Occupational Hazards and Multiple Forms of Exclusion faced by Sanitation Workers

Vidushi Kaul, University of Delhi

Mitu Dash, University of Delhi

Bishnu Mohan Dash, University of Delhi

Abstract: This study aims to explore the complex challenges faced by sanitation workers in India in their daily lives. The workplace hazards are tied to struggles of personal life, and both of these factors reinforce and compound each other. Sanitation workers are involved in managing critical aspects of public health, and yet the discourse around their own health and well-being is neglected in policy corridors. This review paper has synthesized information from existing literature on sanitation workers and incorporates secondary data from sources such as government reports, complete sources. The data were analyzed thematically and key findings were presented in tabular form. The study has addressed the social, cultural, and epidemiological aspects that hinder the upliftment of sanitation workers. Their exclusion is influenced by social- political dynamics, and the archaic concepts of pollution-purity which restrict their social mobility and the capacity to live more dignified lives. The paper also highlights recommendations for Social Work practice towards mitigating occupational hazards and various forms of exclusion faced by sanitation workers.

Keywords: sewer and septic tank work; structural marginalization; occupational hazards; labour precarity & informality; public health & social work

Introduction

Sanitation work is central to India’s public health and urban maintenance systems. Although sanitation workers play a crucial role in maintaining public health, they remain socially invisible and denied recognition and dignity. This contradiction forms the core concern of this review. Most sanitation workers come from Dalit communities and continue to perform hazardous cleanings^[1] under unsafe and degrading conditions. Despite legal prohibitions and welfare schemes, caste continues to shape entry into sanitation work and the conditions under which it is performed. Manual scavenging^[2] and hazardous cleaning persist, reflecting deeply entrenched social hierarchies and stigma. Millions of people are engaged in sanitation work across India, with a substantial proportion involved in sewer and septic tank cleaning without adequate safety measures. Much of this labour is organised through contractual and temporary arrangements marked by low wages, lack of insurance, and limited social protection. Recurring sewer deaths at both city and national levels underscore the risks produced by systemic neglect and weak accountability.

Sanitation workers face overlapping vulnerabilities, including exposure to toxic environments, precarious employment, social discrimination,  and intergenerational poverty. Dalit women experience compounded exclusion at the intersection of caste and gender.

Recent initiatives such as the Swachh Bharat Mission, the Scheme for Rehabilitation of Manual Scavengers (SRMS), and the National Action for Mechanised Sanitation Ecosystem (NAMASTE) aim to eliminate manual scavenging and improve worker welfare. However, the continued occurrence of hazardous cleaning and worker deaths reveals a persistent gap between policy intent and lived reality. This review examines how exclusion operates in sanitation work across social, economic, and institutional domains. While focused on India, the analysis situates sanitation work within a broader regional and global context, highlighting shared patterns of labour precarity and exclusion.

Methodology

This paper is a review-based study that examines occupational hazards and forms of exclusion experienced by sanitation workers in India. A thematic approach was used to synthesise existing research and identify recurring patterns related to caste, health, and social exclusion in sanitation work.

The study draws on a structured search of academic and institutional sources, including JSTOR, ResearchGate, and Google Scholar, using keywords such as sanitation workers, manual scavenging, caste exclusion, occupational health, and Dalit labour. The analysis primarily relies on peer-reviewed studies, government reports, and institutional publications published between 1950 and 2025. Select media sources were used sparingly to provide contemporary context, but they do not form the core analytical basis of the paper.

Sources were screened for relevance, credibility, and clarity. The review integrates interdisciplinary scholarship from social work, sociology, labour studies, and public health, enabling a holistic understanding of how caste and class intersect to shape occupational risk and social exclusion.

Theoretical Framework

This paper is informed by structural violence theory, anti-oppressive practice, and empowerment theory. Together, these frameworks provide an analytical lens to understand the exclusion of sanitation workers and to guide social work responses.

