Malkajgiri district & Hyderabad (Telangana): For years, Yadayya’s routine was to wake up at 4 am and, well before his morning tea or breakfast, consume a quarter bottle of toddy, the local alcohol brewed from the sap of palm trees. Then, he would set off to work, entering 10-feet deep pits to unclog sewers or septic tanks containing untreated sewage, mostly human excrement, water and household waste,  in Medchal, a town in Telangana’s Malkajgiri district, about 30 km north of Hyderabad. 

Yadayya, who requested to be identified by his first name only to avoid retaliation by officials and contractors, has started his day even earlier since March 2020, particularly in the summers. With day-time temperatures in Malkajgiri district rising up to 45 deg C, workers like Yadayya who engage in manual scavenging work had to complete their work underground well before the sun began to climb overhead. 

“Vedi walla kaalipotundi (My body feels like it’s on fire),” Yadayya told Article 14, in Telugu, about why he began to set off for work long before dawn. Temperatures were higher now than ever before in the underground pits, he said. “It gets difficult for us to open up the manholes and clean them during the day in the summer.” 

Paid day wages, Yadayya is a sanitation worker who manually cleans, carries and disposes of waste from sewers, septic tanks or pits. 

Manual scavenging, the outlawed practice of cleaning, carrying or handling human excrement, also includes within its legal definition work such as Yadayya’s, that is ‘hazardous’ and ‘without gear’. Yet, thousands of people, mostly belonging to the scheduled castes, continue to depend on such work, and are increasingly experiencing life and livelihood-threatening challenges on account of rising temperatures.  

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According to the Akhil Bharatiya Safai Mazdoor Sangh, a pan-India association of sanitation workers, two men died as recently as June while cleaning a sewer in Hyderabad’s Saroornagar. “The postmortem report showed that both lost their lives due to heat stroke,” said the organisation’s state president, Deepak Valmiki.

Workers’ collectives have also found rising incidence of bronchitis, tuberculosis, asthma, typhoid and other diseases among workers, all conditions aggravated by heat and humidity. 

Record-breaking heat waves are now 100 times more likely in India than previously, and also likely to be more frequent, the United Kingdom Met Office has  found. Already, prolonged heat wave spells in April in north-west India made it the hottest April in 122 years from 1901 to 2022. 

In the western world too, a series of simultaneous heat waves in 2022 left thousands dead or forced to flee to safer spaces, including in Spain, Portugal, western France and Greece. The United Kingdom had its hottest day ever, with the temperature climbing past 40 deg C in Lincolnshire on 19 July; Spain introduced a heat wave naming and ranking system. 

From women and women farmers to forest-dwellers and other marginalised communities, Article 14 has reported on those impacted by the climate crisis here, here, here, here and here. 

For those whose livelihood depends on climate-vulnerable occupations such as manual scavenging, the changing weather patterns have lethal outcomes on health, medical expenditure and on the ability to continue earning a living, pushing them into more and more perilous circumstances. 

“The temperature in the sewers is three to five degree hotter as compared to temperature on ground,” said Sagar Dhara, an environmental engineer and previously a professor of climate change at Birla Institute of Technology and Science (BITS), Pilani. “Year after year, the temperature below ground levels will get worse.”

He said manual scavengers entering manhole chambers may not be warned early enough about poor oxygen levels, and the heat-trapping effect of gases causes them to fall unconscious. 

In April 2022, the union government claimed there were no reports of deaths due to manual scavenging, but union minister for social justice and empowerment Virendra Kumar admitted that 161 people had died in accidents while cleaning sewers or septic tanks since 2019.

In Telangana, extreme heat and unpredictable rainfall patterns have been more frequent since 2017. In July 2022, nearly 75,000 people were affected and over 17,000 relocated to relief camps in Andhra Pradesh when the Godavari breached the  25 lakh cusecs mark after 16 years, as a result of heavy rains. People in 280 villages were affected, and 36 villages were completely inundated.

