Sanitation workers: The forgotten frontline workers in the fight against the COVID-19 pandemic

25 November 2021
A sanitation worker emptying a toilet
WaterAid/Nelson Owochio

22 November 2021, Abuja, Nigeria – During the pandemic, sanitation workers have been praised as ‘COVID warriors’ in some nations but WaterAid has found many of these workers in developing countries have been forgotten, underpaid, unprotected and left to fend for themselves.

Research carried out by WaterAid at the start of the COVID-19 pandemic on the safety and wellbeing of those who clear and dispose of faecal waste, reveals hazardous working conditions, a dangerous lack of personal protective equipment (PPE), poor training and legal protection, as well as loss of income for millions.

The Project Global Advocacy for Health, Safety, and Dignity of Workers in Sanitation recognises that sanitation workers provide an essential public service to reach Sustainable Development Goal 6.2 (by 2030, achieve access to adequate and equitable sanitation and hygiene for all and end open defecation, paying special attention to the needs of women and girls and those in vulnerable situations”), but often at the cost of their dignity, safety, health, and living conditions. A key barrier to providing support for this profession is the insufficient data on sanitation workers and their work environment. As such, WaterAid commissioned various partners to conduct rapid assessments of sanitation workers in various countries where the organisation works, to understand the working conditions of sanitation workers and identify opportunities to support them.

Sanitation workers include people who clean toilets and sewers, empty latrine pits and septic tanks and operate pumping stations and treatment plants as well as those who clear faecal waste manually, sweep rubbish and transport faecal sludge. WaterAid’s findings also include solid waste workers and cleaners.

Despite providing a vital service ensuring human waste is cleared, stored and disposed of safely, WaterAid found sanitation workers are often marginalised, stigmatised and shunned as a result of their job. Many have worked on the frontline of the pandemic, throughout national lockdowns, in hospitals and quarantine centres and in the heart of communities with poor access to safe water, decent sanitation and good hygiene facilities.

Many sanitation workers told WaterAid they felt forced to go to work during lockdown even if they felt ill, for fear of losing their jobs. They reported having to work for longer hours during the pandemic, taking on additional hours per day while some hospital sanitation workers were even asked to work long hours continuously without additional payment.

Even without the threat of the virus, sanitation work is hazardous. The workforce risk being exposed to a wide variety of health hazards and disease and can often come into direct contact with human waste. Sharp objects in pit latrines and poor construction can cause injury and infection while toxic gases can make workers lose consciousness or even kill them.

The assessment in Nigeria was carried out in Kano City and its specific findings include:

  • Even though sanitation workers face various occupational hazards, including close contact with faecal sludge and injuries and death sustained from equipment, only 25% report using PPE while 75% don’t use any due to accessibility, affordability, inconvenience and because they feel God is protecting them.
  • Overall, there appears to be a lack of coordination between sanitation workers and the government as well as among government bodies, hampering safe and hygienic emptying services.
  • There is weak legal and regulatory framework and poor implementations of existing regulations, laws and policies to support sanitation workers and faecal sludge management at both the national and state level.
  • Respondents stated that there are not enough disposal sites, and the existing ones don’t have drying beds or fencing to limit access to the sites. As a result, faecal sludge is extensively disposed of untreated into the environment.
  • There are challenges with access roads, particularly in the rainy season when they become narrow and inaccessible.
  • 94% of those interviewed stated that they were forced into this profession due to economic hardship (majority live in rural areas), and 6% stated they inherited the business from their father. It appears that poor economic status is the pulling force into sanitation work, with all sanitation workers stating they had no alternative.
  • Manual and mechanical sanitation service providers lack property for their businesses, including office and parking space. As a result, 96% of manual sanitation workers and 67% of mechanical emptiers are using temporary structures, squatting on open land or near their trucks and face eviction due to temporary occupancy.
  • Handwashing (with at least water) after emptying sanitation systems and conducting site inspection appears to be the norm.

Iliyasu Abbas, 50, a pit latrine and septic tank emptier in Nigeria, said:

The major risks we face during our work are harassment, injury, loss of a limb or our lives. About two years ago, while emptying a pit at night, a concrete block from the toilet structure broke off and fell on my head.

In some countries, sanitation workers face widespread and systemic discrimination. WaterAid spoke to one young man in India from a family involved in manual scavenging (which involves dealing with human excreta directly, either from dry latrines, open drains, sewers or railway tracks) who has been unable to find alternative employment due to the stigma surrounding his caste, despite having a degree in Social Sciences from Delhi University.

WaterAid’s film team have shed light on the practice of manual scavenging in ‘The Burden of Inheritance’ - a short film telling the story of a marginalised community in India trapped in a cycle of poverty.  The film premiered on the streaming platform WaterBear* on World Toilet Day, giving visibility and a voice to an excluded and silenced section of society.

