Sanitation, Sanitation Workers and Covid

By Richard Seifman, UNA-NCA Board and Impakter Senior Columnist

Throughout history, good sanitation has been a matter of life and death. Cholera and other pandemics relied on sanitary measures as much as advances in medicine. COVID can be transmitted from waste and as a result, its management is among key factors in controlling the spread of COVID and the newest variant Omicron.

Either forgotten or ignored, crucial to our health and preventing the spread of infection are those who collect and process garbage, operate pumping stations and treatment plants, transport waste, or clean public toilets. And now with the Omicron surge, the need for sanitation and sanitation workers has never been higher. Here is what’s happening in the U.S. as trash piles up and workers take sick:

As the above video shows, so many sanitation workers have called in sick and gone into isolation that some cities in the U.S. have had to delay or even suspend garbage or recycling pickups.

Sanitation workers are often considered towards or at the bottom of working society but play a more direct role in our wellbeing than many company executives or those with advanced educational degrees. As a Malaysian paper put it, “Whenever the word “frontliners” is mentioned, it likely brings to mind images of doctors, nurses and police officers going about their duties to deal with the Covid-19 pandemic. But a frontliner does not necessarily have to be in uniform.”

An indication of how quantities of COVID-related waste has exploded is an estimate in 2020 that globally about 129 billion disposable face masks and 65 billion gloves were used monthly. These amounts have surely further increased.

In these pandemic times, we need sanitation workers at all levels and recognize they are as much at risk of contracting COVID as others providing services.

The global context for sanitation

The UN Sustainable Development Goal 6 drastically changed the focus from access to a household sanitation facility as was prioritized under the MDGs (that preceded the SDGs) to consideration of the full sanitation service chain.

In 2020 it was estimated that 3.6 billion people, or 46% of the world’s population, lacked safely managed sanitation. SDG target 6.2 states in part, “By 2030 achieve access to adequate and equitable sanitation…for all.”

To achieve that goal will be hard. On 19 November 2021, declared World Toilet Day by the UN, a striking aspect of the aforementioned statistic came to light: Those 3.6 billion people don’t have a safe toilet to take away their waste. Public health depends on toilets and the UN urged governments to quadruple their investments in sanitation systems if the SDG 6 goal is to be achieved.

With COVID infections virtually everywhere, this SDG target takes on yet greater importance. There are many aspects to this challenge, but what can and must be done in and by the public space, is critical.

The Inter-American Development Bank put risks this way:

“We might think that the virus disappears, for all intents and purposes, once we place our possibly contaminated garbage outside. Not so for sanitation workers, both formal and informal, who become susceptible to exposure. In close contact with massive quantities of waste, including materials on which the virus can stay alive for many hours, they provide a service that is quite possibly more needed than ever.”

Country and Regional Contexts

While some countries and communities describe sanitation workers as “COVID warriors”, there are many where they are not. And they are left unprotected, having to obtain their own protective personal equipment (PPE) even though poorly paid and getting inadequate if non-existent training in how to do so. A WaterAid study published in November 2021 found that:

• 1/3 of sanitation workers interviewed in Nepal did not receive any PPE from their employers;
• 80% of interviewed sanitation workers in Burkina Faso thought the PPE they were given was unsuitable and even made accidents more likely;
• More than 1/3 of workers in Bangladesh feared losing their jobs if they stopped working during the lockdown;
• Around half of the respondents (66% in Bangladesh; 44% in India; 50% in Pakistan; 61% in Nepal) reported challenges in meeting their daily expenses.

In December 2021 “Interreg Europe” published a survey undertaken by the Association of Cities and Regions (ACR+) of municipal authorities and waste operators across Europe to learn how COVID 19 had forced changes. The survey found that staff shortages, collection frequencies, physical access to civil amenity sites, safe handling of household wastes were all affected and posed challenges.

Good performance was observed, leastways in the early COVID-19 days, when public authorities and waste operators kept to collection schedules and minimized interactions with users while maintaining sorting performance. Further, as there was a decrease in commercial waste generation due to Covid-19 restrictions and economic slowdown, staff and other resources could be usefully reallocated to high priority collection services “such as those of residual waste, food waste, medical waste or residual waste from contaminated households…”.

There are many examples of individual countries which took protective steps, from Europe to North and South America, the Middle East, Africa and Asia. Viet Nam is one such example; the authorities quickly recognized they faced a great increase in medical waste in hospitals and quarantine zones which needed to be addressed. In 2021 they oversaw collection and treatment providing workers with protective suits as recommended by the Ministry of Health and talked about coronavirus prevention measures. And they recommended sanitation workers to be on the priority list for COVID vaccinations.

But Sanitation Workers Sometimes Resist Protective Measures

Sanitation workers reflect wider societal attitudes which sometimes include opposition to vaccination, and as a result, create high-risk situations for communities and themselves.

In November 2021 in New York City 17% of sanitation workers refused to get vaccinated when a mandate went into effect. “We’re being forced to do something against our will,” sanitation worker Michael Cancelleri said. But as the city’s sanitation workers faced unpaid leave, they rushed to get vaccinated and the number of vaccinated workers rose from 67 percent to 76 percent in one day.

The point here is that the fight against COVID has many facets. At its core are sanitary measures which prevent the spread of the virus and must include protecting those who work in this space. We need to recognize and appreciate that these workers are indeed a crucial “Front Line” workforce for us all.

Editor’s Note: The opinions expressed here by Impakter.com columnists and contributors are their own, not those of UNA-NCA. This article was originally published here on Impakter.com. — In the Featured Photo: Municipal sanitation workers carry trash aboard a boat — Senegal Photo: Scott Wallace / World Bank photo collection