On April 19, at around 11 am, Nasreen (name changed), an ASHA worker, received a phone call. She was informed that she has tested positive for Corona.
“Positive report … but I wasn’t suffering from cold, cough or fever”
“Reports for the test that was taken on April 17 suggest that you are COVID positive. Kindly get ready, the van is coming shortly to pick you up from your home”
“But I am fine … ”
The phone was disconnected even before she could ask anything further.
Nasreen is an ASHA worker in a village in Bhopal city of Madhya Pradesh. Due to the coronavirus pandemic, Bhopal is currently in the red zone. A red zone is an area with a substantial number of COVID positive cases. Despite this, Nasreen was not provided with even the basic safety gear like the masks or gloves forget about having sanitisers or personal protective (PPE) kits.
Why is the government ignoring the safety of ASHA workers — the India’s footsoldiers and the frontline workers in this battle against corona? No government officials are ready to answer this.
To understand the safety arrangements provided for these ASHA workers during the pandemic, Gaon Connection spoke to Dr Shailesh Sakalle, deputy director, National Health Mission, Madhya Pradesh. He said: “Why should I tell you all this? I am not authorised for this. I cannot tell you anything about it.” After this, he disconnected the phone call.
Around 10 lakh ASHA workers have become the backbone of rural healthcare during this pandemic. They are the link between the health department and the villagers. They are braving the odds, but their safety seems not to be a concern for the government. They are going door-to-door and are taking care of millions of lives without any safety gear.
After Nasreen tested positive for corona, the ASHA workers working with her are worried for their safety. Talking to Gaon Connection, Nasreen said: “I wonder that even if I recover, people are going to talk to me anymore.”
From dawn to dusk, many ASHA workers like Nasreen are risking their lives while going door-to-door and informing report of every household to the health department. They are paid only Rs 1,000 a month. No hashtags are made on them, they don’t get featured in the media, but in this fight against the coronavirus, these ASHA workers are waging a war afoot that is keeping millions of people safe.
On April 17, when Nasreen went for the testing she didn’t have any COVID symptoms. She hardly knew that she would be tested positive three days later.
According to The Indian Council of Medical Research (ICMR), 80% cases are asymptomatic – a patient will not show COVID symptoms. Dr RR Gangakhedkar, head of epidemiology and infectious diseases ICMR, of the total number of COVID-19 tests conducted so far, only 31% had symptoms of coronavirus. However, 69% of them didn’t show any symptoms.
When we asked Nasreen if she remembers the suspect from whom she might have contracted the virus, she said: “I used to conduct door-to-door surveys with precautions. I used masks that were made at home. When I would come home, I would wash my hands with soap. I was fine. But I don’t know how I contracted this virus.”
Talking about wearing gloves and using sanitisers, she said: “I don’t have gloves and sanitisers. We only used to use our home-made masks. Although corona has spread in the city, there was no such risk in the villages. This is why I didn’t bother about using these things.”
When Gaon Connection contacted Swati Meena Naik, mission director, National Health Mission, Madhya Pradesh, she said: “Madhya Pradesh has been categorised under three zones, red, orange, and green. Considering this, ASHA workers are issued with PPE kits, masks, gloves and sanitisers. Districts have been given the work of procuring these items. Districts of the red zone have already been procured with these kits.”
Talking about Nasreen not getting safety gear, Swati said: “I will check for the data where she worked and why she was not provided with necessary safety kits.”
Swati has issued many letters wherein she had advised timely payment and procurement of PPE kits for ASHA workers and ANMs. However, the ground reality is the other way round.
Meanwhile, Nasreen, who used to go door-to-door providing medicines to TB patients, has been detained in the hospital for more than a week. Her entire family has been quarantined. The area where she lived has been sealed. Around 150-200 people had to go through the screening process as Nasreem had visited their homes. Although no one tested positive, they have been quarantined in their homes.
When we ask Nasreen about the number of times she would wash her hands, she said: “We would wash hands right after we would come home.”
Talking about the precaution she took while stepping out, she said: “I would not go into anyone’s home. I would call out the name of the person living inside and carry out the work. We were to look for cough, cold, fever symptoms among people. We would maintain distance while giving medicines to TB patients.”
Even though there were no COVID patients in the area where Nasreen worked, she contracted the disease. Talking over this issue, Dr Harjit Singh Bhatti, ex-president AIIMS, Delhi, said: “The government may admit or not but we have entered the ‘community transmission’ stage. According to ICMR, 80% of the people are not showing symptoms. There would be many like this ASHA worker who would not show symptoms of this virus. They will be roaming around without any testing. Now, think, how many people would be infected in this way?”
“The Government should have provided PPE kits to all those who are working at this time. The testing level is still very low. We have entered the third stage, everyone must look after themselves on their own. This virus can spread among people from the health workers and vice versa,” said Dr Harjit.
Dr Harjit suggested that those who are going out to work must keep three things in mind, firstly they should wear masks and gloves, secondly, they should observe social distancing, thirdly, they must avoid touching their nose and mouth and they should wash their hands with soap regularly.
Talking about her routine in the isolation ward, Nasreen said: “I offer namaz five or six times a day. I talk to my family over the phone call for some time. Everyone in my family is disturbed. They ask me to get well and go back to them as soon as it is possible.”