Manual Rickshaw to E-rickshaw: Implications on Health

Introduction

Irrespective of locations cycle rickshaw has the tradition of being the most popular vehicle for urban resident. These are the eco-friendly non polluting transport systems. In another way, rickshaw pullers are low wage transportation service provider which plays as the role of backbone of transportation system. According to the estimates of Porier (2009), around 8 millions rickshaw pullers are working in India. Around 6-8 billion passengers travel through cycle rickshaw per year in India (Rajvanshi, 2000).Without considering the circumstances, rickshaw pullers have to work daily to earn their livelihood. Pedal rickshaw jeopardizes the health of the rickshaw puller in many ways.

Manual rickshaw pulling is one of the strenuous and laborious tasks performed by human being which require enormous stamina and lots of energy. Poor working and living conditions along with lack of basic amenities like hygienic drinking water and healthy sanitation make them highly susceptible to health risk. Rickshaws are often prone to road traffic accidents. Improper balance of rickshaws and heavy road traffic are the causes behind accidents. Heavy road traffics also increase the risk of rickshaw pullers of being exposed to air and sound pollution of highest levels. Long working hours (on an average 8 to 9 hrs per day) and inadequate diet result in long-term health issues among rickshaw pulllers (Kumar et al., 2016).

The common health problems of rickshaw pullers include back pain, fatigue, stress, headache, muscle pain, joint pain, heart related problems and respiratory disorder. Survey conducted at Aligarh city revealed that rickshaw pullers are mostly suffering from cough, cold, joints, back and chest pain, asthma, tuberculosis, gastroenteritis, diabetes, blood pressure and stone in gall bladder (Khan et al., 2010).

Rickshaw pullers also become the victims of various health issues due to adverse weather conditions and also get affected by different skin related problems because of extreme hot and humid weather conditions. Irregular, improper and unhygienic dietary intake leads to the gastro-enteric problems of the rickshaw pullers. Most of the rickshaw pullers consume alcohol and are addicted to other drugs. Many of them are unaware about the health related adverse effects caused by alcohol and drugs consumption. There is always a risk of contracting sexually transmitted infections (STIs) and HIV/AIDS among rickshaw pullers. The social factors including personal behavior, ignorance, poverty and lack of basic health care facilities greatly affect the health of rickshaw pullers (Rosato et al., 2008).

Health risk factors

There are a lot of issues which are responsible for ill health of manual rickshaw pullers. The rickshaw pullers often experiences with heavy traffic jam, dust, air, sound pollution, unhygienic food intakes, direct sunlight, massive precipitation, accidental injuries and misbehavior of the passengers. Long term health problems of rickshaw pullers come from the extreme physical stress on daily basis put the rickshaw pullers on (Begum and Sen, 2005).

Air pollution

Air pollution levels cause the severe health problems among rickshaw pullers who are exposed to ambient air pollutants in both short term and long term time periods. Around 6,70,000 deaths per year have been estimated due to ambient air pollution in the Indian cities which are most polluted in the world (Lim et al., 2013). Symptoms of respiratory tract problems, lung function disorder, infections, bronchitis and asthma are common. Air pollution loads are responsible for undesirable birth outcomes, like immature birth and low weight for newborns. Recent studies also reported the increasing risk of diabetes and neurological disorders are associated with air pollution (Yang et al., 2018).

Noise Pollution

Rickshaw pullers are continuously exposed to noise pollution during their working hours which leads to ear problems. The common ear problems include impaired hearing, deafness, infection, wax and otitis. Aage R. Moller also argued that deafness can result from continuous exposure to noise.

Poor Nutrition and Low body mass

To commute more passengers and to increase the income, rickshaw pullers often skip their meals and work in an empty stomach. Irregular and insufficient food consumption do not meet their required nutrients demand. Thus they often suffer from gastro-intestinal problems and have low body mass index (BMI). Unsafe drinking water leads to diarrhoeal disorders among rickshaw pullers.

