Report on health related issues of informal sector involvement in solid waste management Imprint
The Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH was formed on 1 January 2011. It brings together the long-standing expertise of DED, GTZ and InWEnt. For further information, go to www.giz.de.
This publication presents former GTZ activities; due to the change of the company‘s name, these will be referred to in the following as GIZ activities.
Published by: Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH Postfach 5180 65726 Eschborn / Germany T +49 61 96 79-0 F +49 61 96 79-11 15 E [email protected] I www.giz.de/recycling-partnerships
Sector Project Recycling Partnerships (Förderung armutsorientierter und umweltverträglicher Kreislaufwirtschaft-Konzepte)
Responsible: Sandra Spies, GIZ
Author: Susy Lobo Ugalde/Asociación Centroamericana para la Economía, la Salud y el Ambiente (ACEPESA), with contributions from Sofía García Cortés (GIZ)
Contact person at the Federal Ministry for Economic Cooperation and Development: Franz Marré
Eschborn, January 2011
Table of Contents
Table of Contents ...... 3 Abbreviations ...... 5 Executive Summary ...... 6 Part 1. Introduction ...... 8 Part 2. Methodology ...... 9 2.1. Defining the population to be studied ...... 9 2.2. Methodological Process ...... 9 2.3. Selection of the population to be interviewed ...... 11 Part 3. Theoretical Framework ...... 15 3.1. Concept of ISWM ...... 15 3.2. Phases of Integrated Solid Waste Management ...... 15 3.3. Concept of Working Conditions and Environment ...... 16 Part 4. General Characteristics of the Studied Population per Country...... 18 4.1. General characteristics...... 18 4.2. Work Experience ...... 19 Part 5. Health and occupational hazard aspects...... 20 5.1. Perception of the state of health ...... 20 5.2. The case of those working at solid waste disposal sites ...... 20 5.3. The case of those working in the streets recovering recyclable material ...... 25 5.4. The case of those working in micro and small enterprises for the recovery of recyclable material...... 29 Part 6. Results of Group Interviews and Best Practice ...... 34 6.1. The Colombian Case ...... 34 6.2. The Nicaraguan Case ...... 37 6.3. The Costa Rican Case ...... 40 6.4. Best Practices ...... 41 Part 7. Technical Considerations and Recommendations ...... 42 Part 8. Appendices ...... 44 8.1. List of respondents who participated in group interviews ...... 44 8.2. Instruments ...... 49 8.3. Details of the Population Surveyed in Nicaragua ...... 57 8.4. Details of the Population Surveyed in Costa Rica ...... 65 8.5. Some general comments on the Recyclers Association of Bogotá (ARB) and the National Recyclers Association (ANR) ...... 72 8.6. Details of the Population Surveyed in Colombia ...... 73 8.7. Details of respondents who work in recovery centers for recyclable material ... 76 8.8. Colombian work process drawing ...... 77 8.9. Masaya dump work process drawing ...... 78 8.10. La Chureca dump work process drawing ...... 79 8.11. Managua scrap yard work process drawing ...... 80 8.12. Drawing: Work Flow of a Costa Rican Recovery Center for Recyclable Material ...... 81 8.13. Some Photographs ...... 82 8.14. Bibliography ...... 87
3 List of Tables Table 1. Summary of People Interviewed Per Country ...... 14 Table 2. Summary of Focus Group Interviews per Country ...... 14 Table 3. Work-related illnesses caused by conditions exogenous to the work place ...... 16 Table 4. Work-related illnesses caused by conditions in the workplace...... 17 Table 5. Characteristics of the Interviewed People Who Work Collecting Recyclable Material (Percentages) ...... 18 Table 6. Previous Activities Done by Persons Interviewed in Colombia, Costa Rica y Nicaragua ...... 19 Table 7. Comparison of the interviewed persons’ perception of own health (percentages) ...... 20 Table 8. Report of respondents’ ailments according to location ...... 21 Table 9. Summary of occupational risks, procedures in case of accidents and preventive measures according to final disposal site ...... 24 Table 10. Summary of occupational risks, procedures in case of accidents and preventive measures.... 28 Table 11. Ailments and causes according to respondents per country ...... 30 Table 12. Report of respondents’ ailments according to country ...... 30 Table 13. Medicine taken according to disease and country ...... 31 Table 14. Summary of occupational risks, procedures in case of accidents and preventive measures according to country...... 33 Table 15. Results on the work of the human body ...... 36 Table 16. Results for the human figure test ...... 38 Table 17. Results for the human figure test ...... 39 Table 18. Results for the human figure test ...... 40 Table 19. Results for the human figure test ...... 41
List of Figures Figure 1. Methodological Framework ...... 11 Figure 2. The Phases of Integrated Solid Waste Management ...... 15 Figure 3. Working process at the final disposal site ...... 20 Figure 4. Working process in the streets ...... 25 Figure 5. Working process in the streets of Colombia ...... 26 Figure 6. Working process at the centers for recovery of recyclable material ...... 29
List of Photographs Photograph 1. La Chureca Garbage Dump, Nicaragua ...... 12 Photograph 2. Workers in a scrap yard, Managua, Nicaragua ...... 12 Photograph 3. Zagala Garbage Dump, Puntarenas, Costa Rica ...... 12 Photograph 4. Workers in a scrap yard, Cartago, Costa Rica ...... 13 Photograph 5. Representative of La Florida Association, street recycler and Alquería, Bogotá Project workers. Colombia ...... 13 Photograph 6. Masaya dump, Nicaragua ...... 25 Photograph 7. Working tools, La Chureca, Managua, Nicaragua ...... 28 Photograph 8. Escazú Recycling Project, Escazú, Costa Rica...... 32 Photograph 9. Project Escazú Recycles, Escazú, Costa Rica ...... 36 Photograph 10. Masaya Garbage Dump Board of Directors, Nicaragua ...... 37 Photograph 11. Scavenger representatives Managua, Nicaragua ...... 39 Photograph 12. Junkyard workers Managua, Nicaragua ...... 40 Photograph 13. Masaya garbage dump, Nicaragua ...... 82 Photograph 14. Zagala dump garbage pickers, Puntarenas, Costa Rica ...... 82 Photograph 15. Zagala dump garbage pickers, Puntarenas, Costa Rica ...... 83 Photograph 17. Scrapyard worker, Cartago, Costa Rica ...... 84 Photograph 18. Center for recovery of recyclable material, Escazú Recicla, Escazú, Costa Rica ...... 84 Photograph 21. Center for recovery of recyclable material, Desamparados, Costa Rica ...... 86 Photograph 22. Center for recovery of recyclable material, Los Guido, Costa Rica ...... 86
4 Abbreviations
ACEPESA Central American Association for Economy, Health and Environment ALMA Mayoralty of Managua ANR National Recyclers´ Association ARAMBIENTAL Association of Recycling and Environmental Recovery Organizations ARB Bogotá Recyclers´ Association ARENDIEZ Engativá Zone 10 Recyclers´ Association ARUB Association of Recyclers United for Bogotá CyMAT Working Conditions and Environment EBAIS Basic Health Care Units INS National Insurances Institute (Costa Rica) ISWM Integrated Solid Waste Management GIZ Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH MINSA Ministry of Health (Nicaragua) NGOs Non-Governmental Organizations AIDS Auto Immune Deficiency Syndrome WIEGO Women in Informal Employment: Globalizing and Organizing
5 Executive Summary
This document compiles the information of the consultancy “Health-related issues of informal sector involvement in solid waste management” carried out by ACEPESA. The objective of the consultancy, financed by GIZ, is to report on the occupational hazards for the informal sector and preventive measures while working in the solid waste sector.
The field work was carried out in Nicaragua, Costa Rica and Colombia with a total of 118 respondents (52 women and 66 men). The research is based on surveys, focus groups and case studies, with the aim of reconstructing the experience of the people who work in the informal solid waste sector.
The study gathers general information on the studied population, such as age (the average being 38 years), level of schooling reached (most have not completed primary school, although some actually have completed technical studies), years of experience in the activity (in Costa Rica and Nicaragua most have worked in the sector for less than ten years, unlike in Colombia), other jobs held, most of which are also in the informal sector, and their perception of their health (predominantly good to very good).
The main health problems mentioned were kidney problems, blood pressure and diabetes, which are general population problems not directly associated with the occupational type. Dizziness, asthma, coughing, skin diseases, arthritis and urinary tract and kidney infections, on the other hand, could be occupational illnesses, linked to the conditions in which the work is carried out, where there is smoke from the burning of waste, there are no sanitary facilities, and water consumption is low, despite direct exposure to solar radiation and high temperatures.
The most common types of risks and accidents are related to injuries caused by some material, blows and getting hit by trucks, as well as skin infections. There are many more risks associated with the work than the interviewed people mentioned. It seems that because they work in such extreme conditions, they only manage to recognize the most common and visible risks and accidents.
The use of personal protective gear was researched only in the recyclable material recovery microenterprises. Colombia reported the greatest degree of use, thanks to the level of organization this sector has achieved, followed by Costa Rica and in third place, Nicaragua.
Regarding best practices, it is worth mentioning that these were difficult to locate in the conditions studied. Nevertheless, the existence and use of the hook—despite the fact that if it is used carelessly can cause accidents (which does occur)—constitutes tool that speeds up the work, protects from some of the risks found in mixed garbage, and at the same time prevents the need for people to have to be bending over. Its existence has been documented for approximately 80 years in Colombia, although it was not possible to ascertain if it is still being used, as in Bogotá there are no dumps where the presence of informal workers is allowed. On the other hand, it is a much-used instrument in the garbage dumps in Nicaragua and Costa Rica, where the field work for this study was carried out. The use of the tool is an improvement in working conditions.
In the La Chureca dump, where there is a greater level of organization, there is a health center. Given that most of the people who work in the dump live there, attention to health has been a battle won by the organization for the sector.
6 Vaccination campaigns for the population in the three countries have constituted one means of protection from disease for people working in the informal sector.
The organizational development of the sector in Colombia is also worth mentioning as good practice, as together they have been able to confront many problems. The organization drives educational activities and fights to improve self-esteem through social appreciation of the work they do. However, there still remains more work to get people to use personal protective gear.
The organization of the sector implies an improvement in general living conditions; the improvements in the case of Colombia are evident. Yet only as participation of the population is achieved in the separation of recyclable material, in the organization of selective collection systems with the participation of those who already collect, but under better conditions, in the existence of collection centers for the separation of recyclable material, and above all, in the transformation of the material to give it added value, will the people who work in the informal solid waste sector gain the place they deserve in the recycling chain, and will their contributions be recognized and valued by society.
Generally speaking, it is recommended that in Costa Rica and Nicaragua, countries in which there is no formal or national organization of the informal solid waste sector, a national strategy be developed to deal with the problems being faced. In the case of Colombia, despite great organizational development, the sector needs greater support from actors involved in the matter.
It is recommended that, to prevent accidents, risks be eliminated or controlled as close as possible to their source. When this is not possible is when the use of personal protective gear is recommended. The development of a training and technical assistance program to reduce resistance to the use of the protective gear is urgent, as well as the development of studies to design protective gear that adapts to the work conditions, which would also be a possibility to motivate and increase its use.
On the other hand, it must be considered that, once people have been trained in the need to protect their bodies with specialized equipment, the problem of how they will buy said equipment must be addressed, in order to guarantee the sustained use of the gear through time. It is recommended this aspect be studied in greater depth.
It is recommended to delve further into the study of premature aging, as this is a variable that should be considered in the training and awareness-raising programs, as well as in other measures that need to be implemented in each of the countries studied.
7 Part 1. Introduction
This document compiles the information from the “Health-related issues of informal sector involvement in solid waste management” consultancy report carried out by ACEPESA. Its objective is to report on the health risks for the informal sector and preventive measures while working in the solid waste sector. The research brings together the experiences of people working in the informal solid waste sector in Nicaragua, Costa Rica and Colombia. It is made possible thanks to the support of GIZ.
The participation of the informal sector is an important characteristic of the recovery of recyclable or recoverable material in developing countries. The activities of the so-called garbage pickers (buzos or churequeros), scavengers (pepenadores), junkmen (cirujas), paper collectors (cartoneros) or recyclers, do not only constitute a source of income for these people and their families, but also contribute to the conservation of natural resources and represent currency savings for the countries, making it work that is useful to society, despite the fact that it is generally not socially valued.
Work is one of the axes around which human beings’ lives turn in societies. Studies carried out regarding the relationship between work and health affirm that “negative health effects are not a ‘natural’ consequence of work. It is not work that makes ill, rather it is the way production has been organized to obtain the maximum possible yield from workers.’’ (Autonomous Metropolitan University. 1989. “Manual: Conocer para cambiar. Estudio de la salud en el trabajo”. Mexico, Federal District.)
This report presents the methodology applied in the research process, as well as the theoretical framework, specifically concerning integrated solid waste management (ISWM) and Working Conditions and Environment (CyMAT, for its initials in Spanish). In another section the general characteristics of the population interviewed are described per country, the next section addresses aspects of health and occupational hazards according to activity type, after which the information obtained from the focus groups is presented, as well as the results on good practices found. Finally, technical considerations are offered. The field work was carried out in Nicaragua (8 to 10 July 2010), Costa Rica (July) and Colombia (11 to 14 August 2010) with a total of 118 respondents (52 women and 66 men).
This work would not have been possible without the collaboration and support of the following people: in Nicaragua José Antonio Hernández, representative of ACEPESA in Nicaragua, Marvin Moncada, responsible for the Directorship of Public Cleanliness of the Mayoralty of Managua (ALMA) and Manuel Centeno, administrator of the garbage dump La Chureca. In the case of Masaya to Ligia Arauz, who is responsible for the Directorship of Environmental Management of the Mayoralty.
In Costa Rica to Olman Bolaños Rojas, Victoria Rudin, José Chan, administrator of the garbage dump in Zagala, and to Patricia Ulloa. In Colombia to Nohra Padilla, executive director of the National Recyclers’ Association (ANR for its initials in Spanish) and the Bogotá Recyclers´ Association (ARB), to Margarita Orozco Quintero and to Silvio Ruiz of the ARB, and to Ricardo Valencia of Women in Informal Employment: Globalizing and Organizing (WIEGO).
We are especially thankful to all the people who work in the streets, in the garbage dumps and in the recyclable material collection centers who gave us the information on their experiences that made this study possible.
8 Part 2. Methodology
2.1. Defining the population to be studied
In order to delimit the population to be studied, it is opportune to define some concepts:
The Informal Sector is characterized by income or benefit-generating activities that are not regulated by the State, in a social medium in which similar activities are regulated.1
Informal solid waste management sector will be understood in the present study as those persons or micro or small enterprises that work in the management of solid waste, specifically the recovery of recyclable material, and who do not receive official recognition for their work. They generally carry out activities in the phases of collection and recovery of recyclable material and include the following groups:
. The so-called garbage pickers (buzos or churequeros2), scavengers (pepenadores), recyclers, paper collectors (cartoneros) or junkmen (cirujas),3 (the names vary between the countries in Latin America4): people found in the final disposal sites of garbage or in city streets and who recover recyclable material for commercialization. . Micro or small enterprises: those enterprises that receive recyclable material at different points or sites. They generally buy the recyclable material to sell to intermediaries or recycling companies, normally work without legal permits and without recognition from the municipalities.
2.2. Methodological Process
a. Type of study The methodology used is descriptive 5, as the study aims to know the health conditions of the informal recovery of recyclable or recoverable material sector and the experiences the people working in this sector have had regarding the prevention of accidents and illnesses related to this activity.
