HYDERABAD: “Hey, Chettammayi (garbage girl)”, a watchman of an ultra-luxurious housing society calls out as 37-year-old Salamma emerges from her van. Those familiar with nuances of Telugu would instantly recognise the derogatory nature of the term. Undeterred, yet bristling with anger, she declares, “I do have a name,” before shouldering another heavy bag of garbage.
For over 25 years, this widowed mother of five has been collecting garbage in the Uppal area of Hyderabad, but only a few know her by name. At dawn, when the city is still sleeping, Salamma starts her day. The only protective equipment she has is a tattered shirt worn over her saree, which is severely inadequate in safeguarding her or the thousands of women involved in garbage collection from the health hazards involved in their line of work.
On Global Garbage Man Day (June 17), it is important to acknowledge the crucial role played by garbage workers, particularly women, in waste management in Hyderabad. The backbone of this system comprises garbage workers who collect waste using Swachh Auto Tippers (SATs) provided by the GHMC. Of the approximately 5,250 SATs in operation, 4,500 are subsidised by the GHMC, while 750 are privately operated.
Each SAT serves 450 to 500 households, charging an average of Rs 50 per household. Typically, the husbands operate the SATs, while the wives are responsible for garbage collection and segregation. However, in many cases where the men have passed away or succumbed to alcoholism, women assume both roles.
Demand for insurance
The Hyderabad Garbage Collectors Collective (HGCC), actively led by women, has been advocating for health insurance under the Employees State Insurance (ESI) scheme. These workers face frequent illnesses, with a significant portion of their earnings spent on healthcare. Salamma, for instance, underwent two major surgeries during the Covid-19-induced lockdowns due to a tumourous growth in her uterus. While the community provided her with financial assistance, her husband, who passed away from lung cancer in 2011, was not as fortunate. Unaware of his diagnosis, Salamma believes he died from a persistent cough.
When TNIE visited Mudiraj Colony, where Salamma resides, it became evident that many women lacked awareness about their health conditions. Several women expressed concerns about tumour growths, respiratory infections and allergies. While symptoms such as coughing, chronic body pain, frequent fevers and itching eyes were common among all individuals irrespective of gender, women faced additional health challenges.
Most of the garbage workers in Mudiraj Colony belong to the Vadderra community, which is listed under Backward Classes (BCs). People belonging to the community have traditionally been involved in stonecutting while others migrated from different districts in search of employment. After their morning chores, some Vadderra women still engage in stonecutting, recycling or domestic work. Constantly lifting weights beyond their capacity and overexertion lead to musculoskeletal disorders, resulting in chronic body pain, says Dr Arunakumari Badam, a pulmonologist at ESIC Hospital.
Forty-year-old Vajramma, who collects garbage from the Giri Prasad Nagar slum near the Jawaharnagar dumping yard, has been unable to use one of her legs for the past eight months. Bending frequently has recently caused severe back and neck pain. “Sometimes the pain comes suddenly when I straighten my back and my blouse tears in rapid action,” Vajramma shares.Out of the Rs 8,000 she earns, Rs 3,000 (37.5%) is spent on healthcare each month. Under these dire circumstances, she has no choice but to rely on her 12-year-old daughter to drive the vehicle.
Dr Arunakumari compares their situation to a basketball player playing without rest, emphasising that garbage collectors often inhale toxic gases and face challenges in finding timely restroom facilities. She further says that garbage collectors are prone to contracting contact dermatitis, allergic rhinitis, allergic conjunctivitis, Hepatitis B and C, leptospirosis and so on.
Host of issues
Due to the lack of childcare options, women often have to bring their children along for garbage collection, exposing them to the risk of infection. “We cannot leave our children in deserted places like this alone,” says Shobha (name changed), 38, who lives in government houses near Munganoor village, approximately 25 km from where she works. Displaced from their earlier slum near Musi river, they were rehabilitated here, or as Shobha puts it, “thrown here to die”.
