ASHAs on Warpath:
A Counteroffensive Against
Neoliberal Labour Policy
The impressive ASHA rally of 5th September marks the culmination of serious organising efforts which merit some attention. So in addition to a brief report of the event we bring you here a state-level story submitted by an AICCTU leader who is also a senior co-convenor of the All India ASHA/SAHIYA Union, a block level experience sent by a leading AIPWA cadre and a perspective analysis from an editor of Liberation.
Delhi, 5 September 2011. Braving heavy downpour, thousands of Accredited Social Health Activists (ASHA) from different states, notably Jharkhand, Assam (including Karbi Anglong), Bihar, and Uttarakhand, held a maha-dharna at Jantar Mantar near Parliament in New Delhi under the banners of All India Central Council of Trade Unions (AICCTU) and All India ASHA/SAHIYA Association. This was the first ever national-level protest on behalf of more than 7 lakh ASHA workers.
A six member delegation from the dharna handed over a memorandum to the Union Minister of Health and Family Welfare, Mr. Ghulam Nabi Azad. The memorandum pointed out, inter alia, that the Planning Commission has recommended another 4 lakh ASHAs to be added to the existing 7 lakhs by the year 2012 so as to achieve Eleventh Five Year Plan targets on reducing maternal mortality ratio, infant mortality rate etc. It has further recommended appropriate monetary and non-monetary incentives, including higher salary and better housing facilities, to encourage qualified health workers to serve and stay in rural areas. But in practice, these recommendations are never taken seriously, the memorandum observed.
The main speakers who addressed the dharna were AICCTU General Secretary Swapan Mukherjee, Beena Devi (Convenor of the All India ASHA/Sahiya Association), Shashi Yadav (Co-convenor), Subhash Sen (Co-convenor and AICCTU national Secretary), Hemlata Som and Mukul Bhhatacharya (Co-convenors) and other leaders. ASHA leaders from different regions also shared with their colleagues their typical experiences and their resolve to fight on.
The speakers strongly condemned the Centre’s and the state governments’ criminal neglect and disregard for the ASHA workers. The basic fact of recruitment of ASHA as honorary volunteers, they pointed out, subjects them to inhuman exploitation. They are forced to toil only on incentives, do not have fixed duty hours and have to work for twenty four hours a day in extreme insecurity even in remote villages and hill areas. To make matters worse, the list of their responsibilities is always growing with newer items, such as health survey. The condition and treatment meted out to these workers tells the truth about the women’s empowerment in our Country.
The dharna also demanded that resolutions be passed in state assemblies in support of the ASHA workers’ demands.
Through Twists and Turns: the Story of Assam
Starting with 5 ASHAs in Tinsukia district in mid-2007, quickly followed by a district convention attended by about 300 and then a demonstration on 17 JULY before the DC office with about 400 participants, our work in Assam made a really very impressive beginning. But then one problem after another began to crop up. The ruling class parties -- the Congress and the BJP and particularly the Vishwa Hindu Parishad -- began to pull the ‘ASHA’ leadership in opposite directions to snatch the initiative from us. They started a slander campaign against me for I was the only male in all the female ASHA organisation. The BJP succeeded in winning over the leadership and we could not even hold any meeting. After a gap of nearly three years a state-level trade union was formed and registered in June 2010.
However, another government-sponsored organization was formed soon and it started disturbing us in every possible way. But we went on taking one programme after another, like holding a state mobilisation on 3rd October 2010 where more than 3000 ASHAs were mobilized, then a sit-in- demonstration of about 500 in front of the Assam Assembly in session, then again a NRHM Head Quarters gherao on 4th March next year, and so on.
In June 2011, a group of about 40 ‘ASHA’s of the rival organization forcibly disrupted the state council meeting of our union in Guwahati, while a large contingent of CRPF and Assam Police remained silent spectators. Owing to their violent slander campaign and our failure in taking all-out initiative due to dearth of organizers, they were able to restrict our expansion only to 8 districts out of 27 districts in Assam. Meanwhile, infighting has started within the rival organization on the question of funds.
As things stand, the state structure of our union exists in a much deconsolidated state. To bring it back to the right track, district and PHC level workshops should be held, particularly on topics like: the significance of consolidating relations with AICCTU, why and how we should try and elevate ASHA leadership to the level of AICCTU leadership, overall idea of past and present-day working class movement, the protracted nature of the ASHA movement, the need of both grass-roots initiative and initiative from state and central levels, etc.
