On any given day, the Dharna Chowk, an open-air space in Vijayawada, Andhra Pradesh, echoes with the impassioned voices of people trying to draw the government’s attention to their plight. Red flags flutter against the sea of blue saris, as the female workforce comprising Anganwadi workers and Accredited Social Health Activists (ASHAs) have transformed the public arena, staging protests for the past two weeks seeking better working conditions.
Dharna Chowk has turned into a space for women, by women and of women as they remind the Andhra Pradesh government, through novel demonstrations every day, that they are being given short shrift. One day they seek alms from the public, another they play out a tableau of Gandhiji’s three monkeys.
About 55,400 ASHAs in the State are today on protest, demanding nine provisions: of maternity leave, a hike in honorarium from ₹10,000 to ₹26,000, retirement benefits, and dearness and travel allowances. Simultaneously, 1.05 lakh Anganwadi workers and helpers have been on an indefinite strike for the past two weeks in the State demanding that the government concede to 11 demands, including retirement benefits.
K. Padma Kumari, an ASHA from Nagari in Chittoor district, visits Vijayawada to attend meets and protests without fail. Of the nine demands put forth by the ASHAs, one pertains to maternity leave. “There were countless times when I had to wake up in the middle of the night to take a pregnant woman in labour to Tirupati for delivery. Be it a holiday or festival or even when I was sick, I ensured that I was available for the 2,000-odd people I take care of. People in rural pockets depend on us for everything, and we cannot look away when they need us,” she says.
But, when Padma Kumari was pregnant with her first child in September 2019, she was denied leave, because ASHAs do not have maternity leave, a right that every working woman is entitled to. Until the day before her delivery on May 10, 2020, she was on duty.
Lanka Santhi, State general secretary of the ASHA Workers’ Union, affiliated to the CPI’s All India Trade Union Congress, says usually an ASHA does not get more than two weeks of maternity leave. “It also depends on the ‘generosity’ of a medical officer that we report to. We are at their mercy,” she says.
Padma Kumari, a mother of two now, recalls: “I used to walk nearly 5 kilometres every day from Ekambarakuppam [in Chittoor district], where I live, to the ward secretariat in Nagari [in the same district] during the eighth and ninth months of pregnancy when the COVID lockdown was in place. Once my husband dropped me off at my workplace on his two-wheeler, but on his way back, he was intercepted by the police. He had to pay a fine of ₹400 for stepping out during a lockdown. I had to walk, as we could not afford to pay a fine every day.”
After a month of her delivery, she was asked to report to duty. No sooner had she resumed work than she tested positive for COVID-19. “I was admitted to a hospital in Chennai for 12 days due to health complications. We had to borrow money from others to pay the bills amounting to ₹2 lakh. I risked my life for the job. I have tirelessly worked for the people. Why did not even one official feel it necessary to allow us maternity leave? Is it too much to ask for,” asks Padma Kumari, who, along with 40 other workers, was in Vijayawada for one of the protests.
Hearing a teary-eyed Padma Kumari speak about her struggles, all the women, at first scattered across the open space, join in the conversation, each recounting their own agonising experiences.
A. Chandra Sekhar, Andhra Pradesh-Telangana coordination committee member of Human Rights Forum (HRF), says this is because “they are outsourced workers, so not considered employees”.
Overburdened and short-changed
Launched in 2005 under the National Health Mission, ASHAs, according to the National Health Mission website, are trained workers, often the first port of call for many in rural areas.
Their routine field work includes counselling women on the importance of breastfeeding in the first six months, contraception methods, pre- and post-natal care. They ensure that people suffering from an illness take the prescribed medicines every day. They also take part in surveys and vaccination programmes for children. While in other States their duty ends there, ASHAs in Andhra Pradesh feel they have been burdened with additional work and are short-changed.
“As part of Jagananna Suraksha, the State government’s flagship programme, we were asked to put up banners and arrange rooms for doctors who visited the medical camps during the programme,” says 47-year-old Saritha Devi, an ASHA from Proddatur town of YSR Kadapa district. Officially, the government had said ASHAs would conduct a door-to-door survey to identify illnesses in a family and pass on the information to their higher-ups. “Now, we are even being asked to be present with a medical kit at sports events, when Aadudam Andhra [the State-wide tournament] is being organised,” she adds.
Almost every woman who came forward to speak complained about the unfair treatment meted out to them by medical officers, the denial of leave, penalisation for not logging in on time, being made to clean Primary Health Care (PHC) premises or tasked with work not part of their duties.
Additional work online has been another constant complaint. “We should either do field work or just online work. There are many apps to download and update information of deaths and births, along with other information. We also have to take photos of tuberculosis patients who have recovered, and upload those on the app. Many of us find smartphones difficult to navigate. Besides, the Samsung phone that the government gave us has become useless. Many of us had to buy costlier phones with 5G network and more storage. It cost us ₹15,000-20,000,” Lanka Santhi says.
