The nature of Vinita’s job took a drastic turn as she went door-to-door while people stayed indoors — some fearing a police crackdown; others fearing the virus.

“They came in buses, two-wheelers, bicycles. Some came walking. It was an ocean of people,” she recalled, speaking of the virus’ gradual spread.

By Danish Raza

Vinita Devi was in the middle of the second wave of COVID-19. She had no time to think for herself. It was challenging and it called for selflessness. Fear stalked the village lanes as news poured in of people dying.

All she could do for herself and her family was to take all precautions – wear a mask, sanitise her hands, keep a physical distance. She knew it was an infectious virus and she could only continue to serve the people of her neighbourhood if she herself was safe.

Vinita Devi belongs to the seven lakh strong force of ASHA (Accredited Social Health Activists) workers in the country. While the Coronavirus was raging wild, she was out surveying her neighbourhood.

Any migrants in here?

ASHA workers belong to the community they serve, providing the vital last-mile connectivity to the government’s healthcare schemes and are instrumental particularly in far-flung areas because of their strong bonds with the community.

Before the pandemic, Vinita’s focus was childhood immunisation coverage, encouraging pregnant women to opt for safer in-hospital births, and other campaigns targeting women and children. When the pandemic struck, she was supposed to work with everyone in her district in Patna.

Initially, Vinita said, everything seemed normal because the first wave had subsided. But she witnessed herds of people returning to their towns and villages around Patna as soon as urban centres such as Delhi and Mumbai announced a lockdown.

“They came in buses, two-wheelers, bicycles. Some came walking. It was an ocean of people,” she recalled. With this, the virus gradually started spreading across the state, including its rural pockets. Five Bihar districts with a large rural population recorded more than 4,000 active cases in April 2021.

For Vinita, it would mean the nature of her job was to take a drastic turn. She went door-to-door sporting the ASHA worker’s dress-code: a pink saree, ID card and face mask. While people stayed indoors — some fearing a police crackdown; others fearing the virus.

“I knew it was risky but someone had to do it. Who will work to combat the pandemic if all of us decide to stay home?”

Support from Oxfam

To help them with this new task, Oxfam India distributed more than 10, 000 kits to frontline workers in Odisha, Chhattisgarh and Bihar and also trained them to use the kits. This was the first time Oxfam was working with ASHA workers. It was necessary because government capacities were stretched and humanitarians like Oxfam had to step in to serve vulnerable people in some of the farthest corners of the country.

“It was a mammoth task in terms of scale,” said Chandan, program officer, Oxfam India. “We identified districts with maximum number of cases and the ones where we had an in-depth network. There is one ASHA facilitator over every 20 ASHA workers. We worked with them,” he added.

While it sounds a simple exercise, Oxfam India teams had to overcome various challenges. Some of these were systemic. “At the beginning we were told that the government planned to do something similar so we could not duplicate their efforts. When we got the permission and hit the ground, the block community mobilisers (state government) were pressed for time. They were busy with meetings, surveys and campaigns and found it difficult to meet our staff,” said Chandan.

On multiple occasion, Chandan said, ASHA workers were not available for scheduled sessions because they were overburdened.

Vinita said that receiving the kit was the only acknowledgment that she has got so far for her job. “It is a good feeling when someone is able to see your hard work,” she said. She is yet to receive any compensation from the government for the hours she put during the pandemic.

In August 2020, ASHAs staged a two-day strike demanding better pay, better PPE, and minimum wages.

“We are ASHA workers”

At least 44 ASHA workers had died due to the coronavirus by January 2022.

She was not deterred when people in the community were suddenly unwelcoming. “They answered my questions shouting from their terraces and spoke to me through their windows. But that’s okay as long as they gave me correct information,” she said.

The information pertained to returning migrants, including daily wage labourers and students who reported COVID-19 symptoms.

At the same time, she had to field queries related to symptoms, vaccinations and bust myths around the virus. “I used to tell them more or less everything we heard on radio and TV – such as drinking lots of water and the need to stay quarantined if people showed symptoms,” she said.

Despite the challenges and lack of encouragement, Vinita says, she would repeat the exercise full-throttle if the virus strikes again. “This is not optional for us. We are ASHA workers,” she said.

Danish Raza is an independent journalist based in New Delhi. He writes on inequality, current affairs and digital culture. He tweets @razadanish.