Intersections of caste, class, and gender in healthcare sanitation work in India: Social work imperatives for restructuring marginalized women's care work

Housekeeping and sanitary workers are crucial for the functional efficiency and hygiene of healthcare facilities. In India, women from oppressed castes and backward classes are predominantly recruited in these occupations. The work, regarded as “polluting,” is stigmatized, devalued, and lies at the historical and sociocultural intersections of caste, class, and gender. In the context of the COVID-19 pandemic, this paper utilizes the concepts of “feminization of labor” and “care ethics” to read caste into an intersectional theoretical analysis of the organization of marginalized women's labor in such essential, yet invisibilized healthcare work. An exploratory narrative review of literature focusing exclusively on marginalized healthcare housekeepers and sanitation workers in India is undertaken and supplemented with a critical analysis of labor laws and policies to trace the sustained reproduction of the caste-based sexual division of labor in these occupations. I propose that their exploitative terms and conditions are sustained by what I refer to as the “feminine caste contract” – a complex sociopolitical and legal arrangement of precarious, casteist, and gendered work conditions. Recognizing the exploitation inherent in this contract, recommendations are made for social work education and practice to play a key role in restructuring marginalized women's labor in essential care work.