< PREVIOUS SLIDE SLIDE 1 of 5 NEXT SLIDE > Indian migrant workers wait to board buses to return to their home villages as a nationwide lockdown continues on March 28, 2020, on the outskirts of New Delhi, India. © Yawar Nazir/Getty Images

For two days, Jeetender Mahender, a 36-year-old Dalit sanitation worker, has not dared to leave his family's shanty in the Valmiki slum of northern Mumbai, India, except to go to the toilet.

His situation is desperate. The tiny home has no running water or toilet, his family is low on food -- and when he doesn't go to work, he doesn't get paid.

Mahender is trying to comply with Prime Minister Narendra Modi's 21-day nationwide lockdown, intended to help stop coronavirus spreading further among the country's 1.3 billion people. India has recorded 1,024 cases and 27 deaths.

"Social distancing is not just for the sick, but for each and every person, including you and even your family," Modi said in a nationwide address last week.

That might work for India's middle and upper classes, who can hunker down in their condos and houses, preen their terrace gardens, eat from their well-stocked pantries and even work from home, using modern technology.

But the chaos unfolding across India in recent days has spelled out that for the 74 million people -- one sixth of the population -- who live cheek by jowl in the country's slums, social distancing is going to be physically and economically impossible.



"The lanes are so narrow that when we cross each other, we cannot do it without our shoulders rubbing against the other person," said Mahender. "We all go outdoors to a common toilet and there are 20 families that live just near my small house.

"We practically all live together. If one of us falls sick, we all will."

At least one person in a Mumbai slum has already tested positive for the novel coronavirus. As panic grows among India's most vulnerable, thousands of migrant workers are trying to flee the slums for their rural homes, by bus and even by foot, sparking fears they will import the virus to the countryside.

In a radio address Sunday, acknowledging the chaos the lockdown had brought India's poor, Modi asked the nation for forgiveness. But he also urged listeners to understand there was no other option.

1 toilet for 1,440 people

Water is one of the biggest reasons India's poor need to leave home every day.

Sia, a slum dweller and migrant construction worker in Gurugram, near New Delhi, wakes up at 5 a.m. and defies Modi's call to stay indoors. The reason? She needs to walk 100 meters (328 feet) to a water tank that serves her slum of 70 migrant construction workers.

She is not the only one. Most women from the construction site slum wash together there every morning and collect water for the day. With no showers or bathrooms in their homes, this communal tap is their only water source.

The government's Clean India Mission, launched in 2014 to improve infrastructure and eliminate open defecation, claims that 100% of Indian households now have access to toilets.

But Puneet Srivastava, manager of policy at NGO WaterAid India, said the focus of the Clean India Mission has largely been on building household toilets, and a considerable number of slum-like regions have not been included.

In Dharavi in Mumbai, for example, there is only one toilet per 1,440 residents, according to a recent CFS study -- and 78% of community toilets in Mumbai's slums lack a water supply, according to 2019 Greater Mumbai Municipal Corporation survey.

On Sunday, Ministry of Housing and Urban Affairs Secretary Durga Shanker Mishra said: "There is 100% toilet coverage in India, whether people have access to personal toilets in slums or not doesn't matter. They can use communal toilets."

Sania Ashraf, an epidemiologist who works on water, sanitation, hygiene and respiratory illness, said the Clean India Mission had increased private toilets as well as community or pay-per-use public toilet coverage -- but during a pandemic, having access to a shared toilet means little if it is not clean.

Furthermore, poor ventilation can trap contaminated aerosols and "facilitate transmission of the virus," said Ashraf.

That is especially worrying in light of evidence that patients shed the virus through feces, raising the possibility of transmission in communal toilets and places where there is still open defecation.

Workers at risk

The next reason slum-dwellers cannot isolate is simple: they need to work.

Daily wage migrant workers generally live hand-to-mouth, earning between 138-449 Indian rupees ($1.84-$5.97) per day, according to the International Labour Organization.

"They belong to the unorganized sector, they don't get paid the day they don't go to work," says economist Arun Kumar. "It's not just the past few days since the lockdown started, but the momentum towards it has been building up for the past 20 days.

"Supply chains have shut down. Employment is lost. They have no money to purchase essentials. And unlike the rich, they cannot afford to stock up. They buy on a daily basis but now the shelves are empty."

Sonia Manikraj, a 21-year-old teacher who lives in the Dharavi slum, said: "I have to step out to buy food and since grocery shops here are open only from 11 a.m. to 3 p.m. and the roads are quite narrow, there is always a crowd."

Consequently, workers are faced with an agonizing dilemma: go out to work and risk infection, or stay home and face extreme hunger.

Some workers have no choice. Cleaners, for example, are considered to provide an essential service, and are therefore exempted from the lockdown.

"They are required to go to work every day," said Milind Ranade, the founder of Kachra Vahatuk Shramik Sangh, a Mumbai-based organization focused on labor issues. "Some even collect hospital waste and then come back and live in these crowded chawls (slums)."

They are not given any protective gear, such as masks or gloves, said Ranade, and there has not been an awareness campaign to educate them of the dangers of coronavirus transmission.

"What will happen when they fall sick?" Ranade added.

The government's $22.5 billion economic stimulus package includes medical insurance cover of 5 million rupees ($66,451) per person for front-line workers such as nurses, doctors, paramedics and cleaners in government hospitals.

"It may cover the sanitation worker but what about all the others who live around him in the slum and who are equally at risk of contracting the disease from him?" said Raju Kagada, a union leader of sanitation workers in Mumbai.

Kumar said more vigorous coronavirus testing would help. As of March 29, India had conducted 34,931 tests, according to the Indian Council of Medical Research -- or 19 tests per million people. Kumar said testing at a private hospital or lab in India costs 4,500 rupees ($60), while free tests in government hospitals are very limited.

Mahender is a cleaner for a residential community in Mumbai, earning 5,000 rupees ($66) a month, which he uses to support his wife, three children and his 78-year-old father. If he needs medical care, it will not be covered by the stimulus package provisions.

"My phone has been ringing nonstop and the residents of the building where I clean have been calling me back to work," he said. "But I have to go into the building, outside each person's house and collect their trash.

"I have not been given a mask or gloves, not even a soap to wash my hands before my meals. I know if I don't go today, they will hire someone else?"

Migrants who want to go home

Over the weekend, tens of thousands of India's 45 million economic migrant workers began long, arduous journeys back to their rural villages. With India's rail network temporarily shut, many had no choice but to try walking hundreds of miles home.

There was little reason to stay. Most had lost their jobs in the cities due to the lockdown, and the slums have the potential to feed the spread of the virus.

Researchers from the Center For Sustainability said last week that while the reproductive ratio (R naught) for Covid-19 -- the disease caused by the coronavirus -- globally is between two and three, in India's slums it could be 20% higher due to the dense living conditions.

As the slum exodus began, on Saturday the state governments of Uttar Pradesh, Bihar and Haryana arranged for hundreds of buses to ferry migrants home, causing chaotic scenes as thousands descended upon stations trying to claw their way onto buses.

On Sunday, however, Modi urged all states to seal their borders to stop the virus being imported into rural areas. Officials are now scrambling to find millions of migrant workers who had already returned to small towns and villages across the country, in order to quarantine them for 14 days.

Sia, who lives on the construction site in Gurugram, wasn't able to catch a bus. Her options of escaping the slum during the coronavirus outbreak are looking bleak.

"Since our work has stopped, I haven't been paid for 20 days. I get paid $5 a day, the little money I earn helps my family survive," she said.

"As everything is shutting down, I believe we have no option but to live in this poverty and filth in the city."