Permanently Voluntary: Frontline Health Workers In India
Tell us about yourself?
I work as a trade unionist in Pune city, one of India’s large industrial cities, organizing informal sector workers, particularly women with a view to increasing their visibility and recognition as workers making significant contributions to the economy. I have particularly been associated with a trade union of domestic workers, and more recently with Accredited Social Health Activist (ASHA) workers, who function as link workers in health services for low-income households.
ASHA workers have been striking for the past few years, can you elaborate on their concerns?
Over 10 lakh (1 million) rural and urban ASHA workers whose role in the pandemic has been acknowledged from all quarters, continue to be sidelined. Their demand for the recognition of their work in their role as community health workers is deliberately pushed aside by a state system that appears to be thriving on the free labor of women workers. It, therefore, begs the question of why the state continues to not only neglect but openly exploit these workers when they could be developed into a human force that has the potential to substantially help the country to achieve its development goals, especially those related to maternal and child health and nutrition, and the eradication of several diseases.
How did the concept of an ASHA worker emerge?
The National Rural Health Mission (NRHM) which was first set up in 2005 describes the role and responsibility of an ASHA worker—the ASHA will be a health activist in the community who will create awareness on health and its social determinants and mobilize the community towards local health planning and increased utilization and accountability of the existing health services. She is to be a volunteer, with no salary or honorarium, and it is expected that her work as an ASHA worker will not interfere with her normal livelihood.
The ground reality is that ASHA workers are performing duties for more than 7–8 hours a day and almost all days of the week. It is not just that they are not paid or poorly paid for their 24×7 services. They are often asked to do menial tasks, face physical and mental abuse, and are at times forced to part with their meager earnings with corrupt health staff members. The lack of status and indignities they face are a direct product of the “nature” of their work and the fact that they are “poor women” workers with few options.
The underlying assumption that the ASHA workers are also gainfully engaged in some other occupation that provides them adequate income and can therefore easily spare this time for voluntary work, is mischievous, especially, when policymakers are clearly aware of the constantly declining work participation rates of both rural and urban women in the last two or more decades.
What are their demands?
They are organizing into trade unions and pushing demands for minimum wages, social security, and dignity. They called for permanency of their mission and universal legislation guaranteeing the right to healthcare, a minimum wage of Rs. 21,000 ($270), pension of Rs. 10,000 per month($130), an additional COVID-19 risk allowance of Rs. 10,000 per month, and continued insurance coverage.
If you would like to contribute to the series, contact our executive editor Neeta Misra at neeta@businessworld.in
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