AB BUREAU, GUWAHATI
Simonabasti Primary Health Centre, Koliabor, Nagaon. It is 11am. The youngest member of the Oja household of Uluoni village, Devangshi, is wailing. She ‘knows’ that she will be injected with her required dose of vaccine anytime now. Mamoni Bora quietly picks Devangshi up and comforts her and then presses her on her blue border saree, a dress that is well-known across the village. For it is the dress of the Asha baideu, as Mamoni and many like her across Assam are known as. She is a universal figure in the village having served as an ASHA baideu for nearly 15 years. Devangshi’s wailing has come to a halt; an ANM injects her with the vaccine, the kid wails again, and then quietens. It is 11.05am.
Mamoni is one among the 10 lakh-plus ASHA, an ubiquitous feature of primary health, in rural India. These unsung heroes have changed the way basic healthcare is administered in the country. It is to recognize their yeoman contribution, especially during the Covid-19 pandemic, that the World Health Organisation accorded the community with the decorated WHO Director-General’s Global Health Leaders Award on May 22.
They are the interface between the community and the public health system deployed in each village under the National Health Mission programme since 2005. They are responsible for programmes like universal immunisation, referral and escort services for Reproductive & Child Health (RCH) and other healthcare initiatives, as well as construction of household toilets. No wonder, statistics from the National Family Health Survey reflect that post-2005, institutional birth rate has increased multiple times across India, which experts credit to these ASHAs. (See graph)
Dolly Bora Deka of Kuwaritol Primary Health Centre, in Koliabor subdivision recalls the challenges that she faced as a dedicated ASHA. “I was extremely busy during the second wave of the Covid-19 pandemic in 2021. Besides the household chores, I had a one-year-old baby to care for. I also had to report possible symptoms among the villagers while encouraging them to go for Covid tests. In one instance, an expectant mother cursed me no end when I insisted that she should get herself tested,” she tells Asom Barta. “The woman, during her third trimester pregnancy test, along with her husband reported positive. I felt fear surge up my spine since I had accompanied them to the health centre that day. I was worried about my baby.” Dolly says that there are challenges in the profession but adds that satisfaction is more than frustration at the end of the day.
The total number of Asha in Assam is 32,545, out of which 31,334 are posted in rural areas while the rest plays the role of catalysts in urban areas of the State. Besides, there are 2,661 ASHA supervisors to guide these grass- roots health warriors.
There are 80 ASHAs under Simonabasti Health Centre catering to a population of 93,000. They take care of workers from tea estates like Kellydon, Nonoi and Salna, among others. “Undoubtedly, they face many hurdles while discharging their duties. However, their patience and unwavering dedication see them through these tough times,” says Saifur Rahman, Block Programme Manager of Simonabasti Block under NHM.
An extreme form of such a challenge was faced by Barmita Momin of Phulaguri Garo Gaon village in Sonitpur. A village where superstition is widely prevalent, Barmita was once tied to a tree and released only when she ‘compensated’ the villagers with a penalty. Yet, she achieved 100% coverage in the Har Ghar Dastak campaign launched during Covid-19. She had her satisfaction when the Government of Assam bestowed upon her the honour of ‘Asom Gaurav’.
“What gives us satisfaction despite our hectic household routine and on ground duty is the fact that people take us seriously when we suggest something,” says Mili Saikia, an ASHA of Kuwaritol. “Be it the expectant mother or a lactating one, or someone needing a vaccine during times like these, we are consulted,” she adds.
Land surface, hilly terrains or watery roads, on foot or on board a makeshift raft, ASHA baideus are conspicuous by their presence partaking all that a village family goes through. She is never out of action.
