TODAY -

Community health work is work

Bobby Ramakant *

 Community health work is work



This year the Universal Health Coverage (UHC) day is different in a way that never before the UHC message was so loud and clear. From first case of coronavirus eleven months ago to nearly 70 million cases worldwide, the pandemic has made us realize how essential is health security for each one of us - and - unless we ensure development justice for each one of us, no one is protected.

Primary healthcare is the fundamental building block of health systems and community health workers who provide primary healthcare services are the true champions. More importantly, community healthcare work, is also an essential work - failing which, our entire health system is threatened.

Community health workers across the south Asia region have united in solidarity and launched a campaign to assert their rights as workers. Kate Lappin, Regional Secretary for Asia and Pacific, Public Services International (PSI) said that community health workers across the South Asia region play a critical role in providing primary healthcare, raising awareness, and facilitating access to public healthcare to hundreds of millions of rural people. In South Asia, community health workers are almost entirely women who are expected to do this vital work without being recognised as public health workers and without the payment of adequate wages.

precarious work is a threat to public health

Kate added that community health workers currently face the risk of contracting COVID-19 through their work but are perversely denied health and life insurance as well as pensions. Governments have recognised community health workers as 'warriors against COVID-19' yet have routinely failed to provide adequate personal protective equipment (PPE) kits, training, wages or support.

Their repeated requests for provision of safety kits, masks and sanitisers during the COVID-19 door-to-door visits and surveys has been denied by the authorities. With increased risks of exposure to the virus, the pandemic has illustrated that precarious work is a threat to public health.

World Health Organization (WHO) has long recognized the role of community health workers underlining that they "play a crucial role in broadening access and coverage of health services in remote areas and can undertake actions that lead to improved health outcomes."

Rosa Pavanelli, General Secretary, PSI stressed that it is important to formalize the relationship of community health workers with public authorities to enhance their quality of working conditions. This pandemic has shown that how tragic is the scarcity of health professionals globally. No country has been able to keep on treating patients at the level necessary.

International organizations including the WHO are relying on greater task sharing by community health workers to strengthen primary healthcare. It is the women who shoulder lion's share of this essential work. It is necessary to establish policies for ensuring labour and professional standards as well as adequate training and support. It is also vital for governments to regulate the working conditions of all healthcare workers. Rosa added that COVID-19 pandemic has brought home the reality of primary health care as an essential filter to reduce the pressure on hospitals or emergency care.

Unions representing community health workers have documented a range of threats and violations experienced during the pandemic. Community health workers are facing heightened risks of infection and enduring long working hours, psychological distress, fatigue, occupational burnout, discrimination and physical and psychological harassment. Many community health workers have reported not being paid during the pandemic.

In India, there are three groups of community health workers: Accredited Social Health Activists (ASHA) who are all women, Auxiliary Nurse Midwife (ANM), and Anganwadi. Yamuna Tekam, an ASHA worker since four years, represents Nagpur Municipal Corporation Employees Union (NMCEU). Yamuna said that during the pandemic, family wanted her to be home but authorities pressured her to go to the field with a mask.

She was not given PPE and seldom got a glove. Abuses were hurled upon her or survey form was torn or water thrown on her colleagues. Three ASHA workers tested positive for COVID-19 in her centre. She was given Rs 30 per day (Rs 1000 for a month) which was far less than what was due.

Halima Zulqarnain, Central President, All Sindh Lady Health Workers and Employees Union (ASLHWEU), Pakistan, said that community health workers are referred to as Lady Health Workers in Pakistan, and were appointed since 1994 at Rs 900 a month for family planning programme in rural areas. Despite doing vital work, they were not treated with due dignity like other healthcare professionals were.

When they started the movement to get their due, they faced resistance - water was thrown on them, some of them were jailed, some suffered miscarriages in the struggle. One health worker also got a divorce when she went out on the streets demanding justice and rights.

