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Saturday, September 26, 2020

Unrecognised, underpaid and defenceless, ASHA workers wage war against coronavirus pandemic

Acting as the extension of healthcare facilities of India, ASHA (Accredited Social Health Activist) workers crumble under the weight of rising cases and insufficient infrastructure.

Written by Pallavi Singhal | Panchkula | July 29, 2020 3:07:35 am
ASHA workers, war against coronavirus pandemic, Panchkula news, Haryana news, Indian express news Asha workers show a memorandum before submitting it to CMO, Panchkula. (Express photo)

Sejal (30) has spent the first four months of her pregnancy on field at Buddanpur, conducting surveys for the highly infectious coronavirus disease and keeping tabs on its spread in containment zones created in the area. Her salary — a meagre Rs 4000 — for the month of June is yet to be credited to her account.

Acting as the extension of healthcare facilities of India, ASHA (Accredited Social Health Activist) workers crumble under the weight of rising cases and insufficient infrastructure. They have been working incessantly for the past several months in the face of a raging pandemic sans any incentive, healthcare insurance, any protective gear and with salaries far less than that of a daily wager.

More than nine lakh such women have been on the forefront of their individual areas, forming the basic level of the healthcare chain. Despite their role in the system, their work goes mostly unrecognised.

In the past week, four such ASHA workers tested positive for the novel coronavirus in Panchkula, after being exposed to an already positive patient.

Sejal is among the 326 such workers in the district. Her routine for the past few months has remained the same- waking up at 6 am to complete household chores, before she sets out around 9 am to conduct surveys in the field. After collecting her daughter from the neighbour’s home and after lunch, work begins again. Sitting down to make lists, she calls pregnant women and other vulnerable persons in her region to check on their status and then coordinates with her facilitator to send her a compiled list. The rest of the day, she says, is spent playing with her daughter, attending to emergency cases in her area, making sure ambulance reaches them and preparing for the next day.

With Sejal’s husband currently stranded in Amethi, UP, she struggles to meet ends meet and her resolution starts to dwindle. As her pregnancy progresses, Sejal, the lone breadwinner, is torn between prioritising her health or continue working. “There is no concept of maternity leave or even access to free basic healthcare as opposed to what all doctors or any other government employee has,” she said. She will soon have to find a replacement for herself who will agree to do her job. “Only then will the money get transferred in my account,” Sejal added.

Continuing surveillance and keeping track of administering medications and vaccinations to children of her area, keeping a count of high-risk patients, organising meetings for awareness regarding family planning as well as monitoring deliveries in her area has never been such a task. “I used to balance two jobs earlier. I would work as an ASHA during the day time and work part time for a few hours in Chandigarh at evenings. But due to the extra workload these days, which takes up almost all of my day, I have had to quit my part time job,” she said.

Asha workers have acted as the backbone of the healthcare system of India as they collect real time data, do field duties throughout the day to assess spread, check for symptoms, motivate women towards family planning and healthcare, keep demographic records and update all of it each time. Serving as the only mechanism between healthcare system and rural populations, ASHAs have found their workload increased many folds. Now tasked with keeping an eye on moving population, administering several rounds of basic medication and immunization to children who would otherwise receive them in government schools has proven to be a task for them.

Throwing more light on the plight of these ground-level workers, Vandana, the elected president of Asha Workers Union of Panchkula, says, “ASHA workers are the ones who take up each task of the health department and actually take it from paper and documents to the people of the country. We face row of abuses, harassment, threats and witness fights as well as ignorance each day on the job. The rural population remains scared of us as the urban questions and ridicules us. Still, we are the only ones who stand in the fields and do their jobs.”

She further said, “The government is yet to give us any allowance like everyone else. They have given working bonuses to doctors and nurses but nothing to us. Yet we work round-the-clock. We reach a positive patient’s house, if they are scared, we motivate them to go to the hospital. Fifty per cent of our incentives which we used to get under eight heads were taken away from us. We have given several letters to the government to look into the matter and roll it back, but to no avail.”

As per guidelines, ASHAs must female residents of a village that they have been selected to serve, who are likely to remain in that village for the foreseeable future. ASHAs must have at least qualified class 10.

In Panchkula, most ASHA workers are matriculates. Most of them are also widowed or have husbands who do not work, thus making the families rely solely on them for any income. “Most of our ASHAs’ husbands are alcoholic or simply do not work at all. Some are disabled or have passed away. Things are hard for them. Even for those with husbands who work, they mostly work as daily wagers and the lockdown has been bad for them. ASHA’s salaries remain the only source of money for the household now,” says Anju, facilitator of 40 ASHA workers from old Panchkula.

Those who tested positive have also borne the brunt of discrimination. “When we tested positive, the world got to know of it. The stigma attached with the disease has ruined our lives. We cannot meet our children and the four of us remain cooped in two rooms built on the rooftop of one of our houses. My 14-year-old daughter has been cooking food for all of us. Our children haven’t seen us. The administration is refusing to re-test us and our husbands’ employers have asked for proofs that their wives are negative. What do we do? Where do we go?” questioned a 45-year-old ASHA worker who tested positive.

In a bid to draw attention to their issues, the Haryana Asha Worker Association has announced a three-day strike from August 7-9 in protest of their prevailing conditions demanding their 50 per cent incentives, a compensation for ASHAs who contract virus in the field, doubling of their monthly fixed salaries of Rs 4000, availability of PPE kits and other protective gear among others.

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