Examining Determinants of Health among Safai Karmacharis (“Ex-Untouchables” Caste) in Mumbai

The purpose of the two-phase, sequential mixed methods study using Critical Caste Theory (CasteCRT) was to explore the socioeconomic condition, intergenerational caste-based slavery, and health vulnerability of municipal workers associated with the collection, transportation, and landfilling of municipal solid waste in Mumbai. The first phase involved in-depth interviews of 10 Safai Karamcharis and 12 key informants from the Municipal Corporation of Greater Mumbai (MCGM). Individual interviews inquired about household and parental information, migration history, reasons for migration, work history, and expectations from the municipal corporation. The second phase involved cross-sectional survey of 360 Safai Karamcharis from six municipal wards of the MCGM. To identify the diagnosed causes of death, 100 households were interviewed who had lost their earning member in the previous 3 years. A study of Safai Karamcharis employed in the BrihanMunicipal Corporation of Mumbai found that the policies directed at uplifting of workers have been institutionalizing caste-based occupations. The Warsa Hakka policies of the government assure employment of the Safai Karamcharis’ progeny. Other findings highlighted the need to address precarious working conditions; the need for change in caste-specific recruitment processes; educational, financial, and healthcare support; efforts to address their psychosocial slavery; and freedom to voice their concerns. This paper elaborates the factors that keep generations of Safai Karamcharis in this occupation and recommends practical solutions to break the vicious cycle.