Organizing the ASHA workers first started with some NGO members who were also working in the NRHM. Some health workers took an initiative in organizing them in certain districts of Bihar. The traditional Trade Union Centres and Employees’ Organizations have only recently begun thinking in this direction, seeing the potential of these health workers in developing massive contacts among common rural womenfolk. But it is unfortunate that so far as organization, education and assertion is concerned, the efforts of these Associations at the grass root level are far from satisfactory.
Along with the Bihar State Non-Gazette Employees’ Federation and All India Central Council of Trade Unions, the All-India Progressive Women’s Association began organizing the ASHA workers in 2007. Instead of raising issues from above, they began organizing these women at the grass root level and training them. In more than a dozen districts, block-level workshops were organized to understand their problems and discuss as well as resolve them through struggles. District-level conventions were held.
Some of the issues that were on
top priority were:
· identity of the ASHA worker as a health worker,
· a regular wage of Rs. 10,000 per month,
· maintaining her dignity and
· better treatment at the hands of officials.
They also demanded ID cards so as to be able to admit women into the PHCs and
Hospitals without having to answer myriad questions. This demand became popular
in the entire state and ID cards have now been issued all over the state. The
ASHA workers had never been allowed to use nurses’ toilets since the keys were
always in the possession of the nurses or other employees. Now they are allowed
access in several PHCs.
Organization has brought a qualitative change in the consciousness of these workers.
So, we see that the personal complaints regarding low honorariums have given
way to district level meetings and district conferences. Also, ASHA workers are
helping to change the work environment by collectively protesting against cases
of sexual harassment. This has instilled greater confidence and a sense of
unity among them.
Backbone of Rural Health yet Discriminated
The UNICEF and many other agencies have recognized the enormous contribution of the ASHA workers. They form the backbone of rural healthcare and have made immense sacrifices. They are called the ‘ASHA Didis’ in Bihar and rural womenfolk are totally dependent on them in a State which is most backward in terms of social indicators. Although they are appointed on a contract basis and acquire skills during their term of work, they are not being made accountable to the employer i.e., NRHM, rather they are forced to report to corrupt health officials. This is one reason for their exploitation. Many ASHA workers feel that they must be freed from the clutches of the corrupt health bureaucracy so that they can work in an environment which is autonomous and free from corruption; according to them this is one reason why their image is often tarnished.