What are the primary health and socioeconomic vulnerabilities of Kathmandu's informal waste workers?

Informal waste workers (IWWs) in Kathmandu Valley constitute a vital, yet marginalized, segment of the region's waste management system, facing significant health and socioeconomic vulnerabilities. Despite their indispensable role in waste minimization, environmental justice, and the circular economy, their contributions are often overlooked and undervalued.

Here are the primary health and socioeconomic vulnerabilities faced by Kathmandu's informal waste workers:

Health Vulnerabilities

• Direct Occupational Hazards IWWs operate in dangerous and unsanitary conditions with bare hands and minimal safety gear, risking exposure to sharp objects (glass and metal cuts are common, affecting over 40% of workers), toxic chemicals, and infectious diseases. They handle heavy and dangerous waste, endure physically demanding work, and are exposed to toxic fumes, air pollution, and physical exertion. Handling medical waste, including injections, is a particular risk. They also face risks from traffic accidents and animal bites.
• Lack of Protective Measures and Facilities Most IWWs in Kathmandu do not use personal protective equipment (PPE), with two-thirds reporting non-use despite 72.5% considering their work risky. When PPE is used, facemasks and gloves are the most common, but many resort to improvised protection like their own clothing. There is a significant lack of proper sanitary facilities, such as washrooms and changing areas, at landfill sites, which affects their well-being and personal hygiene.
• Health Outcomes IWWs have a higher prevalence of ill health and depressive symptoms compared to the general population in Nepal. In a 2017 survey, 27.4% of IWWs had depressive symptoms, with women, older individuals, and those with disabilities or recent ill health being more susceptible. Common physical health issues include respiratory diseases, eye infections, stomach problems, typhoid fever, diarrhea, and dermatological disorders. Female workers may also experience a high incidence of reproductive and urinary system infections due to inadequate hygienic practices. Additionally, improper disposal of hazardous waste like lead-acid batteries can contaminate water sources, leading to crop spoilage and the introduction of toxic elements into the food chain, ultimately impacting human health. The burning of waste, especially e-waste, releases poisonous gases that can cause respiratory issues, stunted growth in children, miscarriages in women, organ damage, and various cancers.
• Limited Healthcare Access IWWs have poor access to basic social or physical infrastructure, including basic sanitation, water, and power supply. Vaccination rates against preventable infections like tetanus and hepatitis B are low, and access to testing for infectious diseases like HIV and hepatitis C is also limited. Treatment procedures for common ailments are not easily accessible to them. During the COVID-19 pandemic, IWWs risked their lives collecting waste but received no healthcare support from the government, instead facing social isolation and stigma.

Socioeconomic Vulnerabilities

• Financial Instability and Low Income The income of IWWs is varied, unstructured, and unpredictable. Their average daily income (around NPR 500, or USD $4.57) is low relative to the physical demands and hazardous conditions of their work. This income typically only sustains basic livelihoods, with most earnings allocated to essential needs like rent and children's education, leaving little for savings. They often rely on loans for basic necessities, subjecting them to unstable terms and high-interest rates. Their low and unstable income does not reflect their significant contribution to environmental protection.
• Lack of Formal Recognition and Rights IWWs generally operate outside legal and institutional frameworks, lacking formal contracts, social protections, and labor rights. This absence of formal recognition isolates them from social security schemes and legal protection frameworks, making them vulnerable to exploitation and low wages. Despite national laws promising improved rights for informal workers (e.g., Nepal's Labor Act 2017), these have not been effectively implemented for IWWs.
• Social Stigma and Discrimination IWWs, particularly women, face pervasive social stigma and discrimination. They are often associated with dirt, disease, and squalor, and are perceived as a nuisance or even criminals. This leads to social ostracization, disrespect, and isolation, with some women preferring to work in landfills to avoid mistreatment on the streets. Society often unfairly stigmatizes their occupation as low-status and dirty, wrongly associating them with being uneducated or unworthy of respect, which perpetuates a cycle of poverty.
• Limited Opportunities and Support Systems The informal waste sector is characterized by poor organizational structure, limited investment, constrained access to training, and innovation gaps. Many IWWs are forced into this work due to a scarcity of opportunities in the formal sector, insufficient academic qualifications, and precarious survival conditions. Older IWWs, women, children, and disabled individuals are particularly vulnerable. Although some organizations like SASAJA Cooperative (established through the PRISM project) aim to provide financial literacy, educational support for children, and basic healthcare, the long-term effectiveness of such initiatives has been limited due to insufficient sustained support from municipalities and NGOs. The process of formalizing informal workers in Nepal remains limited compared to successful models in other countries that offer stable incomes, social security, and better working conditions.