The research was carried out with people who work in the streets, open air landfills, or micro and small enterprises recovering recyclable material. The sample of people to be surveyed was randomly selected and based on the advice of experts (see Appendix 8.1, the list of people interviewed and those who participated in the focus groups). In total 118 people participated in the study (52 women and 66 men). 6
1 Taken from Manuel Castells and Alejandro Portes /www.monografias.com/trabajos46/residuos-solidos/residuos- solidos2.shtm 2 The term “Churequeros” comes from the workers in the garbage dump Chureca in Managua. 3 These are generally people who separate recyclable materials in open air garbage dumps as well as on city streets. 4 In Costa Rica, they are known as buzos; in Nicaragua pepenadores and in the specific case of people who work in the landfill La Chureca, they are churequeros. In Colombia they are called recyclers (recicladores). 5 Grajales Guerra, Tevni; “La investigación social cuantitativa”; tgrajales.net/invesindex.html 6 Even though an effort was made to interview an equal number of men and women, among the people who work in the streets there are more men. In Lozano, G, 2009, it is pointed out that scavenging is difficult and extenuating work done in the open, which is considered a determining factor for why it is an eminently masculine activity. It also points out that other elements must be considered as they make up part of the existing conditions of this type of
9
b. Tool A two-part questionnaire with open and closed questions was applied (in Appendix 8.27). The first part is on socio-demographic information and the second on medical history.
c. Techniques The focus group is a technique that facilitates group discussion on a specific topic, in which the interviewer asks the group questions and the people interviewed respond according to each one’s own experience, but also discuss about each others’ responses, which allows to clarify, deepen and enrich the information required on the topic of discussion.
The groups should not be composed of more than 10 participants, and the participants should have experience in work linked to the recovery of recyclable material. The general objective of the interview was to obtain information that would allow the identification of the perception of work-related risks and health problems that people who work in the recovery of recyclable material suffer from.
The focus group was structured in two parts. The first was to identify the whole process of recovery and to link each phase to the health-related risks. In the second part the researchers worked with the people to identify in a specific manner the perceived effects of the work activity on their bodies.
In as far as possible, before beginning the focus group interview, the location of the meeting was checked to ensure sufficient space for the number of people who would participate, and ensure that there would be enough chairs, at least one table for the group work, and adequate lighting and ventilation. This was not possible for any of the focus groups. In total the interview required approximately three hours of group work and started with an activity to break the ice and motivate interaction among participants. Five focus groups with a total of 24 people (14 women and 10 men) were carried out: three in Nicaragua, one in Colombia and one in Costa Rica.
d. Observation in the field Observation in the field was done during the questionnaires and the focus groups.
e. Literature review For the development of the theoretical framework a literature review on the concepts of Working Conditions and Environment, and Integrated Management of Solid Waste was conducted. Appendix 8.14, presents the bibliography used.
f. Data analysis
Figure 1 summarizes the methodological framework used.
work, for example: that related to the medium (climate and place where the activity is developed), age, physical condition, nutrition and the risk that spending a lot of time among “garbage” implies. 7 The instrument was revised by Sofía García Cortés (GTZ), it was not possible to apply the observations and improvements in Nicaragua, but it was possible in Costa Rica and Colombia.
10
Figure 1. Methodological Framework
Questionnaire applied to ‘’divers,’’ scavengers, recyclers
Analysis of the Questionnaire applied to micro and small information enterprises in the informal sector
Focus groups with associations or cooperatives
Investigación bibliográfica acerca del tema
Source: Author
2.3. Selection of the population to be interviewed
The informal solid waste management sector in three countries were selected as examples, given that carrying out the research on a wider global scale would be very complex. The cases were selected on the basis of expert advice.
The population to be interviewed was not selected on the basis of statistical formulas, given that the study is descriptive, and that the total number of members of the population to be studied cannot be determined with precision in any of the countries, especially that of the workers in the streets. Rather than determining a sample framework, a deterministic intentional and sequential sampling method was used.8 For this study the following population was worked with:
a. Nicaragua: In the case of Nicaragua the open air garbage dumps of Managua and Masaya were worked in. In Masaya 5 people on the Board of Directors of the Garbage Dump Scavengers (4 women and 1 man) were worked with. In the Managua dump 4 women and 2 men, garbage pickers (churequeros) who voluntarily agreed to participate in the study were randomly selected for the focus group, as working with the association was problematic. This work took place between 8 and 10 July 2010.
In the capital city of Nicaragua the questionnaire was applied to 10 people (1 woman and 9 men) who were located in the streets recovering material, as well as 5 micro and small recyclable material recovery enterprises.
8 Naghi, M. (1987): “Deterministic sampling is based on the researcher’s personal judgment [. . .] these personal judgments are a good estimation of the characteristics of the population, even though they do not allow the same degree of precision as sampling” (p. 191). “Intentional sampling is characterized by the use of criteria and a deliberate effort to obtain representative samples by including typical areas or supposedly typical groups in the sample” (p. 193).
11
Photograph 1. La Chureca Garbage Dump, Nicaragua©Susy Lobo -ACEPESA
Regarding the microenterprises a total of 7 people (2 women and 5 men) were interviewed. It was only possible to carry out one interview with the workers of a microenterprise; in the rest of the cases it was not possible because the owners were not willing to participate, alleging they had no time. Photograph 2. Workers in a scrap yard, Managua, Nicaragua©Susy Lobo -ACEPESA
b. Costa Rica In Costa Rica the questionnaire was applied on 21 July to 12 people (3 women and 9 men) working in the streets collecting recyclable material. To apply the tool, contacts were made with “Hogar Dormitorio” of the Municipality of San José, a shelter where people come for lunch. Two people were interviewed on their way to the recycling collection center to sell their materials.
On 26 July, 2010, 12 people (5 women and 7 men) in the open air garbage dump of Puntarenas were interviewed). In Costa Rica there are no open air dumps in the great metropolitan area, only sanitary landfills where people are no longer allowed to enter. Contact was established through Mr. Jorge Chan, responsible for the Zagala garbage dump. Approximately 25 people work as garbage pickers in this dump, but they do not have an organization. An effort was made to conduct the focus group interview, but most of the garbage pickers are Nicaraguans who live in the country illegally, so they were nervous, and the decision was taken not to continue with the group research process. Only the individual questionnaire was applied.
Photograph 3. Zagala Garbage Dump, Puntarenas, Costa Rica©Susy Lobo -ACEPESA
12 The research tools were applied to 4 microenterprises. It was only possible to conduct the focus group with workers in one case.
Photograph 4. Workers in a scrap yard, Cartago, Costa Rica©Susy Lobo -ACEPESA
c. Colombia In Colombia contact was established with Ms. Nohra Padilla, director of the National Recyclers’ Association (ANR) and the Bogotá Recyclers’ Association (ARB). She facilitated a promoter, Margarita Orozco Quintero, who coordinated the work from 11 to 14 August, 2010.
Photograph 5. Representative of La Florida Association, street recycler and Alquería, Bogotá Project workers. Colombia©Susy Lobo -ACEPESA
It should be noted that in Bogotá there are no open air garbage dumps, as a result of which there are no recyclers in the final disposal sites, and these were not visited for these study.
d. Field work A questionnaire directed at garbage pickers or recyclers who work in the open air garbage dumps in the capital cities of the three aforementioned countries was applied to 58 people. The questionnaire gathers information on health and occupational hazards. • In Nicaragua a total of 30 people (18 men and 12 women), of whom 10 work in the streets (1 woman and 9 men) and 20 in the garbage dumps of Managua and Masaya (9 men and 11 women).
13 • In Costa Rica 24 people (8 women and 16 men) were interviewed, distributed in the following manner: 12 who work in the streets (3 women and 9 men) and 12 at final disposal locations (5 women and 7 men). • In Colombia 4 people (2 women and 2 men) were interviewed.
Another interviewed population was that of the people who work in micro and small enterprises that recover recyclable material. The questionnaire was very similar to that applied to the previous segment of the sample. It varied only in the consultation about the use of personal protective gear. This questionnaire was applied to 36 people, distributed in the following manner:
• In Nicaragua, 7 people (2 women y 5 men) • In Costa Rica, 14 people (6 women y 8 men). • In Colombia, 15 people (8 women y 7 men). In this case the reference is to associations or cooperatives that make up the ARB.
Table 1 shows the summary of people interviewed, for a total sample of 94 people in the three selected countries.
Table 1. Summary of People Interviewed Per Country Population interviewed Questionnaires Totals Nicaragua Costa Rica Colombia F M F M F M Street scavengers 1 9 3 9 2 2 26 Scavengers in final 11 9 5 7 32 disposal sites Micro and small 2 5 6 8 8 7 36 enterprises Totals 14 23 14 24 10 9 94 Source: Author. Based on questionnaires applied as of 30 August, 2010.
Table 2 presents the summary of focus group interviews done. Twenty four people were worked with (14 women and 10 men): • In Nicaragua a total of 14 people were worked with (8 women and 6 men): 5 of the Board of Directors of Pepenadores of Masaya (4 women and 1 man); 6 representatives of the churequeros (4 women and 2 men) and 3 microenterprise workers. • In Costa Rica 5 people participated (3 women and 2 men) who work in a center for recovery of recyclable material. • In Colombia 5 members (3 women and 2 men) of the Board of Directors of an Association of Recycling Families.
Table 2. Summary of Focus Group Interviews per Country Country Women Men Total Nicaragua 8 6 14 Costa Rica 3 2 5 Colombia 3 2 5 Total 14 10 24 Source: Author. Based on questionnaires applied as of 30 August, 2010.
14 Part 3. Theoretical Framework
3.1. Concept of ISWM
The concept of Integrated Solid Waste Management (ISWM) proposes an approach to reaching better and sustainable solutions to solid waste management problems. The ISWM concept used in this study consists of three dimensions of sustainability that need to be integrated: the social actors, the systemic elements and the systemic aspects.
Integrated Solid Waste Management will be understood as the articulated set of regulatory, operational, financial, administrative, educational, planning, and monitoring and evaluation actions for the management of waste, from its generation to its final disposal (Integrated Waste Management Law, Law N° 8839, Costa Rica).
3.2. Phases of Integrated Solid Waste Management
Figure 2 illustrates the phases of ISWM in a simplified model, based on the extraction of natural resources for the production of goods that are then consumed, and partly become waste. The generators of the waste store it temporarily for the municipal or private collection service, after which it is transported to its final disposal site or in other cases to enterprises that recover recyclable material.
Before the formal collection and transportation, part of the recovery sector is composed of the people who work in the streets and gather some material from the sidewalks, markets and other places. These collected materials are sold in small, generally informal enterprises that in turn sell it to other, larger collection, which in turn sell it to recycling companies or prepare it for export (in which case they are in the treatment phase).
On the other hand, in the final disposal sites are found those people who work in the garbage dumps and sell to intermediaries located near the sites or who go to the dumps daily to buy material. These prepare the material for sale to the recycling or export companies. Once the recycling takes place, the raw material returns to the production of goods, where the cycle begins anew.
Figure 2. The Phases of Integrated Solid Waste Management
Production Environment Consumption of of goods goods Collection Treatment and transport
Street Collection Final collection Centers disposal
Source: Authors
15 3.3. Concept of Working Conditions and Environment
Regarding health and occupational hazards, the study is based on the Working Conditions and Environment (CyMAT), 9 theoretical framework. It is defined as the combination of social, technical and organizational factors present in a productive unit, in addition to the environmental risk factors. Combined, these factors create a global work load whose effects act differently on every person, according to each one’s makeup, adaptation capacity and the work he/she does. They affect three levels: the physical, mental and psychic.
The Working Conditions and Environment (CyMAT) framework is based on the principle that work impacts people’s entire lives, on a personal level as well as on the social and economic levels. In Tables 3 and 4 some basic determining aspects of production are mentioned, such as the factors that cause work-related disease, both from conditions outside of the work place, as well as in the work place, and nutritional, living and climate conditions.
Table 3. Work-related illnesses caused by conditions exogenous to the work place Demands Health Consequences Physical Load Static Load Varicose veins, cervicalgia, lumbago. Illnesses: osteoarticular, cardiac, circulatory, phlebitis, dorsal Dynamic Load Insomnia, irritability, digestive problems, severe headaches, kidney diseases, back problems, lumbagos. Mental Load Neurosis, gastric ulcers, myocardial arrest Organization of the Nighttime Work in Premature aging, hyper static dyspepsia, hypostatic Work Shifts dyspepsia, gastro duodenal ulcers, diarrhea, digestive ulcers, neurosis, constipation Permanent Nighttime Premature aging, neurovegetative problems, Work cardiovascular and digestive illnesses Result-based Nervous fatigue, vertigo, severe headaches, Remuneration insomnia, problems: cardiac, respiratory, digestive, vertebral, osteoarticular, arthritic. Monotonous Lot Work Nervous fatigue Repetitive Work Nervous fatigue, physical posture fatigue, psychopathological behavior, degenerative illnesses of the carpel tunnel, back problems, cervicalgia, vertebral problems. Content of the Work Fatigue Source: Vasilachis de Gialdino, 1992, cited by Marin, 1999.
9 Adapted from the Latin American Research in the Working Conditions and Environment in Solid Waste Management Enterprises Chapter. Guatemala, El Salvador, Costa Rica, Bolivia and Perú. By ACEPESA, WASTE and IPES, 1996.
16
Table 4. Work-related illnesses caused by conditions in the workplace Demands Health Consequences Temperature Heat: severe headaches, insomnia, lumbagos, problems: kidney, cardiac Cold: respiratory, pulmonary and cardiac problems Illumination Visual fatigue, physical fatigue, skin and hair alterations. Noise Auditory fatigue, vertigos, severe headaches, acoustic trauma, nausea, anemia, endocrine problems, psychic, psychiatric and neurological disorders Vibrations Nausea, vomiting (less than 1 Hz), lumbago, sciatic, cervicalgia, hernia (1 to 20 Hz), bone and articulation injuries (20 to 30 Hz), vascular disorders (20 to 300 Hz), sensory and trophic disturbances (500 to 1000 Hz). Contamination Hepatic, kidney, and respiratory problems, dermatitis, nervous system affectations, cancer, cardiac and pulmonary problems. Radiations Sterility, cataracts, bone sarcoma, leukemia, congenital malformations, anemia, cancer Psychosocial Environment Organic psychosomatic affectations, neurosis, reactive asthenia, psychopathological behavior. Source: Vasilachis de Gialdino, 1992, cited by Marin, 1999.
On the other hand, according to Laurell (cited by Marín, 1999), “work risks and demands are classified into five groups:
. Group 1. Risks that come from the space worked in: Noise, Vibrations, Temperatures (heat, cold), illumination, humidity, radiation. These risks compose what is called the working environment. . Group 2. Risks that come from the chemical and biological objects worked with and their transformation. Among these are liquids, dust, smoke, bacteria, viruses, gases, and vapors present in the work place. . Group 3. Physical activity demands of the work: include intensity of the work (heavy work, sedentary work) and uncomfortable positions. . Group 4. Demands from the way the work is organized and distributed: This group analyzes aspects that have to do with the work day (length, shifts and rotation); forms of payment (fixed, per item, in installments, incentives, etc.); rhythm, control, danger, monotony of the work and supervision. . Group 5. Risks of the work means in themselves: These include the risks posed by machinery and tools, as well as the facilities as such. “
On the other hand, work contributes to the strengthening of the workers’ physical and intellectual capacities, and thus contributes to identity building, which allows people to link to the society in which they have a place according to the tasks they carry out. With this, recognition is achieved, along with a sense of accomplishment and pride in doing the work. When people work, moreover, they receive a remuneration that should, in principle, guarantee their survival.
Thus exists the challenge of introducing changes that tend toward improving quality of life at work, although the advantages may go unnoticed at first.
