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Dying for a living

By Mari Marcel Thekaekara

In most developed countries, manhole workers are provided bunny suits and respiratory apparatus. In Hong Kong, a sewer worker needs to have 15 licences in order to enter a manhole. In India, conservancy workers – mostly from the balmiki subcaste of dalits -- go in almost naked. The mortality rate amongst them is appallingly high

Every morning in newspapers all across the country, a small news item routinely appears: ‘Sweeper dies in manhole’, or ‘Sewerage worker drowns in septic tank’. The story is given a different headline every day, as the journalists play with words. Most readers do not bother to read the item, which is often just an official report stating the bald facts. I too was guilty of skimming over the items for many years of my life.

Then, in 1998, whilst writing the book Endless Filth, on manual scavenging, the news items came to life when I visited the home of one such casualty, a young Gujarati boy called Hasmukhbhai, in Wadhwan, Gujarat. Barely 19 years of age, Hasmukh died in a manhole. He had recently celebrated the fact that he’d bagged his first contract -- to clean a septic tank for the princely sum of Rs 300. He bought breakfast for friends who were helping him, for Rs 50. He would have to pay them Rs 50 each for the work he’d done. That left Rs 100 for him. He hoped to wheedle an extra Rs 100 from the owner, if the job went smoothly.

The day started well. At 19, Hasmukh was the oldest and in charge. His 16-year-old helpers stood aside as he opened up the manhole cover and waited for the gas to escape. Then the bucket slipped out of his hand and disappeared into the hole. Cursing, Hasmukh bent down, groping about for the bucket. The gas rushed up and he fell inside, unconscious. He never even knew what hit him. It was half-an-hour before he was hauled out with a rope. It was too late. Hasmukh was pronounced dead on arrival at the hospital. His family will never know if he died choking on the gas, or drowned in liquid shit.

Hasmukh’s story made me think about the issue seriously, for the first time. Drowning in liquid shit is what happens to at least 22,327 sanitation workers every year. All belong to the balmiki community.

Human beings shrink from any contact with faecal matter. We are paranoid about stepping on shit even accidentally, with our shoes on. If it does happen, we rush to wash the offending substance off the soles of our shoes. Can we even begin to comprehend the experience that thousands of balmiki men go through every day of their lives?

According to a 2002 report prepared by the International Dalit Solidarity Network -- which includes Human Rights Watch (United States), Navsarjan Trust (Ahmedabad, Gujarat), and the National Campaign on Dalit Human Rights, the government estimates that there are 1 million dalit manual scavengers in India.

I was sensitised to a degree, and began seeing sanitation workers more clearly, observing them closely and talking to them. Yet, even after interviewing Hasmukh’s family, the full impact of the daily grind of the sanitation worker -- the full horror of his existence -- did not strike me. It took a gut-wrenching interview by S Anand in the magazine Tehelka to graphically bring home the reality. Anand explains: “Entering the narrow, dark drain, the worker pushes his only weapon, the khapchi -- a spliced bamboo stick -- to dislodge the block. This exercise could take hours. ‘Holding our breath, closing our eyes, we plunge headlong. We feel our way, poking with the khapchi,’ says Sateesh. It is then that a sudden blast of putrid sludge -- besides methane, hydrogen sulphide, carbon dioxide and carbon monoxide -- assaults the person. ‘Even if we manage not to swallow the toxic muck, it manages to enter our bodies.’ Odourless and colourless, the carbon gases can cause suffocation. The scene is documented in the Drishti film Lesser Humans. The film makes the viewer recoil in horror and was considered too horrible for American audiences to watch.”

If the worker survives the initial ordeal, he crouches inside and loads the sludge into a leaky metal bucket or wicker basket for his team to haul out. Depending on the clog, the entire operation could take up to 48 hours. “We often work after midnight. When people sleep, the flow in the sewers is less, and our work does not disturb road-users,” says Sateesh.

Among sewer workers, there’s a category called ‘divers’, whose brief is to ‘swim’ through the large pipelines, find the blocks, and clear them.

