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Gaza’s Health Sector: Sanitation Workers Are Deprived of their Rights

Delayed Salaries and No Safety Equipment

Mahmoud Abu Al-Hunoud

The labor laws and regulations to protect the rights of sanitation workers in Gaza are there, and are supposed to be guarding their rights to ensure a healthy work environment. Yet for a large group of those workers, their situation can be described as catastrophic, especially for those working in the health sector.

To begin with, their salaries are less than half the legal minimum wage. Additionally, these workers are not provided with means of protection from the dangers of medical waste, and on top of that, are denied paid leave. They suffer from economic, social and health repercussions in an already uniquely difficult situation in the Gaza Strip that forces them to accept poor working conditions in order to escape the scourge of unemployment.

The number of workers in the sanitation sector at private companies in Gaza’s health facilities is estimated at 900, all of which are distributed among 83 health centers and 13 sanitation companies that operate in the Strip’s five governorates of Gaza, the North, the Center, Khan Yunis and Rafah. Workers receiving less than minimum wage are working in hazardous environments; a result of their employers’ failure to provide them with occupational health and safety tools.

According to Ali Al-Jarjawi, the residing lawyer at the Democracy and Workers’ Rights Center (DWRC), the 2005 privatization of the cleaning sector in the Health Ministry contributed to hospitals and health centers seeking better quality cleaning services. However, this “reflected negatively on the status of workers and their rights.”

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900
Workers
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83
Health centers and hospitals
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13
Cleaning companies
Ghaza map
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Gaza Governorates

In 2012, the Palestinian government issued a legal minimum monthly wage of 1,450 Shekels ($414). In 2017, the Minister of Labor at the time issued a regulation obligating employers to enforce the minimum wage. However, the results of the labor force survey published by the Palestinian Central Bureau of Statistics in 2019 show that the percentage of workers in the private sector who earn less than minimum wage in the Gaza Strip reached 80%. Those same workers make an average of 652 Shekels a month (just under $200).

The implications of this shocking statistic are observed in the details of the lives of the affected people. Among them is Bassam, a young man in his thirties, who has worked for a cleaning company for three years with a monthly salary of no more than 700 Shekels ($200). Bassam supports a family of eight. He explains that he goes to his workplace by foot to save on transportation costs.

“Often, my children go to school without a daily allowance. I can barely manage to provide them food, and I stand in bewilderment and embarrassment at their questions about our living conditions. A lot of the time I do not know how to answer them, so I remain silent,” he told the ARIJ reporter.

Bassam’s suffering is not limited to the meager wage he receives; he has suffered many work injuries as a result of handling medical waste. In mid-2019, he had to receive medical treatments and vaccinations over a period of three months due to injuries to his hand caused by a medical scalpel that was lying in the medical waste bags that he collects. The company for which he works was supposed to provide him with special gloves for collecting waste.

In addition to Bassam’s case, this investigation documents three other cases of work-related injuries. In two of the cases, workers were pricked by needles while collecting medical waste, and the third is a case of a skin infection transmitted from a patient.

Cabinet Resolution No. (11) of 2012 Regarding the Adoption of the Minimum Wage in all Areas of the Palestinian National Authority

On 09/10/2012, the Council of Ministers issued Resolution (11) after examining the following: the provisions of the amended Basic Law of 2003, Labor Law No. (7) of 2000, the Cabinet’s decision No. (46) of 2004 regarding the formation of the Wages Committee and the letter of the Chairman of the Wages Committee dated 7/10/2012 regarding the minimum wage. The resolution was also based on the recommendation of the Minister of Labor and Chairman of the Wages Committee and stemmed from the powers vested in the Council by law regarding the requirements of the public interest, as follows:

Article (1)

The minimum wage shall be adopted in all regions of the Palestinian National Authority as follows:
1. The minimum monthly wage in all areas of the Palestinian National Authority and in all sectors shall be an amount of 1,450 Shekels per month.
2. The minimum wage for day laborers, especially those working on an irregular daily basis, in addition to seasonal workers, shall be an amount of 65 Shekels per day.
3. The minimum wage for one hour of work for the workers covered by paragraph “2” above shall be an amount of 8.5 Shekels per hour.

Concerns and Demands

In February 2020, ARIJ conducted a survey involving 30 cleaners at private companies. The results show that 10% of the participants have suffered work injuries while handling medical waste and that 50% have grave concerns about the possibility of being exposed to work injuries.

Additionally, 50% of them confirmed that cleaning companies do not commit to providing durable and protective gloves or special shoes to prevent work injuries. Moreover, 56.6% said that cleaning companies do not provide masks consistently and 63.3% confirmed that they face health risks while dealing with chemicals such as chlorine.

With regard to wages, the results showed that all respondents receive a monthly salary of less than the minimum wage; 66.4% have a salary of around 700 Shekels while 33.4% have a salary of around 770 Shekels. Survey results also show that 46.7% of participants are sometimes forced to walk to their workplace or look for inexpensive means of transportation. Additionally, 83.3% demand that sanitation companies give workers their full rights along with paid leave and 80% of respondents believe that a union that represents sanitation workers and defends their rights should be formed.

chart 50%
cleaning companies do not commit to providing durable and protective gloves or special shoes to prevent work injuries
chart 57%
cleaning companies do not provide masks consistently
chart 63%
face health risks while dealing with chemicals such as chlorine
have a salary of around 700 Shekels
66%
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All surveyed individuals receive less than minimum wage
have a salary of around 770 Shekels 33%
chart 47%
sometimes forced to walk to their workplace or look for inexpensive means of transportation
chart 83%
demand that sanitation companies give workers their full rights along with paid leave
chart 80%
believe that a union that represents sanitation workers and defends their rights should be formed

Waste Resulting from Healthcare

Waste resulting from healthcare is classified as waste that is potentially infectious. Some of these include waste contaminated with blood and other bodily fluids, stored infectious components resulting from laboratory work or waste from patients in quarantine wards. They also include tools, such as mops, bandages, single-use medical equipment, as well as sharp objects such as syringes, needles, scalpels and disposable blades, as listed in a 2018 World Health Organization report, which also highlights that healthcare waste contains microorganisms that may be harmful and can transmit infection to others.

