A small statistic, in the light of the much larger numbers that we encounter these days. But a very dire one, nevertheless. ASHA workers have long made up the backbone of the Indian healthcare system. In the COVID-era, they have been the most immediate and familiar frontline workers for many people, particularly in rural areas. From ensuring vaccinations (both COVID and regular ones), to ensuring that sick people get tested, ASHA workers have been burdened with a great deal of work in the pandemic and yet, are told that they are carrying out a ‘service’ and so must be satisfied with the little they make. Yet, similar expectations are not put on other medical professionals, who are seen as more formal and educated and treated as such. The burden of gender is also imminent. ASHA workers are also frequently chased away from homes and ill-treated, despite the fact that they are responsible for keeping track of basic healthcare.
Recently, ASHA workers wrote to the Prime Minister listing out their demands and stating their condition. As they have explicitly stated, they wish to ensure the “dignity of [their] profession, physical safety…and rightful and lawful wages.” This triple demand has not yet been fulfilled in any form. Instead, their living and working conditions have significantly worsened. Similar movements are on among other women workers, such as pourakarmikas in Karnataka and garment workers in Tamil Nadu and Andhra Pradesh.
A summary of the demands, excerpted from the letter are as follows:
1. We demand that our wages be fixed at a minimum of Rs.18,000 (Eighteen thousand) for ASHA Workers and Rs.24,000 for ASHA Supervisors per month.
2. Every work and task assigned to an ASHA must be in writing and officially recorded. Orally assigning work must stop immediately. And an ASHA should not be made to carry out tasks for any other department other than health. For example, she should not be assigned election duty, school exam duty etc.
3. Every ASHA must be given adequate training by health experts, particularly epidemiologists so that they can give proper service to their communities. Besides, all necessary medicines should be available in sufficient quantities so that we can give primary health care to our communities.
4.Government MUST provide us with thermal guns, oximeters, facial shields, sanitizers, gloves and other PPE for our personal protection.
5. Making us work without adequate PPE must be considered as a criminal offence.
6. We demand 26 weeks leave during pregnancy under the Maternity Benefits Act, 1961.
7. The benefit of all government holidays and weekly holidays should be ensured to us.
8. We demand that every one of us is immediately insured for Rs.50 Lakhs for as long as long as we are made to work under the Mission and that the term of our insurance NOT be limited to the duration of the Pandemic..
9. We demand that the Union Government make a provision to give an additional Rs.10,000 per month as risk allowance till the period of lockdowns and restrictions continue.
10. We regularly expose ourselves to infections, it is quite likely that we will very soon need medical care ourselves. Though most of us are vaccinated, it is likely that we will fall sick given all the new variants. We therefore demand that a hospital bed be assured for us if the occasion arises…Adequate compensation should be given to our families if something happens to us in the course of our Covid-19 duty.
11. Recognise our contribution to the well being of India’s women and children, in particular our fight against Covid-19 by regularising our work and by appointing us as government employees . This will give us much required social security and help us avail the many benefits of Government schemes.
The summary of demands makes one thing clear: that the increasing informalization of ASHA workers’ labour must cease and they must be treated with the dignity and respect that the law provides for them. They earn less than Rs 3000 a month in many states. A lot of payment works in the form of honorariums and informal incentives, which allows for greater exploitation.
There is a great deal of talk about the contribution of women to the Indian economy. Every year, the media celebrates ‘30 under 30’ lists as well as the ‘glass-ceiling’ breakers in the corporate world, but little is said about the women who silently make up the bulk of India’s informal labour force, and even less about the indignities they face. This mere celebration of a corporatized culture of women breaking barriers is a bleak and pointless exercise in eliding the reality of the lives of the majority of India’s working class women who will never make it to any magazine cover, nor do they wish to. Instead, they want their basic rights and in these exceptional circumstances, for the state to recognize their labour and ensure their safety. Many healthcare, sanitation and frontline workers, including ASHA workers, stayed away from their families and children for months during the peak of the second wave to protect them. It is time the state extends a small fraction of the same protection to them as well.