The Forgotten Frontline Workers: Safai Karamcharis, Hospital D-Group Workers, ASHA Workers and Crematorium Workers

While everyone is speaking about the doctors and nurses, who are most definitely working on the frontlines and whose services are, of course, laudable during this pandemic, it is necessary for us to remember the frontline workers who are often neglected – the Safai Karamcharis / Sanitation Workers, the D-Group workers in hospitals, ASHA Workers and Crematorium workers.

Sanitation Workers

Every morning, in every village, town and city around the country, even before the sun rises, armies of lakhs of Dalit Safai Karamchairs awake and leave their homes to begin their daily sanitation work of sweeping the streets, removing garbage, cleaning drains, cleaning toilets, etc. Sanitation Workers are not merely individual members of the sanitation work force out of pure choice; but members, by birth, with inerasable identity and inter-generational continuity.

Sanitation workers, who have worked through the lockdown without any break, play a major role in directly dealing with garbage, cleaning drains, disinfecting public places, hospitals and even containment zones. They are the ones with an elevated risk of COVID-19 infection because the nature of the job puts them into direct contact with the virus. These workers are required to work in proximity to households and apartments for door-to-door waste collections. They work in the containment zones and collect waste from the home quarantine households, placing them at great risk.

Hospital Workers

The Frontline workers in Hospitals apart from doctors and nurses include a large number of workers engaged in  housekeeping, waste management, attenders, lift operators, ward boys, security personnel to name a few. This includes workers in both public and private hospitals. The housekeeping staff ensure cleanliness and hygiene in the premises of the hospital, including the COVID-19 Ward. The task of the attenders is to look after the COVID-19 patients, bringing them medicines, food, water and helping them to the toilets, etc. The security personnel are in-charge of the security of the hospitals. These workers come in direct contact with persons with COVID-19 and deal with biomedical and sanitary waste on a daily basis. They are exposed to hazardous substances and infected waste, are made to clean toilets and bathrooms in hospitals and thus get exposed to risk of infection, even if they are not always ‘directly’ in contact with patients themselves.

Both sanitation workers and hospital workers, in most parts of the country, are employed under sham contract systems in violation of the law and are very often not even paid minimum wages or not even provided with any form of social security measures. They do not enjoy job security either. Their social, economic and working conditions which were already abysmal have been further exacerbated by the pandemic. They are denied even the most basic rights like minimum wages, toilets, drinking water, proper rest, quarantine facilities etc. and are made to suffer from inhuman and unhygienic working conditions. This causes various occupational hazards including back problems, joint pains, high blood pressure and respiratory and heart related illnesses, making them more vulnerable.

Despite guidelines on the same, most of the workers are not provided any safety equipment, let alone PPE Kits which is what they require. They are at a very high risk of coming in direct contact with persons who are COVID positive.

ASHA Workers

ASHA (Accredited Social Health Activist) workers are another group of frontline workers, who are completely neglected. A single ASHA worker looks after more than 1,000 families. The ASHAs are crucial element in primary and community health programmes. During the period of COVID, they are performing the work of contact tracing, conducting regular health check ups, registrations and assisting with vaccinations, spreading awareness, etc. They are on the frontlines and are at a grave risk. However, they are not even recognized as workers and are paid merely incentives and not even paid monthly wages. They have no security of tenure and can be terminated at will. The condition of ASHA workers is extremely precarious, especially during the ongoing Covid pandemic.

Crematorium Workers

Workers employed in the crematorium belong primarily to the dalit communities. They perform the caste-imposed profession of cremating and burying. They work under extremely vulnerable conditions added with violation of their rights like not being paid minimum wages or not being provided with any safety equipments. Those who routinely handle corpses may have heightened risk of contracting tuberculosis, bloodborne viral infection (such as Hepatitis B/C and HIV), and gastrointestinal infections (such as rotavirus diarrhoea, salmonellosis, E. coli, typhoid/paratyphoid fevers, hepatitis A, shigellosis and cholera). As COVID related deaths increased from April, 2021, the crematorium workers have been completely overworked and are in constant risk of catching the virus themselves. Despite being overworked, they are not paid additional wages and continue to be denied even minimum wages. They have not been provided with vaccination either.

Treble Oppression as Dalits, Workers and Women

The Supreme Court, in its order dated 30.04.2021, in In Re: Distribution Of Essential Supplies And Services During Pandemic held that there must be an effective policy to ensure that the nation truly acknowledges the efforts of public healthcare professionals - doctors, nurses, hospital staff, ambulance drivers, sanitation workers and crematorium workers. The SC further directed the Central Government to ensure that facilities such as availability of food, resting facilities during intervals between work, transportation facilities, non-deduction of salary or leave account if afflicted by COVID 2019 or related infection, overtime allowance, in both public and private hospitals, and a separate helpline in cases of COVID 2019 related emergencies  are provided.

These workers despite being recognized by the Government as frontline workers  have been and continue to be neglected. Importantly, these workers largely come from historically oppressed dalit communities. Other than crematorium workers, they are predominately women.

It is necessary that immediate steps are taken to ensure all frontline workers are provided with proper safety equipment including PPE kits, full medical facilities and all basic amenities. All frontline workers must be provided free vaccination on priority. Their access to regular testing must also be ensured. It is also necessary that all workers are made permanent. The exploitative system of calling the frontline workers as ‘contract workers’ or ‘honorarium workers’ must be immediately abolished and they must be paid wages on par with permanent workers. They must be paid COVID allowance at a minimum of Rs. 10,000/- per month and medical insurance of Rs. 50 lakhs under the Pradhan Mantri Garib Kalyan Yojana must be extended to all these workers and their families. [Unfortunately, vast majority of this section of workers are excluded from 50 lakhs insurance saying they are not in ‘direct’ contact with Covid patients. This is a major injustice meted out to them]. It is necessary that immediate steps are taken to ensure fair and dignified working conditions for these workers.