Most of the slums where garbage collectors reside are situated outside the city limits. Due to the absence of government hospitals, Primary Health Centres (PHCs), and even anganwadis in these areas, these women have no choice but to rely on expensive private healthcare. “We are aware that it would be less burdensome to seek treatment at a government hospital in the city. However, that would take at least two to three days. The garbage doesn’t wait for us until then,” says 30-year-old Balamma, who, along with her husband, collects garbage from the Tank Bund area.
The situation worsens during the summer when the heat intensifies the stench of garbage. “The unbearable smell lingers in our consciousness even hours after we finish work. To be able to eat and cope with body pain, we find solace in alcohol,” shares another garbage collector. She requested anonymity as her SAT was recently confiscated by the GHMC following several complaints, which has subsequently subjected her to daily abuse from her husband. In order to survive, they had to borrow money and purchase a private tempo to collect garbage from only 50 houses.
Dr Arunakumari explains that the consumption of alcohol affects men and women differently due to the latter having smaller organs. “The garbage collectors frequently inhale toxic gases during their work. Additionally, the lack of timely urination while working exacerbates the situation. Taking over-the-counter tablets like paracetamol, Dolo 650, or painkillers further increases toxicity. All of these factors contribute to the accumulation of toxins in the body, which can lead to the development of cancer or tumours,” she adds.
The pulmonologist emphasises that during her practice, she has observed a high incidence of developmental and anaemia issues among individuals in this profession. Managing menstruation also poses challenges for these women. While some use cotton cloth, some ragpickers in Shantinagar feel fortunate to find expired but unused packs of sanitary pads at the adjacent dumping yard.
‘Majority of earning goes towards healthcare’
A comprehensive project called WorkFREE, conducted by Montfort Social Institution (MSI), the University of Bath, England, and the India Network for Basic Income, aims to examine the impact of basic income on marginalised communities. “We surveyed about families of 280 garbage collectors, among which 142 possess Aarogyasri cards for healthcare assistance and only five families so far have been able to make use of it,” says Vivek Joseph, a programme coordinator at MSI.
“The initial findings indicate that the funds provided are mainly used for healthcare expenses and debt repayment due to sudden health issues. Participants consistently express the need for healthcare support services. All other things about the profession come later to them,” he adds.
However, bringing these workers under the ESI scheme is deemed impossible by M Sandhya Rani, Joint Commissioner (Sanitation), GHMC, due to the absence of an employer-employee relationship. However, the GHMC is planning to introduce a comprehensive insurance scheme for garbage collectors and provide them with personal protective equipment (PPE) kits, she tells TNIE.“It has also been observed that a lot of SATs are going out of the GHMC limits. The garbage collectors often go out of the city without intimation, causing absenteeism,” she says.
When asked about the possibility of garbage collectors having a platform to voice their concerns, Sandhya points out the presence of strong unions representing them. However, she mentions that in accordance with the procedures and guidelines of the GHMC, no union or garbage collector was involved in the decision to scrap the proposal of increasing the collection fees to Rs 100.
The existing garbage collection system offers flexibility, which causes many collectors to be hesitant about becoming GHMC employees under a contract. As a result, they face challenges in efficiently collecting waste from 500 houses each day, leading to occasional omissions and increased absenteeism.
Undoubtedly, there are notable discrepancies in their work. However, it is essential to consider whether we can show greater sensitivity by establishing a platform to address the concerns of those who collect garbage from our households.
Doctor points out several problems
Dr Arunakumari Badam, compares the current situation of garbage workers to a basketball player playing without rest, emphasising that they often inhale toxic gases and face challenges in finding timely restroom facilities. She further says that garbage collectors are prone to contracting contact dermatitis, allergic rhinitis, allergic conjunctivitis, Hepatitis B and C, leptospirosis and so on
Hidden heroines
On Global Garbage Man Day (June 17), it is important to acknowledge the crucial role played by garbage workers, particularly women, in waste management
(This article is written under the Laadli Media Fellowship, 2023. All the opinions and views expressed are those of the author. Laadli and UNFPA do not necessarily endorse the views.)