Ashish Mittal, an occupational health physician who co-authored ‘Hole to Hell’, a 2005 study of sewer workers by the Centre for Education and Communication (CEC), New Delhi, says: “A manhole is a confined, oxygen-deficient space where the presence of noxious gases can cause syncope -- a sudden and transient loss of consciousness owing to brief cessation of cerebral blood flow. The brain cannot tolerate even a brief deprivation of oxygen. The long-term neurological effects of syncope can be debilitating.”

In most developed countries, manhole workers are protected by bunny suits to avoid contact with the contaminated water. They also sport respiratory apparatus. The sewers are well lit, mechanically aerated with huge fans and therefore not so oxygen-deficient. In Hong Kong, a sewer worker, after adequate training, needs to have at least 15 licences and permits in order to enter a manhole. In India, our sanitation workers go in almost naked, wearing just a lungot (loincloth) or briefs. In Delhi, in accordance with the directives of the National Human Rights Commission in October 2002, most permanent workers of the DJB wear a ‘safety belt’. This belt that connects workers in the manhole, via thick ropes, to men standing outside offers no protection against the gases and sharp objects that assault them. It’s a cruel joke; at best it helps haul them out should they lose consciousness or die inside the hole. The CEC study of 200 DJB manhole workers found that 92.5% of workers wore the safety belt. But this did not prevent 91.5% of them suffering injuries, and 80% suffering eye infections.

Manual scavengers are exposed to the most virulent forms of viral and bacterial infections that affect the skin, eyes, limbs, respiratory and gastro-intestinal systems. Reports show that tuberculosis is rife among the community.

The CEC survey found that diseases like leptospirosis, viral hepatitis and typhoid are common. “During the course of our six-month study, three of the 200 workers died,” recalls Mittal.

Alcoholism takes its toll on more than just the health of the sanitation worker. Apart from bringing on an early death, it wreaks havoc on his family. Every balmiki basti witnesses the inevitable spiral of alcohol-related violence and poverty as a sizeable part of the men’s income disappears into the liquor shops.

Sanitation workers are at the very bottom of the social pyramid; even other dalits consider them untouchable. The only people on whom they can vent their frustration and generations of pent-up anger are women and children.

Most men in the community die young; indeed, the average lifespan of a sanitation worker is 45 years. The civic body does not offer any monetary compensation to these workers for illness or death due to occupational risks, unless the worker actually dies inside a manhole, In Delhi, permanent workers get a monthly ‘risk allowance’ of Rs 50. In some states, the figure rises to Rs 200.

In a tragic farce, sanitation workers often unionise to fight for the right to keep their jobs. With privatisation, they could lose the little security that government employment offers. So they fight for the right to die in their manholes, for this privilege to be theirs alone. They demand reservation for their sub-caste to keep these jobs. It would be interesting to find out if the men who drive the little floor-cleaning vehicles at the Mumbai, Delhi and Bangalore airports are from the balmiki community. I doubt it: once jobs are upgraded they are passed on to people from the dominant castes.

In every balmiki basti, there is a recurring story. The story of the man who dies on duty, drowned in liquid shit or asphyxiated as he opens up a manhole cover. The family is desolate. The municipal corporation or civic body responsible for employing the dead sanitation worker offers, by way of solace and in a gesture of enormous magnanimity, the ultimate consolation prize -- the dead man’s job. A few days after the funeral, the son proceeds to take his father’s place. He knows that the smallest slip could land him in the same hellhole that swallowed up his father. But it’s all part of the life of the sanitation worker.

Death rate for conservancy workers

Ahmedabad NGO Kamdar Swasthya Suraksha Mandal believes that at a conservative estimate, there could be over 1,000 manhole worker deaths per year across India. Santosh Choudhary, chairperson of the National Commission of Safai Karamcharis (NCSK), told Tehelka that at least “two to three workers must be dying every day inside manholes across India.” Another Ahmedabad NGO, Manav Garima, led by balmiki activist Parshottam Vaghela, has documented the deaths of 145 manhole workers in seven years in the municipalities of Vadodara, Surat and Ahmedabad.

According to data obtained in Mumbai under the RTI Act, 2,039 safai karamcharis (SKs) died between 1996 and 2006 in 14 of the city’s 24 civic wards. Projected to all 24 wards in the Brihanmumbai Municipal Corporation (BMC), the figure stands at 3,495 deaths over 10 years in the city with a population of 13 million. At 350 deaths per year from among 22,000 permanent sanitation workers in the BMC, the mortality rate (MR) is 16 for every 1,000 SKs. Says demographer Leela Visaria, former director of the Gujarat Institute of Development Research, “The death rate for urban Indians aged 15-59 years is 3 per 1,000 population. This gives you an indication about the deplorable health status of the Safai Karamcharis.”