A study conducted at Bangladesh to find out the health status of manual rickshaw pullers revealed that around 52% of surveyed rickshaw pullers had low body mass index (<18.5kg/m2) and about 50% were identified as suffering from chronic energy deficiency grade-I (Ahmed and Islam, 1997).

Extreme weather

Rickshaw pullers expose to adverse weather conditions like extreme hot and humid condition, severe rainfall when they are working. They suffer from heat stroke, cold, cough and different dermatological problems like eczema, scabies, dermatitis, itching, rashes, fungal infections etc.

Musculoskeletal problems

The laborious physical exercise of manual rickshaw pullers causes the problems of musculoskeletal problems as chronic pain of joints and muscles. Satapathy et al., 2007 also found musculoskeletal morbidity among 89 percent of rickshaw pullers who are working for more than 5years.

Addiction to drugs

Most of the rickshaw pullers consume narcotics like opium, Ganja (grass), and ‘Charas’ marijuana). This triggers instantaneous energy to uptake these physical activities. They are unaware about the deadly effects of drug consumptions. Drug addictions associate with various health issues including cardiovascular problems, lung disease, hepatitis (B and C), cancer and mental illness. Most of the rickshaw pullers are also vulnerable to sexual interactions with sex workers and become victims of STIs, and HIV (Kumar et al., 2016).

Work of Kumar et al., 2016 also reported that 73% of rickshaw pullers of Ranchi consume alcohols and 77 percent of them are unaware of the consequences of unprotected sex and disease like HIV/AIDS/STIs. Laxmi et al., 2006 have shown the occurrence of sexual transmitted infections (STIs) and reproductive tract infections (RTIs) among 10-15 percent rickshaw pullers.

Psychological problems

Most of the rickshaw pullers are from the marginalized section of society. The occupation of rickshaw puller is associated with social stigma as well, this lead to low dignity, hence leading to psychosocial stress. Psychological problems of rickshaw pullers include their insecurity, relationships with other people, behavioral changes, depression, addiction to drugs and alcohol etc. All of these issues lead to long term disease like headache, diabetes, cardiac problems hypertension. There are also chances of psychosomatic disorder among rickshaw pullers due to addiction.

Other health related issues

There are some direct health impacts of rickshaw pulling such as varicose vein, hydrocele and lymphadenopathy along with increasing chances of tuberculosis infection and chest congestion. Injuries due to road accidents are another serious issue. They also face the eye related problems such as impaired vision.

Intervention benefits

The Indian transportation system is in a transition phase. In 2015, motor vehicle (amendment) bill was approved where battery powered e-rickshaw became valid for commercial transportation in India. Recently, the Department of Heavy Industry, Government of India has taken a significant initiative namely NMEM-2020 (National mission for electric mobility) to introduce electric vehicles and their manufacturing in the country. NMEM plan concentrated on vehicular pollution, energy security and manufacturing capabilities of electronic vehicles.

The Government of India also planned to shift traditional vehicles to electric transporation by 2030. It is necessary to adopt electric mobility on account of rapid reduction in fossil fuel consumption, increasing cost of energy, environmental impact of transportation and concerns over health aspects. To adopt electric mobility, there are some challenges including charging facilities, performance of the e-vehicles, maintenance cost and acceptability of the consumers. These challenges need to be overcome by infrastructure build up and increasing the awareness among the users. Various interventions must be taken into account to adopt this energy efficient and affordable electronic transportation system .

Traditional rickshaws carry its legacy. Although the strenuous jobs that the manual rickshaw pullers have to undergo left a long term impact on their health. These are exposed to heavy traffic problems and pollution loads in urban areas which also worsen the health. Traditional rickshaws used to gap the distance from one point to another, at times almost a mile-long journey with a very low wage. The effort they have to put to complete the services is nothing in comparison to the earning they would make at the end of the day. But they experience high occupational stresses. Musculoskeletal disorders are very common among them.

With the progress of technologies the next generation of rickshaw pullers is tending towards services that are less time consuming, need to put less physical efforts and with better monetary benefits. Under such circumstances e-rickshaw has the potential to become an effective alternative vehicle.

