Invisible wounds: Survivors of sewer work continue to suffer in silence

On a frigid February morning in 2020, Sanjay, a sanitation worker in his forties from Delhi’s Seemapuri, was summoned in haste by a local contractor. A political rally loomed nearby, and the “sewer was overflowing.” Promised Rs 300, Sanjay and two co-workers descended into the narrow pit, unaware that the very air they were breathing carried the lethal sting of toxic gases.

Minutes in, the stench of hydrogen sulfide, methane, and other sewer gases rendered his colleagues unconscious. Urged to check further, Sanjay remembers nothing until waking 13 days later in a hospital bed, tubes snaking through his nose and throat. Diagnosed with acute sewer gas poisoning and pneumonitis, he had survived the ordeal, but the scars — both physical and mental — remain indelible.

“My stomach hurts constantly, my breathing is labored, my heart races,” he said, clutching a small plastic bag of medicines he can no longer afford. “I drink alcohol now to numb the pain. It’s cheaper than medicine.”

Sanjay’s mother, now 70, ekes out a living stitching elastic onto garment tags for Rs 30 a day. Their single-room home crumbles around them; walls are damp, ceilings sag, yet repairs are unaffordable. Despite narrowly escaping death, no compensation, no inquiry, no rehabilitation followed.

Sanjay’s story is heartbreakingly common. This year, the Supreme Court ordered metropolitan cities to pay Rs 30 lakh to families of sanitation workers who die on the job within four weeks. Yet for those who survive, the law offers only vague protections, leaving countless workers like Sanjay invisible.

Soni’s tragedy mirrors this grim reality. Her husband, Sher Singh, survived years of toxic exposure to sewer gases but suffered lung scarring, kidney damage, hepatitis, and tuberculosis before dying in 2024. “We had nothing left for his funeral. Even then, the government says I’m not entitled to compensation. He died a slow, painful death doing this work,” she said. Their four children dropped out of school to help her earn Rs 200 per day segregating waste, most of which goes to debt collectors.

Rakesh Kumar, 50, continues to clean sewers despite severe lung and kidney damage. “I take a nebuliser every day. Without it, I can’t breathe,” he said. For communities like the Valmikis, sewer work passes from generation to generation. Rakesh started at 10, learning from friends, thinking it was easy — sometimes even unearthing gold chains and rings. “This is all I know,” he said.

The 2013 Manual Scavenging Act prohibits hazardous sewer work without safety gear, mandates gas testing, and requires rescue readiness. Yet enforcement remains weak. Informal contractors sidestep the law under the guise of “emergency work,” leaving workers exposed. Advocate Areeb Uddin Ahmed explains that compensation exists for permanent disabilities, but long-term internal injuries like kidney or lung damage often fall through the cracks.

Occupational health expert Dr. Ashish Mittal notes that survivors of sewer gas poisoning may suffer chronic respiratory, neurological, and renal problems. “Even if a person survives, post-exposure symptoms — fatigue, chest tightness, breathlessness — persist for years. Often, the damage is irreversible by the time they return to hospitals,” he said. Many sanitation workers never reach retirement, succumbing to injuries before 60.

While deaths are tallied and mourned, survivors remain invisible. Ashok Kumar Taank of the Dalit Adivasi Shakti Adhikar Manch said, “For every death, there are many unable to work again due to injuries, yet no official records or support systems exist.”

The government’s NAMASTE scheme — aimed at mechanising sewer and septic tank cleaning and providing insurance, rehabilitation, and capital subsidies—has validated 66,961 workers and distributed 45,000 PPE kits across 400 cities. Yet Taank cautions, “Much of Delhi’s cleaning is still manual, especially in narrow lanes where machines cannot reach. Private contractors exploit loopholes, calling it ‘emergency work.’ Workers go down with only a rope and bucket — no safety gear.”

Back in Seemapuri, with no PPE kits available, workers have devised grim survival tests. “If the cockroaches crawl out, it’s safe — the gas isn’t deadly yet. If they’re dead, don’t go in,” Ramesh said.

For these sanitation workers, survival is not a triumph but a daily negotiation with death — a life spent invisible, undervalued, and unprotected, yet absolutely essential to the city’s heartbeat.

With PTI inputs