The ASHA (Accredited Social Health Activist) workers’ protest in Kerala has reached day 65 now, with the workers camping at the Secretariat in Thiruvananthapuram, seeking a considerable increase in their honorarium. Despite their tireless and unselfish work for the community, particularly during the devastating 2018 floods and the unprecedented COVID-19 pandemic, the workers feel deserted, overlooked, and unheard.
The ASHA working group was constituted in 2007 with a mission of making community health initiatives part of the public health care system. Workers were guaranteed a daily allowance of Rs 232 for working for only two hours a day. Initially, the honorarium was Rs 500 a month, which later on increased to Rs 1,000.
Now, the workers get about Rs 7,000 per month, but this is not a guaranteed sum, with quite a few restrictive conditions that are difficult to fulfill. This difference between their increased workload and lack of increase in pay has been a long-standing complaint.
Increasing responsibilities and unfilled promises
The work of ASHA workers has increased several-fold over the years from the originally conceived two hour work. In the catastrophic floods of 2018, ASHA workers showed extraordinary courage and commitment, playing a critical role in public health and relief operations. The COVID-19 pandemic further evolved their role from restricted outreach to complete frontline healthcare, working round the clock in many cases. They played a crucial role in house-to-house visits, patient monitoring, medicine distribution, and vaccination, all while putting their own lives at risk. Their work reached out to helping pregnant women, new-born babies, patients suffering from rabies and tuberculosis, and many more in desperate need of medical attention
Now, the ASHA workers are virtually on call 24 hours a day, making it entirely impossible for them to pursue any other source of livelihood. Their claim for a hike in daily wages from Rs 232 to Rs 7,800 as committed to in the 2021 LDF manifesto is both necessitated and justified. The suggested hike would guarantee a monthly salary of approximately Rs 21,000, which is comparable to that received by other employees in Kerala, including migrant labourers receiving Rs 1,200 for seven hours’ work and domestic workers getting Rs 500 for three hours of work. In comparing the cost range of household necessities in Kerala, the pay of Rs 232 per day is abysmally low.
Economic deprivation and social injustice
A recent survey by the Centre for Development Studies brought to light the dismal situation of ASHA workers. The survey covered 50 workers, all of whom were found to be facing extreme financial difficulties. Thirty-six were from marginalised groups, including Scheduled Castes, Scheduled Tribes, and Other Backward Classes. Seven out of the 10 Scheduled Caste women interviewed do not own houses, and the other three have crushing financial burdens. Even among them, 17 out of 28 have mortgage issues, with most on the verge of losing their homes.
The research also uncovered that 15 among the 50 families covered by the survey rely entirely on the modest earnings of the ASHA worker for survival. In 22 other families, the male populace is bedridden due to sickness or disability, with the ASHA worker left shouldering the full burden of finances. This perilous condition has triggered their requests for a once-only retirement pay of Rs 5 lakh on the age of 62 years, a base pension, and medical insurance with salary deductions.
In contrast, the high-profile labour unions of Kerala do not support the strike of the ASHA workers while they intriguingly condone the same kinds of protests held in other states of India. This double standards strategy has disenchanted not only the employees but also met with widespread criticism from the masses.
The protest in front of the Secretariat has evolved into a potent symbol of secularism and unity. ASHA workers representing a variety of social and religious groups have rallied for a common cause, demonstrating outstanding solidarity and tenacity.
Most of the protesters are highly educated, holding qualifications from higher secondary education to postgraduate levels, with some holding B.Ed. qualifications and research backgrounds. Their clear and multilingual addresses to national media have received widespread support from the public.
In a dramatic display of defiance, a few ASHA employees went on to cut their hair and nailed it on the protest platform—a symbolic gesture of their exasperation and determination to sacrifice their dignity to be heard.
The irony of the situation is stark—those who have cured so many people in the time of epidemics and disasters are now left to beg. It is the shared responsibility of the state and Union governments to meet their demands with concern and urgency. The monetary wastefulness that is common among bureaucrats and ministers needs to be reined in to spend money on these indefatigable healthcare professionals.
The protest of the ASHA workers is not merely a battle for rightful wages but a struggle for dignity and social justice. It’s time the government acknowledged their priceless work and reinstated their dignity by fulfilling their rightful demands.