The battery powered two seater e-rickshaw can reduce the daily physical workloads and tendency to trap in health hazards. It can be the most convenient way of transport to the entire population. In another way, it has the potential to create a scope for better income with lesser impact on the health of the rickshaw puller. The e-rickshaw pullers can able to afford a better nutritional diet and improve their immunity as well as their lifestyle because of the comparatively less stressed service and better income.

In this way to achieve the targeted indicators the rickshaw pullers either need to convert their manual rickshaw to e-two seater-rickshaw or exchange their old manual rickshaw to a new electronic one. Thus, there is an immediate requirement for environment friendly and low cost transportation in Indian cities which can generate better earning opportunities for the marginal population i.e. rickshaw pullers and at the same time will provide an end to end commuting for the commuters. Studies of Nimbkar Agricultural Research Institute (NARI), Maharashtra already proved that by rickshaws designed with electric motor and batteries have the capability to create alternative options for employment and earnings (A.K Rajvanshi, 2002).

The advantages of the two seater e-rickshaw includes the following:

• E-rickshaws are eco-friendly means of transportation as it is battery powered and an alternative of fuel driven vehicles.
• These are environmentally sound as they are non polluting systems.
• As compared with other type of transportation services, e-rickshaws are of low cost for both the drivers and passengers.
• These are easy to drive and it can reduce the physical labour of the manual rickshaw pullers.
• E rickshaw can also provide better income to the drivers. It can generate high income at less maintenance cost.

Conclusion

Manual rickshaw is a low cost, informal, less polluting transportation system especially in urban area. Manual rickshaw pullers are the representatives of marginalized low income group especially in low and middle income countries (LMICs) and they are at higher risk of exposure towards a hazardous life associated with their occupation. However they are not able to access the health care facilities and health benefits provided by Government and other social advantages. Various issues including socio-economic status, illiteracy, unconsciousness and lack of care, migration of rickshaw pullers, paucity of accommodation and arduous work are responsible for their health deterioration and restricted their admittance to health services.

India is a developing country, progressing fast towards the economy of first or second world countries. In this economic setting, at times, this population with very low earnings find it very difficult to earn enough to support their families. Sometimes, it has been noticed that a good number of rickshaw pullers are mostly of higher age group (i.e 45-60), those who find it very hard and tedious to serve in a comparative setting.

Sometimes they are ought to continue their service only because they are the only earning members who can support their families. According to the reports most of the rickshaw pullers do not have their own rickshaws and largely depend on some other people who own their rickshaws. At days, when they could not be able to handover the sufficient and satisfactory amount of days’ earnings, they fall into huge humiliation.

Most of the rickshaw pullers came from villages to try their luck with a better opportunity to improve their earnings, in towns or cities. But these days very few people prefers to ride on manual rickshws. When they feel this sort of failure and neglection, job related dissatisfaction and frustration often leads them towards bad addiction and other misdeeds. Furthermore, their children brought up in an neglected ambiences, fail to cope up with the comparisons to that of the other children of their age group. This brings a clear class difference. Such miserable lifestyle push them towards the dark alleys of the society and they, in most of the times, fail to get rid of the trap they fall in.

E-rickshaws are very helpful alternative to manual rickshaw considering all these gaps. E-rickshaws can reduce the human effort and are ergonomically sound. E-rickshaw is the sustainable means of transportation. It has the potentiality to curb the pollution level. E-rickshaw gives the opportunity to the rickshaw pullers to increase their earnings to improve their livelihood. Battery operated e-rickshaws are of low cost. Battery recharging options are also cost effective. Hence shifting from manual to energy-saving, labour-saving and fuel-saving e-rickshaws can be profitable for the service provider. However, social, economical and technical issues must be evaluated for successful phasing in e-rickshaws.

In this scenario, to improve the socio-economic, health and socio-cultural balance in the society, Government needs to take necessary measures. Hence subsidized economic help is the need of the moment to upgrade this marginal income group from the loophole of backword economic conditions.