Poor health of civic workers swept under the carpet

Lakkanna (name changed) leaves his home in Kodigehalli Gate in Bengaluru even before the city is up on its feet. The nip in the air notwithstanding, he hops on to a bus around 5.45 am every day. After the roll-call at 6.30 am, he is out to pick garbage from households in an auto tipper.

It’s mid-morning and he’s knee-deep in the garbage, segregating dry and wet waste, inhaling the nauseating stench arising from the biological waste. He has been handling garbage for the last 20 years. A contract worker, Lakkanna earns Rs 14,000 per month. After ESI and PF deductions, he gets Rs 12,000 in hand.

“Every other day I end up with severe headaches and body aches. I haven’t gone for a proper health check-up as I just don’t have the time,” he told DH. Lakkanna was unaware of the health risks common in his line of work.

‘Personal protective equipment mandatory’

Situation is no better in other cities

“Civic workers come to us complaining of breathlessness and burning sensation in the hands. Cases of injuries, cuts and skin infections are common. The burning sensation is because of the handling of chemicals in the waste,” said Dr T S Ranganath, Professor and HoD, Community Medicine, Bangalore Medical College.

“It is common to see chronic obstructive pulmonary disease, especially among the women sweepers. This is because of the fine dust they inhale,’’ he informed.

“Sharp instruments and bio-medical waste can cause injuries. Pricks can lead to jaundice and hepatitis. Most of the pourakarmikas are also anaemic because of the lack of nutritional food. Since they can’t eat while working they chew betel leaves with tobacco, which leads to oral cancer,’’ he said adding that the garbage pickers also go for country-made liquor every day which can cause liver failure.

At Ramamurthy Nagar, at the break of dawn, Rama (name changed), another pourakarmika, leaves for work from her home for the Bruhat Bengaluru Mahanagara Palike (BBMP) office at KR Puram. She is a mother of four, her youngest is just three-and-a-half years old. Her husband works as a labourer while her mother takes care of her children.

At the BBMP office, she gives her biometric attendance. Breakfast is served at 8 am. Armed with brooms, she, along with her co-workers, is then ready for the daily grind.

They sweep the streets, sometimes with brooms in both hands, load the cart, and push it. She’s on the road till 2 pm. If it rains, conditions are unfriendly.

The service that civic workers of Karnataka render by keeping its cities and towns clean and trash-free is immense. But the price they pay for their service to us is through their own health. Health risks are many — infections, respiratory issues, cancers apart from pricks and injuries.

Safety gear is not friendly, they say. ‘’Brooms that are given to us are not good or convenient to use. My hands burn after holding it for hours. I find it difficult to eat because of the burning sensation. We are now using brooms that we purchased ourselves from the Tuesday markets, those that come at Rs 15,” Rama said.

“The shoes provided are uncomfortable and it’s very difficult to work with them on. It burns your feet. Pushing the carts is tough and at the end of the day, my bones are cracking and I have aches and pains all over,” Rama said.

Of late, Lakkanna has been taking health concerns a tad bit seriously. “I recently received a message on my phone that some pourakarmikas have been admitted to Kidwai Institute after they were diagnosed with cancer. Hence it has been made mandatory to wear gloves, masks, and boots. I do wear them but the gloves need to be washed after use. Also, it is more convenient to work without gloves. New ones cost around Rs 60 to Rs 80. My shoes are torn because of glass pieces. I need to get new ones,” he said adding, “also, I still haven’t made my health card.”

“No awareness campaigns are being conducted for them. They should be given rubber gloves. Also, the BBMP should make sure that the food provided to them is nutritious,’’ Dr Ranganath said. Inhaling toxic substances is something this community has got used to. “Once in three months, all Pourakarmikas should come for check-ups,” he said.

“There are BBMP’s referral hospitals in the city with good labs, where they can take blood tests. It’s free of cost. All they need to do is carry their BPL card. However, the unfortunate part is that they are not aware of the risks or illnesses. They do not want to take leave and go for check-ups because of the fear of losing wages. Half-day leave should be provided for them to take these tests and check-ups,” he said.

“They should take tetanus toxoid and hepatitis vaccines mandatorily. We have done screening for mothers for risks of cervical cancer,” he told DH.

“Occupational health hazards include respiratory problems, back, shoulder and chest problems. Lack of toilet facilities and drinking water often lead to urinary tract infections, which are not even spoken of,’’ said Vinay K Sreenivasa of Alternative Law Forum.

“They have cuts on the body due to the type of garbage, both on hands and legs. They develop skin problems and rashes due to direct contact with the garbage. These are just some. BBMP has organised some health camps. However, continuous follow-up, which is required, is not done,” added Vinay.

Safety equipment

Maithri Krishnan from the BBMP Guttige Pourakarmikara Sangha informed that safety equipment is not being given to all workers. “What is being given is very difficult to use -- like the boots, which make them sweat a lot. It’s time to figure out a useful model. Masks are not supposed to be worn more than three or five days but they are given only one mask. There is a model safety kit but it is still not given to them,” added Maithri.

Drinking water and toilet facilities remain largely a luxury for many of the workers.

“Drinking water for the civic workers is available only in a few areas, but even that’s not provided. Informal arrangements are made by workers themselves. In some areas even this is not available,” said Vinay.

“We manage with the Rs five-per-bottled water. Breakfast is provided at the BBMP office but there is no place to sit and eat. So we huddle under a tree. It would be good if they could provide us a room to eat,” rued Rama.

“Restrooms and toilets that were supposed to be provided to the workers are not being provided. Many are not allowed to use the toilets that are there. Some are kept locked. BBMP had said it will look into it. The combination of not having drinking water and not being able to use the toilets has serious effects on the health of these workers. It affects women even worse. Since they are not drinking water throughout the day, they don’t use the restroom. There is very serious long-term damage that is caused,” added Maithri.

Lakkanna is cheerful in spite of his health concerns. But this is not the future he foresees for his children. Neither does Rama. They are awaiting a whiff of fresh air.