Today is the third of the five-day door-to-door drive across rural Uttar Pradesh to screen villagers for COVID19-like symptoms. Named as the ‘COVID Samvedikaran Abhiyan’ (COVID Sensitisation Campaign), the screening exercise is being conducted by frontline workers such as ASHAs and ANMs, along with other district and health officials.  

Announced by Uttar Pradesh Chief Minister Yogi Adityanath on May 1 and launched on May 5, this rural drive is expected to cover 97,409 revenue villages across the state.

“We have initiated an early identification drive where our teams go from house to house in each village,” Amit Mohan Prasad, Additional Health Secretary to the state government, told Gaon Connection. The teams talk to people in villages, ask them about their symptoms and distribute medical kits, even before they get tested, Prasad added.

“Additionally, testing teams have also moved into villages. They are conducting rapid antigen tests [to check for COVID-19]. Two community halls in each district are being converted into COVID hospitals, with fifty beds each,” the additional health secretary added.

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According to Prasad, the chief minister has “emphasised the need to go all out and protect the rural areas, at any cost”. 

While this rural drive is underway in full swing, frontline workers conducting the door-to-door survey and helping raise awareness about COVID-19 in villages are unhappy and have some serious complaints. 

ASHAs (Accredited Social Health Activists) and ANMs (auxiliary nurse midwives), who visit 40-50 rural households each day, allege they have not been provided enough safety gear. Also, for almost a year now, they haven’t even received the monthly COVID19 duty incentive of Rs 1,000 announced by the central government.

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For this five-day campaign, these frontline women workers would be given Rs 100 a day. It is to be credited to their bank accounts, Ashutosh Kumar, Unnao’s Chief Medical Officer (CMO), told Gaon Connection.

“We have been asked to survey households in villages. The authorities haven’t provided us with any masks or sanitisers. I feel afraid when I do my rounds,” Prema Devi, an ASHA worker from Bichhiya block in Uttar Pradesh’s Unnao district, told Gaon Connection. “A daily payment of hundred rupees is all that has been announced for this campaign,” she added.

Also Read: ASHAs brave the second wave of COVID19. Without masks, sanitisers and rightful remuneration

The second wave of COVID-19 is sweeping across India, with over 414,000 fresh cases and 3,915 deaths reported in the past 24 hours. A total of 26,780 new COVID19 cases were recorded in Uttar Pradesh on May 6. The state added 353 deaths to its total death toll, which has now risen to 14,501. 

Gaon Connection has been reporting how village after village is in the grip of fever, cold and cough — classic COVID-19 symptoms. Under the prevailing circumstances, a house-to-house screening drive without adequate safety gear may put the already overburdened and underpaid frontline workers at extreme risk.  

Also Read: As COVID19 wreaks havoc on rural India, local medical stores are the only aid for villagers

Rural screening drive

As part of the ‘COVID Samvedikaran Abhiyan’, a team of two — two ASHA workers, or an ASHA worker and an ANM —  has been assigned an average 40-50 rural households a day. These frontline workers ask villagers for symptoms such as fever, cold and cough. They also counsel rural inhabitants and create  awareness about precautionary measures that can control the spread of infection.

If they encounter any seriously symptomatic case, the rapid action team consisting of health officials visits the household to get the patient tested and follow up on treatment. The state government’s campaign holds significance as half the COVID19 infections in the second wave have been reported from the rural areas.

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In Unnao district, about 75 kilometers from state capital Lucknow, 2,600 ASHA workers and ANMs each are part of the drive. So far, they have surveyed 93,842 households and identified 229 suspected COVID19 cases. 

“As per the report, samples of symptomatic persons have been collected by the rapid action team and their report has been asked to be expedited so that timely treatment can begin,” Ashutosh Kumar, Unnao’s CMO, told Gaon Connection.

Meanwhile, in Sitapur district, ASHA workers covered 121,783 of the 159,991 target households on the very first day of the campaign. Of these, 4,390 persons were considered suspected COVID19 cases. 