In neighbouring Pune, there were 227 deaths between October 2005 and September 2007 for a population of 4.4 million. In the four metros, there are 1,07,400 SKs serving a population of 36 million. At an MR of 16, at least 1,718 of these workers are dying every year. For the urban population of 286 million, assuming there are 2,000 SKs per million, conservatively there must be 5,72,000 SKs servicing urban India. At an MR of 16, a minimum of 9,152 of them must be dying in our cities every year. Officially, India has 6.76 lakh manual scavengers — those who dispose human excreta with their bare hands — working in 96 lakh dry latrines. The Planning Commission sub-group on SKs says, “Independent estimates indicate that there could be about 12 lakh manual scavengers.” For these 12 lakh manual scavengers, if we assume a reduced, conservative MR of 8 per 1,000 workers, we arrive at 9,600 deaths per year.

With 5,500 permanent and 1,500 temporary beldars engaged in sewer work for Delhi’s 14 million population, there are 500 sewer workers per million general population. India’s 286 million urban population must be served by at least 1,43,000 sewer workers. Assuming a higher MR of 25 among this group, since their job is most hazardous, 3,575 sewer workers must be dying every year.

All this adds up to 22,327 deaths every year among a cross-section of sanitation workers. Visaria, who is on the advisory council of the Population Foundation of India, says Tehelka’s projections are “very conservative”.

--S Anand, with inputs from Shalini Singh in Mumbai

Reprinted from Tehelka Magazine, Vol 4, Issue 47, Dated Dec 08 , 2007


The beginnings of change

Occasionally, something happens to lift the gloom. Ananth Narayanan, an ordinary citizen (well, extraordinary really because he is not a professional social worker but a businessman with a physics background and a management degree from LIBA, Chennai) has moved a public interest litigation (PIL) in the Madras High Court against the Chennai Corporation that employs people to clean sewage drains manually without protective equipment. The PIL demands that the practice of human beings diving into sewers to manually clean them should be banned, and that machines should instead be employed to do the work.

When I asked Narayanan what motivated him, he replied: “I’ve reached the age of 44. I’m ashamed that I didn’t do something like this earlier. It is a disgrace to my state and my country that human beings have to suffer in this day and age when so much technology is available.”

Narayanan’s actions have had some effect in Chennai. He writes: “Based on the court order, I sent a letter and a reminder to the Secretary, Municipal Administration and Water Supply (MAWS), requesting strict enforcement and also seeking an appointment. I did not receive a reply. Obviously, the bureaucrats as well as the political powers have not taken kindly to my court case.

“I also organised a public demonstration in front of the authorities recently against the court violation. As such, on the ground, I can assure you there is visible compliance of the court order to a large extent, except for a few violations. But, attitudes are not going to change easily.

“But I want to tell you about a few initiatives I am taking. I wish likeminded friends would join these initiatives so that we bring about total, real and fundamental change. Unless we network and push for change, the powers-that-be will be content with only superficial work.

“I am, incidentally, filing a ‘contempt of court petition’ today in the Madras High Court for violation of the court order, making the secretary, MAWS and MD, Metrowater, respondents. The case may come up for hearing next week. This is just to keep up the pressure and keep the issue alive.

“IIT-Chennai had developed a machine for mechanised cleaning of sewer lines. I came to know that the government had not responded positively to this, so the project has been rusting for a long time. Probably they can make more money if they import these machines… Let us see if (the machine) can be made on a commercial scale suitable for the peculiar, poorly designed and hopeless sewerage lines in Indian cities and towns.”

“We can try to push some of the political parties to include total eradication of scavenging and also environmental methods of sewerage disposal as one of their common minimum programmes for the coming Lok Sabha elections. At the Tamil Nadu level, I am working to ensure that at least a few of the parties include this issue in their election manifesto.”

It’s heartening to see that persistence pays. The change may be slow and incremental, but when it comes it will make a huge difference to the lives of these people.

InfoChange News & Features, February 2009