Indian health workers criminalised for protesting

Underpaid and overworked health personnel who serve in rural communities have been dismissed for striking. ​But how else can these vital women have their concerns addressed?

Hundreds of Anganwadi and accredited social health activist (Asha) workers – India’s frontline community personnel who have spearheaded the country’s fight against malnutrition and the Covid-19 pandemic – are facing retaliation charges and dismissals for their protests for better wages and work benefits.

​Nearly 1 000 Anganwadi workers and volunteers in Delhi have been dismissed, while more than 3 000 others have been issued show-cause notices for their participation in the 39-day strike demanding regularisation of their jobs and the implementation of government service rules so workers can get retirement benefits and medical insurance.  

Considered “honorary workers”, Anganwadi workers and helpers have been protesting in the national capital since 31 January after two demonstrations – on 7 September 2021 and 6 January – failed to persuade state authorities to make them government employees. The most recent protest was suspended on 9 March after Delhi’s lieutenant governor invoked the Essential Services Maintenance Act (ESMA), which prohibits any employee strike for the next six months.

The Anganwadi workers who have been issued notices or whose services have been terminated are devastated, since so many families rely entirely on their earnings for survival. “All these terminations are illegal without any hearing. Without any actions, the workers were terminated for participating in the strike,” said Shivani Kaul, president of the Delhi State Anganwadi Workers and Helpers’ Union, which spearheaded the strikes. Kaul also pointed out that the act can only be imposed on government employees. “Clearly, this step is completely unconstitutional and illegal,” she said.

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On 14 March, the union appealed the termination at the high court in Delhi, seeking immediate reinstatement with wages. In the petition, the union stated that its strike was called off after the government prohibited it. The workers were asked to report back to work immediately and to sign apology letters saying they would not strike in the future. 

In its response, the Delhi government told the court that the workers who were terminated from services had refused to come back even after being asked to. It said it would not terminate any more Anganwadi workers or helpers.

The union said that its fight would continue even after receiving threatening letters and suspension notices, and accused the authorities of disrespecting Anganwadi employees. Fifteen Anganwadi workers were also detained in the capital after protesting the termination notices sent to their colleagues.

At present, Anganwadi workers receive a monthly honorarium of about R1 800 and helpers receive R930. They want about R4 800 a month for workers and R3 800 for helpers. In response to the strike, the Delhi government announced on 14 February an increase in pay for Anganwadi workers to about R2 440 and R1 309 for helpers from 1 March. The striking workers declared this inadequate and said the protests are meant to draw attention to their working conditions. They vowed to continue the strike until their concerns are addressed.

Nationwide resentment

On 15 March, hundreds of Anganwadi, Asha and midday meal workers from Haryana, Delhi and Punjab held a protest near the Indian Parliament for a wage increase. The Centre of Indian Trade Unions led the protest backed by the All India Federation of Anganwadi Workers and Helpers, the Midday Meal Workers Federation of India and the All India Coordination Committee of Asha Workers.

In the neighbouring north Indian state of Haryana, the administration terminated 600 workers for demanding an increase in their honorarium. More than 40 000 Anganwadi workers and helpers in Haryana had been protesting since 8 December, but the strike was also suspended after the state authorities invoked the ESMA.

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Workers in Haryana have been demanding that Prime Minister Narendra Modi honour a commitment made in September 2018 to raise the monthly honorarium for Anganwadi workers by about R288 and helpers by R144, along with getting other government employee benefits.

In the south Indian state of Andhra Pradesh, the Anganwadi workers have also been staging state-wide protests demanding the implementation of a minimum wage and payment of allowances. Many Anganwadi and Asha workers were detained for attempting to submit a memorandum of their demands to authorities. On 29 March, hundreds of Anganwadi workers held protests in Madurai city and in the northern city of Ludhiana.

A resilient workforce

Employed under the government’s Integrated Child Development Scheme, India’s 2.5-million-strong Anganwadi and Asha workforce are community workers who serve vulnerable sectors of society, catering to the education and health needs of children under six. They collect data on children’s growth and education, and distribute rations to pregnant women, while also providing them with information about vaccinations, healthcare and sanitation.

Anganwadi was launched in 1975 to combat child hunger and malnutrition. The Ashas are trained women’s community health activists created under the National Rural Health Mission to mobilise the community to use existing health services. Working in close association with each other and other frontline workers such as the Auxiliary Nurse Midwives, the Ashas and Anganwadi largely consist of women workers. They are often divorcees, single mothers or widows who earn an honorarium. They are not entitled to a salary. Spread across the country, their honorarium differs depending on the state, though the component sanctioned by the union government is common to all. They often come from the community they serve and are highly politically aware and unionised, despite the odds. 

When the Covid-19 pandemic put a strain on health facilities, Anganwadi workers led door-to-door check-ups for Covid symptoms and distributed medicines with their fellow Ashas. They were especially critical in fighting the pandemic in the rural areas, helping people deal with the virus and its aftermath. These high-risk responsibilities were in addition to their everyday tasks, including providing meals for women and children, mass immunisation and building links between the government and the community.

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​While the government imposed a nationwide lockdown, Anganwadi workers and Ashas were still expected to work, despite limited transport. Many of them were not adequately equipped to work in the field. Others were not properly trained for their new responsibilities. Despite their contact with possibly infected people, they were expected to function without masks or sanitisers in a virus-stricken environment.

“Ashas and Anganwadi workers have been going to extreme lengths to ensure that the households they serve are able to access state entitlements, raising the question of why their entitlements remain unrecognised,” writes Ayesha Pattnaik, a researcher at an Indian agency working on rural poverty alleviation. “While these workers have been building strong unions with defined collective voices, protests by Ashas and Anganwadi workers across states have been met with police brutality.” She adds that criminalising dissent has meant that the space to claim their rights is shrinking.

​Scholar Suchita Krishnaprasad says the rural women whom the Anganwadi and Asha workers serve are not powerful enough to nudge policymakers to extend decent working conditions to these frontline health workers.

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