Structural Violence

Johan Galtung’s (1969) concept of structural violence helps explain the deep-rooted inequalities that shape the lives of sanitation workers in Delhi. He argues that violence is not always direct or visible—it can also be embedded within social, political, and economic systems that systematically deny certain groups access to opportunities and resources. This form of harm becomes part of everyday life and is often accepted as normal precisely because it lacks a single identifiable perpetrator (Shahid, 2015). In India, caste functions as one such structure. Occupations have long been tied to caste, and tasks considered “impure” or degrading are still assigned to Dalit communities. For sanitation workers, this translates into unsafe working conditions, persistent social stigma, and limited access to healthcare. Galtung’s related concept of cultural violence—beliefs and norms that legitimise inequality—also applies here. Ideas of “purity” and “pollution” naturalise caste-based labour, reinforcing both discrimination and intergenerational exclusion (Shahid, 2015).

Anti-Oppressive Practice

Anti-oppressive practice (Dominelli, 2017) recognises that inequality operates across personal, institutional, and structural levels. Applied to sanitation work, it highlights how caste-based segregation, policy neglect, and unequal power relations shape workers’ everyday realities. Drawing on Freire’s (1996) emphasis on critical consciousness, this framework foregrounds awareness, participation, and collective action as pathways to challenge entrenched systems of exclusion.

Empowerment Perspective

Empowerment theory, central to social work ethics, places participation, solidarity, and social justice at the centre of practice. For sanitation workers, empowerment extends beyond economic improvement. It involves reclaiming dignity, voice, and agency. This perspective informs interventions that support worker organisation, access to rights, and meaningful engagement with policy processes.

Integrative Framework for Practice

Together, these frameworks locate sanitation work within broader structures of inequality while offering a practice-oriented lens for social work intervention. They allow an understanding of both visible occupational risks and the deeper forces that reproduce marginalisation. This integrated approach grounds the paper’s analysis and recommendations in a coherent theoretical foundation.

Forms of Exclusion

Social hierarchies and Caste-Based Occupation

Ghurye analysed caste as a hierarchical system of social organisation and one of the oldest forms of stratification in Indian society (Ghurye, 1950). While early functionalist accounts viewed caste as cohesive, later scholars have highlighted its role in shaping inequality and exclusion (Subedi, 2013). The chaturvarna framework organised society into graded occupational groups, with service and manual labour assigned to the lowest position, influencing access to status and opportunity (Naskar, 2025).

Dumont conceptualised caste as a moral order structured around ideas of purity and pollution (Dumont, 1980). Subsequent scholars emphasised that caste relations are also sustained through economic and political power, moving the analysis beyond ritual to everyday social practices (as cited in Subedi, 2013).

Ambedkar highlighted how Dalit communities were historically excluded from the caste hierarchy and compelled to perform stigmatised forms of labour, including sanitation work (Ambedkar, 2021). He argued that caste operates as a birth-based system that restricts mobility, a view later scholars extended by linking symbolic hierarchy with material exclusion (Béteille, 1991; Guru, 2011).

At the very lowest level of India’s caste system lie the Scheduled castes^[3] also called Dalits or untouchables, who have suffered the most in past and even today, because of their perceived low position in society. Empirical studies show that caste continues to shape sanitation labour in India. Despite regional variations, caste and kinship largely determine entry into sanitation work, which often passes across generations (Paik, 2014; PRIA, 2019). A significant proportion of sewer and septic tank workers belong to Scheduled Castes, underscoring the continued association between caste and sanitation work, see Table 1 (Press Information Bureau, 2024).

Table 1:Caste Profiling of Sewer and Septic Tank Workers

S. No.	Caste/Category	Percentage (%)
1	General	8.05
2	OBC	15.73
3	SC	67.91
4	ST	8.31

Intersection of caste and gender. Women in sanitation work face additional risks of violence as caste intersects with gender in this sector. A research carried out between 2017 and 2021 by the South Asian Labour Network (SASLN) and Rehabilitation Research India (RRI India), indicated that more than 3,189 women who work as sanitation workers reported experiencing sexual assault, abuse, and exploitation at their job (DASRA, n.d.). Women suffer the most from being in the sanitation worker community because, in addition to social marginalisation, they are more likely to experience gender-based violence. The public at large, employers, government employees, families, are more likely to discriminate against women workers. As a result, these women often encounter additional difficulties such as denial of rights, abuse, assault, and sexual harassment (Water Aid, n.d.).