Lady health workers were working during the lockdown but were not given sanitizer, PPE or compensation for this precarious job. Not surprisingly, more than 20 of them tested positive for COVID-19. Halima demanded safer working conditions for all lady health workers, dignity and respect like other healthcare professionals, and fairer wages, insurance and pension.

In Nepal, community health workers are called Female Community Health Volunteers. Gita Thingg, Vice President, Nepal Health Volunteers Association said that they have played a vital role in reducing maternal and infant mortality rates nationwide. In Nepal, the title of 'female community health volunteers' suggests 'voluntary' work but it is 24x7 work, says Gita.

Snacks and basic travel allowance is not a justified compensation for this important service they provide. She demands that government must recognize the critical role they play in health system with dignity. Since 2010 she has been unionising in Nepal to claim the rights and benefits long overdue to female community health volunteers. "We are working, doing labour and we should accordingly get paid, and recognized with dignity and respect, and our rights protected" said Gita.

Jyotsana Shakya, Treasurer, Health Volunteer Organisation of Nepal said that her two family generations have worked as female community health volunteers. Even though the Nepal government ordered involvement of female community health volunteers in committees to respond to COVID-19, this was not well implemented at local level. Despite promise of Rs 1000 allowance by federal government, the local authorities have not paid them.

Mask, sanitizer or PPE was not given to them. When they got tested for COVID-19, almost all of them tested positive and were not allowed to go back home. They were forced to stay in community homes and often the blame was on them. Her union has submitted demands to the government now which includes oximeter. Mayor of her region has assured her of support. They rightly want to be recognized as workers, not mere volunteers. She also demands health insurance for all.

Anand Grover, former UN Special Rapporteur on the Right to Health and senior lawyer in Supreme and High Courts of India, said that every person must have a right to health. Every person is entiled to good healthcare facilities and services which are available, accessible, acceptable, and of good quality - and government has an obligation to ensure this for all.

Community health workers are not volunteers but workers - and - most important workers - because healthcare system is based on primary healthcare. If we do not have primary healthcare we cannot provide health for all. Unless we treat community health workers as 'workers' and not 'volunteers' how will they assert their right to be paid as per the pay-scale of the government?

Anand Grover said that community health workers have done their work with utmost sincerity, professionalism, and most importantly, passion - without the remuneration they are entitled to. He shared that Vidya vs state of Maharashtra legal case shows how an anganwadi worker was told by the High Court that she is entitled to be treated as worker according to industrial laws and thus can go to the labour courts for justice.

Public Services International and unions representing community health workers across South Asia launched a list of joint-demands that include:
- Recognition as public health workers
- Collective voice in decision-making processes
- Occupational safety and health protection
- Dignity at work
- Care for us
- people-centred healthcare system.


* Bobby Ramakant CNS, wrote this article for e-pao.net
The writer is a World Health Organization (WHO) Director General's WNTD Awardee and part of CNS (Citizen News Service) and Asha Parivar.
Follow him on Twitter @bobbyramakant or visit www.bit.ly/BobbyRamakant
This article was webcasted on December 26 2020.



* Comments posted by users in this discussion thread and other parts of this site are opinions of the individuals posting them (whose user ID is displayed alongside) and not the views of e-pao.net. We strongly recommend that users exercise responsibility, sensitivity and caution over language while writing your opinions which will be seen and read by other users. Please read a complete Guideline on using comments on this website.




