Nearly 15 months into the pandemic, it was only last week that Sowmya* (name changed), an ASHA (Accredited Social Health Activist) worker from Kalwakurthy in Nagarkurnool district, was given hand sanitiser. “Earlier, we were never provided with sanitisers, those were given for other health staff,” she alleged. The situation has been equally dire for ASHA workers across Telangana, most of whom have been engaged in COVID-19 related work, they say. On May 6, several workers held a unique online protest by taking photos outside their health centres and alleging that they were not provided N95 masks, gloves and sanitisers for protection against the novel coronavirus.
Despite ASHA workers putting themselves at risk, Sowmya and others lament that the state government has not adequately compensated their work. According to the Telangana Voluntary and Community Healthworkers Union (TVCHU) — the state association of ASHA workers led by Centre of Indian Trade Unions (CITU) — at least 50 of them have died so far, and 500 have contracted the novel coronavirus.
The primary role of ASHA workers is to mobilise the community and help them access health and health related services, including immunisation, ante and postnatal care, Integrated Child Development Services, sanitation and other services being provided by the government.
But amidst the COVID-19 crisis, their role has been redefined. The ASHA workers are now asked to carry out health surveys in villages, conduct COVID-19 tests, and monitor the health of COVID-19 patients under home isolation, though without adequate safety equipment from the government, they say. “We have been getting masks, sanitisers and gloves from charitable institutions so far. Only masks we get regularly from the government. They issue us three pairs of masks monthly,” Sowmya says.
Nagarkurnool District Medical and Health Officer (DMHO) Dr Sudhakar however denied these allegations. The DMHO said that they are regularly providing the ASHA workers with all necessary safety equipment. "The allegations are baseless. We procured 6,000 liters of sanitizers from Raichur, and all the ASHA workers are given 30 pairs of masks per month. We stress on the safety of the frontline workers, so these allegations are wrong," Dr Sudhakar said.
What’s more, the low honorariums of about Rs 7,500 per month is demoralising, they say. Samala Lakshmi, another ASHA worker, says, “For these surveys, we have to visit 60-70 houses in the village daily. Along with that, we have to assist the COVID-19 patients and take care of pregnant women, but our salaries remain the same. For assisting a woman during delivery, I get paid Rs 7,500. If there are no delivery cases, they deduct around Rs 1100 from the honorarium,” she says, adding, “But we don't get paid extra if we are taking more than one delivery.”
On March 21, Chief Minister K Chandrasekhar Rao in the Assembly discussed the inclusion of ASHA workers under the pay revision: "Along with pay revision to government teachers and pensioners, the contract and outsourcing workers who are part of the government machinery like Home Guards, Anganwadi workers, ASHA workers, Society For Elimination of Rural Poverty workers, Vidya volunteers, KGBV employees, VRAs VAOs, and for others, who constitute for 9,17,797 employees, the pay revision will be applicable," he had said.
The Telangana government revised the pay scale of government employees, and in its announcement said that ASHA workers and anganwadi workers were entitled for the fitment of 30%. However, in its guidelines, both ASHA workers and anganwadi workers have not been included.
“Leaving out the ASHA workers from the PRC is atrocious, that too when we are risking our lives and our families’ lives every day. Even the 30% hike to us is a very nominal amount for the services we do, considering we earn only around Rs 7000. We are made to do all the heavy lifting work — from data entry, vaccination, carry out fever surveys and other work — but left out when it comes to acknowledging our services,” laments C Lalitha, an office bearer of TVCHU.
“Our demand is to regularise our jobs, so that we get a fixed income. For our work, we demand a reasonable pay scale of Rs. 21,000,” she says.
The TVCHU wrote a letter to the Chief Minister on June 12, asking him to keep his promise. “The Pay Revision Commission (PRC) guidelines issued on June 11, find no mention of ASHA workers. Due to this the ASHA workers are anxious. Ignoring the promise made publicly in the Assembly is unacceptable. The government should reconsider its decision,” the letter reads. Along with this, the union had demanded the government to regularise their jobs and fix minimum wages.