GROUND REPORT

But working tirelessly, they are yet to be compensated with a decent wage and other benefits

Arjumand Shaheen Andrabi | Clarion India

SRINAGAR —ASHAs, or Accredited Social Health Activists, work as an interface between the community and the public health system In India. They are supporting staff in government health care and assist in: deliveries; immunization drives, identifying and managing pregnant ladies; lactating mothers; births and deaths; family planning services; nutrition services; mobilising; counselling the community; sterilisation camps and follow up TB patients and much more.

Currently, they are also performing Covid-19 duties in addition to their regular work.

Almost six months ago, before the onset of the second wave of Covid-19, the Central Government launched the vaccination drive. The biggest challenge for the authorities was to reach out to the 60% of the population who lives in rural India. The ASHA workers were instrumental in bridging that gap and creating awareness among the people living in the remotest areas. They were largely successful in motivating the people for vaccination.
According to the National Rural Health Mission guidelines, an ASHA worker is supposed to work in a very flexible schedule of work limited to 2 to 3 hours a day, on about four days a week, except during some mobilisation events and training programmes. But, for ASHAs like 32-year-old Naza who is based in the Lolab area of Kupwara in Kashmir, working tirelessly for 30 days to get an incentive of Rs 2,000 at the end of the month is not rewarding.

Amid the narrow and poor road connectivity in rural areas of Kashmir, with poor or sometimes no transport, ASHA workers at times mount the uphill roads and mountains, cross the bridges, go through the dense forests – where they also have the fear of wild animals – to reach out to the targetted population regardless of the time slot and weather condition.

“We are the ones who face the people first. We go to the hilly areas and faraway places, where there is no transport to motivate people for vaccination. We also have to do surveys to keep the track record of vaccinated and unvaccinated people. People don’t take us seriously. They look down upon us as low-grade employees,” said Naza, a mother of two.
“After we motivate people, either they go to the respective health centres or the doctors and other paramedics go to their homes to vaccinate them,” she added.

ASHAs go to the areas in their locality to identify and check the eligibility of the people for vaccination and convince them to take the jab. According to the ASHA workers, some females avoid the vaccine because they think that it will cause infertility and other menstrual problems in them.

The health workers and doctors have constantly been refuting such misconceptions and trying to counsel them about its safety.
The data available on the Covid-19 Vaccine Intelligence Network (Co-WIN) portal shows that four out of ten districts of Kashmir have fewer women getting vaccinated as compared to men.
Every village has a team of five ASHA workers along with ICDS workers, for managing and conducting the vaccination drive in the villages and urban slums.
Razia, a 24-year-old ASHA worker living in the Khodi area of Lolab Kupwara, is six months pregnant. Despite being pregnant, her financial condition does not allow her to be at home or relax. Her husband is a labourer and does not make enough money. She walks through the craggy and uneven roads to perform her duties.

“I almost lost my baby. One day when I returned from work, I felt no movement in my womb. I was freaked out. The baby had stopped moving. I called my doctor, and she advised me to go for the USG. But thankfully after 42 hours, the baby started moving,” said Razia.
According to Dr Fareed, who is presently Block Medical Officer in Sogam, there is no maternity or any other kind of leave for ASHA workers since they are working as daily wagers. If they take any leave they have to compensate for the work on other days.
These health warriors, working as Covid-19 frontline workers, who are now the face of the vaccination drive in rural India, the most vulnerable group to get infected with the virus, have been struggling for long for decent wages and timely compensation. There were reports of deaths of a few ASHA workers also during Covid-19 duty.
After working tirelessly Naza gets a monthly income of 2,000 rupees, which also she doesn’t get on time. Just a few days ago Naza received her monthly incentive after working for straight three months.
Her husband, who is a driver by profession, has been out of work for the past two years. The abrogation of Article 370 in 2019, followed by curfew and shutdown, later the Corona lockdown, when all activities came to a halt, rendered thousands of labourers like Naza’s husband jobless and they had to sit back at home doing nothing.
Living in a single room, old, shabby house, Naza’s house was as gloomy as her life. She is the only hope for her family and children now. From providing necessities like food, shelter and clothes to their education, she has to take care of all, which according to Naza is impossible to manage in the sum of 2,000 rupees.

“We get the issued sum of approximately 2,000 rupees, that too only if the assigned work for the particular month is done. I got my last payment after almost three months. We risk our lives to save people. We are not being provided with Personal Protection Equipment. We also have family and children to look after them, their food, school fee, uniform, and other expenses. How can these expenses be fulfilled with the sum of 2,000 rupees?” asked Naza.

A few weeks ago, CPI(M) leader Mohammad Yousuf Tarigami urged the administration of Jammu and Kashmir to provide adequate incentives/wages to ASHA workers, on the pattern of Covid-19 warriors of the Health and Medical Education Department, to boost their morale in these tough times.

The Special financial incentives scheme for Covid-19 warriors of the Health and Medical Education Department would benefit more than 17,000 employees including resident doctors, medical officers, paramedical/nursing staff, drivers and Class IV employees. But ASHA workers who are the backbone of the health system in rural areas working on meagre incentives have been left out.

In a letter written to Lieutenant Governor Manoj Sinha, Tarigami urged them to include ASHA workers in the incentive scheme for the Covid-19 warriors.

During the DDC elections of 2020 in Kashmir, Razia was pregnant for the first time and she was put up for election duty. On the same day while on duty, Razia had a miscarriage. That day she was shattered, imprecating herself and the work she does, for which they get peanuts in return.

“I had to spend much more money on my health than I got. I don’t want the same thing to happen again. People sometimes allege that we get money for motivating people from the government but the reality is we don’t even get what we deserve,” sobbed Razia.

Both Razia and Naza believe that the government will not be able to manage the vaccination drive and the other basic things without ASHAs.

“We challenge the authorities to do the vaccination process successfully and the other work which we are doing for years, without ASHA workers in the same amount which we are getting.”