(Left - Right) Tanga Zongo, 44, Wendgoundi Sawadogo, 45, and Yadega Sawadogo, 41, manual emptiers. Photograph credit: WaterAid/ Basile Ouedraogo.
Millions of sanitation workers in the developing world are forced to work in conditions that endanger their health and lives, according to the most extensive global study to date on the issue, which has been released this week.

Despite providing an essential public service, these workers are often the most marginalised, poor and discriminated against members of society who carry out their jobs with no equipment, protection or legal rights, often violating their dignity and human rights.

The report is the most extensive exploration to date on the plight of sanitation workers in the developing world. It is jointly authored by the International Labour Organization, WaterAid, World Bank and World Health Organization to raise awareness of the de-humanising working conditions and to push for change.

Sanitation workers are the men and women who work at any part of the long sanitation chain that begins when we go to the toilet and ends when waste is disposed of or reused. Their jobs can include cleaning toilets, emptying pits and septic tanks, cleaning sewers and manholes and operating pumping stations and treatment plants.

Workers often come into direct contact with human waste, working with no equipment or protection which exposes them to a wide variety of health hazards and disease.

Toxic gases, such as ammonia, carbon monoxide and sulphur dioxide in septic tanks and sewers can cause workers to lose consciousness or die. There are no global statistics available, but in India alone, it is estimated that three sanitation workers die every five days. Countless more suffer repeated infections and injury and have their lives cut short by the everyday risks of the job.

Muniraju, 37, hands after manually emptying a pit. Photograph credit: WaterAid/ CS Sharada Prasad/ Safai Karmachari Kavalu Samiti

Wendgoundi Sawadogo has worked as a manual emptier in Ouagadougou, Burkina Faso’s capital city for 15 years, said:

“You have no paper to show that this is your profession. When you die, you die. You go with your bucket and your hoe without recognition, without leaving a trace anywhere or a document that shows your offspring that you have practiced such a job. When I think of that, I’m sad. I do not wish any of my children to do the work I do.”

The work is often informal with workers subject to no rights or social protections. Pay can be inconsistent or non-existent – some workers report being paid in food rather than money. In some countries, sanitation work is a socially stigmatising issue, so workers often work at night to hide their job from their communities.

Tim Wainwright, CEO, WaterAid, said:

“Everyone goes to the toilet and everyone is put at risk of deadly waterborne disease if the waste is not properly dealt with. Sanitation workers, therefore, carry out some of the most important roles in any society. It is shocking therefore that sanitation workers are forced to work in conditions that endanger their health and lives and must cope with stigma and marginalisation, rather than have adequate equipment, recognition and celebration of the life-saving work they carry out. People are dying every day from both poor sanitation and dangerous working conditions – we cannot allow this to continue.”

Kaverappa, 54, being lifted out of a pit by Muniraju, 37. Photograph credit: WaterAid/ CS Sharada Prasad/ Safai Karmachari Kavalu Samiti

Maria Neira, Director of Public Health and Environment at WHO, said:

“A fundamental principle of health is ‘first do no harm’. Sanitation workers make a key contribution to public health around the world – but in so doing, put their own health at risk. This is unacceptable. We must both improve working conditions for these people and strengthen the sanitation workforce, so we can meet global water and sanitation targets.”

Alette Van Leur, Director of the Sectoral Policies Department at the ILO, said: “There is a lack of policies, laws and regulations surrounding sanitation workers, and where they exist they tend to be weak, covering only certain types of sanitation workers, or lack the required financing or enforcement mechanism.”

Jennifer Sara, Global Director, World Bank Water Global Practice, said:

“The time is now. We need more concerted efforts by all sector actors to come together and improve the quality of the lives of sanitation workers. This report represents the first step to better understand the various problems facing sanitation workers and identifies actions that can be taken to reverse the current situation in a more consistent fashion. At the World Bank, we are committed to working towards improving the rights and welfare of sanitation workers within our urban sanitation programs. We are also committed to continuing working with our partners, including WaterAid, the ILO and the WHO, to further raise awareness and make progress on this critical issue.”