17 Part 4. General Characteristics of the Studied Population per Country.
4.1. General characteristics
In Nicaragua 37 people were interviewed (38% women and 62% men). In Costa Rica 38 people participated (37% women and 63% men). In Colombia 19 people participated (53% women and 47% men) from the Bogotá Recyclers’ Association. Table 5 presents the main characteristics of the interviewed population. The Appendices 8.3, 8.4, 8.5 and 8.6, provide more detailed information on each sample selected.
Table 5. Characteristics of the Interviewed People Who Work Collecting Recyclable Material (Percentages) Characteristic Nicaragua Costa Rica Colombia Level of Schooling None 3 5 16 Primary School completed 16 26 10 Primary School not 49 32 42 completed High School completed 5 5 11 High School not completed 14 19 21 Technical Education 14 13 0 Years of Experience Less than 1 year 5 21 5 From 1 to 5 years 46 32 11 From 6 to 10 years 22 24 16 From 11 to 15 years 8 8 5 From 16 to 20 years 11 11 5 From 21 to 25 years 5 3 16 From 26 to 30 years 3 5 16 From 31 to 35 years 0 0 5 From 36 to 40 years 0 0 16 More than 50 years 0 5 5 Source: Questionnaires applied in Nicaragua, Costa Rica and Colombia
In Nicaragua the average age of the people interviewed is 32 years, in Colombia 38 years and in Costa Rica 43 years.
Regarding the level of schooling, the tendency among the population interviewed is non- completion of primary school. In Colombia, the tendency changes with respect to Costa Rica and Nicaragua, given the presence of people with technical studies, as well as in general regarding the other levels of schooling.
Regarding years of working experience, in Costa Rica and Nicaragua most of the people interviewed have less than ten years of experience, whereas in Colombia the opposite is true: respondents indicated having many more years of experience, even regarding traditions or trades passed on from generation to generation.
18 4.2. Work Experience
Seventy six percent of the people interviewed in Nicaragua had had other jobs prior to the recovery of recyclable material; in Costa Rica this was 87% and in Colombia 63%.
In Costa Rica 43% of the respondents who work in these micro enterprises currently have another, parallel job. In the case of Zagala garbage dump respondents, only 17% mentioned currently having other parallel jobs, but these are occasional and have to do with the coffee or sugar cane harvests, or other farm jobs. In the case of the participants interviewed who work on the streets, 75% mention having other jobs.
One hundred percent of the respondents interviewed in Colombia indicate not having any other jobs aside from recovering recyclable material. In the case of Nicaragua it was not possible to consult respondents about parallel activities, due to changes made in the questionnaire after the conclusion of the field work in this country. Table 6 presents the different activities that the people interviewed carry out. There are many similarities between the jobs, particularly the fact that they are informal.
Table 6. Previous Activities Done by Persons Interviewed in Colombia, Costa Rica y Nicaragua Street Workers Garbage Dump Workers Microenterprise Workers Seller of cold water and fruit at Housekeeper (4 of the women Welder and Warehouse traffic lights interviewed mentioned this job) man/woman Shoe shiner Animal Grazing Seller of spare parts Mid-level accounting technician Carrying bags at the market Many jobs: at the mayoralty, free zone, shopping center Housekeeper Motorcycle taxi driver Military Electrical technician Market sales man/woman Administrator Automobile mechanic House wife Farm work Construction Carpet maker Other companies similar to this one Work in a café Watchman/woman Construction assistant Coffee picker Free Trade Zone Police Military Construction work Secretary and receptionist Watchman/woman Sugar mill Housekeeper Builder Farmer (San Rafael del Sur) Printing press Cashier Military Mechanic garage Sales Shrimping boat Selling ice cream Driver Sugar cane harvest and dairy Work in cafés farm worker Maintenance and cleaning Shoe store Punch factory Seafood Shop Selling tortillas (maize patties) Sales agent Taxi washer Fondas (food sales) Unloading potatoes at the market Electricity Topography Shoe store Driver Warehouse man/woman Construction Fruit sales person Shoe store Messaging service Baking cookies ARB community cafeteria Manager of a cooperative Whatever came up Source: Questionnaires applied in Nicaragua, Costa Rica and Colombia
19 Part 5. Health and occupational hazard aspects
5.1. Perception of the state of health
In Nicaragua 27% of people interviewed considers themselves to be in very good health, 46% good and another 27% in poor health. In Costa Rica 71% considers its own health good, 18% poor and 11% very good. In Colombia 95% considers personal health good and 5% very good health.
A comparison of the percentages of each group regarding perceptions of their own state of health is shown in Table 7. In all three countries, “good” was the most common response, and was especially significant in Colombia and Costa Rica. “Very good” was the second option in Colombia, third in Costa Rica, and in Nicaragua “Poor” and “Very Good” are tied. The general perception of personal health is good and very good.
Table 7. Comparison of the interviewed persons’ perception of own health (percentages) Perception Nicaragua Costa Rica Colombia Very Good 27 11 5 Good 47 71 95 Poor 27 18 0 Source: Questionnaires applied in Nicaragua, Costa Rica and Colombia.
5.2. The case of those working at solid waste disposal sites
a. Working Process Figure 3 describes the working process for the final disposal sites visited in Nicaragua and Costa Rica, starting with the arrival to the site. People carry their instruments or means of work, such as the hook, the cart, bags or sacks. It is stressed that the hook allows digging without running the risk of injury and also avoids having to bend down. Then they make their way to the area where the vehicles unload the gathered solid waste. It is at this point where the majority of accidents involving vehicles mentioned by the respondents take place.
Figure 3. Working process at the final disposal site
Material Place Arrival at the Vehicle assortment material in Start work site unloading (hook) bag
Selling End Transfer for storage intermediaries
Source: Authors
People collect the material in different bags. Risks are also present and accidents also occur at this time, as identified by the respondents. The bags are then moved to specific spots within
20 the landfill in order to be sold to intermediaries who go directly to the site. The selling frequency varies according to each material and location; for example, at Zagala the sale is conducted once a week, in Managua and Masaya the frequency varies.
b. Illnesses or diseases Sixty six percent of respondents at final disposal sites mentioned they had some sort of disease. In comparison to Costa Rica, Nicaragua was found to have more respondents declaring to suffer from more illnesses or diseases. It is important to remember that individuals at final disposal sites in Colombia were not interviewed. Table 8 shows the conditions mentioned by the respondents.
Table 8. Report of respondents’ ailments according to location Most frequent ailments Less frequent ailments Knee pain or wear Dizziness Headache Cough Cold or flu Heart problems Kidney problems* Low cholesterol Asthma Anemia High and low blood pressure* Urinary tract infections Fever Skin disease Diabetes or high blood sugar level* Herniated testicle Spine or back pain Arthritis Source: Survey conducted in Costa Rica and Nicaragua
Kidney problems, blood pressure and diabetes are general population diseases and are unrelated to occupational type. Dizziness, asthma, a cough, skin diseases, arthritis, urinary tract infections and kidney disease may be related to the type of occupation, linked to working conditions, where there is smoke from burning waste, no sanitary facilities, and unavailability of direct access to drinking water, while workers are exposed to direct solar radiation and high temperatures.
It was not possible to establish the relationship between the amount of time working on the activity and the disorder, because many did not know or remember for how long they had had their condition.
c. Disease causes The mentioned reasons for their diseases include "the rain and sun; from standing all day in the garbage; crushing plastic; age; work; lack of vitamins; pregnancy; filthy clothing; overexertion; bathing while still being worked up; smoke from burning tires; smoking; bad blood circulation; uric acid". Working under the rain and sun as the most often mentioned cause in both countries, linking their illnesses directly to working conditions. Some respondents claimed to have ailments but did not indicate the cause.
Moreover, they were asked about other conditions, specifically about the presence of fungi, parasites and skin infections. In the case of Nicaragua, people claimed to suffer more from these ailments than those working in Costa Rica. It was found that skin infections are the most common. These conditions are certainly more related to working conditions.
21 d. Coworkers’ conditions When asked about their coworkers’ ailments, they mentioned: fungus, allergies, asthma, flu, sore knee and spine, bone pain, itching, lung problem (tuberculosis), cough, anemia and diabetes.
Interestingly, some of the types of illnesses most commonly expected due to their working conditions, such as fungus and allergies, are only mentioned as a third party condition. It is questionable whether this is associated to some kind of social bias to evidence of poor hygiene or adverse working conditions, leading to shame of recognizing they are suffering from such diseases.
e. Access to health facilities Thirty eight percent of respondents is taking medication. Notably, of the 21 people who reported suffering from diseases, only 12 take medication. One can draw attention to the fact that at the Masaya dump is where most people take medicines. When inquiring about what type of medication they take, the answers were: cough syrup; pills for blood pressure, sugar and cholesterol; for the kidney problem, and vitamins / iron.
In all cases of Zagala in Costa Rica and La Chureca in Nicaragua, the medicine was prescribed by a health specialist, as well as for 50% of cases at the dump of Masaya; the other 50% was self prescribed. These individuals also pointed out that only when they have money they can buy the medicine, even if they should be taking it on a permanent or constant basis.
Regarding other medicine taken when they have some kind of pain, the following were mentioned: headache pills, fever pills, Pitaya leaf (natural remedy), Amargo leaf (natural medicine) and Alka Seltzer (used for stomachaches, headache, heartburn and indigestion).
On access to medical care in a health center, clinic, health facility or establishment, all La Chureca respondents indicated that they have a clinic on site. In the case of the Masaya dump, 7 people responded positively, and 8 people in Costa Rica, taking into consideration that all others are mostly immigrants having no corresponding social benefits. In the case of Costa Rica, the Basic Health Care Units (EBAIS) attend pregnant women and minors free of charge. The service is billed but paid by the state; however, other adults must pay the bill. In the case of the illegal population, these possibly do not visit health centers for fear of exposing their illegal status.
f. Addictions Overall, 44% of people indicated they smoked or consumed alcohol, the amount also varies. Some claimed to have stopped drinking a while ago. The failure to recognize the existence of an addiction could be also explained in the same manner as the recognition of the diseases or conditions of their coworkers; from shame they do not recognize they have an addiction problem.
g. Vaccination and health talks In general terms, 88% of the surveyed population has been vaccinated; 80% at the Masaya and La Chureca dumps, and 100% at Zagala.
The vaccines mentioned were: tetanus, measles, rubella, AIDS.10 Some could not recall the disease. Others indicated that they get vaccinated whenever the country holds national vaccination campaigns.
10 One respondent mentioned this alternative, which indicates some degree of misinformation as such a vaccine is unavailable.
22 In general terms, 38% report to have received some kind of disease prevention health talk; 20% for Zagala, 70% for La Chureca, and 30% in Masaya mention to have received talks.
One side indicated not recalling the topic, and the other mentioned topics like allergies, AIDS (Acquired Immune Deficiency Syndrome) prevention, prevention of diarrhea, sexuality and sexually transmitted diseases, tuberculosis prevention, prevention of mosquitoes (dengue fever), and on a balanced nutrition. Workers in La Chureca have been given more guidance on health protection, which is clearly linked to the current degree of trade organization.
h. Personal hygiene
Overall, 25% bathe before going to work, 34% shower after work, and 41% bathe before and after work. Eight four percent wash their clothes daily and 16% said not to have such a habit. One person mentioned the habit of using the same outfit for a week and getting another outfit after throwing it out at the end of the week.
Some of the reasons for bathing in the morning are: “arriving ‘fresh’ to work and because it gets hot afterwards; because you can also get sick if you bathe after work; because you feel hot“. Amongst the reasons for bathing at night are: “not to be dirty and sleep ‘refreshed’.”
It is observed that despite geographical distance, there seem to be many similarities between the answers. Their responses may be due to trying to respond positively to what is socially desirable, and whether these are real habits remains to be verified. There is no certainty that the mentioned habits are real, because some houses do not even have water.
The habits of bathing daily and especially after work, changing and washing their clothing daily help prevent disease and avoid transmitting the contamination to the rest of the family. These are desirable habits. However, given the majority of respondents’ living conditions, it may be assumed that there is a dissonance between what they do and what they can actually do, and even if there is knowledge on basic hygiene, there is not always access and conditions to bathe and wash clothing. This is not always easy to express, since it hurts the self-esteem, when self- viewed as an inhabitant of another category.
The need for sanitary installations near the final disposal site is evident, in order for people to have access to water.
i. Risks and accidents
Table 9 shows the risks, procedures and preventive measures identified by the respondents.
23 Table 9. Summary of occupational risks, procedures in case of accidents and preventive measures according to final disposal site Site Risks Procedure in case of Preventive measures accident La − Needle and glass − Go to health center − Good shoes to avoid Chureca cuts or injuries if not very serious cuts − Skin infections − Go to hospital if very − Staying away from − Blows with the hook serious vehicles − Death − You cannot do much − Burns other than watch − Being run over or hit − Self heal if not too by a truck severe, one heads home − Call an ambulance Zagala − Contaminated − Seek help to aid − Wear gloves needles them in taking the − Be alert, be careful − Being hit by a truck person to the − Keeping a distance − Using the hook hospital (pointing from the vehicles − Iron or glass injury out that the site − Do not walk around in − Getting run over by manager is available drunk condition a truck for help) − Use the hook − Going home to rest − Put water, salt and Zepol11 Masaya − Falling from a truck − Person is taken to − Lack of personal safety − Rain (no coats or hospital equipment shoes) − The same car that − The Mayor was asked − Needle pricking hits the person for a kit, without any − Stepping on nails takes the person results − Getting fungus − Collect money from − Wash hands thoroughly − Getting run over by everyone, in order − Being careful a truck to help the person − Can cuts with problems. − Hurt someone with − The directive raises the knives used to money to buy cut fabric medicine − Microbes and viruses − Contamination with hospital waste Source: Survey conducted in Costa Rica and Nicaragua
The most common hazards and accidents are related to injuries from some sort of material, getting hit or run over by a truck, and skin infections. Among the actions carried out in the case of an accident, the most common which were cited include: going to the clinic or hospital if it is severe, going home to rest and heal on their own. Among the most general preventive measures proposed are the use of personal protective equipment and first aid kit and watching out for the vehicles.
At La Chureca, 60% said to have suffered an accident. Several of those interviewed, indicated that in April 2010, a vehicle ran over and killed a coworker. At Zagala 58% said to have suffered an accident. Some people spoke of a recent event of a truck running over a woman who had
11 “Zepol” is a brand of a menthol-based soothing ointment used for flu, colds and bronchitis, and its use is very popular because of its low price.
24 also been hit by a stone in the arm. At Masaya, 70% of people said to have suffered an accident.
It is noteworthy that many of the respondents mentioned that they see no risk in their occupation, since this is like any other job, and if there is an accident it is because of a human mistake and not the conditions and working environment.
There are many more risks associated with the job than those mentioned by the respondents. It seems that when work is performed under such extreme conditions, they only recognize the more common and evident types of hazards and accidents
Photograph 6. Masaya dump, Nicaragua©Susy Lobo -ACEPESA
5.3. The case of those working in the streets recovering recyclable material
a. Working Process Figure 4 shows that in the three countries work on the streets begins with a route, in some cases with fixed locations, in order to collect the material, usually in bags, cans, boxes or other containers. To carry the material people use large bags on their backs, in some cases hand carts or, as in Nicaragua using horse carts at times.
If not using animal traction, the person must carry the material to the marketplace for its retailing; in some cases there is separation in these places, in others only direct sales. Accidents and occupational risks were also mentioned during this process.
Figure 4. Working process in the streets
Street Hauling of Transfer to Separation and Start End trajectory material market place marketing
Source: Authors
In the specific case of Colombia, an alternative to the process is shown in Figure 5.
