On the road with sanitation workers in India

Exhaust fumes, heat, work and traffic accidents. Overcoming all these odds, the sanitation workers in India fight a daily battle. Making More Health is committed to ensuring that street cleaners receive medical care, adequate work equipment – and that their children will be better off.

Chinnaswamy bends forward. He stretches out his arm and sweeps up the stinking rubbish of the main street with a bristly hand brush. Food leftovers, plastic bottles, and cigarette butts end up on his dustpan.

Then the 51-year-old pushes himself up, turns around and throws the garbage onto the back of the garbage truck. Two colleagues stand on the truck and squeeze the garbage together, using their bare hands. To the left and right, less than half a meter away from the garbage collectors, mopeds pass by. Every second, there is the sound of a horn, the air stinks of diesel, the sun burns mercilessly on the asphalt.

Street cleaners have a tough job  

The streets of Coimbatore have been Chinnaswamy’s workplace for 17 years. He works here six days a week from 6 am to 4 pm. The street cleaners in India receive a daily wage – depending on experience and type of employment – of less than five euros. A tough job that doesn't bring decent pay or seen as respectful. 

Meanwhile, we are driving out of the city, overtaking cars, rickshaws, drovers and mopeds. Shops and cafés are flying past us to the left and right. After ten minutes, we have left the city behind us, it becomes more rural. We are now driving past banana plantations and fields with grazing cattle. The road becomes bumpier and narrower, the ground changes from asphalt to gravel. After another 20 minutes, we reach a small village in the Erode District: Chinnaswamy’s home.

A good 30 women and children await us. They greet us with a traditional ceremony: an aarti. A large plate of vermilion diluted water is brought out and a piece of camphor piece is set alight in it. Smoke comes up. One of the women dips her index finger into the liquid and then puts a dot on our forehead. Then she empties the remaining liquid on the street behind us. We are asked to walk ahead – and leave all our worries behind. 

"60 percent of road workers die before their 60th birthday," says Maran Thangavel, director of the NGO Vizhuthugal, a partner of our sustainability initiative Making More Health. Cardiovascular problems are the most common cause, but traffic and work accidents as well as lung cancer are also common causes of death. In the last year alone, thousands of men and women in the region got ill while on duty, and 24 died.

"We've been active in India for ten years now," says Manuela Pastore, manager of community activation at Making More Health. "We are looking at how we can help people quickly and relatively easily." The provision of work materials for road workers or the training of Vizhuthugal volunteers are examples of this. However, the focus is on a "much more holistic approach". 

"We are building a system-changing network with local NGOs," says Manuela. We bring together the expertise, network and further education. Afterall, everything is connected to everything." Health is only possible with hygiene and clean water. The welfare of the animals secures food and income for many local people, and only if the family is doing well, the offspring can go to kindergarten and school. "We want to systematically improve people's lives and ensure that they can survive sustainably without Making More Health."

Unprecedented sustainability challenges

We believe that this holistic approach is key to tackling today’s unprecedented sustainability challenges, whether partnering to defeat non-communicable diseases, surging mental health issues, rising antimicrobial resistance, or preventing future pandemics by controlling emerging and infectious diseases in animals: We can holistically improve human and animal health and welfare in many ways. 

To scale-up our potential impact, we are further embedding sustainability into our business strategy, to leverage our strength as a global healthcare company to help eliminate healthcare disparities.

Just like the village community in the Erode District in India. Devadarshini, who lost her father three years ago, can go to school thanks to the help of Vizhuthugal and Making More Health. She is in eighth grade, she reports. Her favorite subjects are biology and mathematics. Her career aspiration: "To become a nurse."

In the afternoon, we meet Chinnaswamy again. He has now finished work and is standing close to at least 100 work colleagues in a queue in Coimbatore. A mobile doctor's station was built on an open space. At wallpaper tables there are volunteers who register Chinnaswamy and his colleagues, measure their blood pressure and ask about their well-being.

With the recorded readings, Chinnaswarny goes one table further. Here sits Dr. Shobana. She smiles kindly at Chinnaswamy, points to the chair in front of her and then reaches for his booklet with the health data.  "The values are developing well. Your blood pressure is still slightly elevated, but it is getting better. I will prescribe you tablets again, which you please take regularly. And then we might be able to do without it next time."

Something has to change, says not only NGO director Maran. His organization has now grown to more than 20 members. Volunteers include an above-average number of young people. "Our social conscience does not let us rest," says one of the supporters. "We can't be indifferent when people get sick because of their work. Health is the most important thing.”


More information: Our engagement to improve health equity for underserved communities

By targeting rural and indigenous communities in India, Making More Health relates to a key objective of Boehringer Ingelheim: contribute towards eliminating health disparities around the globe. Through our Sustainable Development – For Generations framework, we are committed to improving access to healthcare for 50 million people in vulnerable communities by 2030. This is how we define these groups