Meena Devi has looked after the well being of her fellow villagers in Kachura, Uttar Pradesh, for 15 years as an ASHA worker. No two days of work have ever been the same, she said. And COVID19 duties have presented her with their own special challenges.
Kachura (Sitapur), Uttar Pradesh
In the COVID-19 pandemic, while the rest of the world seems to have ground to a screeching halt, ASHA worker Meena Devi’s responsibilities have increased manifold, and she works day and night to fulfil her duties.
Meena, a resident of Kachura village in Sitapur district of Uttar Pradesh, is a part of over one million women community health workers in the country, known as Accredited Social Health Activists or ASHAs, instituted by the Ministry of Health and Family Welfare as a part of the National Rural Health Mission. These frontline women workers are leading from the front as the country faces a massive second wave of the pandemic.
And being at the forefront of the workforce, especially in the times of the COVID-19 isn’t easy. The job of an ASHA worker often demands a lot more than providing healthcare support. It involves tact, diplomacy, sensitivity and a certain toughness to get the job done.
Meena, who is in her 40s, has to employ all the tact and diplomacy at her command to screen rural folks for corona symptoms, convince them for testing, do contact tracing and house-to-house survey, apart from the regular work of monitoring other health activities in the village, including institutional deliveries of pregnant women in the raging pandemic.
Her village Kachura, about 120 kilometres from the state capital Lucknow, has a population of about 2,000 people.
“These days there is a constant sense of dread at all the untimely deaths I see around me. But I do not have the luxury to sit and brood,” said Meena who had been on the job for 15 years since 2006.
Life as an ASHA worker has been challenging, Meena told Gaon Connection. “Initially, the other women in the village taunted me about going out to work. Even my husband was not spared,” she recalled.
In fact in the first two years, Meena’s husband would accompany her on her rounds and not let her go alone to work. “But gradually things changed and now I am at liberty to go to the field alone, take decisions and do my job by myself,” Meena said confidently.
Meena’s day begins at 5 am. “I have to wake up early to cook, clean and feed my family,” she told Gaon Connection. She has three grown up children. A daughter was recently married off, her 24-year-old son works in a bank and another 22-year-old daughter is in college. Meena’s husband is a farmer. By 9 am, she finishes her household chores, and departs to the village for her day’s work. She is often taking care of the younger children in her extended family too, she said.
Each day is different, the ASHA worker said, and sometimes fraught with tension, especially now in the COVID-19 pandemic. “I have to persuade people to get screened or vaccinated, accompany them to get their jab, distribute medicines, and sometimes stick isolation posters on homes where someone has tested positive,” she explained. This last task often led to unpleasantness. “The home owners often protest and fight when we do this,” she said.
Besides the COVID duties she also has to attend to the other calls she gets, like accompanying a woman to the hospital for her delivery, and so on.
Despite putting in seven to eight or even more hours of work a day, Meena said she had no fixed monthly income. “I have to wait for nine months to get six hundred rupees for each delivery. In some months there may be four to five deliveries, in others not even one,” she said.
The pandemic had added to her work burden and that of all the one million ASHAs in the country. However, in the raging second wave of the pandemic, these frontline women workers are working without property safety gear and rightful remuneration. “I have to visit at least ten houses in a day in order to be eligible for the honorarium,” Meena added.
Last year, the central government introduced the Pradhan Mantri Garib Kalyan Package Insurance scheme for all healthcare workers including ASHAs engaged in COVID19 response. The insurance scheme provides a life insurance cover of Rs 50 lakhs [Rs 5 million] in case of death due to the coronavirus. However, many ASHAs haven’t received the Covid incentive for almost a year now.
“The health department has announced a mere thousand rupees a month as incentive for ASHA workers. But it has not given us anything for our protection, no masks, no face shields nor sanitisers,” Meena complained.
While the announcement of Rs 1,000 has been made, they have received nothing yet, said Meena. Last year, she got Rs 5,000 as incentive for five months, between March and July, 2020. While the honorarium of Rs 1,000 has been sanctioned for six months to the ASHA workers since April 2021, Meena Devi is yet to get that money in hand.
Villagers acknowledge the hard labour put in by Meena in these difficult times. “An ASHA worker is of great value to the village,” Kusum Bajpai, gram pradhan of Kachura village, told Goan Connection.
“Whether it is to spread awareness about health and hygiene, or go door to door conveying health-related announcements, spearhead vaccination drives, or help out during deliveries, or organise health check ups for women, an ASHA worker has a very important role to play,” Bajpai added.
Meena smiled as she said: “The very same people who talked behind my back when I decided to work as an ASHA, now approach me for advice if there is a medical problem at home. I never hold back in helping them out,” she said.
And as Meena Devi does the rounds of her village, discharges her health-related services to the people of Kachura, and returns home, it is almost sunset.
“I get home, bathe, cook the evening meal for my husband and children, eat, and only then go to bed,” she said. But sometimes, her day does not quite end with that. “I get called when someone’s labour pains begin at midnight and I have to be by her side, no matter what time of the day or night it is,” she concluded.
And Meena waits patiently till the arrival of the young life.