Coronavirus outbreak: Ensuring water and hygiene facilities for migrant labourers only way to safeguard millions stranded during shutdown

With closure of worksites due to the 21-day lockdown across India since 22 March 2020 as part of the COVID-19 mitigation measures, millions of migrant workers had to suddenly deal with loss of income source, shortage of food and uncertainty about their future. Based on the concern that the situation may prevail for long and owing to the pressures from families, we saw a huge number of migrants across the country leave for their native places during the last week. While some managed to make use of the transport arrangements by the State, some had to undertake the long journey on foot and are still on the road.

An advisory (dated 31.03.20) issued by the Ministry of Health and Family Welfare (MoHFW) suggests various health-related actions for migrant workers, depending on their current location. These include thermal screening, isolation and testing of those with suggestive symptoms, quarantine for those with symptoms, etc for those persons who continue to live in their cities of their local residence, as well as for those who have reached their destination. Further, all those in transit need to be put in quarantine centres that are set up for the purpose.

Close to 300,000 migrant workers would have left for their respective homes in the last few days, as suggested by a news report. In order to cater to the requirements for all such persons immediately, several existing facilities would need to be converted to quarantine centres. In this process, it is possible that mechanisms or systems for ensuring physical distancing and respiratory hygiene; access to water, sanitation and hygiene facilities; and disinfection of surfaces may get missed out. Access to water, toilets and hygiene facilities are important for good health and hygiene of all individuals. However, these become even more critical in the COVID-19 situation, since a handwashing space, running water and soap are essential requirements for regular hand-washing, which is an important prevention measure.

The guidelines for COVID-19 quarantine facilities issued by National Centre for Disease Control (NCDC) mention some of the above criteria, along with other basic requirements such as food, electricity, ventilation, lighting, medical care, housekeeping, etc. However, in addition to these, district authorities and officials designated for managing such quarantine centres should also take measures to ensure that all infrastructure and provisions, including water, sanitation and hygiene are present in adequate number, and are functional and well-maintained; and sufficient quantities of soaps and hand sanitizers are provided to the residents. These measures along with the other requirements mentioned become even more critical in the current situation, for preventing the spread of COVID-19. Arrangement of these facilities need to be prioritized while implementing the NCDC guidelines for quarantine centres. Therefore, following measures are suggested to be taken up on priority:

1. Responsibilities of nodal officials in district or block administration, disaster management authorities, or municipal bodies in for setting up and managing quarantine centres and providing timely and adequate support should be fixed.
2. Mechanisms for adequate supply, storage and handling of clean drinking water for all residents should be put in place.
3. Provision of toilets and bathrooms must be made in the quarantine centre. These should be sufficient in number, so that crowding in queues is avoided and physical distancing is ensured.
4. Provision of adequate number of handwashing stations is very essential, since regular washing of hands is one of the important precautions to prevent COVID-19 infection.
5. 24*7 availability of water in toilets, bathrooms and handwashing stations must be ensured.
6. If the existing building does not have sufficient number of these water, sanitation and hygiene facilities, temporary arrangements must be made
7. Adequate availability of soaps, hand sanitizers and disinfecting agents must be facilitated.
8. Menstrual hygiene products for women and adolescent girls should be made available in adequate quantities at the quarantine centre. A dustbin should be provided too, for disposal of used menstrual hygiene products.
9. All water, sanitation and hygiene facilities must be regularly cleaned and disinfected
10. All facilities must be checked regularly to ensure that they are well-maintained and functional (for example: functional lights and doors in toilets, etc.). Any issues found should be addressed at the earliest.
11. Persons with disabilities and elderly persons may require additional support too.
12. District authorities and other officials may work with local NGOs and civil society groups to facilitate above measures.

Although the MoHFW advisory suggests that all migrant workers in transit are put in quarantine facilities, the same is not mandatory for all those persons who have already reached their destinations. However, quarantine facilities which fulfil all the above measures would be something that such districts might also need to consider. Moreover, some migrant workers who stayed back in their cities of residence have been put up in temporary shelters and relief camps. It is important that adequate facilities and mechanisms for water, sanitation and hygiene are ensured in these places as well, amongst other critical requirements.

Finally, though not directly related to the above issues, it is also important that migrant workers and their families are treated in a dignified and respectful manner, and supported for stress and trauma management arising out of the sudden distress. While there is an MoHFW guidance document on this as well as a directive from the Supreme Court of India, relevant officials and service providers involved must be trained on these approaches, and supported with essential steps for strict adherence to prescribed approaches. It is also important for the authorities to set up systems both for reaching out to, and responding to the families of quarantined migrant workers, as required.

Kanika Singh is the Policy Officer at WaterAid India. She works on issues of sanitation and waste management, with a focus on social inclusion and sustainability.

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