LATEST IN E-PAO.NET
  • Gaan-Ngai @ Iboyaima Shanglen #1 : Gallery
  • COVID-19 Status 26 Jan : Govt of Manipur
  • The making of a tourist spot
  • Life & culture in North East India :: Book Rvw
  • Republic Day at Manipur Legal Services
  • National Flag Hoisting at RGU, Arunachal
  • Imoinu Erat Thouni @ Imphal #1 : Gallery
  • COVID-19 Status 25 Jan : Govt of Manipur
  • Gaan-Ngai, traditional festival of Kabui
  • Get vaccine shot but dont throw away mask
  • COVID-19 : Impact in Manipur :: News Timeline
  • Mysterious dreams :: Poem
  • Inclusiveness of women in sports is key
  • Supports Farmers' Republic Day Parade
  • Living with border disputes
  • Constructing optimistic theory
  • Food items @ Waithou Keithel #2 : Gallery
  • COVID-19 Status 24 Jan : Govt of Manipur
  • A Hymn for Goddess Emoinu
  • The idea of Netaji, Manipur & the INA
  • Narcotic Drugs disposal @Lamlai #2 : Gallery
  • Prize Distribution Ceremony at MitSna
  • The land of jewels :: Poem
  • The business of growing poppy
  • Prison Diary of Lamyanba NK Sanajaoba
  • Manipur Hockey Website launched : Gallery
  • The reality of life :: Poem
  • Mathematics in our lives
  • Girl Child : Marching towards a new horizon
  • Herbal beauty tips
  • A thought on the Nation's Republic Day
  • Saving Manipuri pony & polo
  • COVID-19 Status 22 Jan : Govt of Manipur
  • Aton Yaiphengba, Hekim: eMing
  • What does civility require.. just principle
  • Nine Hills, One Valley : Special Film award
  • Bhuban cave: Holy place of TRC people #2
  • Let's get sneakered - Art & Music event
  • 50 years of existence as a State
  • A New World : Post COVID-19
  • Statehood Day Celebration 2021 : Gallery
  • COVID-19 Status 21 Jan : Govt of Manipur
  • Questions over commissioning Mapithel Dam
  • Gender equality and human rights
  • Manipur first among NE in Innovation Index
  • Becoming mommy - Yes or No ?
  • Student Induction Program at Lilong Haoreibi
  • Uniform academic session
  • Bedlam beginning
  • Grandfather of Uipo Language- Mosel Khaling
  • COVID-19 Status 20 Jan : Govt of Manipur
  • Lt Col Rajeev Bakshi : The Tiger of Tipaimukh
  • Cleanliness Program at Lilong Haoreibi
  • Racism at its worst
  • Gita - An antidote for life in Kali #3
  • Ultimatum from UNC
  • My memories of Imphal from 1941 #14
  • COVID-19 Status 19 Jan : Govt of Manipur
  • Naga Peace Process :: News Timeline
  • Municipal Council, Kakching Khunou
  • Disaster :: Poem
  • Signs of cervical cancer
  • Training Programme on Mushroom Cultivation
  • JCILPS for more teeth to ILPS
  • Wildfire in Dzuko, Senapati #2 : Gallery
  • COVID-19 Status 18 Jan : Govt of Manipur
  • IM says it's "deeply committed" to solution
  • Making of a General :: Book Review
  • Jesus, markets, state, & silenced dialogue
  • Logistics as career option
  • 'Solution expected anytime soon'
  • COVID-19 vaccination [Jan 16] #2 : Gallery
  • COVID-19 Status 17 Jan : Govt of Manipur
  • Bhuban cave: Holy place of TRC people #1
  • Police Guest House CCpur : Gallery
  • Know-how for using herbicides in rice
  • Too much too good ?
  • Roll up the sleeves for Covid shot
  • COVID-19 vaccination [Jan 16] #1 : Gallery
  • COVID-19 Status 16 Jan : Govt of Manipur
  • Empowering women through sports
  • Dzuko 'the Nagmani'
  • 3rd foundation day- National Sport University
  • Research & Publication Ethics Workshop
  • Living Legends of Manipur : Wall Calendar
  • Cong existence felt, will it survive?