‘It Runs In The Family’

Yadayya, a lean, short man in his fifties with teeth stained from paan (betel-leaf) and blisters on his hands, has spent more than half of his life working as a septic tank cleaner. Belonging to the Mehtar community, a scheduled caste, Yadayya inherited his occupation from his father, who lost his life while on the job.

“Abbu went down the line and never came back.” said Yadayya referring to his father’s death. 

Then in his late twenties, Yadayya felt he had no option but to take up his father’s job—he had a mother, a wife and two children to feed, and he had not pursued an education. 

“My father was an alcoholic. It was all very sudden,” Yadayya told Article 14. “It’s like we are destined to die this way.”  

The practice of manual scavenging has been outlawed in India for more than a decade, under the Prohibition of Employment As Manual Scavengers And Their Rehabilitation (PEMSR) Act, 2013. Despite the law, as Article 14 has extensively documented (here and here), the practice is widely prevalent. 

According to the union ministry of housing and urban affairs, the standard procedure for cleaning sewers and septic tanks is through mechanised desilting involving high-pressure water jets, mechanical buckets and remote-control inspection cameras.  

To manually clean manholes, labourers use hand tools such as buckets, brooms and shovels, collecting the sludge in baskets that they then carry to disposal locations. Contractors illegally employ unskilled labourers to do this work at a daily wage of Rs 500 - Rs 800.  

“It runs in the family,” Yadayya said. “Who else will do this dirty work, other than people belonging to our caste?” 

Toxic Gases, Trapped Heat In Sewers

Like many in his line of work, Yadayya consumed alcohol regularly, to numb his senses while working, he said, and it slowly became a habit he could not shake off. 

Sometimes, to escape the heat, Yadayya and his team of workers go down the sewer lines after sunset, working late into the night with the help of a torchlight. 

“In the summers, to make it bearable, we need to keep the manhole open for at least 30 minutes,” he said. “Despite doing this, our eyes, lungs and skin burn when we inhale these gases.”  

From waste material, toxic methane, carbon monoxide and sulphur dioxide gather inside sewers and septic tanks. According to the United States Environmental Protection Agency, gases such as methane are 25 times as potent as carbon dioxide at trapping heat, making underground sewers or septic tanks much hotter than overground temperatures.

Yadayya has been suffering from bronchial asthma for the past decade, and he said the rising temperatures made his condition worse. In the past couple of years, Yadayya has complained of more frequent asthma attacks.

“I had shortness of breath a year into doing this job, but the asthma attacks have been frequently occurring only in the past two years,” he said.

Disease, Distress, Accidents On The Rise

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Article 14 spoke to 12 labourers engaged in manual scavenging work in Malkajgiri. All 12 suffered from asthma, ten complained of worse or more frequent symptoms such as shortness of breath in the past two years, which they attributed to more frequent and sudden weather changes.

According to the Asthma & Allergy Foundation of America, asthma symptoms may flare up when the weather takes a sudden turn, making humidity and temperature shifts worse for those already suffering from such respiratory difficulties. 

The early onset of the monsoon in 2022 did not alleviate conditions for labourers involved in manual scavenging in Telangana. “The weather gods have not been kind to us this year, most labourers are prone to accidents in the rainy season,” said Yadayya.

Two of his friends lost their lives in accidents related to overflowing septic tanks, he said. Suction pipes used to clean septic tanks often cannot bear the water pressure when the tank is overflowing, he said, and in such cases there is no alternative but to clean the tanks manually.

This means labourers climb down into the underground tanks and collect excess water and waste in a bucket. 

“There is no proper segregation between kitchen water, sewage water and flood and stormwater, “ said Bezwada Wilson, national convenor of Safai Karamchari Andolan, a collective that aims to completely eradicate manual scavenging. “This also worsens and makes work conditions hazardous for manual scavengers.” 

The Safai Karamchari Andolan’s roots were in activities initiated by community youth led by Wilson, himself born into a family of manual scavengers. 