Low wages and respect
A PHC unit, usually manned by one physician, does not have the facilities for delivery. In Padma Kumari’s Nagari town, pregnant women are taken either to an Area Hospital, 10-15 km away, or to Tirupati, 50 km away. ASHAs are expected to escort the women to the hospital and be with them until they are discharged.
“Sometimes, the women cannot afford to pay for transport, so we pay their fare,” Padma Kumari says, adding that they spend ₹300 for such trips. In a month, an ASHA worker usually gets two or three pregnancy cases.
Of the ₹10,000 honorarium, the Centre gives ₹3,800 and the State pays the rest. In addition to this, they get activity-based incentives.
A PHC doctor, requesting anonymity, says: “In the health sector, everyone is overworked and underpaid. The State government’s initiatives like the Family Doctor concept and Jagananna Suraksha [health survey] require ASHAs to be on the ground. Considering the rate of inflation, how is ₹10,000 sufficient for any person these days?”
In 2022, ASHAs were recipients of World Health Organization Director-General’s Global Health Leaders Award in 2022 for their role in ensuring that healthcare services of the government reached everyone and for being at the frontline during the pandemic.
N. Anita, 30, from Proddatur of YSR Kadapa district, recalls how she had to face the wrath of an entire village when she asked a father of two to isolate himself when found to be COVID-positive.
“They said I am separating a couple and creating problems in their married life. No medical officer came to my help. It was the village elders who understood the situation and convinced the others,” says Lalitha. “At home, my family asks me why I should continue with a service where my work is not respected, where we are treated unfairly. But for women who want to be independent but have studied only till Class X, this is one of the few options,” she adds.
Anganwadi workers’ agitation
The strike has affected 55,607 Anganwadi centres in the State, where 30 lakh women and children were getting nutritious food in 257 Integrated Child Development Services (ICDS) projects under various government schemes such as YSR Sampoorna Poshana, YSR Sampoorna Poshana Plus, and Take Home Ration (THR). But the workers and helpers do not want to give up.
Andhra Pradesh Pragathiseela Anganwadi Workers and Helpers Union State general secretary V.R. Jyothi says the protestors are demanding that Chief Minister Y.S. Jagan Mohan Reddy implement poll promises — hike in wages, clearance of pending dues, increase in retirement benefits, extension of travel allowance (TA), dearness allowance (DA) and other benefits, and job regularisation. “In Telangana, Puducherry, Karnataka, and other States, Anganwadi workers and helpers are being paid higher wages compared to A.P. In Tamil Nadu, Anganwadi workers are given time-scale,” she says.
When the talks between the government and AP Anganwadi Workers and Helpers Union and other associations broke down, the staff went on an indefinite strike, says G. Bharathi, State vice president of the A.P. Pragathiseela Anganwadi Workers and Helpers’ Union.
The main Opposition, Telugu Desam Party (TDP), along with various teachers unions and other organisations, is extending support to the agitating Anganwadi staff.
Union leader K. Subba Ravamma threatens to intensify the agitation if the government fails to consider their demands. “More than 10 trade unions including IFTU, CITU, AITUC, and other organisations are extending support to the Anganwadi workers’ agitation,” he says.
Given the raging protests, District Collectors directed Village Revenue Officers (VROs), Municipal Commissioners, Sachivalayam staff, Self-Help Group (SHG) women and other staff to open the Anganwadi centres. In response to the direction, the VROs and Sachivalayam employees broke open the locks to open the centres. Angered, the Anganwadi staff lodged complaints with police against the Gram and Ward Sachivalayam staff.
The agitating women organised dharnas at Women Development & Child Welfare project director’s offices, and human chains by closing the centres. They plan to observe relay-fasts, rallies and seize the Collectorates, asking the government to begin talks with the Associations and Unions immediately.
“In some villages, women are reluctant to send their children to Anganwadi pre-schools without ayahs. There was very low attendance at the centres,” says a VRO, unwilling to be named. The Sachivalayam staff were visiting houses, and accompanying the children to pre-schools while SHG women members were asked to prepare food for the students.
Women Development and Child Welfare (WD&CW) Principal Secretary G. Jayalakshmi says that the government has agreed to five of the 11 demands of Anganwadi workers. The retirement benefit has been increased to ₹1 lakh for an Anganwadi worker, and ₹40,000 for a helper, she adds. The upper age limit for retirement has been enhanced from 60 to 62 years, and 78% of the salary of the Anganwadi staff borne from the State component. The age for promotion from a helper to worker, has been increased from 45 to 50 years, she points out.
The strike, however, continues as the main demand for salary hike is yet unmet. On Tuesday, the government held talks with the Anganwadi workers’ union, but it came to a head. “Parents are not sending their children to the Anganwadi centres as Anganwadi workers have the strong support of the local community. Even if some centres are open, there is nobody to cook meals for the children. They are sharing the mid-day meals with government schools in the vicinity,” says an Anganwadi worker.
