When the lockdown was announced, sanitation workers found themselves clubbed together with healthcare workers, the media, and police, as categories of people who were exempt from the lockdown and expected to discharge their duties as usual. They were also counted as ‘frontline’ workers, along with healthcare workers.
However, they have not received the same amount of attention, in terms of having access to protective gear or logistics support (food, water, rest, finances, transport, and so on). Moreover, they are exposed to a great amount of risk while handling biomedical waste during this time, added to which they have no information or training on how to manage it.
India has about five million sanitation workers, a majority of them in the informal sector.
India has about five million sanitation workers—a majority of them in the informal sector. The COVID-19 pandemic has exposed the indifference of our government towards the conditions of these workers across the country, and the gaping holes in our practice of solid and biomedical waste management.
The Central Pollution Control Board (CPCB) did come out with guidelines on handling COVID-19 biomedical waste, but these were focused on hospitals and not on household-level biomedical waste (except for households with suspected or confirmed COVID-19 cases). In the absence of any systems and processes, several states such as Kerala, Maharashtra, or West Bengal, are now struggling with the disposal of biomedical waste.
Related article: How we can support sanitation workers during COVID-19
The Union Ministry of Environment, Forests and Climate Change (MoEF&CC) had notified the new Solid Waste Management Rules (SWM), 2016 to replace the Municipal Solid Wastes (Management and Handling) Rules, 2000. The new rules mandated the segregation of waste at source into three streams: Biodegradables, dry waste (plastic, paper, metal, wood, and so on), and domestic hazardous waste (diapers, sanitary napkins, mosquito repellents, condoms, disposable gloves, and face masks), before handing it over to the waste collector.
In practice, the segregation of waste from households happens only in two streams: wet and dry. When municipalities and waste collectors do not insist on separation, domestic hazardous waste gets mixed either with wet or dry waste, making it unhygienic and hazardous for the sanitation workers who handle it.1
The absence of careful segregation also affects the possibility of recovering, reusing, and recycling dry waste, and compromises the composting process of wet waste, leading to more waste in underground landfills or overground dumpsites.
India also has the Biomedical Waste Management Rules 2016, for the safe and scientific disposal of biomedical waste. However, these are only enforced in hospitals and healthcare facilities (HCFs). HCFs are estimated to generate close to 608 tonnes of biomedical waste per day, of which 528 tonnes per day—87 percent of the waste—is treated. For households, this figure is almost zero.
Biomedical waste is considered to be a small part of the overall composition of household waste, and hence is not properly estimated. The proportion of such waste could be estimated by considering the number of women of menstrual age, usage of baby and adult diapers, consumption of regular medication, and so on.
This non-adherence to rules and lack of preparedness become significant problems in times of public health emergencies.
This non-adherence to rules and lack of preparedness become significant problems in times of public health emergencies. Even now, segregation of biomedical waste is happening only from HCFs or households with suspected or confirmed COVID-19 cases, and not from every household, as the case should have been. This is a matter of serious concern, since nearly 80 percent of COVID-19 cases are asymptomatic, and hence will not fall under households with suspected COVID-19 cases. The risk to sanitation workers is therefore multiplied manifold, as is the risk to public health, since most mixed waste is dumped in the open.
Related article: COVID-19: A unique oppportunity to reform our health systems
Given the situation we are currently in, there is an urgent need to separate and safely dispose biomedical waste generated from households, as well as ensure compliance of waste management rules by healthcare facilities. Here are the actions that different stakeholders can take in the here and now:
Sanitation workers play a crucial role in keeping our cities clean, and the importance of their work cannot be overstated during this time. We cannot fight this pandemic unless they are able to work with safety and dignity.
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