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Indian Express Stories of Strength

Facebook and The Indian Express bring you a series on those at the forefront of the fight against the pandemic. From healthcare workers to government officials to innovators — a look at their day at work, their struggles and challenges.

Through rain and floods, Assam’s community workers battle pandemic

Floods might be as old as Assam, but fighting a pandemic in knee-deep water is a whole new challenge for even the most seasoned health worker.

July 12, 2020 5:29:25 pm

GUWAHATI: It is the wind that has helped Pratima Barman plan her day as an accredited social health activist (ASHA) in Assam’s Dibrugarh district for seven years now.

In the sapori (island) village where Barman lives, a strong gusty wind, coupled with the sight of a brimming Brahmaputra, signals the annual deluge. On such days, the 35-year-old will switch her crisp whilte-and-blue ASHA sari for an older, well-worn one. She will slip on her washed-out rubber chappals, carefully balance her bag on her head, and set out. And then, wading through waters, Barman will call on the pregnant and the sick, the old and the young, and—as she has done over the last three months—seek out those who might be showing signs of a fever, a cold, or a cough. In the evening, she will wash up, sanitising everything from her watch to her bicycle, before entering her house.

Floods might be as old as Assam, but fighting a pandemic in knee-deep water is a whole new challenge for even the most seasoned health worker.

Barman, and her colleagues, are the foundation of the ‘Assam Community Surveillance Program’ — coordinated by the National Health Mission (NHM) — which does door-to-door checks in rural Assam, to find those with symptoms of the novel coronavirus, as well as malaria and Japanese Encephalitis. It is an exercise that has covered more than 30,000 villages so far with an army of ASHAs, anganwadi workers (AWWs), auxiliary nurse midwives (ANMs), multi-purpose workers (MPWs), surveillance inspectors, lab technicians, and doctors, spread out across the state during a debilitating flood that, since May, has affected more than 26 lakh people in 29 districts, and claimed 42 lives. Twenty-four have died due to landslides triggered by heavy rain.

Floods might be as old as Assam, but fighting a pandemic in knee-deep water is a whole new challenge for even the most seasoned health worker. A health worker in Demaji.

“They have gone beyond the call of duty, I am at a loss of words to describe their loyalty,” says Dr Lakshmanan S, director of NHM.

While it is only now that social media is filled with pictures of community health workers — mekhela chadors and saris hitched up to their knees, balancing themselves on makeshift bridges, or squatting precariously on rafts made of banana tree trunks — they say it is a sight that plays out like clockwork every year. “We are getting praised now because of Covid, but we have been wading through waters for years,” says Minu Saikia, 40, an ASHA from Dibrugarh district, one of the severely affected districts this season. Just two weeks back, Saikia slipped in the waters, twisted her ankle, and thereafter, limped back home. “These kinds of things keep happening and we are used to it,” she says, using the Assamese word obhyaax (habit) to describe her relationship with the floods.

While the waters had receded a week back, heavy rainfall has put the state on alert again — subsequent waves will follow in this month, and in particularly low-lying areas, chars and saporis, continue till October at least.

“They have gone beyond the call of duty, I am at a loss of words to describe their loyalty,” says Dr Lakshmanan S, director of NHM.

Anita Medhi, an ANM from Sonitpur District’s Balipara says the floods so far have been ‘minuscule’. “It is just knee-deep till now,” she says, recalling how in the 2019 floods, considered one of the worst in years, she had slipped from a makeshift bridge and fallen right into flood waters below.

Stories like this abound in Assam. “Sometimes floating branches will poke us, sometimes an insect will bite us, who knows what the waters hide,” says Barman, adding that now the fear is of the virus too. Since the pandemic, masks and gloves are new additions to their attire.

In Goalpara district’s Baladmari char, 31-year-old MPW Samsul Alom says they are toiling more this year. “We would do routine check ups earlier too, but this time we go to each and every house, covering a hundred per cent population,” he says, adding that the sub-centre he works at caters to a population of 21,000 people. Hiren Deka, 50, MPW from Baksa district, says, “I have old people in my family, so it is scary but then again, this is a part of the job.”

Barman agrees. “Bhiji-titi holeu jaam. We might be soaked to the bone, but we will still go,” she says. The resolve seems to have stuck through the pandemic — motivation which comes from a sense of responsibility one inculcates from years on the job, which pays ASHAs like Barman and Saikia an honorarium of Rs 3,000 per month.

On June 27, Deka set out on door-to-door calls with his colleagues, amidst heavy rains in Baksa district. “We didn’t expect it to but it started pouring,” says ASHA Jayanti Boro, who was part of the team, “We considered stopping but then decided to get over with it, even if we knew it would be hard.” To reach Katanipara village, where they had to carry out the surveillance, the team had to resort to a raft, tying trunks of four banana trees together. The picture of the two women, Boro and ANM Alari Swargiary — sitting on the raft, deep in conversation, seemingly oblivious of the waters around them — went viral afterwards.

ASHA Jayanti Boro and ANM Alari Swargiary, perched on a banana trunk raft, navigating floodwaters in Baksa district.

Dr Syed Ariful Islam, the 40-year-old who had led the team, said the picture is representative of not just Baksa district, but every part of Assam. “They walk, they cycle, they step into neck deep water,” he says, “With floods in Assam, you never know, one day you will be walking on solid ground and the next day you will be waist-deep in water.” MPW Alom says while he knows how to swim, many of his co-workers feel scared balancing themselves on rickety wooden boats. Getting these, is also, a matter of luck. “Sometimes, an organisation will provide us with one, but on most days we have to find a willing boat to ferry us,” says Rina Namashudra, a 45-year-old ASHA from Dibrugarh district.

Islam feels it would be a big boon if the State Disaster Response Fund (SDRF) could provide dedicated rafts to ferry workers, to make their jobs just a little easier. “There is always a risk of falling, arrangements like this would aid fearless, undeterred service,” he says.

NHM’s Lakshmanan described these times as “unprecedented and unimaginable”. “This is a first for this kind of surveillance and floods. Earlier, weekly immunisation would happen during floods and there was an opportunity plan, make arrangements ahead, but now it is not practically possible for us to arrange boats in every district,” he says.

In Goalpara district’s Baladmari char, 31-year-old MPW Samsul Alom says they are toiling more this year.

While in the last week the waters had receded from Barman’s home in a sapori in Dibrugarh district, the rains from yesterday have flooded her courtyard yet again.

In March, the Central government provided insurance worth Rs 50 lakh for frontline health workers, including ASHAs, if they were diagnosed, or lost their lives, in the line of Covid duty. “But it would be nice if they decided to give us something during our lifetime too,” says Barman.

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