As per the PEMSR Act, anyone employing a person for manual scavenging work, whether directly or indirectly, may be jailed for up to a year, or fined up to Rs 50,000, or both. 

According to Yadayya, however, the problem in implementing the law is a basic one—local governments have not invested enough in portable cleaning equipment.  

“It is difficult for a suction tank to enter small gullies (streets),” he said, referring to the hydraulics-propelled machines used to clean sewers and septic tanks. “In such cases, we are forced to clean sewers manually.”

Yadayya cleans eight to 10 manholes a day, and is paid daily wages. Due to unpredictable rainfall patterns, it is sometimes difficult to find work.

“The contractors never pay us on time,” he complained. “And on top of it, the rainy season means less pay, due to the difficult work conditions” said Yadayya.

Asthma, Infections Exacerbated By Heat 

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“With each passing year, his asthma attacks get worse,” Yadayya’s wife, Jayamma,  said. “He has a drinking problem, I have tried to persuade him to stop drinking, but he never listens.” 

Jayamma has spent several nights searching for Yadayya in the streets of Medchal. He would be passed out, drunk, unable to walk home himself.  

In March 2019, Yadayya complained of severe abdominal pain, and Jayamma took him to a government clinic nearby. They had neglected niggling pains assuming it was on account of  excess alcohol consumption and dehydration.

“The doctor asked us to get tests done at the Medchal government hospital, but we put it off,” said Yadayya. “We were scared of the hospital bills.”

 One day the following year, Yadayya fell unconscious while working. He was taken to Gandhi Hospital in Hyderabad where doctors concluded that he had experienced a mild heat stroke that had caused an acute liver injury.  A heat stroke occurs when the body can no longer regulate its temperature and is unable to cool down, caused often as a result of prolonged exposure to or physical exertion in high temperatures, and excessive dehydration.

His alcohol consumption over years had left him immunosuppressed, doctors said.

People with liver ailments have compromised immune systems, said Praharshini Ganji, MBBS, a hepatologist at Gandhi Hospital. “It is very easy for them to contract infections when exposed to heat and today’s increase in pollution levels,” she said. 

Over the years, Ganji has examined many patients who work as manual scavengers and said she was witnessing more deaths of labourers due to exposure to high temperatures and pollutants for long hours.

“Climate change always affects the underprivileged first,” she said.  

Burgeoning Hospital Bills, Many Approach Moneylenders 

The district administration in Malkajgiri has not enumerated manual scavenging workers nor completed the rehabilitation of even a single manual scavenging worker, according to Valmiki, the state president of the Akhil Bhartiya Safai Mazdoor Sangh. 

Little has been done to prosecute those forcing people into manual scavenging, he said. “There is a lot of corruption involved.”

As Malkajgiri district’s medical facilities are inadequate, most labourers suffering from chronic ailments aggravated by their work conditions travel to Hyderabad for treatment, he said.  

In 2019 and 2020 Yadayya and his family started taking loans from a private money-lender, to help run their household, to pay for Yadayya’s healthcare, and the travel expenses to Hyderabad. 

In the hope of landing a government job, Jayamma made multiple requests to the Medchal Water Board explaining that Yadayya was too unwell to work, but she did not hear back. She sews clothes for people living in and around her neighbourhood in Malkajgiri, work that brings in a meagre and unsteady income.

“The government has launched a couple of loan schemes for manual scavengers, but they stopped sanctioning the loans,” said K Saraswati, the Telangana convenor of the Safai Karamchari Andolan. “They claim they have exceeded the budget.” She said many labourers have sought credit from informal sources. 

Yadayya’s family now owes about Rs 10 lakh to a private money-lender, but there is no source of income t o make regular payments. Unable to work, for now, Yadayya said he didn’t want to enter the underground sewers again, but he may not have a choice. 

(Vidheesha Kuntamalla is a freelance journalist based in Hyderabad. She writes on politics, gender and social justice.)