Bihar’s Accredited Social Health Activists (ASHAs) are battling an existential crisis amid the second wave of the COVID-19 pandemic. With more than a lakh of active cases, Bihar suffers from a shortage of resources to tackle a pandemic where frontline health workers are caught between the devil and the deep blue sea – a callous state government and life-threatening COVID-19. The weary fraternity of frontline health workers has been stretched beyond measure, with state neglect costing lives.

The second wave of COVID-19 saw four ASHA workers lose their lives in the space of 10 days. Two ASHA workers in Banka and one each in Muzaffarpur and Munger are among those who have lost to the deadly pandemic.

The 89,437 ASHA employees in the state are on their feet to bring public health facilities to the doorstep of rural households amid a nationwide outbreak of cases.

Veena Kumari (45), a health worker in Minapur bloc in Muzaffarpur district, died on April 26. A wave of grief gripped his village of Ghosaut a few minutes after his disappearance. After an entire day spent in an uninterrupted vaccination campaign in the villages, she succumbed to COVID-19 at night. Known for her dynamic attitude, Veena lost her life in service to the rural masses. No concrete help reached her family during this time, said Kavita Devi, leader of the block-level ASHA workers’ union.

According to Kavita Devi (40), an ASHA worker based in the same bloc, workers in Bihar are scapegoats during this crisis. They have to face difficulties despite their efforts. The manager of the primary health center (PHC) of Minapur informed Click on Newsclick that the ASHAs left nothing behind to play a dual role. “They ‘disseminated’ information about ‘the’ ‘vaccine’ and addressed ‘reservations’ ‘that the rural masses’ ‘might’ ‘have’ ‘about’ the ‘jab’.

However, she unequivocally condemned the “ingratitude” of the state health department by failing to recognize their diligent efforts in not increasing their fees and expanding social benefits. ‌Year ‌ ‌ ‌ ‌ additional pay rémunération ‌ promised to ‌ them‌ COVID-19 uty their duties. The Ministry of Health and Family Welfare had, by decree of April 2020, directed States to ensure that ASHA workers receive additional incentives for COVID-19 related work and that they are provided with safety equipment to perform their duties.

According to Dr Shiv Shankar, responsible for vaccination of Muzaffarpur district, the vaccination campaign takes place in several phases following the SOPs. He denied the overloading of ASHA workers, saying the driving was most needed amid the pandemic. He pointed out that the state health department and the state government were bodies authorized to comment on compensation.

Poonam Marandi (45), another ASHA based in Chandan Block in Banka District, died while on duty. She coordinated the vaccination campaign between the panchayats and the Chandan Community Health Center (CHC) in addition to the kala azar vaccination. On April 16, during a field visit, she felt tired and was admitted to Katoria Referral Hospital and died overnight, said Purshottam Kumar Thakur, a vaccine course worker. responsible for sending vaccines from PHC to village health sub-centers.

His wife Poonam Kumari, a colleague of Marandi, said Click on Newsclick that frontline health workers had “remained swift from day one of the COVID-19 pandemic, but regular fees and waiting for COVID incentives is a distant dream.” The health department owes me 16 months of payment, which is a huge blow to my family’s financial situation. Reeta Kumari (35) based in Kumarkhand, Madhepura, has applied for social benefits several times and is also waiting for a pending payment for seven months.

The disappearance of Suman, an ASHA worker in Munger, was hushed up because officials at the Tarapur Primary Health Center (PHC) failed to respond to her sudden death, also during working hours. She was a delegate to Tarapur PHC and died on April 11, according to her husband Santosh Kumar. He alleged that the district administration did not seek any compensation, as is the case for frontline health workers who succumbed to COVID-19.

Frontline health workers largely believe that the supplementalVCOVID-19‌target‌‌vaccine‌‌maystrain‌ ‌ on the Auxiliary (“Maternal” “Half-women”). But the unavailability of vaccines in the state halted the drive.

Meanwhile, the state’s health department appears to be indifferent to the challenges facing ASHA workers in the state. A state health department official who requested anonymity said there was no information on the deaths of frontline health workers during the pandemic.

‌‌But cases of ASHA vaccination deprivation also appeared in the first weeks of April. Sarita Gaharwar (32 years old) ‌ from Pairaiya‌ ‌Khurd‌ ‌village, Gaya‌, ‌ missed‌ ‌out‌ ‌on‌ ‌‌her‌ first‌ vaccination ‌shot. ‌ “Other ‌ ASHA‌ ‌workers‌ ‌ have ‌ their vaccine‌ ‌dose‌ ‌ as ‌the ‌PHC officer had‌ sent ‌les‌ ‌an‌ ‌SMS.‌“ She is also worried ”about the“ non-payment ”of COVID-19“ remuneration for duties “, But added” that “” regardless “” of “” that she “” would continue “” to “put” in the “health” of “her” “time”.

According to Shashi Yadav, president of the ASHA workers’ union, Bihar, at least four health workers died during the second wave of COVID-19 during the vaccination campaign. She claimed that the state’s health department ignored their requests for details of those (ASHAs) who lost their lives amid the pandemic. Written requests to the Minister of Health and the CM also remain unanswered. ASHA workers have been persistent in their demand for 10,000 rupees in honoraria and state employee status from ASHA facilitators for the past few years, but none paid heed. . Despite several protests in the SSPs of Bihar, the government has turned a deaf ear to their demands.

Last month, slogans from ek hazaar mein dum nahi, Ikkis hazaar masik manday se kam nahi (Rs 1000 is not enough, we will not settle for less than 21000 rupees as a monthly fee) echoed at the Gardanibagh in Patna during a Mahadharna by ASHA workers.

Recently, the All India Scheme Workers Federation (which includes ASHA, auxiliary nurse midwives and midwifery workers) wrote to the Prime Minister and the Minister of Health demanding insurance coverage of Rs 50 lakh, health insurance of Rs 10 lakh, Rs. 10,000 monthly fees and beds reserved in hospitals for frontline health workers. The demand came against unfulfilled complaints made by Minister of State for Health Ashwini Choubey in a response to Lok Sabha last year where he said ASHAs receive life insurance, accident insurance and pension benefits.

According to data from ASHA unions, the number of beneficiaries of the aforementioned accident insurance is only 330; they received Rs four lakh free of charge, contrary to what the Center claims.

Besides the government’s broken promises on insurance and pandemic incentives, ASHAs are working without basic preventative measures such as disinfectants, masks, gloves and PPE kits. The ASHA facilitator of Samastipur PHC underwent an RT-PCR test and has been awaiting a report for five days without any institutional support from PHC.

The writer is a freelance journalist based in Bihar.