COVID-19: Underpaid and Unprotected, ASHA Workers Face Vaccine Hesitancy and Threats in UP

Lucknow: Lalmati Devi, 48, steps out of her house as early as 9 am wearing two surgical masks, gloves and covering her face with the end of her sari.

Lalmati is an ASHA (Accredited Social Health Activist) worker – frontline health workers as per the government of India – who do not get access to facilities and resources like other health workers, she says.

Every day, Lalmati’s kids stop her from going out for work as they are scared of the impact COVID-19 has had on rural India.

“The government has provided us with an incentive. We even got gloves, masks, oximeters and hand sanitisers once, but that is not enough. The mask is not reusable and has increased my expenses which running a house with three kids and a husband. It is very difficult with this small amount of money we receive as compensation,” Lalmati says, adding: “My kids try to stop me from going to work because they know the situation is very scary outside and that healthcare facilities in the villages are ill-equipped to handle the situation.”.

INCREASED DUTIES

The ASHA worker further says that her workload has increased during the COVID-19 pandemic as now they have to work on other aspects aside from being foot soldiers of the state's healthcare system.

“Earlier our jobs did not entail much aside from helping pregnant women with deliveries and looking into other health aspects. Back then it had zero health risks but now we are at risk as in addition to screening villagers we also come in close contact with people infected with COVID-19. It is like facing death everyday and other than that I have to be ready for any kind of health emergency in the alloted village at any point of time. For all that I get paid only Rs 3,000 and an incentive of Rs 1,000 only,” she says.

THE KIT

Seema Devi, an ASHA worker posted in a village in Kushinagar, elaborated on the problems she has been facing during the course of her work. “I had received the kit from the government last year which includes a thermal scanner, an oximeter and a few other things, but we do not get masks and other preventive items which definitely has an impact on our work and has also increased our expenses,” she says.

“I get paid Rs 3000 and an incentive when there is a delivery in the village. On an average that comes to about Rs 5,000 a month but a quarter of it goes in buying sanitisers, masks and gloves. These are the additional expenses which the government should bear because we are working for them and the masks that we receive from the state are only surgical masks. I know it is not effective in stopping COVID-19 from spreading. The government should keep all this in mind, pay us better and work for our safety,” she says.

The health worker urged the government to conduct a meeting with all the foot-soldiers of the health department, look into their problems and solve them on priority.

FEAR OF TESTING AND VACCINE HESITANCY

Seema Devi, 35, an ASHA worker deployed at the Kudnwa urf Dilipnagar village in Kushinagar district near the India-Nepal border says that she faces a lot of resistance from the villagers for COVID-19 testing.

“There are a lot of rumours circulating in the village. Some say that it is better to die at home with COVID-19 than going to a hospital. The villagers think that we come up with fake positive cases and the elderly people are very adamant on not accepting that there even is a virus. They say it is a flu and that there is no need for vaccination. Some say that vaccination is a way to control births, that it might make them impotent or even kill them. A lot of our time goes in making them understand the importance of vaccination and getting tested,” she says.

Sharing a bizarre experience with Newsclick, Seema Devi says: “Last year a man who returned from some other city was seriously ill and had all the symptoms associated with COVID-19. He begged her to not tell anyone in the health department or in the village about it as he may be boycotted or shunned by the villagers. I had to get him treated in his house with the help of local primary health centre doctors. He recovered after more than a month and fortunately did not require oxygen.”

“These are the difficulties we face in the course of our work on a daily basis and you all know the money we get is peanuts. The kits are not sufficient but we still do our job facing threats to life everyday,” she says.

Another ASHA worker working in a Mahoba village told Newsclick over the phone that people in her village had been threatening her if she carried out testing or vaccination there.

“Last week I received a call from the village and they asked me not to come there for conducting testing or vaccination or I would be attacked. The same day another villager called me and started abusing me as they got to know that I would be going there. I had told this to my immediate senior but they are yet to decide on what to do about it,” she says, requesting anonymity.

The World Health Organisation, which is supporting the state government in training and micro-planning for the drive, said the state has deployed 1,41,610 teams and 21,242 supervisors from the Health Department to ensure that all rural areas were covered.

Additional chief secretary, health, Amit Mohan Prasad, said that apart from the special drive, they had contacted over 16.80 crore people in over three crore households in the state.

Geetanjali Maurya, State head of the Anganwadi Karmachari Association Uttar Pradesh says that the association is aware about the problems being faced by the health workers and that they will be writing a letter to the authorities and the chief minister soon.

“I know that the government has enough resources to save lives but if we are unable to save ourselves first then how will we save villagers,” Seema Devi concluded.