Bihar ASHAs on Indefinite Strike
THE government ‘Accredited Social Health Activists’ (ASHA) workers in Bihar went on an indefinite strike from December 1 with a 12-point charter of demands. They constitute a formidable contingent of nearly one lakh workers spread over all 38 districts of nine administrative divisions in Bihar. The strike call given by the Joint Struggle Forum (ASHA Sanyukta Sangharsh Manch) comprising of three major ASHA unions in the state met with an unprecedented success and on the very first day on 1 December ASHA workers came on the streets in huge numbers with their banners and slogans. They were demanding government employee status and a minimum wage (which the government terms ‘honorarium’) of Rs. 18000 besides many other demands that include 50% reservation for ASHAs in state nursing schools with appropriate age relaxation, appointments as ANM (Auxiliary Nurse Midwife) for qualified ASHAs and as BCM (Block Community Coordinators) for ASHA facilitators, implementation of recommendations by the High-Level committee regarding work conditions and monthly remunerations, and social security benefits including ESI and Provident Fund.
With public health services been almost completely withdrawn from the grassroots after the neoliberal restructuring, it is the ASHA workers who now constitute the backbone of India’s rural as well as urban health sector for the low income to the most poor and deprived sections.
The strike was complete and work remain suspended in primary health centers (PHCs), the emergency health services continued as they were exempted from the strike. The government’s vaccination program which was schedule to begin from 5 December could not take off due to strike.
Shashi Yadav, president of Bihar ASHA Workers’ Union (AICCTU) told in a press conference that ASHAs in Bihar are struggling for a very long time, as in other states, for fixed monthly salary and dignity. Bihar has the second highest (93,687) contingent of around one million total ASHA workers in India. They are the key link (practically, the only link) between healthcare system and rural population and have to perform many essential tasks like treating basic illness, first aid, keeping various records, monitoring sanitation, immunization, rendering help during pregnancy besides their work as health educators and promotors by mobilizing the community towards health awareness. Their job also includes motivating women to give birth in hospitals. They have to keep a repository of primary medicines like ORS, Folic Acid tablets, common tablets like chloroquine, Pills and Condoms, disposable delivery kits, etc with them ready. ASHAs have to work 24/7 as nobody knows when a medical emergency arrives. But this is an irony that the government considers them ‘volunteers’ only not to pay them due wages, irrespective of the fact that they put in lot of hard labour. She told that the Nitish government has not implemented even the agreement made on 29 June, 2015 regarding the increase in so called ‘honorarium’ even after so many years.
They as community health workers are an essential component of central government’s National Rural Health Mission (NRHM). They work in close coordination with gram panchayat, SHGs, ANMs, Anganwadi workers etc to cater to a certain population at village level without any employee/worker status or regular wages. Instead they are paid ‘incentives’ for different tasks at fixed rates which practically is highly underpaid piece-rate payment in accordance with neoliberal payment structures and amounting to modern day slavery.
Bihar has its own additional woes inflicted through extra workload as each ASHA worker has to cater to a population of 1075 against a national average of one ASHA per 900 population.
On 1 December ASHAs assembled in front of all primary health centers all over Bihar to press for their genuine demands. The PHC gherao continued in the following days with increased strength and determination. The support and sympathy to their movement by wider sections of general public became a testimony to the genuineness of their demands. Left parties and major trade union centers issued statements in solidarity.
Solidarity Meetings by Left parties, TU centers and AIARLA in Support of ASHA Strike
All India Agricultural and Rural Workers Association (AIARLA) organized mass protest in their support in all blocks on Dec 5. AIARLA National General Secretary Com. Dhirendra Jha, Bihar State President and Darauli (Siwan) MLA Com. Satyadev Ram, and State Secretary Com. Gopal Ravidas issued a joint statement on 3 December 2018 supporting the ongoing ASHA workers’ strike in Bihar and demanded that the State government hold talks with the ASHA workers and pay them monthly honorarium without delay.
Com. Dhirendra Jha said that ASHA workers are the backbone of rural health services. They work for 24 hours all seven days of the week. Despite this, they get neither proper wages nor the rest due to them. Non-payment of monthly wages to them and failure to regularize them is an insult to the Constitution and to social justice. He further said that AIARLA will organize Block level solidarity meetings on 5 December in support of ASHA workers. Effigies of the Prime Minister and Chief Minister will be burnt at the meetings. ASHA workers are working under the National Health Mission and it is they who are the means of bringing the State’s health services to the people. The Chief Minister had earlier assured them that they would be paid monthly honorarium but today he remains silent on the issue.
CPI(ML) organized solidarity protests in many districts on 7-8 Dec. CPI(ML), CPI, CPM, SUCI, AIFB and RSP issued a joint statement asking CM Nitish Kumar’s immediate intervention to accept ASHA’s demand.
CPI(ML) MLA Mahboob Alam joined ASHA workers in their dharna at Balrampur on 6 Dec. AICCTU Bihar General Secretary RN Thakur demanded fulfillment of their demands and called for solidarity protests by all AICCTU affiliated unions in Bihar. He also demanded regularization of all Aanganwadi and Mid-day meal workers.
The Strike Continues
Hundreds of ASHAs continued to pour in daily to gherao the PHCs leading to a complete halt of health services in Bihar. In Motihari and many other places striking ASHAs held sit-in and stayed at protest site day and night. Many volunteers came forward in arranging for them food etc. In Siwan, they held a massive sit-in protest on 5 Dec in the grounds of the district hospital.
Striking ASHAs blockaded district level hospitals and Civil Surgeon offices which was attended in massive numbers. CS offices remained locked from outside a whole day on Dec 10. The next day there were big demonstrations in front of District Magistrate offices in all districts. The joint struggle forum has now announced to protest in front of Bihar CM if the latter continues to ignore their demands and betray the promises he himself made. A proper notice was served to Bihar administration 15 days in advance but the latter did not bother to even call ASHA organisations for talks. Bihar ASHA Workers’ Union President Shashi Yadav, ASHA Sangharsh Samiti President Mira Singh, Vishwanath Singh and Kaushalendra Verma have warned Bihar government to refrain from using any overt or covert repressive tactics in face of many reports of police and administrative highhandedness towards peaceful ASHA protesters at local levels.
ASHA in Hindi means Hope. The immense success and resolve of this strike in Bihar may prove to be a flagbearer of the ASHA workers’ struggle going on in every state in the country on exactly same set of demands. This strike is a bright ray of hope for the ASHAs who are forced to work in hopeless work conditions without pay and without employee status. This strike exposes the hypocrisy of the establishment as well as new tools of extreme exploitation of working classes which were evolved gradually by the neoliberal policy regime to extract labour and amass profit ultimately for the private players and cronies in the health sector. Now there is a need for a countrywide united initiative of struggling ASHA workers on a single platform. Bihar ASHAs have shown us the way.