  • Day light Thabal Chongba #3 : Gallery
  • COVID-19 Status 15 Jan : Govt of Manipur
  • School Fagathanshi @Leimapokpam: Gallery
  • The voice inside me :: Poem
  • Let's embrace youths self esteem
  • Gita - An antidote for life in Kali #2
  • Bedtime beauty hacks to look young
  • Menace on the roads of Imphal
  • Hill Valley bondage strengthened
  • Narcotic Drugs disposal @Lamlai #1 : Gallery
  • COVID-19 Status 14 Jan : Govt of Manipur
  • Shachi Gurumayum honoured overseas Indian
  • Enthusiasm of LFCA's children
  • Energy Conservation Material Management
  • Commandant 12th Bn NDRF called on CM
  • Water education for sustainability
  • Postpone Public Hearing on Gender Policy
  • Students at the forefront
  • Fuelling the anger
  • COVID Vaccine arrived @ Airport : Gallery
  • Major (Dr) Laishram Jyotin, Ashoka Chakra
  • Mushroom training program at Langmeidong
  • 5 years of Pradhan Mantri Fasal Bima Yojana
  • Drugs ki lansu amani
  • 3rd State Level Jump Rope Championship
  • Vaccine and low count of infection
  • Human fails to learn lessons from Corona
  • My memories of Imphal from 1941 #13
  • COVID-19 Status 12 Jan : Govt of Manipur
  • National Youth Day at Lilong Haoreibi
  • Face it all together: threat of pandemics
  • Majuli - India's only river island district
  • More of a question when, not should
  • Tungjoy re-visited
  • COVID-19 Status 11 Jan : Govt of Manipur
  • COVID Vaccination Meeting with PM: Gallery
  • Fruits & Vegetables grown in North East #2
  • 18th BIG Call : Biotechnology Grant
  • Trade hate for love : Blissful 2021
  • Jump Rope (Judges & Referees) Exam
  • Connecting via Jiri
  • Dhanamanjuri University & its Identity Crisis
  • INA's Honour at the Battle of Imphal
  • COVID-19 Status 10 Jan : Govt of Manipur
  • Ima Keithel @ Kanglatongbi/Sekmai : Gallery
  • Aromatic Oil Extraction training at Huishu
  • Tulihal - Our sweet old local airport
  • Gita - An antidote for life in Kali #1
  • Training on Mushroom at Nagamapal
  • The call for new normal still stands
  • 187 Death Anniv- Maharaj Gambhir : Gallery
  • COVID-19 Status 09 Jan : Govt of Manipur
  • Biocontrol of Parthenium for biodiversity #2
  • A message from mother nature :: Poem
  • New year resolution & complication
  • NEP-2020 : A new Landscape in Education
  • Wildfire in Dzuko, Senapati #1 : Gallery
  • COVID-19 Status 08 Jan : Govt of Manipur
  • Satyamala : Most Fortunate Manipuri Princess
  • Transforming economy of the kingdom of God
  • Events and celebration as career
  • How to protect your lips in winter
  • Poppy plantation & drug trafficking
  • We Continue To Strive Forward
  • Press Club Foundation Day : Gallery
  • COVID-19 Status 07 Jan : Govt of Manipur
  • Bereavement : Grief Reaction
  • Emergency Response System : Gallery
  • This world :: Poem
  • Bitter truth
  • Re-opening and rethinking border trade
  • My memories of Imphal from 1941 # 12
  • COVID-19 Status 06 Jan : Govt of Manipur
  • Fruits & Vegetables grown in North East #1
  • Life goes on !
  • Naga Rapper Macnivil - New Music Video
  • Awareness Prog with Women Commission
  • Farm Acts need of the hour
  • Imphal on eve of New Year 2021 #2 : Gallery
  • COVID-19 Status 05 Jan : Govt of Manipur
  • Cold Storage @ Bishnupur Bazar : Gallery
  • Pronoia - The sociological antidote to corona
  • New Year 2021 :: Poem
  • Careers opportunity in Fashion Industry
  • Economic growth: A mirage so far
  • The law of Habit
  • Zeilad Lake in Tamenglong #1 :: Gallery