25 Figure 5. Working process in the streets of Colombia
Street On site Start End trajectory separation
Source: Authors
Some of the recyclers in Bogota, when organized, tour the streets with an already established trajectory, using human traction, the “sphere cart” or the horse-driven “fox cart”. They then take the materials to a specific spot, usually a park, in order to separate the different types of material; there they wait for the vehicles of the intermediaries’ or cooperatives’ that buy their materials to arrive. This activity usually takes place at night; besides facing the already mentioned health risks, there is also the possibility of theft and trouble with the police.
b. Illnesses or diseases Fifty eight percent of those interviewed in the streets claimed to have some sort of ailment. There was a greater response in Costa Rica compared to the other two countries. This differs from the situation described by the workers of the final disposal sites, where the highest percentage was found in Nicaragua.
The most commonly discussed diseases are: asthma, high and low blood pressure, hepatitis, cough, and foot / leg swelling. The less common diseases include: influenza, pneumonia, near- sightedness, spinal hernia, gastritis, cirrhosis, sugar, dizziness, headaches, fevers, heart, high cholesterol, knee wear and kidney infection.
c. Disease causes The mentioned causes to disease include: "alcoholism, intake of gasoline, to go around in garbage, not drinking much water or eating much, inhaling dust coming out of the garbage and fatigue".
Moreover, they were asked about other diseases such as fungi, skin infections and parasites. In Colombia, they claimed to not have such problems; in Costa Rica and Nicaragua 33% and 50%, respectively, reported having them.
d. Coworkers’ conditions When asked about their coworkers’ ailments, they mentioned: "cirrhosis and alcoholism, skin infections, cough, lung infection, fever, headache, gallbladder problems, high blood pressure, spine issues, head lice, disease from eating garbage, intestinal infections, fatigue, sore feet (burnt) and AIDS".
It seems that just like those working at the dumps, these may attribute to others what they may be suffering.
e. Access to health facilities Thirty five percent of respondents are taking medication. In the case of Costa Rica 100% of respondents who reported taking medication said they were prescribed by a health specialist; in Nicaragua 75% this corresponds to 75%, while the other 25% are self prescribed. In the case of Colombia 2 people are self-medicated.
When inquiring about what type of medication they are taking, the responses were: “headache, calcium, injected insulin, asthma and blood pressure, fever and liver".
26 About other medicine taken when they have some kind of pain, were mentioned: "headache, aspirin for the heart, antibiotics, sleeping pills, flu and diarrhea."
On access to medical care in a health center, clinic, health facility or establishment: 90% of people surveyed in Nicaragua have access to a clinic, in the case of Costa Rica, 58%, and 75% in Colombia.
f. Addictions In the case of Colombia, one person (6%) admits to drinking alcohol. In the case of Nicaragua, 7 people (70%) indicated they smoke; regarding the intake of liquor, 8 people (80%) admitted to drinking alcohol. In Costa Rica, 9 people (75%) indicated they smoke; in the case of alcohol intake this corresponded to 6 people (50%). Many people pointed out that they can buy cigarettes or liquor depending on the amount of money they count on.
Some individuals mentioned that some time ago they quit drinking. In Costa Rica and Nicaragua, a higher percentage of people who reported smoking or drinking alcohol was found, compared to Colombia.
g. Vaccination and health talks In general terms, 92% of the surveyed population has been vaccinated. In Costa Rica 92%, 90% in Nicaragua, and 100% in Colombia have been vaccinated. The mentioned vaccines include: tetanus, whooping cough, influenza, polio, swine flu, measles, rabies, dengue fever and rubella.
On health talks for disease prevention, 38% of respondents in all three countries confirmed to have received some kind of talk. This is the same as for those working in the dumps, analyzed in the previous section. In Costa Rica, 50% mentioned that they have received talks, 100% in Colombia and 40% in Nicaragua. The topics mentioned are: AIDS, swine flu, venereal diseases, dengue fever and cholera.
h. Personal hygiene
Overall, 42% of respondents in the three countries bathe before going to work, 27% does so after work, and 31% take a bath before and after work. 42% washes their clothes after work. Some indicated they throw out their clothes and does not wash it at all.
They bathe before going to work mainly “to go ‘cool’ to work, I do not like water at the end of the day; water is too cold at night". One reason for bathing after work is to "rest easily".
i. Risks and accidents In Colombia, 50% said they had had an accident, 67% in Costa Rica, and 60% in Nicaragua. In general terms, 62% have suffered an accident. This percentage is very similar to those reported by people working at final disposal sites.
27
Photograph 7. Working tools, La Chureca, Managua, Nicaragua©Susy Lobo – ACEPESA
Table 10 shows the occupational hazards and preventive measures listed by the respondents.
Table 10. Summary of occupational risks, procedures in case of accidents and preventive measures Country Occupational Risks Preventive Measures − Existence of hazardous waste − Being careful − Glass cuts − Do not scavenge − Acquiring infections through pharmaceutical Colombia − Falling off of a horse waste − Injury from syringes − Go to the doctor or − Getting run over hospital − Tetanus injection − Blows − Do not walk alone − Being robbed − Taking air in − Snakebite − Wear disinfectant (self- − Death / Electrocution prescription) − Cutting / I got a an umbrella stick in my arm − Find a hospital Costa Rica − Copper burns − Caution − Disease from microbes in the garbage − Use gloves and be − Eating spoiled food careful − Lifting heavy bags − Traffic accident − Being hit − Try to dodge − Abuse from others − Walking streets with less − Acquiring a disease (syringes) traffic − Cut − Do not touch needles − Poisoning − Not being in only one Nicaragua − Twisted a foot / hand fracture spot − Getting mugged − Get in God's hands − Lung disease from the contact to waste − Use Lysol (liquid − Scabies disinfectant) that I got − Sticking a nail in your foot − In case of an accident − Getting run over you call an ambulance Source: Survey conducted in Colombia, Costa Rica and Nicaragua
The most common types of hazards and accidents are related to injuries and cuts with some material, accidents with trucks, skin infection (this is similar to those mentioned in final disposal sites), as well as getting robbed. They mention that accidents that have already taken place are getting run over by a vehicle and cuts.
28 Among the general proposed preventive measures mentioned are: be careful of the vehicles and do not visit dangerous place where they can be assaulted, visiting the doctor, go to the hospital or getting a shot, use of personal protective equipment and disinfectant use.
5.4. The case of those working in micro and small enterprises for the recovery of recyclable material
a. Working Process In general, the recovery centers in Costa Rica, Colombia and Nicaragua, show similarities in their work process. It starts when the material reaches the center; it is then weighed there; then it is located on specific places in the center according to material type; it is then segregated according to the specifications or requirements of the recycling companies or larger intermediaries. Once this work is done, the material is stored. It can happen that it is directly sold on site, or rather moved to the recycling companies, where the process ends, as shown in Figure 6.
Figure 6. Working process at the centers for recovery of recyclable material
Classification Arrival of Location in Start material at the Weighing designated and Storage
center spot SeparationCl
Transfer to Selling recycling End companies
Source: Authors
Appendix 8.7 presents a summary of the number of people interviewed, and the number of people who work in rehabilitation centers for recyclable material.
b. Illnesses or diseases Fifty three percent of the respondents in micro and small businesses mentioned to have some sort of condition. Costa Rica was found to have the most respondents to say they had diseases. This was a similar situation for the case of street people, not so for those working in final disposal sites.
The types of illnesses and their causes are detailed in Table 11.
29 Table 11. Ailments and causes according to respondents per country Nicaragua Costa Rica Colombia Ailment Cause Ailment Cause Ailment Cause Hepatitis High blood Unknown Head A cyst pressure hematoma Kidney infection Low blood Vitamin 5 deficiency from birth Sight problems At birth pressure control pills Back pain A rock fell Flu Unknown for one person, and Hernia and Carrying heavy on top of for the other “not taking care sciatica loads him and taking a shower without problems cooling down beforehand”. Finger From work Problems with Calcium swelling molars deficiency Allergies After age 45 High blood- From a sugar level cesarean section Asthmatic – One case was from being Ulcer Eating while since abandoned in a hallway at mad childhood birth, and another person mentioned it as hereditary. Depression The father left them and is now Gastritis Vile rebound responsible for the family Thrombosis Unknown Shoulder Unknown wear Back pain Unknown Source: Survey conducted in Colombia, Costa Rica and Nicaragua
c. Coworkers’ conditions Table 12 shows the answers to the inquiry on their coworkers’ ailments. Many similarities exist irrespective of the country, the most frequent being muscle aches and the flu. It is noteworthy that in Colombia stress is mentioned, but not in other countries.
Table 12. Report of respondents’ ailments according to country Colombia Nicaragua Costa Rica Back and leg pain (specially for Allergy to treating paper Allergy to dust women) Fatigue Colds, flu, fever Cough and flu Stress Back and leg pain Older people have fainted Stomach ache Flu Headache Bone pain from overexertion Asthma Numbness in hand, from taking a shower without cooling down Source: Survey conducted in Colombia, Costa Rica and Nicaragua
d. Access to health facilities Thirty six percent of respondents take medications. Costa Rica is where most people take medicines. Table 13 shows the responses about the type of medication taken.
30 Table 13. Medicine taken according to disease and country Colombia Costa Rica Nicaragua For tooth aches Blood pressure, triglycerides, Neurobión (for the vitamin 5 brain) For headaches For stomach ache Sweets (for hepatitis) For gastritis For allergies For depression Source: Survey conducted in Colombia, Costa Rica and Nicaragua
On access to a clinic or health post facility, 93% of the respondents in Costa Rica have access to health centers, 56% in Colombia and 100% in Nicaragua. By comparing this result with the other sectors by country, Nicaragua presents a greater percentage of people who have access to a health center (La Chureca dump 100%, scavenging on the street 90%, and Masaya 70%). 75% of street recyclers in Colombia say they have access, 58% in Costa Rica and 67% in the Zagala dump (this information is particularly noteworthy given the system of universal health care that exists in Costa Rica).
e. Addictions Fifty percent of people in the Zagala dump mentioned that they smoke and drink alcohol; in the case of Nicaragua, at La Chureca as well as in Masaya, 40% of people indicate their addiction. 86% of the individuals indicate that they smoke or drink alcohol. In total for Costa Rica and Nicaragua 71% do, and for Colombia it is 100%.
f. Vaccination and health talks In Colombia, 80% of people have been vaccinated, in Nicaragua and Costa Rica 100%. Most people said they've been immunized against tetanus; some also reported having been vaccinated for measles and yellow fever, smallpox and influenza.
Overall, 92% of the surveyed population has been vaccinated. Just like the percentage found in the street workers, and in the case of final disposal sites, it is 88%. On health talks, in general terms, 33% of those interviewed indicated to have received some kind of disease prevention talk. In Colombia, 47% mentioned that they have received talks. In Costa Rica, 100% indicates that there have been talks. In Nicaragua, 71% say they have received talks. The mentioned topics include "hygiene, first aid, measures against dengue fever, influenza, uterine cancer, use of personal protective equipment, AIDS and hazardous waste".
g. Personal hygiene In all three countries, 39% bathe before going to work, 30% bathes after work, and 31% bathes before and after work. 47% indicates washing their clothes after work.
People argue that they bathe before work, because "if you do so after work you feel taut, out of habit, to feel cool, it's bad to take a shower after work". The reasons for bathing before and after work are, "because I like to be clean" or "because I feel hot". The bathroom at the end of the day was argued on "going to bed feeling clean".
Regarding clothes washing, the percentage found in this sector and the street scavengers is very similar. In the case of final disposal sites it isn’t similar because respondents indicated that 84% wash their clothing after work. In the case of bathing the percentages found in the other two populations are very similar.
31 h. Personal safety equipment On the use of personal protection, only those working in micro and small enterprises were consulted. In Colombia, 100% of the people mentioned use personal safety equipment. It was observed during the visits that not all people use it, although it was confirmed that they did have the equipment. One person indicated that the boots are heavy and her legs hurt when she wears them. The belt is used primarily by men.
Photograph 8. Escazú Recycling Project, Escazú, Costa Rica©Susy Lobo -ACEPESA
In Nicaragua 43% of respondents said they use personal protective equipment. Of the 5 microenterprises, only 3 mentioned personal protective equipment. The difference with the equipment mentioned in Colombia is remarkable. This can be explained by the degree of formality of these companies and the fact that the sector is organized. In Costa Rica 75% of respondents indicated the use of personal protective equipment.
In general terms, the equipment comprises: gloves, dust respirator or mask, welding mask, apron, boots, raincoat or coat, uniform, glasses, shoes, caps (glass), hat and belt or girdle. 67% of the people in Colombia mentioned the use of machinery or equipment, 42% in Nicaragua and 43% in Costa Rica.
The equipment mentioned is "machete, shovel, broom, knife, packer (one case mentioned that to have received training and the other person already knew how to use it), tricycle and scalpel, hitting tools, strong tube, acetylene, weights, hammers, mallet, several types of wrench, guillotine, emery knife". Some people reported that they already knew how to use the tools, while claimed to have received training.
a. Risks and accidents The most common types of hazards and accidents are related to injuries and cuts with some material, blows, presence of hazardous waste, heavy objects falling on them, lifting heavy loads, allergies and falls. Some people commented that there is no danger whatsoever. Among generally proposed preventive measures are: “visit the doctor or go to the hospital, use of personal protective equipment, be careful to keep order and cleanliness in the premises, place hazardous waste in another container”. In Costa Rica, 64% said they had had an accident, 57% of respondents in Nicaragua, and 47% of respondents in Colombia.
Among the accidents include: "cutting a finger with the machine, crushing fingers, small cuts, I reached into the packer, I crushed my hand with the glass breaker, I fell (slipped or from a car), I stuck a pointy piece in my foot". Table 14 shows the occupational hazards and preventive measures identified by respondents.
32 Table 14. Summary of occupational risks, procedures in case of accidents and preventive measures according to country Country Occupational Risks Procedures in Preventive measures case of accident Costa Rica − Cut with a bottle − Call 911 − Wearing glasses − Accidents involving machinery − Go to the − Personal protection − Medical waste is very dangerous National measures − Things can fall over Insurance − Be careful not to talk − Crimp hands Institute (concentrate) − Blows (INS) − Tell them to be more − Heavy lifting (causes lower back pain) − Turn to first careful − Noise aid − Be careful not to get − Allergies (dust) − Go to the ones hands on glass − Fungi (working with the garbage) clinic − Maintaining maximum − Fall cleanliness in the aisles Nicaragua − Cuts − You must − Use the belt to load − Hitting your fingers with the mallet take people − Take the risk − Blows to the health − Injuries center − Robbery − Something falling on top of me when unloading − The scrap is dirty − Straining − The mosquitoes in the junk Colombia − Getting sick from pollution − Learning to manipulate − Injuries materials − Cuts − First Aid − Diseases from odors − If it is severe you must − Pricking with needle go to the hospital or a − Fall doctor − There are toxic residues, hazardous, − Not handling garbage sharp objects − Using safety equipment − Heavy objects fall, dislocating the − There is a health spine brigade − There are biological hazards − You have to give talks − Blows − You can’t take − Slipping everything home − You can find residues that are − Use creams unknown − Dangerous objects go to − Hernias a red garbage bag − Allergies − There are acids Source: Survey conducted in Colombia, Costa Rica and Nicaragua
Overall, 56% of respondents have had an accident. This is a lower percentage than that found in landfills (63%) and for the street scavengers (62%), which can be explained by the degree of formality of the activity in relation to the above. In these places the conditions are different, you may have less risk and more security measures, among others.
