Suman Belhara, 47, an accredited social health activist (ASHA) in Delhi’s congested Neb Sarai area, offers instructions to a man who has tested positive for COVID.
“Please quarantine for a week and avoid contact with others. Take these tablets if the fever goes up, drink fluids and I will come back in a couple of days to check on you,” Belhara tells the patient.
Belhara is one of the million-strong female social health activists in the country, who have formed the core of India’s community health care delivery in recent years. Such workers often risk their own health and safety to assist others, carrying out long working hours for low wages.
It is nearing the end of Belhara’s shift, who has to cover over 450 households. She has gone to 25 different houses in the last nine hours, conducting surveys and checking for coronavirus symptoms.
She and several others have worked throughout the pandemic to offer health care services and information in rural communities and urban slums.
Suman Belhara said she has been working nonstop to deliver health care services since the pandemic began
‘We work relentlessly’
“I have no fixed hours. Sometimes, work spills over until well past nightfall. We work relentlessly,” Belhara, a mother of two, told DW.
“In April, it will be two years since I started doing this work, tracing and testing people with COVID symptoms in their communities and providing the first response,” she said.
“When we ASHA workers started off, there was no formal or elaborate training. There was just a briefing at a local hospital, where I was given instructions on how to conduct surveys, take notes and create awareness around the virus,” said Belhara.
Women like Belhara have risked their own personal safety to go door to door for several months, trying to persuade people to get the COVID-19 vaccine in some of the country’s most remote corners as well as crowded urban slums.
“We did not have adequate health safeguards and protective gear to start off with and this made us vulnerable to the virus. I contracted COVID in June and it was awful. Two months later, my brother-in-law died during the second wave,” she said.
Because of the duties spurred by the pandemic, ASHA workers across India have been working up to 14 hours a day, as well as on weekends.
Broken promises made to ASHAs
Authorities in several states had assured them earlier that they would have improved wages, but did not keep those promises. ASHA workers called a national strike in September of last year in response.
Over the past year, there have been sporadic protests in several parts of the country, as ASHA workers demanded more pay as well as the working status of government employees.
Most workers earn anywhere between 10,000 and 15,000 Indian rupees (€118-178, $134-200) per month, and receive performance-based incentives for the delivery of health care services instead of fixed salaries.
For instance, the government pays them $4 for every institutional delivery that they facilitate in rural India, and $1.50 for the full immunization of a child younger than one year old.
Created in 2005 by the National Rural Health Mission to help provide health care services to people, especially women and children in far-flung areas, these frontline workers are usually tasked with carrying out prenatal and newborn babies’ care, encouraging immunization, family planning and treating basic illnesses.
In the central state of Chhattisgarh, Rekha Sahu, 36, has often had to wade through rough waters, trek rugged terrain and walk for kilometers to reach villages in the district of Sukma.
On average, Sahu covers a 40-kilometer distance, partly by public buses and partly on foot. A married mother of two children, Sahu lives in Gumma village where, since 2010, she has worked with 11 others to serve about 80 families in the area.
“It was extremely difficult to convince people to take the vaccine. Though every panchayat (village council) set up vaccination centers, convincing villagers was a real task,” Sahu told DW.
“Hesitancy and misconceptions are common among villagers, particularly women,” she added.
ASHA workers have been instrumental in furthering India’s vaccination campaign
‘Mitanins’ help tackle vaccine hesitancy
In Chhattisgarh, these female health workers are referred to by their colloquial name: mitanin. Door-to-door campaigns and the work carried out by mitanins have helped ward off rumors and get villagers inoculated.
On some occasions, medical teams were chased away by locals when they tried to approach them, and women fled to forests.
“I was lucky, but my colleagues in other districts were abused and sometimes pelted with stones during their COVID-19 surveys last year,” said Sahu.
Sahu admits that some standard services that the organization provides, such as family planning, have taken a backseat due to COVID-19.
This includes sharing information with mothers on the newest contraceptives, and educating women on healthy timing and spacing of pregnancies.
Sahu said her personal journey as an ASHA worker began with a strong desire to positively impact her community, especially for rural women in her state, who have limited access to medical facilities.
UNICEF, which has provided training to many frontline workers across the country, has also acknowledged the importance of ASHA workers.
“The training has ensured that the lifesaving work continues for the most vulnerable mothers, pregnant women and tribal community members, even under the most difficult circumstances,” Yasumasa Kimura, UNICEF’s India representative, told DW.
Edited by: Leah Carter
India: Community health workers bear brunt of COVID efforts
Source: Pinoy Pop News
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