People's Democracy

We are Health Workers, not ‘Social Activists’!

Ranjana Nirula

THE hot sun was beating down mercilessly, but they came pouring in, wave upon wave, some of them carrying their children, undaunted by the sweltering heat with temperatures of over 40 degrees, raising slogans like “We are workers! Pay us minimum wages!”, “We care for others. Who will care for us?”   Parliament Street, in the heart of the capital city, was flooded with over seven thousand ASHAs from ten states - from Jammu, Uttarakhand and Haryana in the North to Kerala and Andhra Pradesh in the South, from  Orissa in the East to Maharashtra and  Rajasthan in the West,  and from the two big states of Uttar Pradesh and Bihar.

The ASHAs came on May 4, to march to parliament, under the banner of the All India Coordination Committee of ASHAs, to tell the government that the invaluable work they do of saving the lives of new mothers and infants, creating awareness about health issues in the rural areas, acting as the link between the poor and health services, must be recognised and compensated adequately. They came to protest against the daily humiliation they face from the administrative and medical staff at health centres, from members of the panchayats, and against the meager amounts they receive as incentives for their work, incentives that are paid irregularly and after a lot of harassment. They came to demand their rights as workers – the right to minimum wages, the right to proper working conditions, the right to work with dignity and respect. They spoke passionately and angrily about their desire to help the poor, especially women and children, in their villages and the difficulties they face, in the process.

The ASHAs dharna on Parliament street was addressed by CITU leaders - A K Padmanabhan, president, Tapan Sen, general secretary, M K Pandhe, vice president, and Dev Roye, secretary - all of whom pointed out the importance of the  work done by ASHAs and the necessity of their being recognised as workers.  They said that it is only through their organisation and struggle  that the ASHAs will be able to win their demands. AR Sindhu, working committtee member of CITU pointed out that the government is trying to divide the health and nutrition workers like the ASHAs, ANMs and anganwadis to prevent them from uniting for their common demands.

Brinda Karat, CPI(M) Polit Bureau member, in her rousing speech,  spoke about the government plea that the ASHAs work is part time and thus does not merit consideration as full time employment.  She said that despite parliamentary committees recommending that ASHAs be paid a monthly remuneration, the UPA government is unwilling to do this.  Sudha Sundararaman, general secretary of AIDWA, Noorul Huda, finance secretary, AIKS and other leaders also greeted the demonstrators, assuring their support.

Later a delegation comprising of Ranjana Nirula, VV Presennakumari (Kerala), Suryawati (Andhra Pradesh), Banabasini (Orissa) and  Manjula (Bihar), led by CPI(M) MPs Ram Chander Dome, TN Seema and Jharna Das, submitted a memorandum  to the union health minister, Ghulam Nabi Azad.  In January 2009 the then health minister had assured a monthly remuneration of Rs 500 for ASHAs, but this has not been implemented. Now, the present health minister flatly refused to consider a fixed monthly remuneration for ASHAs, even though it was pointed out that the states of West Bengal and Rajasthan are paying Rs 800 and 950 per month respectively to ASHAs, in addition to the incentives. It is evident that this government, while mouthing sympathy for the aam aadmi, pleads lack of resources to give even a  paltry amount to those whose work and contribution is crucial for the health of the poor, but is ever ready to give lakhs of crores as concessions to the corporate sector. 

The 7.89 lakh ASHAs form a key component of the flagship programme of the government, the National Rural Health Mission (NRHM), which was started in 2005. Their tireless efforts have led to a fall in the Maternal Mortality Rate and Infant Mortality Rate, due primarily to increased institutional deliveries, facilitated by the ASHAs.

Despite this the government perceives ASHAs as volunteers or social activists, who should work for peanuts, because they are doing ‘social service’. Supposedly they have other jobs or income generating activities, and they do this work part time. How untrue this is when there are no job opportunities in the rural areas and in fact ASHAs have to work for at least 5-6 hours a day to complete all the jobs they have to perform, traveling long distances especially in tribal areas, and they are on call 24x7, for pregnant mothers. Still more work is loaded on them during epidemics, for conducting surveys, etc.   The lack of recognition of their work is also because it is seen as an extension of housework, the value of which is totally disregarded in society.

Just fifteen months ago, in February 2009, the CITU had organised a convention of ASHAs in Delhi, in which over 900 ASHAs participated.  The CITU had decided to organise the ASHAs because of their deplorable conditions of work and intense exploitation. In this short period, unions of ASHA workers have been formed in eleven states, with a membership of around 40,000 and they have been agitating continuously for their demands.

The All India Coordination Committee of ASHAs has decided to strengthen the ASHA workers unions and to intensify struggles in the states on the demands of ASHAs, focussing on the demand for monthly remuneration on the lines of West Bengal and Rajasthan.

Demands

1.                 NRHM be made a permanent programme

2.                 ASHAs be regularised as permanent rural health workers

3.                 Monthly honorarium be paid to them, pending payment as per the Minimum     

          Wages Act

4.                 All incentives be paid regularly and through individual bank accounts

5.                 Rooms be provided for ASHAs in PHCs, CHCs and hospitals

6.                 Medical kits and adequate medicines be provided

7.                 Two uniforms a year, ID card and badge be given to ASHAs.

8.                 BPL card be provided to all ASHAs

9.                 Health insurance and social security benefits be provided

10.             Harassment of ASHAs by health and administrative staff be stopped

11.             ASHAs to get training and priority in promotion to ANM status