Delhi sent this ASHA on pandemic duty. And all but abandoned her when she got the virus

Babli, 35, tested positive for coronavirus on June 18. It was inevitable, she says, given her line of work.

Babli, who does not use a second name, is an accredited social health activist, or ASHA, in the national capital. ASHAs are community health workers who are engaged in monitoring pregnant women and ensuring institutional deliveries, assisting in immunisation and vaccination drives, and spreading awareness about family planning. In this pandemic, they have been deployed on the frontlines of the health emergency, tasked with doing household surveys, keeping an eye on quarantined people, and educating the public about the new disease and how to stay safe. There are some 9,00,000 ASHAs in India and 5,730 in Delhi.

For about a month until she caught the virus, Babli, who lives with her husband and two daughters, aged 14 and 11, in Delhi’s Seemapuri, was involved in conducting a coronavirus survey in Seemapuri, Jain Mandir Basti and Dilshad Garden, including in containment and red zones. It was the hardest assignment that Babli has had to undertake in eight years as an ASHA.

In the initial weeks of the lockdown, ASHAs were tasked with tracking those with travel histories and monitoring them for symptoms. As the coronavirus infections surged in Delhi, the work got more intense, and riskier. According to Usha Thakur, general secretary of the Delhi ASHA Workers Association, every ASHA in the city was assigned survey and surveillance work at some point during the lockdown. “The problem was that initially our workers were not even given masks, gloves or sanitizers for protection,” she said.

On June 15, Babli came home from work feeling mildly feverish. She took a paracetamol and decided to sleep it off, only to wake up with fever, cold, and a sore throat. That evening, she got a message on the ASHA WhatsApp group announcing a testing drive for healthcare workers at the Seemapuri dispensary.

She got herself tested the next day. The result came back positive. “I did not get any help from the government after I tested positive,” she complained. “The doctor I saw didn’t even tell me to go in quarantine. I quarantined voluntarily in a room on the third floor of our building that was vacant. My husband was found negative, but another ASHA that I worked with tested positive.”

Her symptoms subsided after a few days but she continued self-isolating for two weeks. In that time, her husband would bring up food and leave it outside the room. “I got tested again after 14 days and the result came back negative,” she said. “I was very lucky I didn’t require hospitalisation. It would have been quite difficult for someone like me to get treatment.”

She is one of at least 137 ASHAs to have tested positive for coronavirus in the city so far, according to Kavita Yadav, All India United Trade Union Centre’s Delhi coordinator for ASHAs. In all, Delhi has reported 1,27,364 infections so far, with 3,745 deaths.

For her plight, Babli blames the Delhi government, which she claims sent ASHAs out, even into containment zones, without the proper protective gear. “We were just given a mask, gloves and sanitizer, and sent inside the lanes of Seemapuri. Those lanes are so narrow two people cannot walk side by side,” she complained.

It only added to Babli’s anxiety that the pandemic had rendered her the family’s sole breadwinner. Her husband, an embroidery worker, had lost his job just before India went into lockdown in late March. “He was getting less and less work well before the pandemic hit,” Babli said, referring to her husband. “And then he lost his job.”

So, the family has been stretched for money for quite some time. Babli was compelled to take her younger daughter out of private school last year because they could not afford the fees and send her to the public school which her older daughter also attends.

An ASHA gets a monthly salary of Rs 3,000 and there’s a “core incentive” of equal amount. The incentive is paid based on how many “points” out of six the ASHA earns, each point being worth Rs 500 and assessing her performance in undertaking her main functions. The pay is often delayed and several ASHAs Newslaundry spoke with said they never received the incentive in full, no matter how hard they worked.

They also complained that the additional incentive of Rs 1,000 a month for April, May and June announced by the Delhi State Health Mission for every ASHA engaged in coronavirus surveillance was quite meagre for the work they did, at great personal risk. They put in long hours carrying out household surveys and screening patients in home isolation, apart from performing their routine functions.

Sonia Sinha, 32, an ASHA since 2013, said when she was asked to conduct household surveys for coronavirus infection, she got so scared she asked to quit. “My husband did not want me to go out and conduct the survey because it was very dangerous for my family, but I was told by the AHSA authority that I could not leave at this time of emergency,” said Sonia, who lives with her husband and two children in Seemapuri.

Her colleague Samina, 40, didn’t have the option of leaving her job though she was as scared. Samina, who doesn’t use a second name, has been the sole breadwinner of her family since separating from her husband three years ago. She has six children, two of whom are married and live separately. The other four live with her in a small apartment in Seemapuri. “My job is the only source of income for my family,” she said.

The ASHA Workers Association had repeatedly requested chief minister Arvind Kejriwal and health minister Satyendar Jain to raise the salary for ASHAs to Rs 10,000 per month, at least for the duration of the pandemic. The pleas went unheeded, so ASHAs struck work on July 21 to press their demands of better wages and employment conditions.

On July 23, the association’s representatives met Jain, the health minister, to resolve the matter. "It was an usual meeting. The government gave us assurances, like every other time, but nothing substantial,” said Usha Thakur, who attended the meeting. “The minister said ASHAs on Covid duty, which involves keeping a tab on patients in home quarante, will be given Rs 100 per patient. But not all ASHAs are on home quarantine duty. What about the rest?"

Newslaundry reached out to Delhi’s nodal officer for ASHAs Monika Rana as well as its health minister for comment, but didn’t get a response. This story will be updated if a response is received.

Babli returned to work on July 1 and was again involved in household surveys until July 6, when she was assigned back to her routine work, mainly spreading awareness about family planning. Though she is no longer at as much risk of infection, Babli remains anxious.

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