It is time for a second round of balcony clapping in India — one just for our sanitation workers who are fighting the coronavirus pandemic and handling garbage at home and hospitals.
Indian hospitals are overstretched with rising Covid-19 cases, and the Narendra Modi government has allowed patients with mild symptoms to stay and be treated at home. Hundreds of thousands of migrant workers, students and pilgrims will also be returning to home quarantine.
This naturally shines light on the work done by sanitation workers. It’s time to talk about garbage seriously. And the measures we put in place today for the pandemic will go a long way in undoing years of neglect that sanitation workers have been reeling under.
How much biomedical waste will be produced in these circumstances and how will it be disposed? Will there be systems put in place and awareness generated to segregate and incinerate the hazardous and contagious waste produced in villages, towns and cities? Is there any mechanism to protect India’s sanitation workers and 40 lakh rag pickers in such situations? In any case, they were the most vulnerable groups even before the outbreak of the pandemic.
Increasing contagious waste
The government and municipal authorities have not informed the sanitation workers and the rag pickers about the impending danger of a possible spike in coronavirus infections. No mass media campaigns have been launched yet. Perhaps, municipal authorities don’t wish to frighten the sanitation workers. They can’t even dismiss them because most sanitation workers are not regular employees. They are mostly informal workers. The rag pickers are not even paid. They earn their livelihood, if it can be called one, by picking things from the waste and selling them. We cannot even bring in the Essential Services Maintenance Act or ESMA for the rag pickers.
India produces around 600 tonne of biomedical waste every day in its health care facilities. Some of these are disposed properly in common biomedical waste treatment facilities (CBWTFs). India has as many as 198 such facilities and 225 hospitals have captive incinerators. These are not adequate even in normal circumstances and they are not evenly spread. As many as seven states do not have a single CBWTF.
India is going to produce even more biomedical waste during the pandemic. Wuhan saw the quantity of its garbage increase six times during the pandemic, and the city had to construct a new waste treatment plant and add 64 mobile waste treatment facilities.
This increase in waste output is due to two simple reasons. Because the disease is highly contagious, personal protective equipment (PPE), masks and gloves are being used in large numbers and have to be discarded after a single use. The other factor is that, normally, hospitals produce a large amount of non-contagious waste like water bottles, medicine packets, papers, etc. In normal situations, such items are segregated in different bags and sent for dumping at the municipal yard. But now, most of these things have to be disposed along with hazardous biomedical waste, because the coronavirus can survive up to 24 hours on cardboard and for 72 hours on plastic and metal surfaces. Hospitals are the new hotspots.
India not ready to handle Covid waste
The Modi government is aware of the problem of hospital waste management and has done the ritual of issuing guidelines for handling, treatment and disposal of Covid-19 waste at healthcare facilities, quarantine centres, sample collection centres and laboratories. It’s very comprehensive and follows international protocols.
But the truth of the matter is that we are actually not ready to handle hazardous Covid-19 waste, at least not everywhere.
— We have come across news of used masks being dumped without segregation and medical waste, including PPEs and gloves, trashed in public places. This happened even in Delhi, where the law enforcing agencies are in a better position to handle such violations.
— Our sanitation workers are still handling such waste mostly without any protective gear, gumboots, gloves and masks.
— There was no awareness campaign on sanitation, isolation, waste disposal before the government issued guidelines to keep Covid-19 patients with mild symptoms at home.
— We, as citizens, are not habituated to segregate biodegradable and non-biodegradable waste. Culturally, we are not accustomed to even talk about garbage. Most hospital staff do not follow proper protocols of waste segregation. We are actually asking for too much when we are expecting Indians to segregate Covid-19 waste and dispose it properly. It needs persuasion and training.
So, where do we go from here? These are a few measures for the government to consider.
— The announcement to give Rs 1 crore compensation to the family members of any deceased sanitary worker is a good step taken by the Arvind Kejriwal government in Delhi. Other states must follow. This can be taken up at the level of Union government because deaths of sanitation workers are being reported across India.
— Provide sanitation workers with protective equipment. Follow international conventions and protocols. Pay them adequately. Don’t forget that the threat to life and probability of dying is higher inside a sewer than at the India-Pakistan border. This may sound like hyperbole, but we are living in un-real times.
— Launch a massive campaign to make people aware of the importance of segregating Covid-19 waste, and put a system in place so that they can hand it over to designated persons. This is easier said than done. But the government and municipalities must try it. We don’t have any other option, because in the coming days there will be patients amongst us.
— The violations of Covid-19 waste disposal guidelines by healthcare facilities must be dealt with sternly. Usually, such guidelines are hardly taken seriously because there are more than 27,000 cases of violations in a year.
The author is the former managing editor of India Today Hindi magazine, and has authored books on media and sociology. Views are personal.