HOW many deaths will it take before it is accepted that too many people have died? In just 35 days between mid July and mid August, in New Delhi alone, 10 sanitation workers died while they were engaged in the poorly paid and extremely hazardous task of manual scavenging. They entered sewers to clean them without even minimal precautions (such as using safety gear) that would have allowed them to deal with the noxious and even toxic gases, slippery floors, high walls and often very high temperatures in sewers. It was the responsibility of their employers to ensure that the workers had the safety gear and that they used the equipment.

Manual scavenging is defined as “the removal of human excrement from public streets and dry latrines, cleaning septic tanks, gutters and sewers”. The practice is still widely prevalent in India, driven by class and income divides and much more by caste and patriarchy. All manual scavengers in the country are Dalits, and even among Dalit castes, such workers tend to be lower in the hierarchy, coming from some of the most marginalised and oppressed sub-castes.

And within such work, there is a clear gender divide: women workers dominate in the cleaning, removal and carrying of faeces from toilets in both rural and urban areas. This work tends to be the lowest paid, with some recorded instances of unbelievably low rates such as Rs.150 a month and a roti or two a day from each household thus served. The men clean septic tanks, gutters and sewers. Both tasks are unpleasant and unhealthy and carry severe risks to life.

It is clearly one of the most perilous occupations in India. Remarkably, there are no official data on this, but independent surveys indicate that at least 1,370 deaths occur every year during such work, and this is probably a serious underestimate. As many as 2 per cent of these workers have been estimated to die in the course of their work because of lack of protective equipment and minimal safety measures. In any case, these workers have major health problems and tend to die early because of the continuous inhalation of noxious fumes, the susceptibility to disease that comes from dealing with faeces and related risks. Such work directly leads to nausea, skin infections, anaemia, diarrhoea, vomiting, jaundice and trachoma, which affect not only the men who enter sewers and septic tanks but also the women who carry uncovered loads of excreta on their heads. It is common to find cardiovascular degeneration, musculoskeletal disorders, infections, skin diseases and respiratory ailments among such workers. And because they are so poorly paid, they suffer from undernutrition and cannot avail themselves of adequate preventive or curative health services.

After the latest spike in such deaths in the capital, there was some reportage and some outcry, typical of the episodic and sensation-driven interest that characterises media coverage of most matters in India. But imagine the coverage if the same number of soldiers had died, or even if as many cows had suddenly been found dead in the same city. What is worse, there is simply not enough attention given to the fact that official practices, along with the current Central government’s flagship Swachh Bharat Abhiyan (SBA) campaign, actually make matters significantly worse by implicitly relying on this form of labour without any concern for the lives, safety and working conditions of the workers.

Two laws promulgated by the Central government in the past two decades have sought to address the issue of manual scavenging. The Employment of Manual Scavengers and Construction of Dry Latrines (Prohibition) Act, 1993, does not ban such work but rather seeks to regulate its conditions. However, it has no real provision for punishing those who do not comply. Unsurprisingly, it has had no impact in addressing either the existence or the nature of this practice.

Prolonged agitation and lobbying by the Safai Karmachari Andolan (SKA) and others led to the Prohibition of Employment as Manual Scavengers and their Rehabilitation Act, 2013. This Act prohibits the construction or maintenance of insanitary toilets and the engagement or employment of anyone as a manual scavenger. It also forbids the employment of workers for hazardous cleaning of a sewer or a septic tank (that is, without adequate safety gear and other precautions) even in emergency situations. Violations can result in a year’s imprisonment or a fine of Rs.50,000 or both. If a worker dies while performing such work, even with safety gear and other precautions, the employer is required to pay compensation of Rs.10 lakh to the family.

The law also requires the government to survey and estimate the actual number of such workers and take immediate measures to rehabilitate them with other employment. It fixes responsibility on each local authority, cantonment board and railway authority to survey unsanitary (dry) latrines within its jurisdiction and to construct sanitary community latrines. All this was further strengthened, at least legally, by a case heard in 2014, Safai Karamchari Andolan vs Union of India, in which the Supreme Court ordered the abolition of the practice of manual scavenging and asked for the rehabilitation of such workers.

Sadly, implementation has been poor and the punitive action taken hardly serves as a deterrent. Manual scavenging continues unabated, as the recent more publicised deaths indicate. Official data from the Central and State governments massively understate the practice, exemplifying the extraordinary ability of Indians to render invisible any reality that is uncomfortable. The underestimation is endemic to both official data collection and policy approaches, which deal with the problem by assuming it away.

Thus, the Socio-Economic Caste Census (SECC) of 2011 identified 1,80,657 manual scavengers across the whole of India, whereas the SKA estimates that there are more than six times that number, around 1.2 million. The latter seems more reasonable, given the Census 2011 estimate of 2.6 million dry latrines in the country and many more created since then.

So these official claims are easily disproved. Consider an investigative report on Uttarakhand—one of the five best performing States according to the SBA dashboard, with supposedly 100 per cent coverage of individual household latrines. The SECC identified only 12 manual scavengers in the rural areas of the State, and the official SBA records claim there are none left in the State. But reporters visiting Haridwar district found eight such workers in a single village and at least 500 dry latrines (all requiring manual collection of excreta) in the area served by a single gram panchayat. In nearby Udham Singh Nagar district, which the SBA has also declared open-defecation-free, it was found that every third household still lacked a toilet and most of the newly installed toilets were dry and required manual cleaning.

Some of the worst offenders in perpetuating manual scavenging are not private contractors but public agencies. For example, Indian Railways is the largest employer of manual scavengers. It is impossible to identify how many since they are classified as “sweepers”, but the numbers required must be huge since the overwhelming majority of trains rely on open toilets that dump faeces onto railway tracks. Most of the workers who have to clean this up (manually, of course) are employed through contractors and earn at best around Rs.200 a day. They are lucky if they get gloves to wear, and certainly they get little else as protection or safety gear. (If they did get these, apparently they could no longer be considered to be manual scavengers!) Only around one-third of all coaches have been fitted with modern bio-toilets thus far.

This deeply entrenched, and deeply casteist, approach to manual scavenging is part of public policy and explains why the SBA is also in effect relying on this appalling practice. The explicit aims of the SBA were fourfold: to eliminate open defecation, to eradicate manual scavenging, to bring in modern and scientific municipal solid waste management, and to effect behavioural change regarding healthy sanitation practices. But the energy and resources have been concentrated on the first, with some naming-and-shaming attempts on the fourth. The critical areas of eradication of manual scavenging and rehabilitation of workers and the associated need to address solid waste management have been all but forgotten.

Therefore, what has been happening is that lots of new toilets are being constructed but without any strategy to address how they are to be cleaned. They are seldom if ever linked to sewage, drainage or water facilities, and there has been little or no investment in procuring mechanised equipment for the physical removal of excreta.

Finally, the SBA has almost no concern for the rehabilitation of manual scavengers, which is part of its mandate and even required of the government by law. The current Budget allocates the princely sum of Rs.5 crore for rehabilitation, and of course, it is easy to claim that the government does not need to spend much to rehabilitate such workers when their existence is denied in the first place. So workers who cannot get other employment because of caste discrimination in what is anyway a stagnant labour market are forced to go back to manual scavenging.

That is why, as SKA convener Bezwada Wilson points out, “Swachh Bharat represents toilet users, not toilet cleaners.” Until we respect and ensure dignity to all manual scavengers and make sure that no one needs to do such work again and that those who have been forced to undertake it are provided gainful employment in decent conditions, a scheme like this will remain a sham.