33 Part 6. Results of Group Interviews and Best Practice
6.1. The Colombian Case
Representatives of other Bogotá recycler associations were gathered at the ARB offices, analyzing their position on critical issues for the movement. They agreed to share their views on the guild’s health issues, mentioning as major health problems that “the children are chronically malnourished, there is no nutritional balance and this is a concern for parents; young people aged 15 to 20 working with man-hauled carts have problems in their spine and discs due to overexertion, since survival depends on volume. The use of the “sphere cart” (these are wood planks with rollers to form a cart which is pulled by a rope), as well as the tricycle, is inappropriate and causes many accidents, and when there are slopes, there is also physical overexertion. Many of these young people work at night and this causes the hypothalamus to wear. Many have to walk 10 to 15 km per day, and police officers take away the material which is then lost. When using horse carts, the horses live inside their homes, and most times the children’s’ beds are next to the animals resulting in parasites and vectors. A struggle of the movement is the improvement of housing, since most people live in precarious conditions; a culture of personal protective equipment usage must be created, as many people say the gloves are uncomfortable and many children ride the carts along with the pets."
The following risks were pointed out: “the lack of traffic signals on the ‘sphere carts’ cause accidents, especially at night; the bags may have hazardous waste material; you don’t know what is coming; the ‘cent war’ (la guerra del centavo) increases theft of what has taken so long to retrieve; bad posture, overexertion, the work hours, cold weather; they eat next to waste material and never at mealtimes; you must go for long walks and this causes fatigue; and we have found bone problems of 15 to 20 year olds.”
When asked about the outcome of the investigation, which points out that the majority of respondents indicated they have a good or very good health, they answered: "because they never do checkups. If they did, they would find that they have calcium deficiency as well as kidney, liver, and respiratory system problems. From an early age they develop their immune system, so in cases where a rich kid would get sick, a recycler’s child wouldn’t, as the latter are raised in this environment."
When there is physical exhaustion due to overwork or performance of shameful work, premature aging occurs. Although not mentioned by the respondents, this is a constant observed during the investigation.
Another struggle is getting out of social exclusion, in order to obtain recognition of their work. Society has a social debt with the recyclers, since they have worked for the environment; even when curbside recycling was declared a crime with the passing of a law, they fought and managed to win the battle.
Another interview was carried out with the board of directors of the Associative Company of Family Recyclers “Muzkbys”12, which belongs to the ARB. The meeting was held at the secretary’s home.
12 The company, formed by 40 families, began operation in 1996 but did not achieve its legal status until the year 2000. The interview was conducted with 5 members of that board. Bosa is town number seven in the Capital District of Bogota, capital of Colombia. It is located southwest of the city. According to the information provided by the
34 All members of this company use tricycles or horse carts (called "horse fox" in Colombia). Uriel says that some people have a “fixed source”; i.e. they go to certain neighborhoods where they collect the garbage arranged in front of homes (with everything mixed in the bags) and they place it in their "horse fox". They then take it to a parking lot and separate the recyclable material, put it on their horse carts, take it home and sell it once a week. Children choose toys from the bulks formed at their homes. He leaves for work every morning at 4:30 a.m.
Others have tricycles (3 wheelers), as is Armando’s case. After gathering the material, he sells it directly to an intermediary because he gives better pricing. Armando comments that on Tuesdays he goes to work to an area where “people have more money”. Sometimes he leaves for work at night from 5 to 10 pm and then sells the next day. He also states that the city council appointed specific localities for them, providing them with a jumpsuit as uniform, which they use in special places; when they go to other districts they use everyday clothing.
Juliana says she works in the morning, picks up anything she finds, and with the help of her “horse fox” picks up rubble. Patricia comments she wakes up early morning, and with her horse covers areas similar to the one she lives in, and includes some hospitals in the route. They usually go out to collect items three times a week.
They recognize the organization has been important, due to the fact that they now have representation, and people understand that they recycle, that it is an opportunity, and have gained recognition. They comment that a while ago they had an ambitious project, which consisted of putting a collection center in the city center of Bosa, but the lack of experience and the intermediaries and non-governmental organizations (NGOs) took the money, so they did not succeed. They do want to try it again, because it is a way to improve working conditions and living standards.
Amongst the mentioned problems they said "there is a lot of competition and not all people have wanted to form part of the organization because they are not interested or because it has done nothing for them."
When asked about their health, they reveal that their ailments are due to "stress when the personal economy gets bad; the moving – they must bend down, stand up, drop; muscles give them trouble, since they must turn the ‘horse fox’; there is waist pain from being on the cart all day. If it’s on the tricycle, there is also a lot of movement; when it rains they freeze cold and the clothing dries off right on them since their own body warms it; it’s a lot of exercise.”
Drawings of the human body were used to illustrate the situations shown in Table 15. Regardless of sex and age, the complaints of pain are very similar.
respondents interviewed, the name means “a new world for a better life” in German. Despite the inspirational value of the name, it is important to clarify that the German origin of the word appears to be mistaken, as no reference to a similar word was found in the German language.
35 Table 15. Effects of the work on the human body (Pain) Women Men Ages 30 and 41 Age 54 Age 27 Age 43 Hand pain Stomach pain (from Aching arms, forearms, and Aching arms, forearms, and bending down) wrists wrists Shoulder pain Shoulder pain Shoulder pain Shoulder pain Knee pain Knee pain Leg and muscle pain Leg and muscle pain Back pain Hand pain Back pain Back pain Throat pain Head ache Ankle pain Ankle pain Headache Foot pain Foot pain Buttock pain Headache (from sitting) Foot pain Source: Group interview. Bosa, Colombia.
With regard to the risks they mentioned that "when you are on the ‘horse fox’ a car can hit you, the horse can rampage, the wheels can burst and descachar and the cart breaks down; we get sick from getting wet and the from dus; when we open up a bag the smell goes straight to the lungs; the bags contain syringes, cans, glass, razors, pins."
Photograph 9. Project Escazú Recycles, Escazú, Costa Rica©Susy Lobo -ACEPESA
They mention that the ARB has given courses. On one occasion they filmed a video which showed a working day, and they pointed out all the problems caused by not wearing safety equipment. Some people work with gloves and masks. But they add that opening a bag with gloves on can take them half an hour.
When consulted on measures taken or what could be done about this situation, they said “separation programs should be promoted at the source, because in this way the already separated material can avoid many accidents at work; they should get organized in order to find the appropriate protective equipment for their conditions; and work on raising awareness on its use.”
Finally, two people drew the work process; photographs of the drawings are shown in Appendix 8.8.
36 6.2. The Nicaraguan Case
13 a. Recyclers Association of the Masaya Garbage Dump The interview took place behind the dump administrator’s booth. Those interviewed specialize in certain materials; for example, those working with "pichingas" (plastic containers) are called “pichingueras”, those working with “telas” (fabrics), are called “teleras”.
Some people start work from 6:30 to 7:00 a.m. and then change clothes, some start work at noon, while others start at 4:00 p.m. About the working tools, the “teleras”, for example, only need a bag which they get from the same bags which the fabric is found in. For other activities, they use a hook and a sack. Aura said that she made her own hook, and has already made two other hooks. This instrument helps her take out “pichingas”, aluminum, copper and paper.
Photograph 10. Masaya Garbage Dump Board of Directors, Nicaragua©Susy Lobo -ACEPESA
Lucia mentions that the most common diseases are "fungus, fever and pimples". Reina also mentions that "they get cut and itchy". Other problems are "blows to the head, falling in attempt to climb the truck, something which falls from the truck and onto them, fabric lint irritates the eyes, dust in the summer disturbs the throat and nose, itchiness, and when it rains smoke increases".
Two years ago a doctor would arrive and vaccinate them, give them treatment for fever, for a cold, and had a kit, but not anymore.
The “teleras”, which are like 18, in addition to retrieving and selling the fabric they find on site, also make hammocks, bags, and shorts, thereby getting some additional income. The mentioned risks include "falling and that a bulk falls on top of me; the truck people aren’t careful when they throw the packages; last week it happened to a lady and almost got killed".
They mentioned that working at the dump improved their income. For example, José used to work carrying loads at the market and that was not enough for a living. Now they find many things that people throw out, such as toasters, fans and televisions. He now earns more to send his children to school.
Nonetheless, they reveal to have problems with the municipal workers, who take material, making less what gets to the dump. In the past (former administration) city hall gave them gloves, boots, masks, raincoat; they promised them a booth, a shed and a dressing room, as well as talks, but it hasn’t been fulfilled.
A psychological test was conducted in reconnaissance of ailments in the drawing of a human figure. Table 16 presents the results.
13 The Association was established approximately 8 years ago and has 66 members.
37 Table 16. Results for the human figure test Women Men Ages 25 and 29 Ages 35 and 42 Ages 44 Headache (from the load) Headache (from the sun) Headache Back pain Neck pain Back and tailbone pain Aching arms Aching arms Leg pain Leg pain (at night) Back and tailbone pain Knee pain Foot pain (from running) Leg pain (from walking) Foot pain Hand pain Foot pain (from crushing) Hand pain Shoulder pain Aching forearms Neck pain Foot pain Knee pain Shoulder pain Stomachache (from hunger) Hand pain Breast pain (from breast feeding) Aching forearms Stomach pain (from menstruation and bending down) Brain pain (from the throttle you just want to go home) Source: Group interview. Masaya, Nicaragua.
Some of the comments made when commenting on the human figure were "the head hurts because the burden of the entire bundle on your head, then the neck and back hurt from the weight load and the sun, legs hurt from so much walking and walking and at end of the day your feet hurt. The feet hurt from crushing plastic bottles, the neck hurts from the thinking, knees hurt at night, the stomach from hunger since sometimes the job does not feed, menstruation bothers more because you have to exert yourself while crushing, and hands hurt from gripping the hook hard all day".
When they are sick they contribute with money, each person gives what they can, and start a joint fund. They point out that they need a doctor at least every two months. Finally, they drew the work process; the pictures are shown in Appendix 8.9.
14 b. Representatives from the La Chureca dump in Managua Despite the efforts made, the group interview with representatives of the association could not be carried out. The association brings together people who live and work in La Chureca, so several people that ended their work were asked for the possibility of doing the interview, which was held in the courtyard of the house of one of the people.
The daily working process involves preparing the work tools and making their way for the finding of material at the dump; some specialize by product, gather the material and sell them at the end of the day in some cases and in other cases they do so once a week.
Table 17 shows the ailments expressed by people interviewed by the human figure.
14 The La Chureca dump exists since 1977 and has a 42 hectare extension. It is located in the surroundings of the Acahualica neighborhood, in the western area of the capital. It is estimated that thousands of Nicaraguans who live off of the collection of recyclable materials work there.
38 Table 17. Results for the human figure test Women Men Ages 18 and 22 Age 31 Age 28 Age 43 Headache Headache (from the sun) Neck pain Forehead pain Hip pain Throat ache (from a dry Shoulder pain Neck pain throat, coughing, enduring thirst, and the stench makes you spit frequently) Leg pain Shoulder pain (from the load) Heart pain (from a Elbow pain blow) Aching forearms Stomach pain (from bending Groin pain (from a Tailbone pain down) bruise) Tailbone pain Sore hands (when you wash Knee pain Hand pain them thoroughly) Shoulder pain Knee pain (from the Foot pain Aching arms movement and walking) Foot pain (from the body Tailbone pain Foot pain weight) I get a skin rash from the repugnance, it itches Source: Group interview. Managua, Nicaragua.
Regarding the risks they mentioned these exist when "the tractor compacts the garbage and pulls back, it can hit us; there are hospital syringes which can hurt us; we can get cut with a piece of glass or pricked with a nail; a TV screen has cut us; we get sunstroke from the sun, giving us fever and vomiting; lack of food makes us weak, when there’s no lunch, no drinks, no cold water.” Photograph 11. Scavenger representatives Managua, Nicaragua©Susy Lobo -ACEPESA
Finally, they drew the work process; the pictures of the drawings made by the person at La Chureca are shown in Appendix 8.10.
c. Workers at a junkyard It was possible to work with a group of 3 workers in a junkyard; in the other cases this was not possible, because they had a lot of work. The interview was conducted at their workplace.
Their comments about the pain they feel are "back pain when carrying something heavy, the feet from both walking and carrying loads, shoulders from loads, and wrists from striking and striking".
Table 18 shows the results from the work done through the human figure.
39 Table 18. Results for the human figure test Age 16 Age 26 Age 28 Headache Headache Neck pain Shoulder pain Neck pain Shoulder pain Foot pain Tailbone pain Aching arms Wrist pain (when striking) Tailbone pain Ankle pain Knee pain Back pain (from lifting loads) Source: Group interview. Managua, Nicaragua.
The work process described by the workers is simple: once the customer takes the materials, these are weighed and stored in a specific location in the center, according to its type. Subsequently the customer is paid. Since most of the material is junk, they do not need to perform many tasks. In some cases they must cut the material to make it smaller, here is where they mention facing occupational hazards, particularly when using the grinder and other equipment to hit the material.
Finally, they drew the work process; the pictures are shown in Appendix 8.11.
Photograph 12. Junkyard workers Managua, Nicaragua©Susy Lobo -ACEPESA
6.3. The Costa Rican Case
The Escazú Recycles program is driven by the Municipality of Escazú and the Association of Families of San Antonio of Escazú (ASOFAMISAE)15.
Regarding the work process, it entails that once the material comes in, it is weighed and placed in a location of the center, and it is then moved to the areas corresponding to classification and segregation. Paper is separated by type and color, and then packed, like cardboard. Glass is broken by color and placed in special containers. Plastic is sorted and packed, like aluminum.
The situation of the company varies widely from the cases of Nicaragua and Colombia; however, health problems are common, as shown in Table 19.
15 This last group is the one that manages the center of recovery of recyclable materials. While it may be mentioned that this initiative has municipal support for the solid waste collection on a selective basis, the situation in the center does not change much from other private initiatives. This initiative began in 2001.
40 Table 19. Results for the human figure test Women Men Age 37 Age 46 Age 21 Age 35 Back pain Foot pain Shoulder pain Shoulder pain Knee pain Knee pain Back pain Back pain Hip pain Calf pain Wrist pain Neck pain Source: Group interview. Escazú, Costa Rica.
The mentioned ailments are very similar, regardless of sex and age. Finally, they drew the work process, presented in the photograph in Appendix 8.12.
6.4. Best Practices
Regarding the working tools, it was found that at the two landfills visited in Nicaragua, people use a hook which helps them locate the material without bending down and also allows them to clamp the material. They can also dig around without running the risk of cuts or punctures. Although the research inquired about its origin, people could not give responses regarding where it came from.
A modified version of this hook was found in the Costa Rican dump. Many people who work there are from Nicaragua, and adopted the use of a hook, much smaller than the one used in Nicaragua; they also failed to give reasons to its origin. It is made with an umbrella stick which folds at the end. The production material is a waste product found in the same dump.
Of all the visited initiatives, the existence of this hook can be mentioned as a good practice; it is unknown though if it is applied in Colombian dumps.
In the landfill of La Chureca, where there is a higher level of organization, there is a health center, given that the majority of people working at the dump live there. The organization has allowed the aspect of health care to become a battle won by the sector.
The health campaigns to vaccinate the population of the three countries, has been a way to protect the informal sector’s workers against disease.
The organizational development of the sector in Colombia is also worth mentioning as good practice because they have been able to face many of the problems together. The organization promotes educational activities and struggles to improve their self-esteem through social value appreciation of their work. However, more work is still needed in order for people to make use of personal protective equipment.
Another goal they have considered is to get people to separate the material at its source; this could prevent many accidents and occupational hazards. Appendix 8.13 shows some photos of the study that have not been included in this document, illustrating the respondents’ work.