A gender-based violence that has persisted as a part of the social order is manual scavenging. it affects 80% of women (Singla & Tulsyan, 2020). In the rural areas of India, it is mostly women who are forced to perform manual scavenging (Shahid, 2015). Johan Galtung’s typology of cultural violence can be used to explain this violence which happens in the form of manual scavenging. If women refuse to perform manual scavenging, it can invite violence, abuse, and torture to them and their families. Dalit women are considered weapons of war during caste based violence and are often sexually violated to incite fear in the community (National Campaign on Dalit Human Rights, 2022).  Female sanitation workers are the most marginalised section of this community. Female sanitation workers face double discrimination on account of their caste  and also their gender. Dalit women face various forms of abuse and harassment, often perpetrated by men across all castes, including those from their own communities (National Campaign on Dalit Human Rights, 2022).

People often experience additional barriers when gender discrimination overlaps with other forms of oppression. Inequalities based upon caste, class, are extremely common in India. All the existing inequalities interact with each other and often exacerbate discrimination faced by women belonging to certain groups which results in compounded discrimination.

Precarity of Employment and Economic Exclusion

Generational poverty has placed Scheduled Castes among the most economically marginalised communities in India. The Agriculture Census (2015–16) shows that Dalits owned only 9% of total land, reflecting long-standing exclusion from productive assets (National Campaign on Dalit Human Rights, 2022). In the sanitation sector, this translates into widespread employment insecurity. Most sanitation workers lack formal contracts and social protection, with contractual and outsourced workers earning substantially less than permanent employees (Thorat, 2021; PRIA, 2019).

Economic exclusion is further evident in the inadequate compensation provided to families of sanitation workers who die during work. Delays and partial payments leave households financially vulnerable and deepen insecurity (Dwivedi et al., 2023). Limited access to alternative livelihoods and continued discrimination in formal employment restrict mobility, reinforcing dependence on sanitation work across generations (Thorat, 2021).

Political Exclusion

The perspectives of sanitation workers, most of whom belong to Scheduled Castes, rarely influence decisions related to their work, safety, or welfare. The limited dialogue between policymakers and sanitation workers reinforces their marginalisation. Caste bias continues to shape governance, allowing discrimination and neglect to persist within institutions. As a result, stigma and policy failure reinforce one another, keeping sanitation workers largely invisible in policy spaces.

On the basis of data and reports reviewed above, it can be understood that sanitation workers experience multiple forms of exclusion and marginalization, which have been tabled below (see Table 2).

Table 2: Multiple forms of exclusion and marginalization

S. No.	Forms of exclusion	Examples
1	Social Exclusion	Caste based discrimination; untouchability. Unequal access to public spaces and essential amenities. Work perceived as dirty, unhygienic, low value. Intersection of caste and gender: Case of female sanitation workers.
2	Political Exclusion	Invisibility in policy corridors. Lack of participatory approach. Fragmented budget. Low accountability.
3	Economic Exclusion	Low wages. No social protection benefits. Precarious employment. Risk of poverty.

Sanitation workers are stuck in an intergenerational vicious cycle. There is lack of access to education, influenced by social- political dynamics, and the archaic concepts of pollution-purity restrict their social upliftment and the capacity to live more dignified lives.