About 163 persons in the district have been provided with medical kits and 2,245 counted as showing COVID19 symptoms.

Also Read: As COVID19 wreaks havoc on rural India, local medical stores are the only aid for villagers

Over 90 kilometres away in Shahjahanpur district, of the 63,089 households to be surveyed, ASHA workers have already completed 58,384, and identified 778 persons with suspected COVID19 symptoms.

Between the devil and the deep sea

Having returned after conducting the survey in her Mulhim village in Sitapur’s Khairabad block, ASHA worker Vimla Devi told Gaon Connection the situation in her village is grim.   

“I am assigned a target of fifty households a day. I have not been provided the basic necessity of a face mask or a sanitiser. The government might have announced an extra monthly amount of Rs 1,000 to be paid for the COVID duty, but I have not received any extra payment since April, last year,” Vimla  Devi said.

Similar are the woes of Meena Devi, an ASHA worker from Sitapur’s Kachura village in Pisawan block — “When we asked for proper protective gear to conduct the door-to-door drive, the superintendent told us to talk to the swaasthya shiksha adhikaari [Health Education Officer]. When we went to him, we were told to go and talk to the CMO,” she complained.

“Some of us even cried in front of these officials but to no avail. There is a lot of risk in surveying the households. We are desperate for money, which is why we have no option but to do this work,” Meena Devi said, her eyes welling up. “If we leave this job, we won’t be able to survive. If  we continue doing it, there is constant fear of death,” she added.

An ASHA worker from Barabanki told Gaon Connection on condition of anonymity that work has become full-fledged exploitation. “If we raise any complaints, officials scold us. We haven’t even received our salaries, which often come late,” she said.

Rs 1,000 incentive missing for months 

Last April, the Ministry of Health and Family Welfare had directed state governments to provide financial incentive of Rs 1,000 a month to all the ASHA workers engaged in services during the pandemic. 

A number of ASHA workers told Gaon Connection they received the COVID19 duty incentive for the months of March and April last year but there has been no such payment since.

“When Corona started last year, we received the extra Rs 1,000 for our work in the months of March and April but nothing since,” 35-year-old Nidhi Verma, an ASHA worker from Barabanki’s Fatehpur block, told Gaon Connection. “It’s a tsunami of Corona this year and the government hasn’t even provided masks and gloves, leave alone the incentive,” she said.

In Mirzapur district, about 280 kilometres from Lucknow, ASHA workers said they have been provided with masks and sanitisers, but supply of medicine is negligible.

“The government has provided us with a mask, sanitiser and gloves. But we are tracing households with negligible medical supplies,” Meena Devi, an ASHA worker from Sugapakh village in Mirzapur told Gaon Connection. “We have been given ten tablets of paracetamol and two sachets of antibiotics. It is hard to distribute this among a large number of people in need,” she said. 

To address this problem, Meena Devi said they handed over the medicines to the government hospital in the nearby Patehara block. “We tell people to take their medicines from the hospital, because we anyway don’t have enough supplies to cater to everybody who needs them.” 

Mirzapur district’s CMO PD Gupta told Gaon Connection that a total of 72,979 households have been visited by 2,056 teams of ASHA workers. “Altogether, 533 people with COVID-like symptoms have been identified. The ASHA workers are providing medicines to persons who cannot access the community health centres (CHCs) and primary health centres (PHCs),” he said.

Also Read: Supreme Court directs the Centre to rethink its vaccine policy to be in line with the Constitution

Guddi Baby, a 45-year-old ANM from Uttar Pradesh’s Barabanki, said that despite the high-risk, frontline workers were carrying on with their duties. “During the survey, some people truthfully spoke  about their health condition, but many hide their situation for fear of being quarantined and taken elsewhere by authorities. There is a lot of distrust amongst people when it comes to believing in the government,” Baby told Gaon Connection.

Reported by Mohit Shukla in Sitapur, Virendra Singh in Barabanki, Sumit Yadav in Unnao, Brijendra Dubey in Mirzapur, and Ramji Mishra in Shahjahanpur. Written by Pratyaksh Srivastava.