Work Injuries and Warnings

Bid invitations are proposed through the Ministries of Health and Finance. The Ministry of Labor requires that bidding sanitation companies adhere to the standards and conditions for providing personal protective equipment (PPE) necessary to protect workers from the risks and diseases of the profession. But it seems that not all companies comply with this.

Ahmad Al-Madhoun, Head of the Occupational Health and Safety Department at the Palestinian Ministry of Labor in Gaza, explains that the Ministry’s Inspection Department sent written warnings to ten cleaning companies at the end of 2018 for contravening some of the bidding terms and the Labor Law. Disciplinary reports were directed to two cleaning companies while another company’s file was sent to Public Prosecution for not complying with the conditions of the bid by not providing PPE.

Dr. Rami Al-Abadleh, Head of the Central Committee for following up on cleaning companies at the Palestinian Ministry of Health in Gaza, highlights that during 2018, ten work injuries were reported to the Ministry of Health, whose role, he explains, is to follow up on the cleaning services provided by these companies. This role also entails dictating the specifications and the health requirements that should be followed.

The recent tenders put forward primarily included the commitment of companies to providing occupational safety means for these workers, he added. This is in addition to providing them with preliminary examination before work, immunizations, adherence to the provisions of the Palestinian Labor Law and granting them leave as stipulated by law.

Occupational Safety by Law

Article (90) of the Palestinian Labor Law states that the Cabinet of Ministers shall cooperate with the specialized authorities to issue regulations pertaining to occupational health and safety and the work environment. These include means of personal protection for workers against work hazards and occupational diseases. Article (1) of Palestinian Cabinet Resolution No. (49) of 2004 also affirms that the employer must provide the necessary precautions and measures to protect workers from occupational hazards that may arise within the work environment. Employers must also provide workers with appropriate PPE, such as protective clothing, glasses, gloves, shoes, etc. and guide them in how to use these.

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Massive Violations

Sanitation worker Abu Muhammad lives in difficult conditions and has a low monthly wage that barely lasts a couple of days due to life’s demands. He also works in an insecure environment, and on top of all that, is deprived of his right to paid leave as stipulated by law.

“Weekends aside, we are denied official holidays, occasions, sick leave and annual leave. Paid leave is a right, but we do not get any of that,” he told ARIJ.

According to Fayez Al-Omari, Executive Director of the private institution of Labor Resources Center in Gaza, workers in this sector also suffer from delays and irregularities in their salaries. These delays may sometimes go beyond six months.

He says that despite this, most workers hold on to their jobs due to rampant unemployment in the Gaza Strip and the increase in poverty rates. Moreover, many are reluctant to file complaints for fear of being fired.

In this regard, Mona Rostom, the Director of the Democracy and Workers’ Rights Center (DWRC) of the Gaza Branch, says that over the last two years the Center has received many complaints from sanitation workers in the health sector. Most of these are related to low wages, delayed salaries, arbitrary dismissals and paid leave.

She added that a field visit campaign was carried out in cooperation with the Ministries of Health and Labor whereby many violations of the rights of these workers were documented.

At the same time, many of these problems had already been solved and that there was an “improvement” in how some companies dealt with labor issues, she told ARIJ.

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The Need to Unionise

Abu Hazem, the Director of a cleaning company, attributes the lack of commitment of cleaning companies to enforce the minimum wage law and the delay in disbursing salaries to “the lack of adequate government support in the tenders that are put to contract with cleaning companies. This is in addition to the conditions of blockade and Palestinian division.” In his opinion, all of this negatively impacts the status of cleaning workers and companies.

Ahmad Al-Hindi, a spokesman for cleaning companies, also offers an explanation on the lack of commitment in providing occupational safety equipment. He says that companies adhere to the terms of the tender “depending on the capabilities available to them.”

The difficult financial conditions that these companies suffer are due to the “irregular payment of their dues” by government agencies. This forces many of them to only provide the basic requirements for work, the task of cleaning hospitals and the health of patients. They also suffer from the accumulation of debts to merchants and to supplying companies, he told ARIJ.

The solution for sanitation workers may be the formation of a union that represents them and defends their rights, Rostom believes. She makes it clear that the Democracy and Workers’ Rights Center had previously trained a group of workers to represent their colleagues and that there are important steps in this regard that may soon translate into the formation of a union.

As for solutions, Dr. Salameh Abu Zuaiter, Head of the General Union of Health Service Workers, stresses the need to enhance the supervisory role of the Ministry of Labor. He emphasizes that new tenders put up for contracts with cleaning companies should take into account the enforcement of the Palestinian Labor Law, especially in regards to the minimum wage.

The Ministry should also force companies to provide insurance and bank guarantees to ensure that workers’ salaries are paid at the end of each month, provide all means of protection and occupational safety, and grant sanitation workers paid leave as stipulated in the Palestinian Labor Law.

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A memorandum submitted by several labor centers to the Ministry of Labor to enforce the minimum wage law in the case of sanitation workers
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A labor complaint filed by a number of labor centers for cleaning workers' rights