Health Hazards and Occupational Risks

A research paper which looked into the abysmal working conditions of sanitation workers suggested that 10 sanitation workers in the capital city died in Delhi within a span of 35 days in the same year while working in sewers without wearing protective equipment (Ghosh, 2017). The inside of sewer has dangerously high temperature, noxious gases, towering walls and greasy floors. Asphyxiation is the most common cause of death inside sewers (Lakhera & Kaul, 2024). Even if sanitation workers do not die at work, most of them live with debilitating health problems due to prolonged inhalation of toxic fumes, the risk of disease associated with handling excreta, and other factors. Such work directly causes trachoma, vomiting, diarrhoea, anaemia, skin diseases, and nausea. Heart disease, musculoskeletal issues, infections, skin conditions, and respiratory problems are frequently observed as a result of which their life expectancy is significantly reduced. Musculoskeletal issues occur as a result of lifting, carrying, pushing/pulling of heavy objects and poor postures for a significant amount of time (Emmatty & Panicker, 2019). Liver diseases like Hepatitis A, B and C are caused by pricks from sharp objects (Emmatty & Panicker, 2019).

Additionally, because they are usually paid so little, many of them are not able to afford preventive or rehabilitative healthcare. They are stuck in vicious cycle of getting exposed to ill-health and subsequently not being able to access adequate treatment for the same.

In another study conducted in Karnataka, ailments that were most frequently reported by sanitation workers were injuries and respiratory troubles (Rangamani et al, 2015). Most workers did not pay attention to their illnesses and kept going to work as they did not want to lose out on daily wages or get replaced for taking time off (Bose, 2019). Most of these affected workers don't go for medical attention. Health insurance rarely covers workers in the sanitation sector. Self-medication was common. Intake of alcohol was prevalent to cope with challenges of their work. (Bose, 2019).

 

Coping Mechanisms

Alcohol as a means to cope with psychological distress was noted amongst sanitation workers. Drinking alcohol was a common way for them to forget about their health issues and to deal with the inhumane nature of their work (Rangamani et al., 2015). This deepened their health issues and further pushed them into a toxic cycle. A 32-year-old sanitation worker explained sewage workers drink alcohol at work in order to cope with cruel workplace conditions (Penkar, 2019). He said that it was not possible to go in without being intoxicated or numb.

On the basis of the research studies reviewed above, different types of occupational hazards faced by Sewer and Septic Tank Workers have been categorised and listed below (see Table 3).

Table 3:Occupational hazards faced by sewer and septic tank workers

S. No.	Type of Hazard	Occupational hazards faced by sewer and septic tank workers
1	Chemical	Exposure to harmful gases such as methane, ammonia, carbon monoxide and hydrogen sulphide.
2	Ergonomic/Physical	Intense labour in confined and slippery spaces, risk of falls, poor postures for prolonged periods of time.
3	Biological	Exposure to pathogens/contaminated water.
4	Psychological	Stress due to nature of work, adverse effect of poor physical health, social stigma. Alcohol used as coping mechanism

Sewer and Septic Tank Deaths in Delhi: Absence of municipal regulation & accountability

In October 2024, three workers died while cleaning a sewer at a construction site in southwest Delhi owned by a Public Sector Undertaking. The workers were employed on a contractual basis through a private company. Such incidents continue despite the Prohibition of Employment as Manual Scavengers and Their Rehabilitation Act, 2013, pointing to ongoing gaps in regulation and accountability in outsourced sanitation work. Fact-finding reports note that deaths in hazardous cleaning are often recorded as accidents rather than addressed as violations under the Act, allowing institutional neglect to persist (Sharma, 2025).

