Arshad Boota Maseeh* looks pale and tired. His starkly visible cheekbones, the heavy bags under his eyes and his twitching lips are a testament to the fact that he may have recovered from Covid-19 only at a high cost. The 45-year-old sewer cleaner lives in a cluster of other low-income non-Muslims in Narayanpura, a neighbourhood in Karachi’s Ranchore Line area. He is now heavily in debt, with six months’ of salaries still pending from the Sindh health department. The deadly virus may not have taken Boota Maseeh’s life but it has certainly pushed him into extreme poverty.

“I am now a shadow of my former self,” says Boota Masih, who has now resumed his job — an eight-hour shift of cleaning a ward at a government hospital. “The doctors have recommended that I rest and regularly take a nutritional diet. But I have a family to feed, all my savings have gone in treatment and not many alternate revenue sources are available. If I get re-infected, it is going to be doom and gloom. I will lose the battle for survival.”

Sanitation workers all over Pakistan are associated with jobs that include cleaning toilets, emptying pits and septic tanks, cleaning sewers and manholes — often using their bare hands to unclog pipes through which faeces, plastics and hazardous hospital wastes pass. Muslims are not preferred for this job — as it is considered nasty and dirty — hence they are usually given to non-Muslims, in itself a discriminatory institutional practice. According to a 1998 government census, Christians fill about 80 percent of sanitation jobs. Lower-caste Hindus mostly fill the rest.

An excerpt from a qualitative assessment report by the international NGO WaterAid, published on June 24, 2020, reiterates that the pandemic has adversely hit the already under-pressure finances of the very poor sanitation workers. “The lockdown affected their multiple sources of income and thus decreased their monthly income considerably, making it difficult for them to meet expenses such as house rent, utility bills, school fees, repaying loans and others,” reads the report. “For this, they took help from family/friends and their employers. They also obtained food items from shopkeepers on loan, got discounts from schools, sold assets and cut down expenses.”

Aside from pending salaries, exposure to medical waste and faulty or no PPEs have left sanitation workers in Sindh vulnerable and helpless in battling the pandemic

The report further adds that the majority of sanitation workers continued work during the lockdown but with an increased workload. The rest discontinued work because of offices’ closure, lay-offs and/or were sent on paid leaves during lockdown — these were mainly sanitation workers employed at private offices and homes.

While the private sanitation workers have no job security, the government-contracted workers are no better off, as they are waiting for their dues from the Sindh government for the past six months.

“According to the minimum wage bill passed by the Sindh government, the sanitary workers are entitled to receive 17,600 rupees per month, but practically they are handed over merely 6,000 rupees, with delays lasting for months,” says Pirbhu Satyani, a regional head in Hyderabad of the NGO Strengthening Participatory Organisations (SPO). “The government has not yet issued their wages for the last six months.”

For Samuel Pyara, chairman of the Implementation Minority Rights Forum (IMRF), it’s just not their finances which have become a dilemma for the sanitary workers, but the continuing lack of occupational safety and health measures is a looming threat to their survival.

“It is sad to note that the state has left the sanitary workers from Karachi to Kashmir to struggle,” Pyara laments. “As if they are not worth any consideration. The thought behind it is the inconsiderate institutional elitist mindset against those who belong to the lowest strand of the society. The second wave of Covid-19 is rampant and, despite the Supreme Court of Pakistan’s directives, sanitary workers are on their jobs either without the mandatory Personal Protective Equipment [PPE] or with faulty ones.”

WaterAid in its report also found the protective equipment given to the sanitary workers to be “uncomfortable to use and of poor quality, especially gloves and masks. Apart from the shortage of equipment, respondents also complained about their faulty fitting and the cost implication of buying/acquiring them repeatedly.”

In its judgment on June 8, 2020, the Supreme Court of Pakistan states all authorities should be directed to provide to sanitary workers all required safety kits, in order to ensure that, while doing their work, their health is not adversely affected by any disease.

The judgement says, “We note that sanitary workers, although employed for doing sanitary work, this does not mean they should do sanitary work where their health and life may be jeopardised. They should not be asked to work beyond the call of duty. If they are made to do work which has the remotest possibility of their being affected by such disease or ailment which may pose a threat to their life, strong and effective steps should be taken by the federal government, provincial governments, local governments, cantonment boards, ICT [Islamabad Capital Territory] and Gilgit-Baltistan governments, for ensuring that all sorts of safety kits are mandatorily provided to sanitary staff, and none of them should be allowed to work without safety kits being made available to them.”

The judgment added that, if legislation to this effect has not been made by the federal government, provincial governments, local governments, cantonment boards, ICT and Gilgit-Baltistan governments, they should ensure that such legislation dealing with this very aspect of the matter should be made, which is very important and a requirement under Article 9 of the Constitution.

“Despite the orders, we see that no PPEs are given to the sanitation workers all over Pakistan,” says Pyara. “The sanitation workers are more prone to be infected because of their proximity to medical wastes and longer hour duties in hospitals than anyone else. All they are getting is baseless assurances.

“After the Supreme Court orders, the Attorney General asked me to draft a bill on this matter which he has promised will be presented before the National Assembly while the KP [Khyber Pakhtunkhwa] government has passed the KP Occupational Safety and Health Bill, 2020, in light of the judgment,” he says. “But the fact remains that sanitation workers are as vulnerable as they were before. There has been no progress, neither any implementation on court orders.”

Despite multiple attempts to reach Sindh local bodies minister Nasir Hussain Shah and his media team for the provincial government’s take on the developments, no official response was given till the filing of this story.

While the state may have at least finally acknowledged on paper that efforts do need to be put in place for the safety of vulnerable sanitation workers, it appears little or nothing has been done on the practical front for sanitation workers exposed to hazardous medical waste.

In words of Boota Maseeh, “Forget about climbing the social ladder — we are demanding as basic a thing as right to life. Because today, our survival is at stake and there is no one there to give a helping hand.”

The author is a graduate of Politics and International Relations from Royal Holloway University of London. He tweets @ebadahmed
*Name changed to protect privacy

Published in Dawn, EOS, December 13th, 2020