After attending a three-day training organised by the Building Water Business (BWB) programme in 2023, Md. Ismail Hawlader became the first sanitation worker in his area to adopt safe faecal sludge management practices. His annual turnover grew from 25,000 Bangladeshi Taka (BDT) in 2020 to BDT 530,000 (~€3,745) in 2024. The change was not just in his methods — it came from a structured market that the BWB programme built between trained sanitation workers and Health Promotion Agents. 

Ismail, 50, has worked as a sanitation worker for over 30 years in Bakerganj Upazila, Barishal District, Bangladesh. He started at Grameen Bank, worked a period with Dhaka City Corporation, and currently works under Bakerganj Paurashava while taking freelance pit-emptying work in Rangasree Union. Before the training, he and other sanitation workers used traditional manual desludging methods — without protective equipment or structured disposal practices. Faecal sludge disposed of incorrectly contaminates soil and water sources, raising the risk of waterborne diseases including diarrhoea, cholera, and typhoid. Workers themselves faced serious health risks: infections, skin diseases, and respiratory problems. 

The three-day training covered personal protective equipment (PPE) — gloves, boots, protective clothing, helmet, mask, and goggles — and environmentally sound disposal techniques. All participants received PPE at the end of the training. Ismail now follows a structured process: preparing a safe disposal site, applying disinfectants before and after sludge transfer, using dry ash for odour and pest control, transferring sludge with a bucket and rope to minimise spillage, and sealing the site with soil once the work is complete. 

The BWB programme also trained Health Promotion Agents (HPAs) — local entrepreneurs who go door-to-door to raise awareness about the risks of self-managed desludging and to promote trained sweepers’ services. A Memorandum of Understanding (MoU) formalises the arrangement: HPAs receive a commission from sweepers for each confirmed client after the job is completed. This structure links demand creation directly to professional service delivery. 

Rangasree Union has 5,057 households, with nearly a quarter facing economic constraints that make hiring professional services difficult. Many families have historically managed pit emptying themselves, without training or safe disposal methods. The HPA-sweeper model addresses this by making professional desludging more visible and accessible — and by building the case, household by household, for why it matters. 

Ismail supports his wife, two daughters, and three sons through his work. Despite his income growing substantially, sanitation workers in Bakerganj continue to face social barriers — excluded from community events and engaged by neighbours only when their services are needed. The BWB programme is running community outreach sessions and working with local leaders to address these perceptions and recognise the public health role that professional sanitation workers play.