Indignity, disease, death — the life of a sewer worker in Pakistan

Around 84 sewage workers have died in 19 districts of Pakistan over the past five years, says an advocacy campaign group

A sewer worker who is popularly known as Mithoo emerges from the sewer. — Photo by author

A dark head emerges, followed by the torso. The balding man heaves himself up, hands on the sides of the manhole, as he is helped by two men. Gasping for breath, the man, who seems to be in his late 40s, sits on the edge, wearing just a pair of dark pants, the same color as the putrid swirling water he comes out from.

This is an all-too-familiar sight in Karachi, with its over 20 million residents producing 475 million gallons per day (MGD) of wastewater going into decades-old crumbling sewerage-systems.

After over a hundred dives into the sewers in the last two years, Adil Masih, 22, says, “I have proved to my seniors, I can do the job well.” He hopes to be upgraded from a kachha (not formally employed) to a pucca (permanent) employee at Karachi’s government-owned Karachi Water and Sewerage Company (KWSC), formerly known as the Karachi Water and Sewerage Board and is commonly referred to as the water board, in the next six months.

Earning Rs25,000 ($90) a month, which Adil gets as a lump sum of Rs75,000 ($269) every three months, the pay will rise to Rs32,000 ($115), which is the minimum wages in Sindh province set by the government once he becomes pucca.

“The first time is always the most terrifying experience,” recalls Amjad Masih, 48, sporting a metallic earring in his left lobe. Among the 2,300 sewer cleaners under the employment of the KWSC, to do manual scavenging to unclog the drains, he claims to have taught Adil the dos and donts of diving into the slush. “You have to be smart to outdo death, which is our companion as we go down,” he says.

It is not the army of cockroaches and the stink that greets you when you open the manhole lid to get in, or the rats swimming in filthy water, but the blades and used syringes floating that are a cause for concern for many as they go down to bring up the rocks and the buckets of filthy silt.

But getting into the sewers is a last resort. “We first try to unclog the line using a long bamboo shaft to prod and loosen the waste, when that fails, we climb down into the gutters and clean them with our hands,” explains Amjad, employed with the water and sanitation company since 2014, and becoming permanent in 2017.

Toxic cauldron

Although the civic agency claims the workers are provided personal protective equipment to shield them from chemical, physical and microbial hazards, many, like Amjad, refuse to wear it.

“I need to feel the rocks and stones with my feet to be able to bring them up,” he says. “Nothing happens,” adds Adil. “We go to the doctor for treatment and are back at work.”

A former KWSC official, speaking to IPS on condition of anonymity, said there have been several deaths and injuries. “It is up to the supervisors to ensure they only send men down the manhole who comply with safety regulations.” He said the protective gear must include gas masks, ladders, and gloves as the “bare minimum,” as there are definite health risks as well as the risk of losing your life.

More than the physical hazards, it is the invisible danger stalking these men, in the form of gases like methane, carbon monoxide, sulfur dioxide and nitrous oxide — produced when wastewater contains chlorine bleaches, industrial solvents and gasoline — when mixed with concrete in drainpipes — that have taken the lives of these cleaners.

Earlier in March, two young sanitation workers, Arif Moon Masih, 25, and Shan Masih, 23, died after inhaling toxic fumes in Faisalabad, in the Punjab province. In January, two workers in Karachi met with a similar fate while cleaning sewerage lines.

According to Sweepers Are Superheroes, an advocacy campaign group, around 84 sewage workers have died in 19 districts of Pakistan over the past five years. In neighboring India, one sewer worker dies every five days, according to a 2018 report by the National Commission for Safai Karamcharis.

“I had almost died once,” recalls Amjad, of how he got “gassed” and passed out. “Luckily for me, I did the job and came up and then collapsed.”

Sewer work is dirty but essential work in a busy city like Karachi. A worker popularly known as Mithoo rests after unblocking sewage. — Photo by author

But there have been quite a few of his colleagues, he says, who have died due to inhalation while still inside.

Adil said he has inhaled gases quite a few times too. “My eyes burn, and when I come out, I vomit and drink a bottle of cold fizzy drink and am set again,” he said. But the last time it happened, he had to be hospitalised as he had passed out.

With time, says Amjad, they have learned to take precautions.

“We open the manhole lid to let the gases escape before going in,” he says. A dead rat floating on the surface is a giveaway that there are gases, he adds.

The KWSC cleaners work as a team of four. One is sent down wearing a harness tied to a rope. If something is not right or he’s done the job, he tugs at the rope, and the three men waiting outside immediately pull him out. But the man is pulled out after three to four minutes have elapsed without waiting for the tug “in case he has become unconscious,” explains Amjad. He claims to be able to hold his breath for as long as five minutes because “I have to sometimes go as deep as 30 feet.” Adil is only able to do a maximum of seven feet and hold his breath for no more than two minutes, but the gases are found in shallower drains. Along with buckets of silt, the drains are often clogged with stones and boulders that need to be brought up, to allow the water to flow freely.

Amjad and Adil also take on private work, like the rest of the KWSC sanitation workers. The agency knows but looks the other way. “If they can get earn a little extra, it is ok,” says the officer.

“We are called to open up blocked drains by residents and restaurant management and for a couple hours of work, we are able to earn well,” says Adil.

