People's Democracy

Serving Others, While Starving Themselves

Ranjana Nirula

�For months we look after pregnant mothers, visiting them regularly, taking them to the PHC, to the doctor for checkups, but sometimes when their labour pains start at night, there is no conveyance to reach them to the hospital in time as our village is very far away. Then the delivery has to take place in the village and we are not paid the incentive due to us. Is it fair?� said Kamala Devi, an ASHA from Uttarakhand.

The word �ASHA� means hope and the five hundred plus women who came pouring into the grounds of Vithalbhai Patel House on February 19, 2009 for the first national convention of ASHAs came with hope in their hearts, for a better deal from the government, for proper remuneration for their work, for better conditions of work, ready to struggle for their rights and, most important of all, for recognition as workers. They came from eight states including snowy Jammu and Kashmir, from Orissa, Madhya Pradesh, Uttar Pradesh, Bihar, Haryana, Uttarakhand and from as far as Andhra Pradesh. Along with them came around two hundred mid day meal workers from twelve states, including Manipur and Maharashtra, Kerala and Karnataka, along with the ones mentioned above, for the first national convention of mid day meal workers, called by the CITU at the same venue.

ASHAs are Accredited Social Health Activists, the grass root level functionaries under the National Rural Health Mission (NRHM) of the government. The ASHAs are meant to be trained female community health activists, who are to act as a link between the health centers and the villagers. One ASHA is selected from each village or cluster of villages, to serve a population of 1000. In hilly, deserted or tribal areas, population norms are relaxed, if necessary. The ASHAs are women who are �married/widowed/divorced�, aged 25-45 years. They should be educated �upto eighth class�.

They have a wide range of jobs, including creating awareness about sanitation, hygiene, immunisation, nutrition, providing information about health services, providing primary medical health care for minor ailments and escorting patients to medical centres. They have to inform the PHC/Sub Centre about the birth and deaths in the village, deliver the DOTS course and oral rehydration, distribute folic acid tablets and chloroquine to patients, create awareness about HIV/Aids and alert authorities to unusual outbreaks. The ASHAs are to work in coordination with the anganwadi workers and the ANM. They are to be provided with regular training to upgrade their skills.

The catch is that the government clearly states �� these ASHAs would be honorary volunteers, there is a provision to provide them with performance-based compensation for undertaking specific health or other social sector programmes with measurable outputs�.�

It is only too evident that the government envisages the ASHAs to be �social workers�, just like the anganwadi workers, who should work without any wages, but can get some �incentives�. The government expects the over six lakh ASHAs in the country to deliver this wide range of health services, surviving on love and fresh air.

The ASHAs are not paid their incentive for institutional deliveries or the TA/DA for training programmes on time, and corruption in the payment process is common. They are ill-treated by the hospital staff and have no facility to even rest at the hospital, despite travelling long distances with patients. Recently the government of India announced a monthly payment of a paltry Rs 500 for them, but it is yet to be implemented.

The mid day meal workers, over 20 lakhs of them, cook and serve meals to over 12 crore children in schools, under the National Progamme of Nutritional Support to Primary Education. This centrally sponsored scheme was launched in 1995 and now covers all the blocks in the country. It is the largest programme of its kind in the world, covering 9.5 lakh schools/education guarantee scheme centres in the country.

Under this programme, the government of India supplies free foodgrains and provides assistance for cooking costs at Rs 1.50 per child per school day to the states (except for the North Eastern states where the amount is Rs 1.80 per child per school day). The state governments contribute at least Rs 0.50 and Rs 0.20 respectively.

The job of cooking food is allotted to local women�s/mothers self help groups, NGOs, or personnel directly engaged by the village education committes, PTAs/ gram panchayat /municipality, etc.

Those engaged in cooking food under the scheme all over the country have to work for at least 5-6 hours a day and receive a pathetic amount varying from Rs 100 to Rs 650 in different states. They are forced to do other jobs in the school and are under constant pressure to keep the authorities happy in order to receive their payment and retain their jobs.

