Imagine the streets of your neighbourhoods, hospitals, and schools choked with rotting waste. Imagine what would happen if sanitation workers stopped working—the rotten stink lingering around your houses. What will happen if we do not change our mindset and continue to disrespect sanitation workers? Wouldn’t that hamper their work and force them to stop, all because of society’s so-called pride?
Every day, around 27,000 sanitation workers nationwide—including about 2,000 in the Kathmandu Valley and over 5,000 waste pickers—keep our cities functioning by collecting, segregating, and disposing of waste, managing septic tanks, and safeguarding public health. Yet despite their essential role, they endure gruelling work conditions with little or no protection.
A 2025 survey of 790 sanitation workers in five municipalities—Bharatpur, Janakpur, Pokhara, Biratnagar, and Nepalgunj—found that many suffer from body pain and injuries, showing how physically demanding their work is. Most work without basic safety gear such as gloves, masks, soap, or changing rooms. Every day, they risk cuts from broken glass, infections from hospital waste, breathing problems, and exposure to serious diseases.
On top of physical risks, many face psychological burdens due to caste-based stigma. Landlords refuse them housing, children are teased in schools, and some workers even change their names to avoid discrimination.
Social stigma
Nabina Giri has worked at Bharatpur Cancer Hospital as a sanitation worker on daily wages for the past seven years. Her duties are wide-ranging: sweeping floors, cleaning medical equipment, scrubbing toilets, and changing patients’ bedsheets. When assigned to the chemotherapy ward, her responsibilities become even more demanding. There, sanitation workers are given double masks and gloves and must wear full-body protective gear while disinfecting hospital materials. “We have to collect the waste from the chemo ward separately, using different plastic bags and ensuring it is not mixed with other waste,” she explained.
She works eight hours a day in the hospital, risking her health, yet she is only paid for the days she is present. If she misses a shift, her wages are deducted without consideration. “Even though I come here every day, and even though this is one of the top hospitals in South Asia, sanitation workers are treated as outsiders and paid only as daily wage labourers,” Giri said. “Around 94 sanitation workers are working here on daily wages, and we all face the same problems.”
At least those who work in hospitals are treated somewhat differently, as they are provided with uniforms and safety gear. But those working for municipalities are seen differently—they are still treated as lower-class people.
Despite their crucial contribution, they remain an invisible and neglected workforce. While working in different sectors, they often face neglect and even verbal abuse from the very people whose surroundings they help keep safe and clean.
Many are looked down upon simply because of the nature of their work, as though their contribution holds little value. Yet no one stops considering what would happen if they chose not to show up one day. Hospital corridors would remain dirty, classrooms unhygienic, and the streets buried under waste piles. Their labour is the backbone of public health and hygiene. However, society continues to treat them as if they are invisible.
Neglected laws
The Local Government Operation Act, 2017, outlines managing sanitation, solid waste, and public health locally. However, it does not specifically address sanitation workers' rights, wages, or job security. Most sanitation-related laws are written regarding services, infrastructure, and environmental management. While they acknowledge sanitation as essential, they fall short of recognising and protecting the workers who carry out this vital, high-risk labour. As a result, sanitation workers continue to be treated as “daily wage outsiders”.
Although the Act empowers local governments to hire workers on a contractual basis after workload assessment, many sanitation workers still do not receive the basic salary guaranteed under government law. Most do not have appointment letters, fixed salaries, or job security. Despite doing some of the riskiest jobs in society, they are among the lowest paid. There are more than 17,300 sanitation workers nationwide, most of whom come from the lowest castes and have limited access to education. This makes them particularly vulnerable—not only socially and economically but also in terms of health. With little or no training, they are often compelled to work in extremely unsafe conditions, constantly exposed to the risk of infection.
The country’s urban population produces around 49,000 tonnes of solid waste daily. Hospitals produce 1 to 1.7 kilograms of healthcare waste per bed daily. According to the Ministry of Health and Population, around 274 hospitals in Nepal collectively produce 10,520 tonnes of non-hazardous medical waste and 3,094 tonnes of hazardous medical waste annually.
Worryingly, about 27 per cent of infectious (hazardous) waste is mixed with general waste, posing significant public health risks.
In this alarming context, the relevant agencies often give sanitation workers no training or safety skills. The Department of Water Supply and Sewerage Management, through the Urban Water Supply and Sanitation (Sector) Project, recently initiated training for frontline sanitation and waste workers in 14 municipalities. The training aimed to equip them with knowledge about occupational health and safety (OHS), hygiene rules for work, and infection prevention, while informing participants of their rights and responsibilities.
The project, funded by the Government of Japan for Poverty Reduction, was implemented under the “Prevention and Control of COVID-19 through WASH and Health Initiatives in Secondary and Small Towns Project (PCWHISSTP).” Training was provided to sanitation workers in hospitals and municipalities.
“I had never received such training before. I was completely unaware of my safety while handling hospital waste,” said Radha Kumari Chaudhary, a sanitation worker at the Urban Health Centre in Tikapur. “I used to pick up hospital waste without wearing masks or gloves, and no one in the hospital told me it was unsafe. But after the two-day training, I know my health and safety. I also realise the risks of infection when coming into contact with patients’ blood and medical waste. Now I make sure to use whatever protective materials are available in the hospital to keep myself safe,” she said.
Sabita Shrestha, who has been working at Suryabinayak Municipal Hospital for the past three years, said she was completely unaware of safety measures before participating in the training. “I used to run after patients without wearing a mask or gloves, and I did not know there was a risk of infection. Most of the time, sanitation workers must clean patients’ blood, dress their wounds, and change their bandages without a mask. But thanks to the training, I am now aware of safety measures and know how to remain alert when caring for infectious patients,” she said.
Deputy Director of the Project, Manina Baidhya, said the situation of sanitation workers in society is not good, and the training under the COVID-19 Response Project was conducted in 15 local bodies to assure them about their safety and highlight their vital role in society. “We want their work to be dignified like other jobs, and we want their pay to be equal to that of other employees,” she said.
Initially, the training was provided to workers with a minimal budget. Still, such training should be extended to all workers across the country and other employees to raise awareness about the role of sanitation workers in society, Baidhya added.
(Aryal is a journalist at The Rising Nepal.)