Janitorial work reserved for Christians

Adil and Amjad are unrelated but carry the same surname—Masih—which points to their religion—both are Christians. According to WaterAid Pakistan, 80% of sanitation workers in Pakistan are Christians, despite them making up just 2% of the general population according to the 2023 census. The report Shame and Stigma in Sanitation, published by the Center for Law & Justice (CLJ) in 2021, connects sanitation work to the age-old caste system prevalent in the Indian sub-continent that attached birth to occupations.

“This ruthless practice has died down to a large extent in Pakistan, but sanitation is probably the only occupation where this traditional caste structure continues,” it points out.

The CLJ’s report carries a survey of the employees of the Water and Sanitation Agency (WASA), which provides drinking water and ensures the smooth working of the sewerage systems, and the Lahore Waste Management Company (LWMC), which is tasked with collecting and disposing of solid waste from households, industries and hospitals in Lahore city, in the Punjab province.

WASA has 2,240 sanitation workers, out of which 1,609 are Christians. The LWMC has 9,000 workers and all of them are Christians. 87% of the employees in both organisations believed “janitorial work is only for Christians,” while 72% of Christian workers said their Muslim coworkers “believe that this work is not for them.”

Adil Masih and Amjad Masih work in the sewers of Karachi, a dangerous and low-paying occupation. — Photo by author

The same is true for Karachi as well. Till about five years ago, the KWSC would advertise for the job of sewer cleaners, specifically asking for non-Muslims but stopped after receiving criticism from rights groups.

“We removed this condition and started hiring Muslims for the cleaning of sewers, but they refuse to go down the sewers,” said the KWSC official. In Punjab province, the discriminatory policy of employing only non-Muslims belonging to minorities for janitorial work was struck down in 2016.

With half of Karachi being dug and new drainage lines being laid, much of the work is being carried out by Pathans (Muslims belonging to an ethnic group) and, until last year, by Afghans too. “They are wading in the same filthy water,” says Amjad.

He got a much more lucrative job—working as a sweeper in an apartment building and earning more.

“Being a permanent employee with a government department means lifelong security; the job is for keeps,” he explains. “And on a day-to-day basis too, life is slightly easier. You are not harassed by the police, get sick leave and free healthcare, and there are retirement benefits too, and you cannot be kicked out on any one person’s whim.”

Way forward

But Amjad and Adil’s work and how they are treated by their employers are in complete contrast to what the Pakistani government has signed under the Sustainable Development Goals, especially Goal 8—of improving the working conditions of sanitation workers. It also seems unlikely that targets 8.5 “full employment and decent work with equal pay” and 8.8 “protect labour rights and promote safe working environments” will be met by 2030.

Farah Zia, the director of the independent Human Rights Commission of Pakistan, talking to IPS, pointed out that Pakistan had made little progress in meeting the criteria for decent work for sanitation workers, considered amongst the most “marginalised labour groups in Pakistan’s workforce.”

Not being “paid a living wage or to live in an environment free of social stigma,” Zia said they were not even provided ample safety equipment and training to protect themselves from occupational hazards. In addition, she pointed out that the 2006 National Sanitation Policy was outdated and fell “short of addressing these concerns.”

The same was observed in Sindh province, where Amjad and Adil live. “Although the Sindh government had adopted a provincial sanitation policy in 2017, it did not address the concerns related to the working and living conditions of these workers in the province,” Zia pointed out

In 2021, in line with SDG 8, WaterAid Pakistan (WAP) worked with the local government in the Punjab province’s Muzaffargarh district to ensure the safety of sanitation workers. Apart from provision of safety equipment and access to clean drinking water, the organisation advocated that these “essential workers receive the respect and dignity they deserve,” said Muhammad Fazal, heading the Strategy and Policy Programme of the WAP.

Naeem Sadiq, a Karachi-based industrial engineer and a social activist who has long been fighting for the rights of these men has calculated the highest and lowest salaries in the public sector.

“The ratio of the salary of a janitor to the senior most bureaucrat in the UK is 1:8, while in Pakistan it is 1:80. The ratio of the salary of a janitor to the senior-most judge in the UK is 1:11, while in Pakistan it is 1:115. The ratio between the salary of a janitor and the heads of the highest-paid public sector organisations in the UK is 1:20, while in Pakistan it is 1:250,” he told IPS.

Sadiq wants a complete ban on manual scavenging. “I don’t know how we let our fellow men enter a sewer bubbling with human waste and poisonous gases,” he tells IPS, adding, “We need machines to do this dirty, dangerous work.”

The KWSC has 128 mobile tanker-like contraptions equipped with suctional jetting machines that remove the water from the sewers so that cleaners can go down a 30-foot manhole without having to dive into it to remove silt, timber and stones that cannot be sucked out and have to be brought up manually,’’ said the KWSC official.

That is not good enough for Sadiq. A year ago, he and a group of philanthropists came up with a prototype of a simple gutter-cleaning machine (using the motorbike’s skeleton), which he claims is the cheapest one in the world, costing Rs 1.5 million (USD 5,382).

“It can be sent deep into the sewer to bring up stones, rocks, sludge and silt, and a high-pressure jetting contraption to unclog the lines.”

It is now up to the government to use the design and start manufacturing the contraption called Bhalai (kindness, benefit). “We are absolutely willing to share the design,” said Sadiq.


Zofeen Ebrahim is an independent journalist. She posts on X @zofeen28


This article was originally published by the Inter Press Service news agency's UN Bureau. It has been reproduced with permission.