Invisibility of migrants

“There is a nexus of police and private contractors, making it difficult to track migrant workers” (Kaul, 2025).  Most Sewer and Septic Tank workers are hired through private contractors in the Delhi Jail Board (DJB) and MCD.  Government agencies are not permitted to appoint manual scavengers, yet this is flouted by hiring private organizations, which employ them contractually (Lakhera & Kaul, 2024). The workers are often not provided with proofs of identity and employment, as told by a contractual worker at DJB (Kaul, 2025). The situation is far worse for migrant workers who work as manual scavengers because their place of work is different from their of birthplace—as a result of which they are often neglected by government bodies. They do not have necessary documentation because of which assistance from State becomes challenging (Penkar, 2019). In case of worker deaths, the kin of deceased worker often struggles to prove that their family member was an employed sanitation worker; because of inadequate documentation and shady hiring practices (Kaul, 2025). This reproduces the cycle of inequality for the workers’ families that are forced to deal with the loss of their loved one, also an earning member, and settle for unfair compensation meted out by contractors as they do not have enough resources to fight a legal battle (Kaul, 2025). Most sanitation workers do not have adequate documents related to identity and occupation, because of which they are not able to avail social protection measures (Sharma, 2025).

Data retrieved from Press Information Bureau regarding deaths of Septic Tank and Sewer related deaths have been tabulated below (see Table 4) (Press Information Bureau, 2022).

Table 4:Septic tank and sewer related deaths in Delhi (2019-2022)

S. No	Year	No. of Deaths
1	2019	10
2	2020	4
3	2021	4
4	2022	4

Government initiatives for upliftment of sanitation workers

The Indian constitution guarantees the fundamental right to life under Article 21; which includes the right to live with human dignity. This can be interpreted as the right of every individual to have right to food and other basic necessities in order to live a dignified life.

“The right to health is supported by the Directive Principles of State Policy found in Part IV of the Indian Constitution. In accordance with Article 39(E), the State is required to protect the health of workers. In accordance with Articles 42 and 47, the State is also required to ensure equitable and humane working conditions. Additionally, under Article 243G of the Constitution, the Panchayats and Municipalities are given the authority to improve public health in addition to the State (Sirohi, 2021)”.

The first legislation to start conversion of dry latrines to pour-flush latrine was Protection of Civil Rights Act, 1955. This law was meant to minimize manual dealing of human waste (PRIA, 2019).

The SC and ST (Prevention of Atrocities) Act, 1989 has legal provisions to protect people from caste-based discrimination and employment in inhumane practices like manual scavenging (PRIA, 2019). However according to NCRB data, atrocities are not dwindling. By the end of the year 2021, about 96% of cases of atrocities against Dalits were pending in court (National Campaign on Dalit Human Rights, 2022).

The 1993 Employment of Manual Scavengers and Construction of Dry Latrines (Prohibition) Act followed. This law criminalized employment of manual scavengers with regard to dry latrines. This Act's implementation remained unsatisfactory; in fact, the Supreme Court was compelled to track the success of the 1993 Act because of the Public Interest Litigation (PIL) that Safai Karamchari Andolan (SKA) brought in 2003. (PRIA, 2019).

The central government started the Scheme for Rehabilitation of Manual Scavengers (SRMS) in 2007 with the objective of providing financing and training for manual scavengers to take up alternative careers (PRIA, 2019). However here is critical structural barrier is not considered which that of caste. They hesitate to try other occupations or start their own enterprises (for example, tea stalls) because it involves interface with a variety of people daily and the fear of discrimination runs deep. (Bakshi et al., 2021).

The vision of National Urban Sanitation Policy, launched in 2008 was to create totally sanitized cities.  The policy outlined that such cities will be free from open defecation, manual scavenging and provide proper safety equipment to personnel (National Urban Sanitation Policy, 2008).

The Prohibition of Employment as Manual Scavengers and Their Rehabilitation Act, 2013 gives a more comprehensive description of manual scavengers as well as Hazardous Cleaning and lays forth provisions for punishing offenders. (PRIA, 2019). Swachh Bharat Mission was launched by Ministry of Housing and Urban Affairs (MoHUA) for urban areas in 2014. The objectives were to eliminate open defecation, eradication of Manual Scavenging by converting insanitary toilets to sanitary and to change behaviour of public towards sanitation practices (Department of Urban Development, n.d.). Urban Swachh Bharat Mission 2.0, launched in 2021, included a new objective: eradication of hazardous entry into sewers and septic tanks, through mechanisation of sewer and septic tank cleaning operations and funds for desludging equipments were provided (Press Information Bureau, 2023).

