It was a Saturday afternoon. Twenty-two-year-old Din Islam was collecting garbage from different houses at Sarafatganj Lane in Gandaria—his ankle covered with a polythene bag.

Din Islam was struggling to pull the garbage carrying-van with his right leg which became injured three days ago when he was stomping on the trash in his van. A needle of a syringe penetrated his right foot.

"I had to take the tetanus shot as well as medicine worth around Tk 300 which I paid for with my own money. But even then my foot became sore and the wound accumulated pus," said Islam who lives in Dhalpur.

"I could not walk but now I can because the doctor extracted the pus. Although I am not fit, I have to work because otherwise I will have no income," said Islam who earns only Tk 6,000 monthly.

He said his employer did not provide any safety gear like masks, gumboots, or hand gloves. The employer provided only an apron.

Like Islam, over 10,000 garbage management workers of two city corporations in Dhaka work without any safety gear which, in most cases, puts them at risk of health hazards.

Abdul Aziz, leader of DSCC Scavenger and Workers Union, said they do not get protective gear to do their job except some masks.

"We commonly face fever, cold-related problems and some of us have chronic diseases like cancer and liver problems," he said.

Sanitation workers are at a greater risk of infection, injury and death than average workers, and rarely have insurance or access to health services. Given the nature of their work and their living conditions, they are at higher risk of getting infected with COVID-19 compared to the general population.

These workers also face the risk of road accidents.

"We work at midnight because of which we also face the risk of road accidents and I narrowly escaped from a road accident on June 25 while working one night," said Sobindra Das, who has been working in Dhaka City Corporation for the last 18 years.

Dr AS Nurullah Awal, health adviser policy and advocacy at WaterAid, said waste management is a big chain where workers are involved in different stages and, therefore, they face different kinds of risks.

"The waste in our country is not collected in the proper way—hazardous waste is also mixed with general waste. If sorting were done properly, then we would have been able to avoid or reduce many risks but that is not happening," Awal said.

Due to longtime effects, workers are at risk of contracting different kinds of chronic diseases like kidney, liver or lung disease and as a result their productivity falls. Many end up with cancer in the long run and in a number of cases, they die early or develop many complicated diseases, he added.

"Health insurance is also very important as they often face different kinds of health problems. Providing institutionalised support for treatment costs is important.  Authorities will have to recognise their work as risky work, this recognition is crucial," Awal said. 

DNCC chief waste management officer Commodore M Saidur Rahman said they issued different safety measures like gumboots, masks and hand gloves for permanent garbage management workers. They also gave aprons but the workers do not wear them as they do not feel comfortable, he said.

Rahman said there are around 2,600 garbage collectors and in 8 privately managed wards, there are 830 and the rest of the 4,500 workers do door-to-door collection. He said they provided washable masks seven to eight times, two to three pairs at a time, but most of the time they do not want to use these.

When asked whether the workers get any risk allowance or have any health insurance, he said they have taken an initiative to provide health insurance and they are working on it."We have an agreement with Anowar Khan Modern Medical College Hospital and they provide first aid to them," Rahman said.

Chief waste management officer of DSCC, Air Commodore Md Badrul Amin, said they had provided masks, gumboots, gloves, aprons, raincoats, soaps and sanitizer to the workers. They cannot work comfortably wearing these, because of which they do not want to wear them, he said. "We have around 5,000 workers—2,500 are permanent staff and the rest are working on a daily basis. We have provided safety gear to all of them," he said.

It is tough to provide them training as they have to work on a regular basis, but training is being given in groups at times, he said.

He said they also distribute Tk 100 every month to the workers so that they can purchase soap. "We provide financial help from the mayor's fund if they get sick but there is no insurance and we are working on it," Amin said.