On the Clinical Waste Discussion Forum we have previously commented on the fate of rag pickers and other scavengers salvaging items from untreated medical waste and facilitating is repackaging for reuse.

Though we focus on the extreme health risks to those scavengers and to those for whom unsterilised items may be reused, there are other issues at stake that we cannot overlook. Rag pickers and scavengers have an unbelievably hard life, barely surviving on the most meagre of income. But though we criticise the illicit salvage of items from medical wastes, in general resource recovery is the current ‘big think’. We might prefer source segregation and automated sorting but we still operate picking lines for some wastes so the differences are not so great.

To my surprise, Indian rag pickers are a formally organised community with a trade body and union representation. This comes to light as the battle against a series of new incinerator installations intended for waste-to-energy operations that will cripple the rag picker trade.

Perhaps this is the way to go. A cleaner, safer process that is more efficient. But for some, it is the loss of livelihood.