41 Part 7. Technical Considerations and Recommendations
The informal solid waste sector fulfills an environmental task that has not been quantified in most Latin American countries. Nevertheless, regardless of gender and age, the work of material recovery is linked to informality, and a subsistence and precarious economy, a situation that varies little between countries. In their daily work, under conditions that can be considered inhuman, these people recover from the garbage material that is later incorporated into the productive process, reducing the environmental damage caused by natural resource extraction, energy consumption during production, and the volume and contaminating characteristics of the garbage dumps and landfills where such valuable material would otherwise end up buried.
These people normally work exposed to the weather, recovering material with their hands or with the help of rudimentary implements like the hook, gloveless, hatless, and without masks or mouth covers, eating and dressing from what they find. They live alongside the flies and other disease transmitters. They do it because they have stayed outside of a social, economic system that neither values nor recognizes their work.
The work carried out by people in the open-air landfills, in the streets and in the recyclable material collection centers, especially in Costa Rica and Nicaragua, is neither socially nor economically recognized. In Colombia the organization of the sector has fought important struggles through which improvement in living conditions have been achieved.
The body is the primary working tool, assisted by some equipment like a hook and a bag, a wheeled cart, a tricycle, or a horse-drawn cart. Some collection centers have more sophisticated machinery like packers, weights or shredders. Nevertheless, in most cases the materials are mixed, which implies multiple risks.
Despite this situation, it was found that a large part of the population interviewed does not see beyond the ‘’violent’’ risks like being run over by a vehicle or cut by a piece of glass. The working conditions are part of daily life, which is why awareness of their own reality is difficult. In the cases in which there is conscious awareness, respondents indicate that the measures that can be taken are little or none.
Given that working without equipment has been the norm, there will always be resistance to change in occupation health –related issues, like in other aspects of life. This situation can only be addressed through training and awareness-raising that change is possible and brings about positive consequences. In addition, equipment adjusted to each person must be sought. For example, if a glove is too big, the person will not feel comfortable using it.
Even though in Colombia the greatest rate of personal protective equipment use was found in recycling centers, there is still a general refusal to use the equipment. This is not only the case for this sector. Rather, it is generally present among many workers, including the formal sector. Nevertheless, as in formal enterprises the companies are held responsible for work- related accidents, stricter, more effective and continuous controls regarding use of protective gear are normally applied.
The most common justification given for not using protective equipment is discomfort and the limitation of the freedom of movement needed to work. Notwithstanding, as the fundamental purpose of the equipment is to avoid that any part of the body comes into contact with
42 external risks, it is imperative that the sector be reached with training programs. These programs should work on the refusal to use protective gear, and create awareness about the occupational hazards to which they are exposed. In some cases a feeling of impotence to change current conditions was detected. Thus another pending task is to work on aspects of self-esteem and appreciation to show that changes are possible and that conditions can be improved.
Results show that most people interviewed perceive their own health as good and very good, despite this being a subjective indicator linked to their few medical grievances or feeling fine. One explanation for this is the development of defense mechanisms to the environment, or also because the work requires a good physical condition, resistance and strength. Without a doubt, medical examinations could indicate the true situation of each person in this regard. It can be assumed that the true situation is worse than perceived by the workers themselves. In addition, it was detected that respondents reported more illnesses when referring to their colleagues than themselves. This may indicate that responses regarding their perception of their own health are not completely transparent, possibly for fear of being criticized by the others.
Beginning work as children, and under arduous conditions, as well as excessive work, causes a physical wearing-out that translates into premature aging. It is recommended that this issue is addressed in-depth, as it is a variable that should be taken into account in training and awareness-raising programs, as in other measures that need to be implemented in each country studied.
Regarding street workers, there is a thin line between people who work collecting material to provide for their families and those who do it to maintain a substance addiction. In the latter case—in contrast to the former—the activity is not permanent, is associated with delinquency and robbery, and is carried out by people with university degrees. Society tends to marginalize these people, the police harass them and the general population does not distinguish between the groups. The struggle to make visible this difference has not been easy, even in Colombia, where the recyclers’ movement has been working for over 80 years.
Although the risks and accidents in the microenterprises, associations or cooperatives that have achieved a greater recognition and degree of formality are somewhat different from those of people who work in the streets or the open air landfills, conditions persist that negatively affect workers’ health. These include the fact that materials are not separated, noise, dust, and lack of ergonomic considerations in the work place.
Among the good practices identified is the existence and use of a hook. It speeds up work, protects from some of the risks found in mixed garbage and prevents people from having to bend over constantly. Its use has led to some minor accidents. Improvements in its design and a standardization of its use for this type of work could bring positive consequences.
43 Part 8. Appendices
8.1. List of respondents who participated in group interviews
Survey:
Street People: Nicaragua. Scavengers: Name Place where survey took place 1. Víctor Manuel Altamirano Roberto Huembes Market 2. José Giovanni Blanco Altamira Park 3. Marcos Antonio Salgado Matus Altamira Park 4. Franklin Antonio Pilarte López Park near SINSA 5. José Francisco Guerrero Los Robles Park 6. Carmen González Los Robles Park 7. Luis Alberto Solís Espinoza Los Robles Park 8. José Tomás Alvarado Managua Shopping Center 9. Juan José López Ruiz Altamira neighborhood street 10. José Noel Palma Díaz Colonia Centroamérica street
People from the Masaya dump: Nicaragua: Name 1. Guadalupe Antonio Honday López 2. William Jirón Arias 3. José Hernández Palacios 4. Johnny Isaac Gutiérrez Tapia 5. Sandra Isabel Aguilar 6. María Luisa Cano 7. Aura Antonia Hernández Palacios 8. Maritza del Carmen Castillo García 9. María Auxiliadora Jarquín López 10. Teresa Benítez
People from the La Chureca dump, Managua: Nicaragua Name 1. Guadalupe Ramos 2. Carlos Alberto Torres 3. Ana Hernández 4. Santos Yamileth Solís 5. Belkis Tatiana Rivas 6. Pedro Rafael Pérez Cortes 7. Miguel Ángel Morales Hernández 8. José Daniel Méndez Téllez 9. Martín Silva 10. Claudia Mercedes Hernández
44 People from micro and small enterprises: Nicaragua Name Place where survey took place 1. Roberto (refused to provide last name) 2. Erwin Javier Mendoza Morales 1 y ½ blocks from the small tree, Managua 3. Joselyn Obando In front of Gadala María, Managua 4. Silvia Elena Reyes ½ block east from the traffic lights in the ring between Las Colinas and Reparto Schik (neighborhood), Managua 5. José Adonis Meléndez García District II, Acahualinca, Portón Azul 6. José Luis Rodríguez District II, Acahualinca, Portón Azul 7. Cristian Esteban Meléndez Prado District II, Acahualinca, Portón Azul
Street people: Costa Rica. Scavengers. Name 1. Godofredo Calderón Peraza 2. María Eugenia Paniagua Valenciano 3. Katia Lobo 4. José Rojas Centeno 5. Freddy Cerdas Álvarez 6. Norlan José Plata López 7. Roan Hines 8. Edgar Rodríguez 9. Patricia Jiménez 10. Carlos Lara Flores 11. Santiago Roma Román 12. Álvaro Cortez Soto
People from the Puntarenas dump: Costa Rica Name 1. Liliana Mejía 2. Arnot González 3. Facundo Morales Reyes 4. Jennifer Carolina Arias 5. Herminio Arguello Martínez 6. Sixto Avilés Machado 7. Elena Arguello Martínez 8. Elizabeth Mejías Olivares 9. Mirian Pérez Corella 10. Juan Carlos González García 11. Roberto Alemán Barrios 12. Carlos Luis Villafuerte Dijeres
45 People from micro and small enterprises: Costa Rica Name 1. Damaris Velásquez López 2. Luis Aurelio Morales Loría 3. Carolina López Carrión 4. Daniel Alvarado Bonilla 5. Wilbert Rosales Monge 6. Marlene Arias 7. Bryan Enrique Piedra Chacón 8. Manuel Antonio Delgado Castrillo 9. Ileana Guevara Guevara 10. Marlene Chacón Cubillo 11. Milena Delgado Castrillo 12. Gerardo Ariel Ríos 13. Francisco Aguilera Castro 14. Pastor Valverde
Street people: Colombia. Recyclers Name 1. Alfredo Rodríguez Flores 2. María Concepción Garzón* 3. Sonia Otárola 4. Raúl Ríos *Does not belong to the Bogota Recyclers Association
People from recovery centers for recyclable material: Colombia. Recyclers Name 1. Ángel René García 2. Diego Fernando Aley 3. Maryury Agudelo 4. Paola Alfonso 5. Mauricio López 6. Lidia María Baca 7. Carmen Morales 8. Carlos Fernando Vargas 9. María Márquez Morales 10. Graciela Valderama 11. David Galvis 12. Miguel Antonio Hernández 13. Reinaldo Roso Arévalo 14. Carmen Tulia Gómez 15. Mercedes Morales
46 Group Interview:
Microenterprise Portón Azul. Managua Name Place of interview Age (years) Years of experience José Adonis Meléndez District II, Acahualinca, 28 1.5 García Portón Azul José Luis Rodríguez District II, Acahualinca, 26 5 Portón Azul Cristian Esteban Meléndez District II, Acahualinca, 16 3 Prado Portón Azul
La Chureca, Managua, Nicaragua Name Age (years) Years of experience Belkis Tatiana Rivas 18 2 Rosa Urbina Sánchez 22 5 months Carlos Javier Rivas 41 5 Felicita Chavarría 31 7 Katherine Carolina Rivas 18 1 Lester Emilio Rodríguez Latín 28 9
Masaya dump, Nicaragua. Recyclers’ Association Name Board of Directors Age (years) Years of experience Position José Hernández Palacios President 44 10 Aura Antonia Hernández Vice President 29 8 Palacios Reina María López Secretary 35 8 Lucía Rodríguez Fiscal Officer 25 4 Mercedes Isabel Vargas Member at large 42 5 Rocha Source: Group interview. Masaya, Nicaragua.
Bogotá, Bosa, Colombia. Associative Company of Family Recyclers “Muzkbys” Name Position Age (years) Years of experience Uriel Rivillo Legal Representative 43 33* Armando Chiguosuque President 27 17* Martha Murcia** Member at large 54 20 Patricia Ardila Secretary 41 21 Juliana Bejarano Supervisory Board 30 22*** * Both started at the age of 10 **Currently working at the Alquería (for this month) *** Started working at the age of 8 Source: Group interview. Bosa, Colombia.
47 Escazú, Costa Rica. Escazú Recycles Name Position Age (years) Years of experience Bryan Piedra Chacón Operator 21 6 months Manuel Delgado Castrillo Operator 35 2 Ileana Guevara Guevara Operator 46 8 Marlene Chacón Manager/Operator 46 8 Milena Delgado Castrillo Operator 37 8 months
Other interviews Name Organization 1. Camilo Torres ARAMBIENTAL 2. Jorge Alberto Skinner Representative for plastic recycling small business owners 3. Henry Navarro ARAMBIENTAL 4. Gustavo Mariño Suba Recyclers’ Network 5. José Ricardo Cabiativa Association
48 8.2. Instruments
Questionnaire for garbage pickers, scavengers, and recyclers
I. Socio-demographic information 1. Name of respondent: 2. Gender: F M 3. Age: 4. Schooling:
None Incomplete High-school Technical Complete elementary Incomplete elementary Complete High-school Graduate 5. How long have you worked with solid waste? 6. Have you done other work before this one? Yes No Go to question 9 7. Which one(s) and for how long?
8. Do you perform other work parallel to this one? Which one(s)? Which of these is your primary business?
II. Medical History 9. What do you think of your health condition? Very bad Good Bad Very good 10. Why?
11. Do you suffer from any diseases? Si No Go to question 14 12. What is this condition due to and since when do you have it?
13. What are the causes of your condition?
14. Furthermore, do you suffer from other illnesses like: Fungus Skin infections Parasites or worms
49 15. Which have been the most common diseases or ailments for the people working with you?
16. Do you currently take any medication? Yes No Go to question 20 17. Which medication do you take?
18. Why do you take the medication?
19. Who told you to take it? Doctor Friend Relative Another person 20. What medicine do you take when not feeling well? What? What for? ______21. Do you have access to a health clinic? Yes No 22. Do you smoke? Yes How many cigarettes per day? No 23. Do you drink? Yes How much? How frequently? No 24. Have you been vaccinated? Yes No Go to question 29 25. Which vaccines? 26. When was the last time you were vaccinated? 27. What did you last get vaccinated for? 28. How often do you get vaccinated? 29. Have you received health talks about disease prevention? Yes No Go to question 33 30. What do you remember from those health talks?
31. Did you follow any advice given in these talks? 32. Which advice? Are you still using those tips? Why?
33. Do you wash your clothes after work? Yes No
50 34. Do you bathe before or after work? Before After Why?
35. What are the risks in your work?
36. What do you do, or what have you and your colleagues done, against these risks?
37. Have you or any of the people working with you had any accidents at work? Yes What kind? No 38. What do you do when you have an accident at work?
Thank you
51 Survey for the micro and small enterprise for the recovery of recyclable material?
I. Socio-demographic information 1 Name of respondent: 2 Name of the company where you work at: 3 Number of workers: 4 Gender: F M 5 Age: 6 Schooling: None Complete high-school Technical Complete elementary Incomplete elementary Incomplete high-school Graduate 7 How long have you worked with solid waste? 8 Have you done other work before this one? Yes No Go to question 10 9 Which one(s) and for how long?
10 Do you perform other work parallel to this one? Which one(s)? Which of these is your primary business?
II. Medical History 11 What do you think of your health condition? Very bad Good Bad Very good 12 Why?
13 Do you suffer from any diseases? Yes No Go to question 16 14 What is this condition due to and since when do you have it?
15 What are the causes of your condition?
16 Furthermore, do you suffer from other illnesses like: Fungus Skin infections Parasites or worms
52 17 Which have been the most common diseases or ailments for the people working with you?
18 Do you currently take any medication? Yes No Go to question 22 19 Which medication do you take?
20 Why do you take the medication?
21 Who told you to take it? Doctor Friend Relative Another person 22 What medicine do you take when not feeling well? What? What for? ______23 Do you have access to a health clinic? Yes No 24 Do you smoke? Yes How many cigarettes per day? No 25 Do you drink? Yes How much? How often? No 26 Have you been vaccinated? Yes No Go to question 31 27 Which vaccines? 28 When was the last time you were vaccinated? 29 What did you last get vaccinated for? 30 How often do you get vaccinated? 31 Have you received health talks about disease prevention? Yes No Go to question 37 32 Who organized the talks? The company?
33 What do you remember from those health talks?
34 Did you follow any advice given in these talks? 35 Which advice? Are you still using those tips? Why?
53 36 Does the company control or motivate these measures?
37 Do you wash your clothes after work? Yes No 38 Do you bathe before or after work? Before After Why?
39 Do you use personal protection equipment? Yes No Go to question 41
40 What equipment do you use?
41 Do you use any type of machinery or equipment to do your work? Yes No Go to question 43 42 What kind of equipment? Have you been trained to use it?
43 What are the risks in your work?
44 What do you do, or what have you and your colleagues done, against these risks?
45 Have you or any of the people working with you had any accidents at work? Yes What kind? No 46 What do you do when you have an accident at work?
Thank you
54 Focus Group Interviews
The following procedure was followed for the focus groups:
Step 1. “Drawing the work process”
The activity involves collectively drawing the work process. The interviewer will guide the drawing process by asking questions both to clarify and to go more into depth.
Instrument 1 Drawing the work process Purpose Identify occupational hazards and health problems associated to each phase of the work process.
