Editorial: Frontline workers sans a lifeline

In March 2020, when the pandemic had begun in India, Prime Minister Narendra Modi had exhorted us to come together on the Janata Curfew, and bang pots and pans together as a symbol of encouragement and gratitude to the frontline workers who were putting their lives on the line to help India overcome the Covid crisis. However, even as the exercise was in progress, inspired by our counterparts in Europe, there was a feeling that it might all be optics. Frontline workers, including conservancy staffers in the developed world are paid more than the minimum wage, and are in a position to take care of their daily needs without depending on government handouts.

But that’s not the case in India, where workers in some of the riskiest vocations are inversely compensated for their labour. Take for instance, the plight of the Accredited Social Health Activist (ASHA) workers. These women who work in pandemic care services are part of India’s one million strong community of healthcare labourers who have been instrumental in pushing our vaccination milestones to new heights, thanks to door-to-door campaigning, tracing and testing of COVID patients, and collection of surveys. Unfortunately, these women are paid a pittance as they log 18 hour days, foregoing holidays and sick leaves entitled to them and eke out a hand to mouth existence.

These workers had complained early on during the pandemic that many of them had to spend through their own pockets for essentials such as PPE suits, masks and gloves as the government had failed to provide them with ample stocks. Last September, ASHA workers across India had called for a national strike, demanding benefits and improved wages which were promised to them. A call to regularise their employment on lines of permanent government workers had been one of their key demands, which had not materialised owing to their status as voluntary workers, who worked full time. The workers had also sought pension, a government ID card and free travel in buses.

A brainchild of the National Health Mission (NHM), these workers were supposed to be paid in the range of Rs 10,000-15,000 per month, coupled with performance based incentives. Here in Tamil Nadu, where there were as many as 3,000 ASHA workers in 2020, the responsibilities of these social workers were not just limited to COVID care but also ensuring the health of pregnant women in rural parts by guiding them to the nearby primary health centres, taking care of the immunisation of children under five, as well as visiting new mothers as part of postnatal care. Unfortunately, the delayed payment of wages and incentives, as well as the poor working conditions have led to heavy attrition.

One must also consider how fundamentally flawed our remuneration systems are. Last November, over 3,000 sanitary workers employed in primary health centres on a contract basis, since 2005, demanded their services be regularised in line with a pay hike. For the past seven years, these workers were getting paid a measly Rs 1,500 per month for working 12 hours per day. The TN government took cognisance of this as Health Minister Ma Subramanian said last month that the government is considering appointing ASHA workers over the age of 42, with the requisite educational qualifications as permanent nurses in TN. The government is holding talks with the NHM for the same. Subramanian also spoke about how 4,900 healthcare staffers have also been onboarded for the Makkalai Thedi Maruthuvam scheme.

We must not ignore the learnings of the pandemic and continue our apathy towards frontline workers. Those who serve at the forefront of our most essential public utilities must be treated with the respect and the economic consideration that they truly deserve.