expenses. Loss of income during the lockdown was compounded by a rise in food prices, additional expenses for safety gear and hygiene supplies. Across the board, sanitation workers had very limited access to social protection or safety nets of any sort, with only a small minority being covered by some sort of insurance, and many missing out on emergency support measures introduced during the pandemic.

Regional Advocacy Manager (South Asia) of WaterAid Vanita Suneja said, “Sanitation workers have very little choice but to continue working throughout this pandemic, but they do so with little reward and often with none of the protective measures they need to keep them safe and healthy.”

“The South Asian governments must put in place a comprehensive safety net to protect these workers, including health insurance, guidelines and training, that covers informal roles as well. Only with proper job recognition and protections will these essential workers be able to stay safe whilst carrying out some of the most important roles in our society,” she said.

Also read: Underprivileged families suffer most due to lockdown: Study

The report highlights a clear need for sanitation workers to receive immediate support in order for them to cope with the heightened risks as the pandemic continues. In the longer term, efforts are also required to improve the working and living conditions of sanitation workers, and to address the deep-rooted structural inequalities that have relegated them to the margins of society.