In sum, the ASHA have a great urge to get organized. Wherever we took initiative, we succeeded. And yet, we have not taken sincere initiative in most districts and states. The CITU has successfully organized the Anganwadi workers at national level and also taken initiative to organize the mid-day meal workers. This should sensitize us to the task of organizing the health workers, an overwhelming majority of whom live below poverty line and in villages where they are closely integrated with the downtrodden rural population. There must be adequate direction and guidelines from Party, AICCTU and AIPWA leaderships in this regard. Women leaders can play a more effective role here than male comrades; so we must build up women trade union leaders in good numbers.
Subhas Sen, Co-convenor, All India ASHA/Sahiya Association and AICCTU national Secretary
Grassroots Experience of an AIPWA Activist
The seventh West Bengal State conference of AIPWA (2006) decided that to solve the long-standing problem of our very weak mass base, we should pay special attention to unorganised working women. Accordingly, I started organising the mid- day meal workers and ASHAs in Polba-Dadpur area of Hooghly district. Group meetings, at first combined ones involving both ASHA and mid-day meal workers and then held separately, became the platform for formulating demands and charting the course of advance. Since then and to this day, the two separate streams have developed together, united in a strong bond of solidarity under the banner of the women’s association.
Gradually we realised that the work is more of a trade union nature and went in for formation of a district level union. We did not opt for a state-level union because we had hardly any work in other districts of the state. Demonstrations and deputations – under the AIPWA banner to start with and then under the union banner – at BDOs, the DM, the CMOH etc with regular follow-up actions enabled us to solve some local problems like non/late- payment of dues and other harassments. On 29 July a more than 700 strong demonstration and deputation at the office of the Health Secretary, Government of West Bengal, was organised in Kolkata, with some 600 participants from our district and the rest from West Medinipur and North 24 Parganas districts.
Unfortunately we could not attend the 5th September Delhi rally, mainly because many of the activists were undergoing training. However, block level demonstrations and deputations are going on to address burning local grievances as well as the overall demands. In addition to ASHAs, some other forces – such as a few disgruntled CPI (M) elements, vaccine carriers (male) attached to the Health Department and willing to form a union – are also approaching us.
The health workers are more articulate, having at least secondary level education; and quite sensitive about their rights and dignity. Compared to the mid-day meal workers, they are objectively more organised among themselves. During the initial training period, some 300 to 400 of them stay together in the training centre (I utilised this opportunity by secretly meeting them there) and later serve in sub-primary health centres in groups of 6 to 20 or so. They meet together at the panchayat office every second and fourth Saturday to discuss the progress and problems of work with block- level health officials. Moreover, they are relatively young and belong to the same age group (25 – 40).
Thanks to these positive features, I did not find it difficult to locate panchayat level organizers-in-the making and by networking them through mobile phones (most of them have one) it was possible to take prompt initiatives. Of course, I also meet them in groups. No AICCTU organizer is associated with the day-to-day work, although political help and guidance from AICCTU state leadership is always forthcoming since union formation.
We are yet to match the agitational activities with adequate attention to political education and party building. This should be taken care of mainly at village levels, but we are yet to put in place a proper mechanism for that. Moreover, ASHA contacts are coming also from areas where we have no party presence.
We are also facing opposition from others and there will be more of it in the days to come. There is a continuous warning from the Trinamul Congress to health workers: ‘you can go with the union only so long as it is not red’! The TMC is also trying to attract our forces. ‘Come to us’, they say, ‘Didi will solve your problems’. The CPI (M) is not totally inactive either and we have a potential contender in the SUCI-led state level ASHA union. So far we have been able to thwart such political pulls and pressures through lively political discussions as and when the issues/questions emerged. But unless we fill up the gaps mentioned above and spread our work by involving more cadres, a setback is not precluded.
My experience tells me that alongside the trade union, the women’s organisation too has a lot to do here. ASHAs routinely encounter misbehavior during field work and in hospitals. Usually their husbands and in-laws accept the job as such because it earns some money for the family, but they often try and control her movements, especially on holidays and after nightfall, complaining that household duties are getting neglected. At the moment the “head of the family” in most cases support the wife’s involvement in union activities, but I’m afraid the situation may change once it appears that no major financial benefit is forthcoming. Unless they are educated to fight such patriarchal bondage at home and oppression outside, their activism is bound to suffer. However, the more important fact, the principal aspect of the scenario, is the palpable rise in the democratic consciousness and assertiveness of these health workers, which make them a major force of women’s movement and therefore an important constituency of AIPWA.