Recently the government has been making efforts to get the cooking work done by NGOs including religious organisations like the ISKCON. Such organisations have no accountability and they also collect huge funds from various sources in the name of feeding children, which never reach those they are intended for. The government also tried to introduce Ready to Eat food instead of freshly cooked food, but the attempt was resisted.

In view of the deplorable conditions of both ASHAs and mid day meal workers, who come from the poorest and most deprived sections of the rural population, the CITU had decided in its working committee meeting in New Delhi in October 2007, to organise the ASHAs and mid day meal Workers. Many state committees of CITU have taken up this task seriously. Unions have been formed in several states and struggles conducted for the demands of both sections, resulting in some demands being met. Recently a meeting of all those in the CITU who are organising the ASHAs and mid day meal workers was held in Mumbai and a decision taken to hold national level conventions of both sections in Delhi, on February 19, 2009, to highlight their problems and formulate a charter of demands for them.

Hemalata welcomed the delegates to the convention of ASHAs, which was presided over by A R Sindhu and a presidium of ASHAs from the states. Inaugurating the convention, M K Pandhe pointed out that CITU has taken the initiative to organise the ASHAs as they are not even recognised as workers by the government of India. They have no social security benefits, and let alone not getting the minimum wage, they are made to work almost for free. He stated that they must be prepared to struggle hard for their rights and must strengthen and expand their organisation.

Ranjana Nirula placed the declaration and demand charter before the delegates, for discussion. Brinda Karat, member of the Polit Bureau of the CPI(M) and MP, Rajya Sabha, addressed the convention. She stressed that ASHAs should be regularised and given payment on par with the anganwadi workers. She stated that the government is trying to create divisions amongst poor women, between ANMs and ASHAs, but we will get together, along with anganwadi workers and will unitedly fight for our rights.

Eight delegates participated in the discussion on the declaration and demand charter and related their conditions of work and problems, after which it was adopted unanimously.

The convention resolved to observe March 18 as an all India ASHAs Demands Day in all the states, and to form a coordination committee of ASHA unions on the national level, in order to take the struggle forward.

In the afternoon, a convention of mid day meal workers was held at the same venue, presided over by A R Sindhu and a panel of mid day meal workers from different states. The general secretary of CITU, Mohd Amin, inaugurated the convention and urged the mid day meal workers to unite and form strong unions so that they can struggle effectively for their rights. Sindhu placed the declaration and demand charter and ten delegates took part in the discussion on it. One delegate from Manipur said that they were not paid for 7-8 months and the delegate from Orissa reported that only Rs 200 per month is paid to the cook and Rs 100 to the helper.

A delegation led by Tapan Sen, secretary CITU and MP, Rajya Sabha, met the education secretary, Anshu Vaish and submitted a memorandum regarding the demands of the mid day meal workers. It is the first delegation to the central government, raising the demands of this section of workers.

After the declaration and demand charter were adopted unanimously by the delegates, it was decided to observe March 26 as a mid day meal workers� Demands Day, through rallies, demonstrations, meetings, etc., in all the states and to form a co ordination committee at the national level.

Both the conventions were very successful in view of the enthusiastic participation of the hundreds of women and their firm commitment to organise and struggle for their rights.

What is very clear is that the government of India is withdrawing from its responsibility for providing health and education facilities. It utilises the common notion that all such work, whether of the anganwadi workers and helpers, ASHAs or mid day meal workers, is just an extension of the housework that women normally do, and therefore not worthy of any recognition, let alone payment for it. That is why they are all considered �social workers�, and expected to slave for long hours, doing what is essential for the health and well being of the poor, especially women and children, for a pittance, while literally starving, themselves. The government is happy to collect huge funds for health and welfare activities from funding agencies but is not prepared to acknowledge or reimburse those who are crucial for the provision of these services.

This situation has to change and these women are going to change it - through their organisation, through their unity and their struggle.