Tim Wainwright, WaterAid Chief Executive, said:

The COVID-19 pandemic has highlighted the vital role sanitation workers play in our communities – but it has also revealed the vulnerability of this essential workforce that is often undervalued and overlooked. It’s unacceptable that so many sanitation workers operate without the support and safeguards they need. 

“WASH services are critical to maintaining public health and will be fundamental to surviving and recovering from the pandemic, and future pandemics - but without sanitation workers, these services will not function. We must invest and support the workforce, not just for the sake of public health but also for the economy - to ensure universal access to decent sanitation and a better future for all.”

Dr Andrés Hueso González, Senior Policy Analyst at WaterAid, said:

It’s vital governments, local authorities, employers and the general public take action to support sanitation workers so they can do their job safely, with the dignity and recognition they deserve. These key workers should be protected through legislation, policies and guidelines that ensure workers have appropriate PPE, regular training, a decent wage and access to health insurance and social security. Sanitation workers also need to be recognised, respected and supported by institutions and by individual citizens. We all have a role to play in tackling and removing the deep-rooted discrimination they have endured for far too long.

Evelyn Mere, Country Director, WaterAid Nigeria, said:

In addressing the sanitation crisis, we must ensure that all gaps in the sanitation value chain are covered. Without sanitation workers, sanitation systems will not function, and this will lead to catastrophic consequences in public health. Sanitation workers render a huge and valuable public service and they must be valued, supported, and protected. Governments must take urgent measures to institute policies that change the general practice in the sanitation value chain and improve the working conditions of sanitation workers. We must protect the rights of the workers who sustain our sanitation systems and contribute meaningfully to safeguarding the rights of this marginalised population of the society


For the full media briefing please read:

Case study photos and B-roll of sanitation workers in Nigeria available to download:

For the studies conducted in South Asia:

For the study in Nigeria:

For the study in Burkina Faso:

The Burden of Inheritance Trailer: a WaterAid film looking at a community involved in manual scavenging in India, can be found here: TRAILER | The Burden of Inheritance | WaterAid

The Burden of Inheritance Full Film: can be found here:

*WaterBear is the first interactive streaming platform dedicated to the future of our planet - providing access to award-winning and inspirational content that empowers members to dive deeper, learn more and take action.


For more information, please contact: Oluseyi Abdulmalik, Communications & Media Manager, WaterAid Nigeria on [email protected], or +234 8034312391

In West Africa: Kine Diop, Regional Communication Manager at [email protected] 

In London: Carla Prater, Senior Media Officer at [email protected] OR Susan Springgate, Senior Media Officer at [email protected].

Notes to Editors: 


With many workers undocumented and defecation still a huge taboo in many societies, tackling the issues surrounding the sanitation workforce is challenging. WaterAid is increasing awareness and raising support for sanitation workers, advocating for governments to recognise and protect the rights of the workforce. More research is also being conducted to better understand how to help improve working conditions and empower these vital but forgotten frontline workers.

WaterAid is working to make clean water, decent toilets and good hygiene normal for everyone, everywhere within a generation. The international not-for-profit organisation works in 28 countries to change the lives of the poorest and most marginalised people. Since 1981, WaterAid has reached 28 million people with clean water and nearly 29 million people with decent toilets. For more information, visit,; follow @WaterAidNigeria, @WaterAid or @WaterAidPress on Twitter, or visit us on Facebook at,

Global WASH stats:

  • 771 million people in the world – one in ten – do not have clean water close to home.[1]
  • 1.7 billion people in the world – more than one in five – do not have a decent toilet of their own.[2]
  • Around 290,000 children under five die every year from diarrhoeal diseases caused by poor water and sanitation. That's more than 800 children a day, or one child every two minutes.[3]
  • Every £1 invested in water and toilets returns an average of £4 in increased productivity.[4]
  • Just £15 can provide one person with clean water.[5]

*Nigeria WASH stats:[6]

  • Only 9% of the population have access to basic water, sanitation, and hygiene services.
  • 60 million people (30% of the population) lack access to clean water.
  • 112 million people (56% of the population) lack decent toilets.
  • 46 million people (23% of the population) practice open defecation.
  • 167 million people (84% of the population) lack basic handwashing facilities.
  • Only 3% of schools have access to basic water, sanitation, and hygiene services.
  • Only 4% of healthcare facilities have access to basic water, sanitation, and hygiene services.
  • Only 2% of parks and markets have access to basic water, sanitation, and hygiene services.


[3] Prüss-Ustün et al. (2014) and The Institute for Health Metrics and Evaluation (2018)

[4] World Health organization (2012) Global costs and benefits of drinking-water supply and sanitation interventions to reach the MDG target and universal coverage

[6] 2019 WASH National Outcome Routine Mapping (WASH NORM)