India’s ‘barefoot counsellors’ make life bearable

For impoverished women who are abused and depressed, the care of untrained mental health workers presents the only possibility of getting some relief from their despair.

After giving birth to her first child in 2007, Neeta Khandekar* didn’t return to her husband’s home for eight years. It all started with a bill of 5 000 Indian rupees (R195), which Neeta’s husband Ritesh* declared was his in-laws’ responsibility to pay.

Ritesh believed in the conservative practice of a woman’s maternal family bearing the medical expenses of the first child. Neeta’s father Mangesh* said that she had terminated her first pregnancy, so this was the second child and not his responsibility. This ego battle between two men escalated to verbal fights, with the families snubbing each other. 

Eight years later, in 2015, Neeta and her son were still separated from Ritesh. “Despite all that had happened, we loved each other and I wanted to return,” said Neeta, who had been deeply affected mentally by the tussle between her husband and her father. “I wanted to be rid of these mindless fights.” 

7 March 2022: Maya Patil visits Khutwad village in Maharashtra state to investigate a continuing mental health case. Often, accredited social health activists go beyond the call of duty to help women at risk. 

Then Maya Patil, an accredited social health activist (Asha) from Khutwad village in the Kolhapur district of Maharashtra state, intervened after hearing the story. She contacted an Asha from Shirol in Kolhapur, Netradipa Patil, for help. Eventually, after complicated interventions and deliberations involving both families, the problem was solved and Neeta moved back home.

“Everything turned out to be perfect and the bond between both the families healed,” Maya said proudly. Netradipa added: “This issue was rooted in sexist traditions. But with proper counselling, we finally made sure both the men let go of their ego.” 

Together, Netradipa and Maya have trained over 20 Ashas who have helped hundreds of women like Neeta. Ashas, who are essentially community health workers, work mainly in rural districts. Their services are invaluable in these areas, where public healthcare facilities are spread thinly and long distances between clinics and hospitals make them difficult to access. 

Medha Kale, a Maharashtra-based activist advocating for improved women’s healthcare for over two decades, said Ashas often serve as “barefoot counsellors” for women in impoverished households. “As they belong to the same community, they understand their problems, stresses and burdens better than professional healthcare givers.”

A needed hand

Globally, an estimated 736 million women have been subjected to physical or sexual violence, or both. Netradipa wanted to help abused women in her home state by building a movement of solidarity and support for them. It has since expanded to over 10 states, which is significant because an estimated 86% of women in India who face violence never seek help. 

During her visits to rural communities, she identifies abused and depressed women, takes their contact details and invites them to call her when they need her. Getting the women to open up takes several calls, Netradipa said, and repeatedly visiting the house of a victim of abuse is risky because of opposition from family members, especially the men. Using her network of social activists, she arranges for local help if the cases are not in her vicinity.

These days, social media makes it possible for her to send inspiring poems, messages and videos to these women, and she’s even started WhatsApp groups for women to support each other. She offers hands-on support to victims via video calls, too. 

“None of this is part of our official duty, yet we do it because people trust us,” said Netradipa. “We haven’t got any proper training on mental health, but we learned this from interactions with people.” 

23 March 2022: Netradipa Patil updates her WhatApp status each day. “At least 500 people see my status daily, and many even thank me for inspiring them,” she says.

Ashas take on far more than what is expected of them by the health department, including dealing with the police and handling legal affairs when women are abused. But the government does not recognise them as full-time workers. 

“We are volunteers even today and have no legal benefits, not even the minimum wage,” said Netradipa, who also leads Kolhapur’s Asha union representing over 3 000 workers. 

“Ashas in Maharashtra average a monthly pay of merely Rs 3 500 to Rs4 000 (R684-R782),” added Maya. “Forget pay for mental health services – our department doesn’t even know how we built a support system for women.” 

Saving lives

For three days in October 2021, Shreya Sardesai* didn’t answer calls or reply to Netradipa’s messages. When she went to Sardesai’s house, she found her in tears saying life had become meaningless. Immediately, Netradipa took the depressed woman to her own house in Shirol, 25km away. “She collapsed three times before we reached my home.” 

After her husband’s death, Sardesai faced physical and mental abuse and was finally left abandoned by her family and children. “She attempted suicide four times,” said Netradipa, who took Sardesai to a hospital in Shirol. “She would sleep the entire day and didn’t say a word for five days.” 

It took a month for Sardesai to open up about what had happened to her after her husband died. A villager fell in love with her, and when she spurned his attention, he gave her biscuits spiked with sedatives while giving her a lift to the office where she was working. He then made sexually abusive videos and started blackmailing her. This incident became public and she quit her job. 

16 March 2022: Accredited social health activist Anita Ravan from Shiroli village takes note of the plight of migrant workers in her community. She identifies people who need support and then arranges mental health facilities.

When Sardesai’s parents learned that she was at Netradipa’s, they filed a police complaint alleging she wasn’t safe. This forced the women to travel 40km to a police station so that Sardesai could give a statement saying it was untrue. After investigating, the police dismissed the case.

For 45 days, Netradipa counselled Sardesai daily for at least four hours, arranged food and medicines, and helped her recover. She also took her to visit multiple doctors. “Motivational words like ‘keep trying’ don’t help [on their own],” said Netradipa. She took Sardesai to see a psychiatrist, who prescribed antidepressants, and slowly she got her to meditate and exercise. 

Despite this success, Netradipa knew Sardesai could slip back into depression. And in mid-December, when Sardesai returned to her village, she indeed abandoned her antidepressants and instead took five sleeping pills in a day to avoid reality. 

23 March 2022: Netradipa Patil visits a home in Shirol.

“This time, I had informed a few community members to look after her and update me,” said Netradipa. And this helped Sardesai, who slowly began feeling safe in the same village she wanted to escape. “Today, I’ve started travelling on my own, and I never want to go back into the same cycle,” said Sardesai. 

She now texts Netradipa daily and is actively looking for working opportunities while trying to enrol for a graduation course. “Even my parents wouldn’t have done so much. I won’t forget this until I die.”

“Today, after almost five months, when I look at Shreya I feel surprised. She not just overcame her trauma but has inspired me to keep working,” said Netradipa. 

*Names have been changed to protect identities.

If you want to republish this article please read our guidelines.