National Action for Mechanized Sanitation Ecosystem (NAMASTE) scheme was jointly launched by Ministry of Social Justice and Empowerment and Ministry of Housing and Urban Affairs in 2023. The objective of the scheme is to reduce fatalities in sanitation work to zero and to achieve cleaning operations through mechanised safety devices. It also intends to skill and formalize sanitation workers through formation of Self-Help Groups and entrepreneurship initiatives (Ministry of Social Justice and Empowerment, 2024).

Despite the assumption that there are legal mechanisms and policies that protect their rights, the reality is much worse for majority of sanitation workers (Kumar et al, 2023). They do not receive due acknowledgement or a respectable position in society. They are pushed to the fringes of society. India's sewer cleaners continue to operate in spite of a ban on manual scavenging. Placing a legal ban is only a procedural step which does not address the deeper, systemic issues rooted in centuries of social and economic marginalization. Ban can be counterintuitive as it can allow such practices to happen covertly; thereby increasing the vulnerability of the workers involved. The prevalence of caste system compels them to engage in these activities. Policies do not address the social, cultural and epidemiological aspects that hinder the upliftment of sanitation workers.

There is also the issue of inadequate financing to solve the issues of sanitation workers. Since sanitation work comes under many ministries, the budget is fragmented, which makes it challenging to tracking how fund is being allocated and used (Bakshi et al., 2021). A governance framework that unites all levels (central, state, sub-state) and holds them accountable is missing. (Bakshi et al., 2021). A vast majority of sanitation workers in India are employed informally, making it impossible for them to take advantage of benefits given under government programmes and schemes. In India, 72% of sanitation workers lack any kind of social protection, and 77% lack a formal contract (Dwivedi et al., 2023).

The government's only sources of information about sanitation workers' deaths are news articles and civil society organizations (Dwivedi et al., 2023). A reliable mechanism for tracking sanitation workers' deaths from getting into septic tanks is missing. The social and economic welfare measures for sanitation workers also have little effect, primarily due to the lack of precise data regarding the number of sanitation workers. There is no robust mechanism for collecting data on sanitation workers in real time. There is need to upgrade research and data collection methods. The scope and extent of any problem is mapped by statistical data and observing trends. If there is no data, the issue cannot be tackled. There should be more transparency and the public should be kept informed. On the basis of government reports and studies reviewed above, notable government initiatives for the upliftment of sanitation workers have been listed below (see Table 5).

Table 5:Government initiatives for upliftment of Sanitation Workers

S. No.	Name of Legislation/Policy/Scheme	Year	Objective (s)
1	Protection of Civil Rights Act	1955	To minimise manual handling of human excreta by converting dry latrines to pour-flush latrines.
2	SC and ST (Prevention of Atrocities) Act	1989	Provided legal protection against caste-based discrimination, including forced engagement in manual scavenging.
3	Employment of Manual Scavengers and Construction of Dry Latrines (Prohibition) Act	1993	Criminalise employment of manual scavengers for cleaning dry latrines.
4	Scheme for Rehabilitation of Manual Scavengers (SRMS)	2007	Provide financial aid and vocational training to support transition to alternative livelihoods.
5	National Urban Sanitation Policy (NUSP)	2008	Achieve fully sanitised cities; eliminate open defecation and manual scavenging; ensure worker safety through protective equipment.
6	Prohibition of Employment as Manual Scavengers and Their Rehabilitation Act	2013	Expand definition of manual scavenging; prohibit hazardous cleaning without safety gear; introduce legal penalties.
7	Swachh Bharat Mission (SBM)	2014	Reducing open defecation and promoting cleanliness; positive ripple effect on sanitation workers.
8	Swachh Bharat Mission – Urban 2.0 (SBM-U 2.0)	2021	Focus on mechanised sewer/septic tank cleaning; provide funds for desludging equipment; eliminate hazardous entry.
9	NAMASTE Scheme (National Action for Mechanised Sanitation Ecosystem)	2023	To prevent deaths that happen as a result of hazardous cleaning practices by updating machinery and equipments.

