COVID-19: Uninsured and unprotected on the front line


A day in the life of a sanitation worker during the pandemic

Hoby Randrianimanana


The clock strikes eight on a Sunday morning in Antananarivo, the capital of Madagascar. 51-year-old Randriamiandrisoa Jean Juste, “Ramery,” is the first member of his crew to show up at work and gets ready for his 24-hour shift.

Although he has worked at SAMVA (a waste collection and management company) since 2014, Ramery – along with many of his colleagues – is still a temporary worker, but hopes to become permanent one day. With a wife and two children to provide for, Ramery says he will do anything to preserve his job because finding a new one at his age would be hard.

collecting trash


Ramery begins work after taking a sip of rum shared among the crew. Drinking alcohol is a common practice among sanitation workers, as it is believed to help suppress feelings of disgust and protect against infections. Ramery and his crew manually handle various types of waste illegally dumped in garbage bins, including dead dogs, diapers, sanitary pads, faecal sludge and chemicals. Working at night is particularly challenging for the crew as they don’t have lights.

collecting trash 2


“Sometimes, we just smell whatever we touch to identify it,” says Ramery, having recounted a story of one night when he jumped into a bin to collect trash and landed on thick faecal sludge that almost buried his entire lower limbs. He wasn’t able to wash until his shift ended.



Since the COVID-19 outbreak started, Ramery’s crew has handled a lot more medical waste than usual. The crew is sometimes sent to collect waste at hospitals, especially when their storage bins and incinerator are at capacity.

“It’s very risky to go there because we don’t have proper protection. I got my hand punctured by a syringe once. It got swollen severely, so I didn’t work for three days, and you know, skipping work, even just for one day, is risky because you may get fired or don’t get paid,” says Ramery.

showing mask


Ramery is constantly at risk of contracting COVID-19, even when collecting waste in residential areas, where people throw used face masks and other PPE in their domestic waste.

“This just shows residents don’t care about our safety and dignity,” laments Ramery. “At other times, they literally spit on us and call us with degrading nicknames.” He says he is terrified about catching Coronavirus and often gets upset by the thought that if anything happens to him, his wife and children would be left with nothing, no pension, no social security and health coverage.

truck leaving


After filling up the refuse truck for almost three hours, Ramery and his crew take rest in the truck bed—on top of a pile of trash—during the 30-minute trip to the landfill.

“Although this job requires a lot of physical strength, it is not as exhausting as my old job as a blacksmith in my hometown, Antsirabe,” says Ramery. “I feel old now. I get tired and out of breath easily. That’s why I don’t put my face mask on when I work. I wish we had a special mask that allows us to breathe comfortably.”



At the landfill, Ramery’s truck dumps everything in one place. They don’t segregate the trash because that would cost them a few more hours and they still have a few trips to complete before their shift ends.

“We let waste pickers handle that job, which they’re very happy to do because it’s a treasure to them. We simply caution them about the virus,” says Ramery, who appears unworried by having lunch with his crew in the dirty truck bed as they’re driving off the landfill.

Ramery son


Ramery’s adult son, Randriamiandriasoa Elie, 25, works with him in the crew. Married, Elie is also a temporary worker. With two younger children to provide for, Ramery confesses his family struggles financially.

“More than half of my salary (250,000 Ariary or about US$70) goes to pay off our rice debt. After we buy everyday items such as coffee and sugar, we often end up with around 60, 000 Ariary (US$15) to live in a month,” he explains. “And that doesn’t even include other essentials, such as soap and water. We pay 100 Ariary for a bucket of water every day from someone’s well. I only wash at home after work and use the little water that’s available. Sometimes, I don’t wash at all as we need to spare water for cooking.”