Procedure The person who guides the interview explains how to work through the process and the objective sought. He/she calls for everyone’s participation in creating the drawing, emphasizing that each participant’s experience is very important. Instruction: "Think of a normal working day and as a group draw how you do your job. Try to remember what you use, where you are, which dangers and problems you face and draw them too". During the drawing process, the interviewer throws questions as the group progresses, and also encourages everyone’s participation. Once the drawing is completed, it is posted on a wall and there is a discussion about the picture, making sure all risks or health problems related to the recovery of material are present. Then, if during the drawing process, improvements to the tools and equipment they use were not explicitly mentioned, directly ask what improvements or innovations have been done in order to work better. At the end, a reflection will be put forth on the positive and negative aspects of the work process. Materials Flipchart, 10 color markers , masking tape
Timing 1 hour and 30 minutes
55 Step 2. “Workplace and health and working conditions”
The goal of this step of the interview is to recognize the link between working conditions and environment, as well as the health – illness process of individuals.
Instrument 2 The workplace and health and working conditions Purpose Identify the link between the working conditions and environment, as well as the health – illness process of individuals.
Procedure The interviewer gives each participant the material (human figure according to respondent’s gender) and a pencil. Once each participant has the material, the interviewer says: "Now close your eyes and go over your body in your mind. Remember how your body feels at the end of a work day. Review each part: head, shoulders, face, arms, trunk, legs, and feet. Now open your eyes and use the pencil to mark or shade in the body parts where you feel any discomfort or pain". The interviewer asks to write on the paper their age and timeframe in which they have been working with "garbage." -Give no more than 10 minutes. Once the exercise is done you proceed to: . Post the pieces of paper on the wall . A person other than the author of the paper will discuss the work . Afterwards, the author explains what he tried to express . The process continues in the same manner until each person of the group has had his turn . People should choose the most representative body assembly for the group, and the highest contrasting one . The group makes a quantitative summary of the complaints they revealed on the sheets with the figures and records them below the figure which has the most ailments marked on it.
Materials Human figures of men and women to point out aches and pains, pencils, masking tape
Timing 1 hour
In addition, the following information will be collected:
I. General Information 1. Name of organization or company 2. Year established 2. Total number of members/workers: Total of men: Total of women: 3. Legal recognition from:
56 8.3. Details of the Population Surveyed in Nicaragua
A. Scavengers (“Pepenadores”) For people working on the streets recovering recyclable material or scavengers, 10 people were interviewed: 9 men and 1 woman. The following characteristics were found: i. Age
50% of the individuals are 36 to 45 years old, 30% are 46 to 55 years old and 20% are 26 to 35 years old16. There was no one under 26 years of age, nor over 55, as shown in Figure A.1.
Figure A.1. Age range of individuals working on the streets of Managua recovering recyclable material
20%
26 to 35 years 50% 36 to 45 years 46 to 55 years 30%
Source: Survey conducted in Managua, Nicaragua
ii. Educational level
Figure A.2 shows that 40% of people didn’t complete elementary, 20% didn’t finish college, 20% didn’t finish high-school, only 10% completed high-school, and another 10% completed elementary school, there weren’t any individuals with technical studies. It is noteworthy that all respondents had completed a certain level of schooling.
16 According to a study on the informal sector in 5 districts of Managua, Nicaragua, by ACEPESA, for UN-HABITAT Nicaragua, the following was found from a 104 scavenger population of the capital: 7% were less than 19 years old, 24% were 20 to 29 years old, 23% were 30 to 39 years old, 20% were from 40 to 49 years old, 18% were from 50 to 59 years old, 6% were from 60 to 69 years old and 2% were older than 79 years.
57 Figure A.2. Educational level of individuals working on the streets of Managua recovering recyclable material
Incomplete college 20
Technical 0
Incomplete high school 20
Complete high school 10
Incomplete high school 40
Complete elementary 10
0 10 20 30 40
Source: Survey conducted in Managua, Nicaragua
iii. Years of experience
Figure A.3 shows how 60% of people have worked in the activity for 1 to 5 years, and then the experience is limited to 10% for less than 1 year, 10% also for the cases from 6 to 10 years, 11 to 19 years and more than 20 years.
Figure A.3. Time which the individuals working on the streets of Managua have been recovering recyclable material
70 60 60
50
40
30 Percnetage 20 10 10 10 10 10
0 Less than 1 1 to 5 6 to 10 11 to 19 More than 20 Years of Experience
Source: Survey conducted in Managua, Nicaragua iv. Work experience
80% of the individuals have done other types of work previously to the recovery of recyclable material. From the 20% who answered to not have had a different previous job, one case answered this because the person has worked since the age of 7 in the recovery of material.
58 The tasks mentioned were maintenance and cleaning, shoe polishing, selling fruit and cold water at traffic lights, housekeeping, electrician, auto mechanic, clerk, construction worker, security guard and soldier". v. Perception of health status
40% of the respondents believe their health is good, 30% consider it to be very good and another 30% consider it bad. No one pointed out their health to be very bad.
Individuals who replied that their health is good cited as a reason "thank God I don’t get any diseases, right now I’m just hung-over, because generally I feel more or less, and because I don’t suffer from any pain I get to rise at 4 in the morning for some physical activity (military)".
Individuals that replied to their health status as very good mentioned as a reason: "thank God, I hardly ever have gotten sick and thank God I have been healthy". Those responding that their health is bad, cited as a reason "because often I have a fever, headache and a cough; I have a kidney infection; I have had diarrhea and fever and I have neuroses from consuming so much, including gasoline”.
B. “Churequeros” For those working in La Chureca (city of Managua’s municipal dump) recovering recyclable material, 10 individuals were interviewed: 5 men and 5 women. The following characteristics were found: i. Age
40% of the individuals are 20 to 30 years old, 20% are younger than 19, 20% are 41 to 50 years old, 10% are 31 to 40 years old, and 10% are 51 to 60 years old, as shown in Figure B.1.
Figure B.1. Age range of individuals working in La Chureca recovering recyclable material
45 40 40 35 30 25 20 20 20
Percentage 15 10 10 10 5 0 Younger than 20 to 30 31 to 40 41 to 50 51 to 60 19 Age Range (years)
Source: Survey conducted in Managua, Nicaragua
59 ii. Educational level
60% of the individuals didn’t complete elementary, 20% finished elementary, and another 20% didn’t finish high-school. It is noteworthy that most of them live in La Chureca. iii. Years of experience
Figure B.2 shows that 40% of the individuals have worked in the activity for 11 to 19 years, while another 40% has worked for more than 20 years. The experience is limited to 10% for less than 1 year and another 10% for the cases from 6 to 10 years.
Figure B.2. Time that the individuals working in La Chureca have been recovering recyclable material
45 40 35 30 25 20
Percnetage 15 10 5 0 1 to 5 6 to 10 11 to 19 More than 20 Years of Experience
Source: Survey conducted in Managua, Nicaragua iv. Work experience
50% of the individuals have done other types of work previously to the recovery of recyclable material, while the other 50% confirmed to have worked since a young age in La Chureca, so it is their only experience. One case was found in which the person worked in a free trade zone, but went back to working at La Chureca.
The tasks mentioned were security guard, free trade, housekeeping, sugar mills, farmer (San Rafael del Sur), and soldier. v. Perception of health status
60% of the respondents believe their health is good, 30% consider it bad and another 10% consider very good. No one pointed out their health as very bad. Individuals who replied that their health is good commented positions like "because I feel health; I don’t get sick even if I go to La Chureca; I never get sick; I am healthy, but I must take care of myself”. On responses for very good health, it was commented that “I don’t suffer from any disease”. And on bad health it was pointed out that “I have skin problems from so much smoke, it’s a lot of smoke in the lungs; because I drink alcohol”.
60 C. Masaya garbage pickers (“Pepenadores”) For those working at the Masaya dump recovering recyclable material, 10 individuals were interviewed: 5 men and 5 women. The following characteristics were found: i. Age
30% of the individuals are 31 to 40 years old, 20% are 20 to 30 years old, another 20% are older than 61, 10% are younger than 19, another 10% are 41 to 50 years old, and another 10% are 51 to 60 years old, as shown in Figure C.1.
Figure C.1. Age range of individuals working in the Masaya dump recovering recyclable material
30 30
25 20 20 20
15 10 10 10
Percentage 10 5 0 Younger 20 to 30 31 to 40 41 to 50 51 to 60 Older than 19 than 61 Age Range (years)
Source: Survey conducted in Masaya, Nicaragua
ii. Educational level
Figure C.2 shows that 60% of the respondents didn’t complete elementary, 20% finished elementary, 10% didn’t finish high-school, another 10% has incomplete high-school studies, and one person is still attending school. It is noteworthy that all respondents had completed a certain level of education. One can draw attention to the fact that the person that has no studies whatsoever is 40 years old, which is relatively young.
61 Figure C.2. Educational level of individuals working in the Masaya dump recovering recyclable material
70 60 60 50 40 30 20 Percentage 20 10 10 10 0 None Complete Incomplete Incomplete high elementary elementary school
Education level
Source: Survey conducted in Masaya, Nicaragua
iii. Years of experience
60% of the respondents have worked in the activity from 1 to 5 years, the other 40% from 6 to 10 years. The site has approximately 8 years of operation. iv. Work experience
90% of the individuals have done other types of work previously to the recovery of recyclable material, while the other 10% stated they hadn’t since they are young. The tasks mentioned were “housekeeping (4 women indicated this activity), animal grazing, carrying packages in the market, driver of a ‘motorcycle-taxi’, clerk at the market, house chores, and making rope mats”. v. Perception of health status
70% of the respondents believe their health is good, 20% consider it very good and another 10% consider it bad. No one pointed out their health as very bad.
Individuals who replied that their health is good commented positions like "one does not always feel good, sometimes one gets spinal pain; one has felt well, although having a cold from the rain; because I am sick and I haven’t gotten sick; I have barely ever gotten sick”. The reasons for very good health include “take care of myself so I don’t catch anything”. Poor health reasons include “at work the sun shines on me and then comes the rain; my bones ache and I frequently get a fever and a headache”.
D. Micro and small enterprises For those working in micro and small enterprises recovering recyclable material, 7 individuals from 5 companies were interviewed: 5 men and 2 women. The following characteristics were found:
62 i. Age
Forty three percent of the individuals are 20 to 30 years old, 29% are 31 to 40 years old, 14% are younger than 19, and another 14% are 41 to 50 years old. No one older than 50 years was found, which indicates a relatively young population, as shown in Figure D.1.
Figure D.1. Age range of individuals working in micro and small enterprises recovering recyclable material
41 to 50 14
31 to 40 29
20 to 30 43 Age Range (years) Range Age Younger than 19 14
0 10 20 30 40 50
Percentage
Source: Survey conducted in Managua, Nicaragua
ii. Educational level
Figure D.2 shows that 43% have some college studies, 29% have incomplete elementary studies, 14% have completed elementary, and another 14% have completed high school.
Figure D.2. Educational level of individuals working in micro and small enterprises recovering recyclable material
50 43 45 40 35 29 30 25 20 14 14 Percentage 15 10 5 0 Complete Incomplete Complete high College elementary elementary school
Education Level
Source: Survey conducted in Managua, Nicaragua
63 iii. Years of experience
57% of the individuals have worked in the activity for 2 to 5 years, 14% less than 1 year, another 14% from 6 to 10 years, and yet another 14% has worked 11 to 19 years, as shown in Figure D.3.
Figure D.3. Years of experience of individuals working in micro and small enterprises recovering recyclable material
11 to 19 14
6 to 10 57
2 to 5 14 Years of Experience Less than 1 14
0 10 20 30 40 50 60
Percentage
Source: Survey conducted in Managua, Nicaragua
iv. Work experience
90% of the individuals have done other types of work previously to the recovery of recyclable material, while the other 10% stated they hadn’t since they are young. The tasks mentioned were “welder, warehouseman, selling spare parts, masonry helper, soldier, manager, a lot of jobs: mayoralty, free trade zone, shopping center, and other companies similar to this one”. v. Perception of health status
According to the perception of health status, 57% affirms to have very good health and 43% consider it bad. Amongst the reasons for having good health are "wither I have not had illnesses, I have barely ever had anything bad, because nothing has ever happened to me on my skin”.
On responses for very good health, it was commented that “I feel very healthy, because I get checkups and the Ministry of Health (MINSA) provides checkups every couple of months, I haven’t been sick”.
64 8.4. Details of the Population Surveyed in Costa Rica
A. Street scavengers (“Buzos de la calle”) For people working on the streets of San José, Costa Rica, recovering recyclable material, 12 people were interviewed: 9 men and 3 women. The following characteristics were found: i. Age
25% of the individuals are 31 to 35 years old, 17% are 51 to 55 years old, another 17% are 56 to 60 years old, 8% are younger than 25, and another 8% are older than 61, as shown in Figure A.1.
Figure A.1. Age range of individuals working on the streets of San José recovering recyclable material
30 25 25
20 17 17 15 8 8 8 8 8 Percentage 10
5
0 Younger 26 to 35 31 to 35 36 to 40 41 to 45 51 to 55 56 to 60 Older than 25 than 61
Age Range (years)
Source: Survey conducted in San José, Costa Rica
ii. Educational level
Figure A.2 shows that 42% didn’t complete elementary, 17% finished elementary, 17% didn’t finish high-school, and the other 17% has technical level studies; 8% have no education whatsoever.
65 Figure A.2. Educational level of individuals working on the streets of San José recovering recyclable material
45 42 40 35 30 25 20 17 17 17
Percentage 15 10 8 5 0 None Complete Incomplete Incomplete Technical elementary elementary high school
Education level
Source: Survey conducted in San José, Costa Rica
iii. Years of experience
Twenty five percent of the individuals have worked in the activity for less than 1 year, another 25% has worked for 2 to 5 years, 16% has 6 to 10 years, 17% has been in the business for 11 to 20 years and another 17% more than 21 years, as shown in Figure A.3.
Figure A.3. Years of experience of individuals working on the streets of San José recovering recyclable material
25 27 Less than 1 year 2 to 5 years 6 to 10 years 11 to 20 years 17 25 More than 21 years
17
Source: Survey conducted in San José, Costa Rica
66 iv. Work experience
One hundred percent of the individuals have done other types of work previously to the recovery of recyclable material. The tasks mentioned were “housekeeping, snack bar, coffee picking, clerk, driver, mid-level technical accountant, and construction work, seafood shop, washing taxis, electricity, shoemaker and warehouseman". v. Perception of health status
Regarding the perception of health status, 59% state they have good health, 33% consider it to be bad, and 8% refer to very bad health. Unlike the other surveyed populations, these refer to very poor health, but at a low percentage.
Individuals who replied that their health is very good cited as a reason "doctors say I am healthier than they are". Reasons for considering good health include “I am physically well, in general I have good condition, I haven’t gotten any tests done, even if alcohol has an effect on my health, I don’t suffer from other illnesses, I haven’t been sick for more than a year”.
People who respond that their health is bad, cited as a reasons "many of my brain cells are dead; I’m diabetic; because I have asthma”. The reasons for considering very bad health include “I am asthmatic; I have high blood pressure; I have had pneumonia”.
B. Zagala dump garbage pickers (“buzos”) For the individuals recovering recyclable material at the Zagala dump, in the Puntarenas district, Central Pacific, Costa Rica, 12 people were interviewed: 7 men and 5 women. The following characteristics were found: i. Age
51% of the individuals are 41 to 50 years old, 17% are 31 to 40 years old, 8% are older than 61, another 8% younger than 19, and another 8% between 20 and 30, as shown in Figure B.1.
Figure B.1. Age range of individuals working in the Zagala dump recovering recyclable material
70 58 60 50 40 30
Percentage 17 20 8 8 8 10 0 Younger than 20 to 30 31 to 40 41 to 50 Older than 61 19
Age Range (years)
Source: Survey conducted in Puntarenas, Costa Rica
67 ii. Educational level
Figure B.2 shows that 50% didn’t complete elementary, 17% completed elementary, 17% have incomplete high-school, 8% completed high-school, and 8% has no education at the age of 45.