Civil Society Advocacy and Social Work Endeavours

Civil society organisations have played a significant role in addressing caste-based exclusion and unsafe working conditions faced by sanitation workers. Movements such as the Safai Karmachari Andolan (SKA) have brought sustained attention to the persistence of manual scavenging and have used advocacy and legal strategies to hold the State accountable (Human Rights Watch, 2014). Other organisations, including Navsarjan Trust, have combined community mobilisation, research, and litigation to push for policy reform and social protection, while initiatives such as Sulabh International have focused on technological interventions to reduce dependence on manual cleaning.

Feminist and intersectional advocacy has further highlighted the gendered dimensions of sanitation work, drawing attention to the marginalisation of Dalit women within both labour structures and policy spaces (Special Correspondent, 2009). At the local level, organisations such as Vizhuthugal and READ work directly with sanitation workers by providing legal awareness, skill development, and educational support. Through community-based research and collective organising, these groups translate lived experiences into policy-relevant evidence (Cawood & Bhakta, 2021).

Overall, civil society and social work initiatives have helped bridge the gap between policy intent and everyday realities. Their efforts demonstrate how collective action, legal mobilisation, and sustained engagement can challenge exclusion and support more dignified and secure conditions for sanitation workers.

Conclusion and Recommendations for Social Work Practice

The recommendations presented below are directly informed by the thematic findings of this review. Persistent caste-based exclusion and stigma point to the need for anti-oppressive and rights-based interventions. Employment precarity reveals gaps in legal protection and social security, while widespread occupational hazards underscore the need for preventive and trauma-informed health responses. Together, these findings shape the proposed social work interventions, which are intended to be actionable, inclusive, and grounded in rights-based practice.

1. Psycho-social counselling and trauma support services for sanitation workers, especially women workers who have experienced gender-based violence, survivors of serious illnesses or accidents, families who have been affected by sewer-related deaths and those suffering from alcohol addiction can be facilitated through NGOs, government run Mental Health Institutions, University-based initiatives.
2. Sanitation workers are not educated about their rights, so legal literacy camps can be organised for their community. They can also be connected to paralegal volunteers as well as legal aid panels that can help them when they are treated unfairly or meet unforeseen accidents in their workplace. Here, Social Workers may collaborate with Delhi Legal Services Authority (DLSA) and law colleges.
3. Many sanitation workers do not have adequate identity or employment proofs, making them invisible in welfare and legal systems. Social workers can provide assistance in linking workers to Aadhaar and health insurance schemes like Ayushman Bharat. This can be achieved by involvement of local administration, and NGOs.
4. Given their political exclusion and limited representation in decision-making spaces, sanitation workers often remain invisible in policy processes. Social workers can advocate for and facilitate their active participation in policy discussions. A worker-led approach can bring lived experiences into policy spaces and inform decisions that directly affect their lives.
5. Caste-based stigma and insecure employment continue to limit sanitation workers’ movement into other forms of work. Social workers can support alternative livelihood pathways, particularly for women workers. This may include vocational and skills training, along with small-scale entrepreneurship support, in collaboration with NGOs and municipal bodies. Such efforts need to be accompanied by community dialogue and public sensitisation to address stigma and enable dignified work.

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Author´s Address:
Vidushi Kaul, Research Scholar
Department of Social Work, Delhi School of Social Work
University of Delhi, Delhi
vidushikaul99@gmail.com

Author´s Address:
Dr. Mitu Dash, Assistant Professor
Department of Psychology, Bhim Rao Ambedkar College
University of Delhi, Delhi
mitudashsaigal@gmail.com

Author´s Address:
Dr. Bishnu Mohan Dash, Professor
Department of Social Work, Bhim Rao Ambedkar College
University of Delhi, Delhi
bishnudash2006@gmail.com