To tap the potential inherent in this sector and to develop organisers and party members, we have plans to hold classes on the two papers of last year’s political literacy campaign (on (A) women’s movement and (B) revolution and party) and also on trade union issues. The challenges are tough, but if we tackle them collectively, the prospects are very bright indeed.
Chaitali Sen (West Bengal state secretary, AIPWA)
At the Confluence of Workers and Women’s Movement
(Arindam Sen with inputs from comrade Rajendra Pratholi, Uttarakhand state secretary)
The upcoming agitations and organisations of rural health workers are powered by a new awakening of a seven lakh strong contingent of women workers who have entered the labour force over the last five years or so and whose ranks are steadily swelling, even as the workforce in many other sectors are on the decline. They also represent a powerful challenge thrown up to an obnoxious set of labour policies of the neliberal state: casualisation of permanent jobs, extremely exploitative feminisation of low-paid work and denial of even minimum wages, not to speak of government employee status, to those engaged in hundred percent public projects. In the backdrop of our first national initiative in this sector, it is time to reflect on the experience gained so far and on the path that lies ahead.
So far the fastest development in this sector – reminiscent of but probably surpassing the speed witnessed in Assam about four years ago – has been recorded in Uttarakhand. The work started here with midday meal cooks and spread to Anganwadi and then to ASHA. But the last became the first in a matter of about four months since summer this year, when a drastic cut in honorarium (see Liberation, August 2 011) made the ASHAs extremely agitated and the Party and the AICCTU took prompt, concerted, energetic steps to mobilise them. Following a number of massive and militant demonstrations in block and district headquarters and the state capital, the rural health workers crossed long and difficult miles – mostly from hill tracts – to throng the national capital on 5th September. However, comrades are very much alive to the challenge of quick consolidation, the lack of which leaves the yet-to- be-registered (process started) union vulnerable to pulls from other forces.
Like Uttarakhand, other states too display their special features of evolution of work in this sector. Rather than running for uniformity, we should creatively build on this features. In some cases, especially in initial stages, it may be necessary to use an apparently NGO style or form of mobilisation – for the proletariat can defeat the bourgeoisie only by selectively adapting to its own needs the techniques, including organisational techniques, developed by the latter – provided we are careful about our communist orientation and content of work.
In addition to state features we should also take into careful consideration a very special characteristic of ASHA organisations. These are essentially trade unions no doubt, but of a special kind. While other TUs represent the striving for workers’ liberation from the yoke of capital and its state, those in women-only or women-dominated trades represent, in addition, a strong urge for women’s liberation from patriarchal bondage and oppression institutionalized in the capitalist state. When a young wife in our semi-feudal setting steps out of her home to appear in interview for the job, undergoes training for days together if selected, and then starts spending a major part of the day beyond the four walls, a great change occurs in her relations with the family, society and state. She experiences a new (relative) freedom and also a hundred restrictions sought to be imposed on that freedom. Point 7 of the charter of demands submitted to the Government of India reflects such gender concerns and various local issues routinely crop up at the grassroots.
Given this real- life interpenetration of class and gender issues/aspects, it is but natural that both the AICCTU and AIPWA have contributed to the development of work in this sector, though not in uniform ways. In Bihar for example, it has been basically a joint venture of sorts, while in Uttarakhand there was little involvement of AIPWA, which on the other hand took the entire initiative in Hooghly district of West Bengal. Such regional variations will be there, but generally speaking what we need is complementary roles of both organisations – which can be achieved not spontaneously or casually (in the name of “naturalisation”) but only under specific guidance and monitoring by the Party.
However, this must not lead to an artificial compartmentalisation of tasks. Quite to the contrary. Only by taking up the concrete issues of a particular trade (both class and gender-related) can a women’s organisation acquire an active mass following among labouring women. And only by concerning themselves also with the live gender issues (in addition to economic demands) of working women can a TU strike deeper roots among them. To ensure both is the function of the party leadership, which is committed to developing a class-focused women’s movement as distinct from a narrowly conceived feminist movement and a revolutionary TU movement that rises above narrow trade unionist politics and culture to pursue holistic emancipatory aims encompassing class, caste and gender. With adequate homework, the forthcoming national conferences of our TU centre and women’s organisation can help that process in significant ways.