Figure B.2. Educational level of individuals working in the Zagala dump recovering recyclable material
Incomplete high school 17
Complete high school 8
Incomplete elementary 50
Complete elementary Education level Education 17
None 8
0 20 40 60
Percentage
Source: Survey conducted in Puntarenas, Costa Rica iii. Years of experience
50% of the individuals have worked in the activity for 1 to 5 years, 25% has worked 6 to 10 years and 17% has more than 20 years experience. One person actually stated to have 30 years experience in the business. Nobody belonged in the 11 to 19 years experience range. iv. Work experience
75% of the individuals have done other types of work previously to the recovery of recyclable material, while the other 25% confirmed to have done only that activity, and others claim to be too young.
The tasks mentioned were “shrimp boat, construction, cutting sugar cane, dairy farm, shoemaking, ‘fondas’ (selling food) and selling tortillas”. v. Perception of health status
Regarding the perception of health status, 67% state they have good health, 25% consider it to be bad, and 8% refer to very good. It was qualified as good because “I barely ever get sick, and I never get sick regardless of the present hazards”.
It was qualified as bad due to “I had a truck accident; I suffer from all ailments; my bones hurt when it rains”.
68 C. Micro and small enterprises For those working in micro and small enterprises recovering recyclable material, 14 individuals were interviewed: 8 men and 6 women. The following characteristics were found: i. Age
21% of the individuals are 46 to 50 years old, 21% are older than 66, 14% are younger than 21, and another 14% are 36 to 40 years old, as shown in Figure C.1.
Figure C.1. Age range of individuals working in micro and small enterprises recovering recyclable material
25 21 21
20
14 14 15
10 Percentage 7 7 7 7
5
0 Younger 22 to 25 26 to 30 31 to 35 36 to 45 46 to 55 56 to 65 Older than 21 than 66
Age Range (years)
Source: Survey conducted in San José, Costa Rica
ii. Educational level
Figure C.2 shows that 43% didn’t finish elementary, 17% completed their elementary studies, 17% have incomplete high-school, 8% completed high school, and 8% was found to not have any education being a 45 year old.
69 Figure C.2. Educational level of individuals working in micro and small enterprises recovering recyclable material
50 43 45 40 35 30 25 21 21 20
Percentage 15 10 7 7 5 0 Complete Incomplete Complete Incomplete Technical elementary elementary high school high school
Education level
Source: Survey conducted in San José, Costa Rica
iii. Years of experience
43% of the individuals have less than q year experience, 29% have worked in the activity for 6 to 10 years, and another 7% has worked 11 to 19 years, and 14% has more than 50 years in the business. This can be interpreted in the way that there is a significant staff turnover on the one hand, and on the other hand, a large group with a great continuance and experience in the business, as shown in Figure C.3.
Figure C.3. Years of experience of individuals working in micro and small enterprises recovering recyclable material
More than 50 14
11 to 19 7
6 to 10 29
2 to 5 7 Years of Experience Less than 1 43
0 10 20 30 40 50
Percentage
Source: Survey conducted in San José, Costa Rica
70 iv. Work experience
86% of the individuals have done other types of work previously to the recovery of recyclable material, while the other 14% confirmed to have done only that activity; one because he has only done this activity, and the other one because she was a housewife. The tasks mentioned were “field work, secretary and reception, unloading potato in the market on Saturday afternoons, selling ice cream, car shop, fruit punch factory, sales agent, snack bar, printing, housekeeping, topography and police department". v. Perception of health status
Regarding the perception of health status, 86% state they have good health, 14% consider it to be very good. One person mentioned his health is very good because “I feel really well, I barely ever get sick”.
The reasons why people stated to have good health include “I feel well, I am healthy, I have only had the flu, I have high blood pressure, I was bad but now I am well, I haven’t been to the insurance company, I have no ailments, I just have asthma, I don’t feel bad, I’m an athlete, and I seldom get sick”.
71 8.5. Some general comments on the Recyclers Association of Bogotá (ARB) and the National Recyclers Association (ANR)
ARB is an apex organization, which emerged in 1988, but becomes official on November 15, 1990. It brings together 25 grassroots organizations formed by families, which are organized into associations or cooperatives. These 25 organizations represent approximately 2100 organizations that bring together 6,500 to 7,000 people.
ANR is a national organization that brings together some Colombian 50 000 families (300,000 people). It began its duties in 1991 and in 1993 it was legally established.
Both trade associations have great reputation and experience not only in Colombia, but worldwide.
Recycling in Colombia originates to 1930, due to political, economic and social problems. Silvio Ruiz, union coordinator of the ARB, explains the causes taking as starting point that from those years, "the population has lived a process of war and violence, where originally it was about trying to solve a problem wealth. This resulted in the displacement from the countryside to the city".
"Currently, about health issues, only 5% of ARB members pay social insurance. In Colombia, the system is privatized and the social costs amount to 53%, so that the payment for recyclers is not possible in most cases, given their limited income”.
One of the main struggles of the ARB has been the recognition and respect on behalf of the population towards the recyclers’ work; through the use of a uniform they have won respect from the police and managed people to not have them mistaken for thieves.
72 8.6. Details of the Population Surveyed in Colombia
A. Street recyclers (“Recicladores de la calle”) For people working on the streets of Bogotá, capital of Colombia, recovering recyclable material or scavengers, 4 people were interviewed: 2 men and 2 women. The following characteristics were found: i. Age
50% of the individuals are 31 to 35 years old, 25% are 51 to 55 years old and 25% are 61 to 65 years old. ii. Educational level
50% has no schooling level, while the other 50% did not finish elementary school. iii. Years of experience
25% of people have worked in the activity for 21 to 25 years, 50% have 26 to 30 years experience and another 25% have more than 41 years experience. iv. Work experience
25% of the individuals have done other types of work previously to the recovery of recyclable material, specifically as fruit seller, and 75% claim not to have worked in anything else in the past. v. Perception of health status
100% claim to have good health. The reasons mentioned are “sometimes I get sick, the sun and rain make me sick, I catch a cold once in a while, I don’t get sick, 14 years ago I had surgery because I got run over by a car, even when my leg gets swollen”.
B. Recyclers at recycling centers For people working in centers for the recovery of recyclable material, 15 people were interviewed: 7 men and 8 women. The following characteristics were found: i. Age
33% of the individuals are 20 to 25 years old, 13% are 26 to 30 years old, 7% are 36 to 40 years old, 20% are 41 to 45 years old, and 27% are 46 to 50 years old, as shown in Figure B.1.
73
Figure B.1. Age range of individuals working in recycling centers in Bogotá, Colombia
33 35 30 27 25 20 20 13 15
Percentage 10 7 5 0 20 to 25 26 to 30 36 to 40 41 to 45 46 to 50
Age Range (years)
Source: Survey conducted in Bogotá, Colombia
ii. Educational level
Figure B.2 shows that 13% have no schooling whatsoever, 40% didn’t complete elementary, 7% completed elementary, 13% finished high-school, and 27% didn’t completed high-school
Figure B.2. Educational level of individuals working in recycling centers in Bogotá, Colombia
13% 27% None Incomplete elementary Complete elementary Complete high school 13% 40% Incomplete high school 7%
Source: Survey conducted in Bogotá, Colombia
iii. Years of experience
7% has worked in the activity for less than 1 year, 13% has 1 to 5 years experience, 2% has 6 to 10 years, 7% has 11 to 15 years, another 7% has 16 to 20 years, 13% has 21 to 25 years, 7% has 26 to 30 years, and 27% has 36 to 40 years, as shown in Figure B.3.
74 Figure B.3. Years of experience of individuals working in recycling centers in Bogotá, Colombia
30 27
25 20 20 13 13 15 7 7 7 7
Percentage 10 5 0 Less 1 to 5 6 to 10 11 to 16 to 21 to 26 to 36 to than 1 15 20 25 30 40
Years of Experience
Source: Survey conducted in Bogotá, Colombia
iv. Work experience
75% of the respondents have done other types of work previously to the recovery of recyclable material, 27% claim not to have worked in another sector in the past. The mentioned jobs include “driver, construction, shoemaking, messaging, housekeeping, fieldwork, factory work, cookie making, at the ARB cafeteria, at a cooperative’s management office, whatever comes along, and as a street vendor”. v. Perception of health status
Regarding the perception of health status, 93% state they have good health, and 7% consider it to be very good.
The reasons why people stated to have very good health are: • “I barely ever head to the doctor’s • Work is tough, I suffer from spine and arm pain • I seldom get sick • I haven’t had any kind of pain, I feel well • I’m blessed • I don’t suffer from any disease, only tooth ache • Nothing hurts • I don’t feel sick • I barely get sick, I have a good physical condition and I don’t smoke • I feel good • The only discomfort I have is an ulcer and I haven’t had surgery yet”
The person mentioning to have really good health owes it to: • “I don’t feel sick”
75 8.7. Details of respondents who work in recovery centers for recyclable material
The following table shows the number of respondents who work in recovery centers for recyclable material.
Number of respondents according to staff members of recovery centers for recyclable material Country Staff members Number interviewed % of respondents Colombia Women Men Total Women Men Total Pensilvania17 2 4 6 2 2 4 67 Parque 2 1 3 2 1 3 100 Metropolitano La Florida18 Alquería19 66 3 2 5 8 El Porvenir20 33 1 2 3 9 sub-total 4 5 108 8 7 15 14 Nicaragua 0 Traffic light scrap 1 2 3 1 1 33 yard Bronze scrap yard 1 1 1 1 100 Paper purchase 4 4 1 1 25 Portón Azul 3 3 3 3 100 Frente Gadala Scrap 1 1 1 1 100 yard sub-total 2 10 12 2 5 7 58 Costa Rica 0 Escazú Recicla 8 7 15 3 2 5 33 El Molino 9 1 10 1 2 3 30 Recyclub Fibras 5 5 10 2 1 3 30 El Tiribí 3 3 3 3 100 sub-total 22 16 38 6 8 14 37 Total 28 31 158 16 20 36 23 Source: Survey conducted in Costa Rica, Colombia, and Nicaragua
17 This project sells to recycling companies. They have a collection vehicle, although some members take the material directly there with their horse carts, according to Mr. Edwin Burbano, director. 18 The initiative was developed in 2008 due to an agreement with City Hall; they use a tricycle where the plastic bags are placed with the material, and they have a small warehouse; they are also composting; the materials are taken to another cooperative who sells it (Engativa Zone 10 Recyclers Association -ARENDIEZ). 19 This is a pilot initiative with the Bogotá City Hall and ARUBA (United Recyclers Association of Bogotá), ARAMBIENTAL (Cooperative Association for Recycling and Environmental) and ARB (Bogotá Recyclers Association). 66 people work in two shifts, it initiated in 2006; it is currently recovering 20 tons per day, informed Mr. Nilson Ladino. 20 Mr. Jilmer Acero comments that the El Porvenir cooperative was founded 20 years ago, has 33 members which work in nursing homes and hospitals, the materials arrive separated with the exception of PET, which is prepared in the warehouse.
76 8.8. Colombian work process drawing
Prepared by Patricia Ardilla from the Associative Company of Family Recyclers “Muzkbys”, Bosa Bogota, Colombia
Prepared by Armando Chiguaosuque from the Associative Company of Family Recyclers “Muzkbys”, Bosa Bogota, Colombia
77 8.9. Masaya dump work process drawing
Prepared by Sandra Isabel Aguilar, María Luisa Cano, Aura Antonia Hernández Palacios, from the Masaya dump, Nicaragua
78 8.10. La Chureca dump work process drawing
Prepared by Lester Emilio Rodríguez Latín, Belkis Tatiana Rivas, Rosa Urbina Sánchez, Carlos Javier Rivas, Felicita Chavarría from La Chureca, Managua, Nicaragua
Prepared by Katherine Carolina Rivas from La Chureca, Managua, Nicaragua
79 8.11. Managua scrap yard work process drawing
Prepared by José Adonis Meléndez García, Distrito II. Managua, Nicaragua
Prepared by José Luis Rodríguez and Cristian Esteban Meléndez Prado, Distrito II. Managua, Nicaragua
80 8.12. Drawing: Work Flow of a Costa Rican Recovery Center for Recyclable Material
Prepared by Marlene Chacón, Escazú, Costa Rica
81 8.13. Some Photographs
Photograph 13. Masaya garbage dump, Nicaragua©Susy Lobo -ACEPESA
Photograph 14. Zagala dump garbage pickers, Puntarenas, Costa Rica©Susy Lobo- ACEPESA
82
Photograph 15. Zagala dump garbage pickers, Puntarenas, Costa Rica©Susy Lobo- ACEPESA
Photograph 16. Housing at the La Chureca dump, Managua, Nicaragua©Susy Lobo- ACEPESA
83
Photograph 16. Scrap yard worker, Cartago, Costa Rica©Susy Lobo- ACEPESA
Photograph 17. Center for recovery of recyclable material, Escazú Recicla, Escazú, Costa Rica©Susy Lobo- ACEPESA
84
Photograph 19. Center for recovery of recyclable material, Pensilvania, Bogotá, Colombia©Susy Lobo- ACEPESA
Photograph 20. Recycler housing in Bosa, Bogotá, Colombia©Susy Lobo- ACEPESA
85
Photograph 18. Center for recovery of recyclable material, Desamparados, Costa Rica©Susy Lobo- ACEPESA
Photograph 19. Center for recovery of recyclable material, Los Guido, Costa Rica©Susy Lobo- ACEPESA
86 8.14. Bibliography
ACEPESA, WASTE e IPES. 1996. “Investigación Latinoamericana en el capítulo de las condiciones y medio ambiente de trabajo en microempresas de gestión de residuos sólidos. Guatemala, El Salvador, Costa Rica, Bolivia y Perú”. Unpublished.
Asamblea Legislativa de la República de Costa Rica, 2010. “LEY N° 8839, Ley para la Gestión Integral de Residuos”, La Gaceta Number 135, 13 July, 2010. San José, Costa Rica.
Florisbela dos Santos, Anna Lucia y Gunther Wehenpohl. 2001. “De pepenadores y triadores. El sector informal y los residuos sólidos municipales en México y Brasil”. En Gaceta Ecológica 060, from the National Ecology Institute, México, DF.
Grajales G., Tevni. “Tipos de investigación” From www.tgrajales.net/invesindex.html.
Lozano, G.; Ojeda, S.; Armijo C.; Favela H.; Aguilar W. y Cruz S. 2009. “La basura como opción de trabajo: un perfil socio demográfico de los Pepenadores”. II Iberoamerican Symposium on Waste Engineering. Barranquilla, September 24 and 15, 2009. Engineering Institute. Universidad Autónoma de Baja California, México. DF.
Marin Araya, Maritza. 1999. Graduation Thesis. “Diseño de un modelo integral para el mejoramiento de las Condiciones y Medio Ambiente de Trabajo en el Matadero Municipal de Estelí, Nicaragua”. Universidad Fidelitas. Engineering Faculty, School of Industrial Engineering, San José, Costa Rica.
International Labor Organization. Ministry of Labor and Social Security. Integral Quality and Modernization Program. “Capacitación participativa: metodología de la visualización.”
Universidad Autónoma Metropolitana. 1989. “Manual: Conocer para cambiar. Estudio de la salud en el trabajo”. México. DF.
87 Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH
Dag-Hammarskjöld-Weg 1-5 D-65760 Eschborn/Germany T +49 6196 79-0 F +49 6196 79-1115 E [email protected] I www.giz.de