Manual scavenging - Scenario, threats and feasible solutions

Why manual scavenging

Have you ever met those people who clean sewers? They are from the poor and often the uneducated unorganized sector of the society – the easily exploitable class of the society.

India is a country where millions of people in the urban and rural do not have access to adequate sanitation. Open defecation is a common practice.

The urban society produce wastes. Our  urban planners have created sewer lines running throughout the cities that eventually take all the sewage generated in a city and probably into some sea. These sewer lines should be cleaned in order to remove any clogs.  

Poverty and unemployment forces people to take up this profession.

Risks of manual scavenging

Lakhs of people engaged in manual scavenging works in unorganized sector do not normally use any personal protective equipments. This can lead to medical issues like skin diseases, nausea, jaundice, anemia.

The H2S gas

Hydrogen sulfide/ H2S   is a colourless gas known for its rotten egg smell and is acutely toxic and a leading cause of death among workers in sanitary sewer systems. It is normally a product of microbial reaction that breaks down organic matter in the absence of oxygen. It is slightly denser than air. The higher density of the gas when compared to atmospheric gas makes it difficult for the gas to escape once it is generated or accumulated in the sewers and hence once it is generated in sewers, the gas hardly escapes. The US National Institute of Occupational Safety & Health (NIOSH) has classified that a level of H2S gas at or above 100 ppm is Immediately Dangerous to Life and Health (IDLH). It means that the concentration of H2S above 100 ppm will cause immediate and irreversible health effects or would damage the person’s ability to escape from the dangerous atmosphere – A condition that makes it impossible for the sewer workers to escape even when they identify that the atmosphere contains H2S. The TLV – TWA value of H2S is 1 ppm, which means that a person working in 8 hour shifts a day for 5 days in a week can have exposure to 1ppm of the gas. Any exposure beyond that will cause health risks.

What are the potential health effects of hydrogen sulfide?

Main Routes of Exposure: Inhalation; eye contact.

Inhalation: VERY TOXIC, can cause death. Can cause severe irritation of the nose and throat. Can cause life-threatening accumulation of fluid in the lungs (pulmonary edema). Can cause, excitement, headache, dizziness, staggering, sudden collapse ("knockdown"), unconsciousness, and death Long-term damage may result from a severe short-term exposure. Can harm the nervous system. Can cause lung injury. A single exposure to a high concentration can cause a long-lasting condition like asthma. If this occurs, many things like other chemicals or cold temperatures can easily irritate the airways. Symptoms may include shortness of breath, tightness in the chest and wheezing. {Reactive Airways Dysfunction Syndrome (RADS)}.

Skin Contact: Skin irritant

Eye Contact: EYE IRRITANT. The gas irritates the eyes. Direct contact with the liquefied gas can freeze the eye. Permanent eye damage or blindness can result.

Ingestion: Not a relevant route of exposure (gas).

Effects of Long-Term (Chronic) Exposure: Conclusions cannot be drawn from the limited studies available. May harm the nervous system. Symptoms may include restlessness, reduced ability to think, muscle tremors, memory loss and personality changes. May harm the respiratory system.

Carcinogenicity: Not known to cause cancer.

What are first aid measures for hydrogen sulfide?

Inhalation: Take precautions to ensure your own safety before attempting rescue (e.g. wear appropriate protective equipment). Move victim to fresh air. Keep at rest in a position comfortable for breathing. If breathing is difficult, trained personnel should administer emergency oxygen. DO NOT allow victim to move about unnecessarily. Symptoms of pulmonary edema may be delayed. If breathing has stopped, trained personnel should begin artificial respiration (AR). If the heart has stopped, trained personnel should start cardiopulmonary resuscitation (CPR) or automated external defibrillation (AED). Avoid mouth-to-mouth contact by using mouth guards or shields. Immediately call a Poison Centre or doctor. Treatment is urgently required. Transport to a hospital. NOTE: Victims may pose a threat to responders due to the release of hydrogen sulfide from their clothing, skin, and exhaled air.

Eye Contact: Immediately flush the contaminated eye(s) with lukewarm, gently flowing water for 15-20 minutes, while holding the eyelid(s) open.

First Aid Comments: Some of the first aid procedures recommended here require advanced first aid training. All first aid procedures should be periodically reviewed by a doctor familiar with the chemical and its conditions of use in the workplace.

Ban on manual scavenging

Ban on manual scavenging - The Indian government has banned manual scavenging through the Prohibition of Manual Scavengers Act, 2013. The law says, any contact between excreta and a labourer employed to unclog a drainage pipe or sewage treatment plant is prohibited by law, and the occurrence of such a trespass or the non-provision of safety gear or disinfectants to the labourer will lead to the prosecution of the contractor and the employer. However, effective implementation of this act is still pending putting the lives of the lakhs of manual scavengers in India at stake.

As per the Prohibition of Employment as Manual Scavengers and Their Rehabilitation Bill, the district magistrate has to ensure that no person within his/her jurisdiction is engaged as a manual scavenger or constructs an insanitary latrine and that manual scavengers are rehabilitated. It makes it mandatory for municipalities, cantonment boards and railway authorities to construct adequate number of sanitary community latrines within three years of this act coming into force.

The penalty for employing a manual scavenger or constructing an insanitary latrine, is imprisonment up to one year or a fine of up to Rs 50,000 or both. Insanitary latrines should be either converted or should be demolished by the occupier.

Solutions

In a country like where I live, I can be certain that they do this to protect their ailing family from poverty. Why doesn’t rehabilitation of manual scavengers happen? Is their rehabilitation even possible? Yes it is possible. If you rehabilitate all the workers involved in the profession, then what will happen? The situation is still the same. This will just create a shortage for manual scavengers. Someone else in need of money, someone who shoulders an ailing family will come forward and take up the responsibility. If not ‘A’ then ‘B’ will do it. You have rehabilitated ‘A’. Now who will rehabilitate ‘B’?

 So what is the solution? The solution is strict compliance with the law that states ‘Insanitary latrines should be either converted or should be demolished by the occupier’, urban planning that does not require the workers to enter and clean sewer line, worker education, first aid and emergency trainings to workers taking into consideration the worst case scenarios, designing and re-engineering our cities for the better, constructing latrines in places where open defecation is a common practice.

References

http://www.bbc.com/news/business-35958730

https://www.youtube.com/watch?v=-UYWRoHUpkU

https://www.ccohs.ca/oshanswers/chemicals/chem_profiles/hydrogen_sulfide.html

PS: Suggestions and recommendations will be incorporated in the article.