A Tough Pill to Swallow

Dr. Dhairya Shrivastava

By Dr. Dhairya Shrivastava, MBBS, MBA

Dr Dhairya Shrivastava discusses the plight of Biomedical waste (BMW) workers in New Delhi, India in her Two part series “Think Before you Waste”

Think Before you Waste – Part 2

In continuation with my previous blog, part 2 of this mini-series will highlight current solutions to mitigate the woes of the biomedical waste workers. While the pandemic has been around for about a year now, the solutions to the sudden deluge of BMW are still in infancy.


Part 2 will focus on the solutions offered by the government and citizens as well as unique collaborations like the India Protectors Alliance (IPA), which has been instrumental in bringing about scale grants for the cause of BMW and sanitation workers.

Government led solutions…

While guidelines for BMW have been released, compliance with these guidelines has been inadequate due to massive volumes of BMW in the Indian capital. While Supreme Court of India has directed all municipal corporations and state pollution control boards to use the ‘COVID-19 BMW APP’ for tracking BMW daily, the application has only 10K+ installations, compared to an estimated 1.7 lakh HCFs in the country (Source Google play). The Delhi High Court has asked the government to “scrupulously follow” CPCB guidelines for COVID-waste, which the state government claims it has been following.

Citizens to the rescue…

Despite funding constraints in a battered economy, a few non-governmental organizations (NGOs) offering solutions to waste management have started dispensing their services and advocating for awareness campaigns. Priti Mahesh, Chief Programme Coordinator at Toxics Link, a Delhi-based NGO, told NDTV: “We have been working on raising awareness about COVID-19 waste around Delhi. Everyone must daily dispose of the COVID waste in a more scientific way and prevent this waste from reaching the dumping yards. Contaminated masks and gloves pose serious health threats to waste pickers, who mostly deal with it with bare hands.” However, with the scale of problem, a much more coordinated direction is needed.

India Protector Alliance…

In early 2020, Samhita, an NGO, along with Hindustan Unilever, RBL Bank and Bill & Melinda Gates foundation formed the India Protector Alliance (IPA) to “equip workers in healthcare and sanitation workers with the necessary tools to pursue livelihood activities safely and lower the risks involved in dealing with COVID-19 response and prevention at the frontline.” 


The activities of the IPA were spearheaded by Dr Nachiket Mor, experts at the Cipla Foundation, and the NFSSM Alliance, and led to beneficial impact on more than 1.9 million lives pan-India. The IPA had taken a “holistic approach” to tackle the need of sanitation workers. In the initial phases of the pandemic, they distributed PPEs to frontline workers and gave direct cash transfers. They donated essential healthcare equipment like high flow oxygen concentrations, cylinders, ventilators, and other equipment to undersupplied hospitals and low-income families.


In continuation with these efforts after the COVID wave had subsided in 2020, the IPA continued to provide access to security schemes and entrepreneurship training to BMW workers. In just a year, IPA became a collaboration between 45+ organizations, which included corporations and foundations, and thus was able to support “the most pressing needs” of the Indian sanitation ecosystem.

Image source: Deccan Herald

Way Forward

The above solutions give glimmers of hope to the plight of biomedical waste workers and the sanitation ecosystem in India. We see that in the acute phase of the problem, stakeholders stepped up to vocalize for the cause of biomedical waste workers.


Moving forward it is imperative to realize that the concerns regarding the sanitation and BMW workers should not be transient, coinciding with the pandemic waves. Instead, a wholesale strategy needs to be adopted by the government to safeguard their needs even during non-crisis times. 

What's next on A Tough Pill To Swallow

In the next two part miniseries “Straighten Our Spine,” I will to talk about the basic building blocks of any healthcare system, the grassroot workers and safe environments for healthcare workers. The first part will deal with how yet another subsection of the Indian healthcare system, ASHA workers (Accredited Social Health Activists), are often ignored despite playing a vital role in grassroots care. The second part will deal with the rising incidents of violence against doctors in India and how a safe, secure environment is a basic need to ensure quality services. 

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