ASHA workers, crucial to India's vaccination drive, threaten to walk out

Besides being poorly paid, most of them are working without gloves, masks or sanitizers two years into the pandemic.

Dressed in pink, the women have gone door to door for months, persuading people to get Covid-19 vaccines in some of India’s remotest corners, hinterlands and crowded urban slums, often risking their own personal safety.

For their trouble, they make about $40 a month, a wage barely enough to make ends meet. More than a million of these frontline healthcare workers across the country -- pivotal to Prime Minister Narendra Modi’s goal of inoculating the nation’s entire population and reviving the $2.6 trillion economy -- are soon about to snap.

Nine Asha workers Bloomberg News interviewed across India said authorities who earlier assured them better wages, personal protective equipment and safe working conditions haven’t kept those promises despite a two-day stoppage last year. Even worse, some say they haven’t been paid for months. 

The All India Trade Union Congress is planning protests in New Delhi when the nation’s parliament is in session through Dec. 23, said General Secretary Amarjeet Kaur. “We are talking to other trade unions and are planning a national strike in December for all scheme workers,” said A.R. Sindhu, national secretary for the Communist-linked Centre of Indian Trade Unions.  

The threat of another walkout by the workers comes at a critical time when India is still struggling with its vaccination targets. Only 32% of India’s 1.4 billion people had received two shots, according to Bloomberg’s vaccine tracker Wednesday, while Modi has an ambitious goal of getting all adults fully inoculated by the end of the year. A strike could also deal a blow as the omicron variant of the coronavirus poses a new risk to recovery efforts around the globe.

Bridge to communities

Asha workers are crucial to Modi’s door-to-door Covid-19 vaccination campaign launched in November. They have detailed knowledge of their neighborhoods, and they are far more likely to persuade residents to get the shots. They act as a bridge between health authorities and local communities. 

Created in 2005 as a stopgap arrangement to help provide more than 55 health-care services to people, especially women and children, in far-flung areas, the Asha program has been instrumental in eradicating polio from the developing country. Now the workers have the added burden of Covid-19, all for a paltry activity-based honorarium, which averages about 3,000 rupees ($40) a month for most of them. If lucky, some can earn double that amount. 

But they want the government to set minimum wages for them, like farm hands or cleaners, some of whom can make as much as $260 a month.

“Time has come to give them minimum wages because now they have become crucial to the system,” said T. Sundararaman, New Delhi-based global coordinator for the People’s Health Movement. “When they were created we were talking about 12 hours a week. Now the whole burden of primary care has shifted on them and they are working more than the regular staff.”

Workers with Accredited Social Health Activist (ASHA) from India's National Rural Health Mission wearing pink robes and protective masks, talk to a resident, left, as they conduct a door-to-door survey on the coronavirus in Delhi on July 2, 2020.

The concerns being raised by the Asha workers aren’t new. Besides the issue of pay, two years into the pandemic, most of them still continue to work without gloves, masks or sanitizers. Those who need to travel far don’t have access to a safe place to stay overnight, or shelter when temperatures soar or dip.

Irked at being ignored, the women in pink are escalating their stir, demanding minimum and timely wages and better working facilities. They joined other workers’ unions in September for a one-day strike, and the protests have gathered momentum since.

On Nov. 10, Asha workers in Kolhapur, a town about 230 miles south of Mumbai, stopped vaccine-related work over non-payment. In the northern state of Punjab, where local elections are likely early next year, they have stayed away from all services barring emergency care such as child birth since Nov. 25, according to Balbir Kaur, 51, who is the chief of the union in the district of Ludhiana. 

“Since the assembly polls are nearing and they are seeking votes, may be they will now listen to us now,” said Kaur, adding she hadn’t been paid for months. A spokesperson for the state government did not reply to an email seeking comment. 

As a result of the protests in pockets of the country, some experts are already starting to see a dip in the pace of vaccination. Vivekanand Jha, executive director for India at the George Institute for Global Health, said ignoring their concerns may undermine the fight against Covid-19.

“People who are marginalized would suffer,” Jha said.

Beaten up 

Poonam Pandey, 35, said when she and her associates had gathered in Shahjahanpur, a small district in the northern state of Uttar Pradesh, to present a letter of demands to Chief Minister Yogi Adityanath at a political rally, police beat them up. A spokesperson for the state government did not respond to a text message asking for a comment. The spokesperson for the federal Health Ministry also did not return a call and message asking for their response. 

“We were called corona warriors and we did everything the government asked us to,” Pandey said on the phone, recounting the horror she endured. “Now we are being beaten up for asking our dues. I demand justice, where will I get it? They are the government, they can do anything. What can we do?”