Speaker: Niladri Chakraborti
Sanitation workers provide an invaluable public service. However, the nature of their work exposes them to various occupational and environmental hazards putting their health at serious risk. While existing policy, laws, and government programs underscore the importance of safeguarding their health and safety, the reality is often different. This poster highlights the emerging health issues among the sanitation workforce, established through periodical health camps conducted in five town panchayats in the Coimbatore district of Tamil Nadu, India. These findings emphasize the necessity of regular health camps for sanitation workers as one of the preventive measures against their occupational health outcomes
Background: Sanitation workers by virtue of their work are exposed to various occupational and environmental hazards. Exposures often lead to either diseases, disorders, or accidents. While existing policy, laws, acts, and government flagship programs endorse the importance of their regular health screening and vaccination, implementation remains incomplete. Sanitation workers attached with larger urban local bodies such as a municipal corporation, municipalities still manage to receive sporadic healthcare but, sanitation workers from smaller towns and from informal sectors are mostly left out. With this status quo, an effort was made to organize regular health camps for the formal and informal sanitation workers and their family members from five contiguous small towns in Coimbatore district of Tamil Nadu – Periyanaicken Palayam, Narasimhanaicken Palayam, Gudalur, Veerapandi, and Karamadai – in collaboration with private trust hospitals. The poster highlights the emerging health issues associated with sanitation workers and demonstrates the necessity of regular health screenings for them as one of the preventive measures against their occupational health outcomes. Regular health camps are also envisaged to influence the health-seeking behavior of the sanitation workers
Methods: Private hospitals were approached to organize the health camps for sanitation workers since government hospitals from these towns failed to extend their support due to their skeletal workforce. Initial health camps rendered services such as general screening, diagnostics, counseling, and free medicine. However, based on the emerging health issues specialized doctors – ENT specialists, gynecologists, etc. were roped in and referral services were introduced. So far, 11 health camps have been organized over a period of two years and more than 500 sanitation workers and their family members have benefitted from them. Health cards have been issued to all the sanitation workers. Demographic data and ailment records were captured from the patient register and health card. Separate interviews were conducted with the beneficiaries and attending doctors to understand emerging health issues and how they are associated with their occupation.
Findings/ Results: These health camps shed light on the dominant illnesses affecting workers. Through these health camps, it was possible to identify key focus areas and patterns in terms of health issues. Based on observations made at these camps, the emerging health issues include:
· High blood pressure
· Anemia (mainly among women workers)
· Stomach ulcers (workers have to report for work early in the morning which forces them to skip breakfast often leading to ulcers and contributes to anemia)
· Orthopaedic and muscle pain (inflammation as a result of intense physical labor)
· Skin problems
· Alcoholism and substance abuse (which leads to other issues such as hypoglycemia)
The findings further underscore the need to replicate such camps on a much larger scale to be able to systematize mandatory health check-ups for this largely informal workforce.
The outcomes of the health camps underline the need for a standardized healthcare system for the sanitation workforce. Drawing on the results of these health camps, it has been proposed to institutionalize the health camps by facilitating Memorandum of Understanding (MoU) between the five town panchayats – Periyanaicken Palayam, Narasimhanaicken Palayam, Gudalur, Veerapandi and Karamadai – and private hospitals. Efforts to provide technical assistance to sanitation workers by linking them with government health insurance schemes are underway. Recommendations to strengthen the existing policy and regulations, streamline the health monitoring process to establish a sustainable healthcare model for the sanitation workforce which can be adopted by other urban local bodies are in progress.