  • COVID-19 Status 04 Jan : Govt of Manipur
  • Biocontrol of Parthenium for biodiversity #1
  • Child Nutrition and their future
  • Guilt free self love - Not a sin!
  • 'Anguish over wild fire at Dziikou Valley'
  • Another message for another year
  • Lamphelpat: Victim of unplanned urbanisation
  • Politics and the War Against Drug
  • Ibudhou Marongkhong Haraoba #4 :: Gallery
  • COVID-19 Status 03 Jan : Govt of Manipur
  • Eyek Tamba :: Learn the Manipuri script
  • Linguistic Society of America 2020 to Manipur
  • Time for Modi-Shah duo to ink the final pact
  • Vanishing Lamphelpat calls for conservation
  • New Community Centre at Ningthoukhong
  • Disturbed Area status: An unwelcome gift
  • Paona Independence League of Burma #3
  • COVID-19 Status 02 Jan : Govt of Manipur
  • Presentation of Tourism in Manipur : Gallery
  • Manipur's super cops
  • The passing moment- clock of life :: Poem
  • Executive Committee of 2021-22 YMC
  • Take care of your hands this winter
  • RK Bhubonsana : Profile- Literature Awardee
  • COVID-19 Status 01 Jan : Govt of Manipur
  • Prayers to honourable Home Minister
  • Book Release of Cheerom Meihoubarol
  • Chronicling activity of Veterans in Manipur #2
  • Biswajit Basu as Director (Projects), NHPC
  • Imphal on eve of New Year 2021 #1 : Gallery
  • COVID-19 Status 31 Dec : Govt of Manipur
  • Downloadable Manipuri Calendar :: 2021
  • Featured Front Page Photo 2020 #6: Gallery
  • Bidding Goodbye 2020 with a toast of Corona
  • Let us not down NK Sanajaoba's Spirit
  • Dr Konika Khuraijam- SDP Achievers Award
  • One Day Adventure Programme at Lamdan
  • On stepping into a brand New Year
  • Welcome 2021: Will it be another happy days
  • Romita Yumnam is Mrs Jhansi 2020 : Gallery
  • COVID-19 Status 30 Dec : Govt of Manipur
  • Mrs Romita Yumnam crowned Mrs Jhansi 2020
  • Year's End - 2020 :: Poem
  • Bye - Bye 2020 :: Poem
  • Maya Kuki in top 25 in Mrs Universe 2020
  • 2020: Decisive for the BJP in Manipur
  • The other side of Amit Shah & Manipuri talent
  • My memories of Imphal from 1941 #11
  • COVID-19 Status 29 Dec : Govt of Manipur
  • The cry of a disgruntled citizen
  • KVRSS Annual Research Awards 2020-21
  • Manage to reduce it
  • Life is a matter of choices
  • Painting Competition : Right to Information
  • New virus strain: The world is worried
  • Mayang Imphal Keithel #1 : Gallery
  • COVID-19 Status 28 Dec : Govt of Manipur
  • January Calendar for Year 2021 : Tools
  • Shanti Thokchom #43 : Trip to Grand Canyon
  • 2020 as the 'Year of Science'
  • Sampurna Raas Leela at Guwahati
  • Significant 2 hours delay in leaving lmphal
  • Biren will be Chief Ministerial candidate
  • Amit Shah @Imphal [Dec 27] : Gallery
  • COVID-19 Status 27 Dec : Govt of Manipur
  • Organic cultivation of tomato
  • Xmas during pandemic - a time to reflect
  • Reviews of Loktak Downstream Project
  • Amit Shah: Man behind ILP in Manipur
  • S Lonphai, Henglep Sub-div, CCpur : Gallery
  • Works of Haobam Paban Kumar #2 : Gallery
  • Pukhrambam Narjit : Asangbi Sanagi Medal
  • Paona Independence League of Burma #2
  • Khamba Thoibi Jagoi at JNMDA #1: Gallery
  • Cherry Blossom at Mao #1: Gallery
  • Festive mood in CCpur for Xmas: Gallery
  • Ningol Chakouba @ Thanga #2: Gallery
  • State level Nupi Lan Day : Gallery
  • Sory Wahengbam - Actress Gallery :: eRang
  • COVID patient cast vote @Wangoi : Gallery
  • 'Zehara' - Manipuri Movie :: eRang Classic
  • SPONSORED ADS