New Delhi: Disposed facial masks, gloves, half-eaten plates of food, candy wrappers, cigarette packets, used paper cups and even an empty alcohol container — these are items that fill up the garbage bins just outside Ram Manohar Lohia (RML) Hospital in central Delhi.
A swarm of flies hover above the bins while sanitation workers clean the surroundings. Some wear masks, some wear gloves, some wear both and others neither.
The workers say they are afraid to do their job since they run the risk of contracting the infection while segregating the garbage and disposing of it.
“Relatives and patients who visit hospitals dispose masks and gloves outside the gates. We feel scared when we have to pick up them up. Our co-worker has already got infected and so has his mother. We are very scared,” said a sanitation worker at RML Hospital on condition of anonymity.
Last week, on 25 April, a sanitation worker with the Municipal Corporation of Delhi (MCD) died of Covid-19. A South Delhi Municipal Corporation (SDMC) sanitation worker and an assistant sanitation inspector had tested positive along with him.
Earlier in the month, on 5 April, two sanitation workers — one at RML Hospital and another at the North Delhi Municipal Corporation (NDMC)’s Charak Palika Hospital — also tested positive.
At a time India’s total Covid-19 cases have crossed 29,000, the risk sanitation workers are facing due to inappropriate gear has only magnified. In Delhi alone, there are over 3,000 cases and nearly 100 hotspots.
The Delhi High Court is currently hearing a plea filed by activist Harnam Singh who has sought personal protective equipment (PPE) for sanitation workers as well as testing them and their families for the disease. The court has sought a response from the Centre.
The garbage system
ThePrint visited sanitation workers at three hospitals — RML Hospital, Safdarjung Hospital and Charak Palika Hospital — to find out what their working conditions are like during the pandemic.
At Safdarjung hospital too, gloves and masks lay strewn with other waste around disposal bins outside the hospital. Sanitation workers were found cleaning the premises without gloves while masks hang around their necks.
“We don’t get masks and gloves. We have to go and ask the authorities every day. If we’re lucky we get the masks in a couple of hours but sometimes we have to wait for two-three days,” said a sanitation worker requesting anonymity.
“Whenever we ask, we are told there isn’t enough. We don’t know where these disposed masks and gloves come from, but we have to segregate them,” the worker added.
Another sanitation worker, who also asked to not be named, said, “Authorities keep asking us to use scraps of cloth as masks. But what about gloves? We have to pick up the waste with our hands,” he said.
According to the amended Bio Medical Waste Management Rules 2016, bio medical waste has to be segregated at the source from other waste material.
Hospitals are required to maintain four colour-coded bins — yellow for human anatomical waste, animal waste, body waste, tissues etc; red for biotechnological waste from labs, solid waste such as disposable items including PPEs; blue/white/translucent for sharps waste which are devices or objects used to puncture or lacerate the skin; and black for discarded medicines, ash from biomedical waste, chemical waste like insecticides and disinfection.
While handling waste from the bins, workers need to be equipped with proper gear such as masks and gloves.
The rules also specify that waste from Covid-19 wards are to be separated in double layered bags. Dedicated Covid-19 collection bins have to be used to transport this waste, which should be directly picked up by collection vans.
The World Health Organization’s guidelines also say that all the waste generated, including used PPEs, should be collected safely in designated containers and bags, treated and then safely disposed of, preferably on-site.
“If waste is disposed incorrectly, in the wrong bin for example, we ensure waste is segregated into the correct bin, we label them as bio-medical waste, hazardous or non-hazardous or otherwise, and give it to the collection team,” said a sanitation worker at Safdarjung Hospital.
What happens at hospitals
While NDMC workers clean the public areas outside the hospitals, waste management within the hospitals is handled by contractual employees. However, it is the hospital’s responsibility to provide PPEs to all sanitation workers.
“All offices in the hospital have gloves and masks which anybody can come and take at any time. Ninety-nine per cent of the people visiting hospitals are now wearing masks and gloves. The disposed masks could be from anyone,” said Dinesh Narayan, the public relations officer at Safdarjung Hospital.
Officials at RML Hospital said there was no shortage of PPE for workers on its premises.
“Sanitation workers are given the same protection as doctors. Not everyone needs PPEs. But masks and gloves are being given every day. We are also training our sanitation staff to handle Covid-19 waste,” said Dr Meenakshi Bharadwaj, medical superintendent at RML Hospital.
However, the Akhil Bharatiya Safai Mazdoor Sangh, a sanitation workers’ union, claims workers often don’t receive enough PPE.
“Supervisors often give out only 100 masks and gloves in a ward which has 500 workers. These workers not only need masks and gloves but gum boots as well as sanitised brooms and spatulas,” said Sanjay Gahlot, the Delhi chief of the union.
At NDMC’s Charak Palika Hospital, masks and gloves could be seen improperly discarded at the bins both inside and outside the hospital.
“We use spatulas to segregate masks and gloves or gauze from other waste. But a worker inside the hospital has tested positive. We feel scared while segregating,” said Rajkumar, a NDMC worker who sweeps the streets outside Charak Palika hospital.
Sanitation supervisors in each of the three MCD wards are expected to distribute masks and gloves to all workers. There are a total of 67,323 sanitation workers in employ, according to the Akhil Bharatiya Safai Mazdoor Sangh.
“Workers get masks and gloves when their attendance is marked at the beginning of every shift. There’s no shortage at all,” said Dr Shakuntala Shrivastava, chief medical officer of the NDMC.