No end to troubles: Assam’s health workers’ pleas fall on deaf ears

At about 11 am on May 25, scores of Mekhela-clad Anganwadi workers and helpers across various age groups gathered outside the District Social Welfare Office in Guwahati’s Beltola neighbourhood, a few kilometres from Dispur, the state capital. Moments later, their gathering snowballed into vociferous sloganeering amid security personnel keeping tabs on them. “Axom Sarkar hai hai!” (down with the Assam government!) kept echoing the office’s premise for the next three hours as they entered the third day of their 4-day-long protest for their demands. 

This was a state-wide protest which started on May 23 and ended on May 26 and was being organised by All Assam Anganwadi Workers’ and Helpers’ Association (ASAWHA), the Assam wing of All India Federation of Anganwadi Workers and Helpers (AIFAWH), affiliated to Centre of India Trade Unions (CITU). 

Jupitora Nath, an Anganwadi Worker (AWW) in her late 40s, told EastMojo she travelled over 50 km to reach the protest site and that their demands must be heard this time. “We want government recognition for the workers and helpers; we want monthly salary instead of the honorarium; clearance of one-time payment for the retired workers and helpers; Provident Fund and Pension schemes after retirement; infrastructural development of Anganwadi Centres, and recognition for the mini-workers as full-fledged workers,” Nath said looking visibly disgruntled. She also mentioned that they have been protesting in pursuit of their demands since 2015, but till now their protest has fallen on deaf ears. However, they seem adamant about their demands this time. “We are not going to back down this time, the government must listen to our cries,” the mother of three added. 

But months after the protest, there seems to be no progress made, and the first line of defence for millions of Indians remains as vulnerable as ever. 

India has 13,89,110 Anganwadi Centres as of 2021, of which Assam has a total of 61,715 operational Anganwadi Centres, involving over 1.2 lakh workers and helpers. Over the last few years, AWWs across India enlisted in the Integrated Child Development Scheme (ICDS) — a flagship programme launched in 1975 by the government of India which is aimed at addressing malnutrition, health, and also development needs of young children, and pregnant and nursing mothers—have been demonstrating their indignation against their respective state and central government, but to no avail. 

Even in February 2023, hundreds of Anganwadi workers and helpers in India’s capital marked a-year long sit-in strike following the termination of 884 Anganwadi Workers and Helpers in March 2022 after they protested for better wages, pension schemes, health benefits, provident funds (PF), etc. Similar large-scale protests were also reported in southern India and the North. In short, the protests in Assam were not in isolation; rather, it was a reflection of a national pattern. 

Underpaid and Unsung

When this reporter asked Anima Gogoi, an Anganwadi Helper (AWH) protesting in Guwahati, how she managed her household with her honorarium, the 39-year-old let out a chuckle that betrayed her misery. “Are you trying to embarrass me,” she asked. Overhearing Gogoi, another Anganwadi helper Jinuwara Begum joined the conversation, informing the reporter helpers are paid Rs 3,250. “How do you run a household with just Rs 3,000? Even a gas cylinder costs Rs 1000. What’s left?” Gogoi questioned sarcastically. 

The Anganwadi workers and mini-workers receive Rs 6,500 and Rs 4,500 respectively. This includes Rs 4,500 and Rs 3,500 respectively that the Centre pays for the workers and mini-workers and a meagre Rs 2,250 for the helpers. 

These are some of the lowest allowances paid by a state to Anganwadi workers (AWWs) and helpers. As per data available with the central government, AWWs and AWHs in Goa, Andhra Pradesh, Haryana and Karnataka receive some of the highest honoraria in the country (minus the additional allowance they receive from the central government). The Kejriwal-led Delhi Government, in February 2022, said Union territory pays the highest allowance to AWWs and AWHs. 

Explaining why the ICDS workers in Assam receive a low honorarium, economist Dipa Sinha, Assistant Professor at the School of Liberal Studies at Dr B.R Ambedkar University, Delhi, said the reason could be the state’s overall lower revenue generation against the northern states. “It is much more difficult for northeastern states without the centre’s support,” Sinha said, adding, “For many of the central schemes when the ratio of salary contribution is 50:50 or 60:40 for other states. For Assam and other Northeastern states it is 90 per cent the centre and 10 per cent state.” 

The penurious circumstances among the workers and helpers in Assam, nonetheless, get even more pitiful for sole breadwinners, widowed or separated AWWs and AWHs. Take the example of Johura Begum, 44, from Uttar Chamarali, a revenue village in Hojai that borders Karbi Anglong Autonomous Council. 

Johura has been an AWW for over two decades and is a mother of three children. She is the only breadwinner in her family as her husband cannot work due to health reasons. For Johura, her job is her only lifeline but sustaining five people proves too challenging. Her two-room concrete house, which she has been building since 2013, remains in shambles because the allowance she receives is too meagre to continue its construction. “I hardly manage two daal-bhaat (rice and lentil) meals a day throughout the month; my dream of completing this house will remain a dream,” she said. 

Left without choices or any savings, Johura said two of her elder sons now work as daily wagers to help her family. “I even forced my children to drop out of school,” Johura said. “Even if I had worked as a house-help, I would have earned better wages.” 

The cries for better honoraria for the AWWs and AWHs in Assam has now grown louder with the Centre of Indian Trade Unions (CITU) weighing in on to demand fair wages for AWWS and AWHs. According to Tapan Sen, the organisation’s general secretary, the trade union in the 44th sitting of the Indian Labour Conference in 2015 recommended that ICDS workers must be recognised as government workers, “and if they are recognised as government workers, then they are to be paid minimum wages as per the Minimum Wages Act, 1948.” 

“According to the Minimum Wages Advisory Board, today considering the long hours of shifts they put in and inflation, then each worker should be paid at least 800 rupees as a daily wage.” But unfortunately, these recommendations have not been implemented, he told EastMojo. 

Do everything, ask nothing

Sahida Begum, who was demonstrating in Hojai’s Shankerdev Nager on the last day of the 4-day-long protest, said Anganwadi workers are only required to perform six services under the ambit of ICDS, but they are often tasked to perform activities not prescribed in ICDS. Sahida said along with prescribed ICDS works, they are all tasked with performing other duties, ranging from block-level office works, National Register of Citizens, Covid-19, Ayushman Bharat, and Orunodoi to even the National Education Policy. “We have to work 14-15 hours a day to manage the workload,” Sahida said. 

“We feel like manual workers now,” she added.

To make matters worse, the workers now have to log in online via an App called Poshan Tracker to record their daily activities ranging from their attendance to registering children’s weight and nutrition among other things. 

Even though they log out from the app at 12 pm, Sahida said, they have to visit homes to check on nursing mothers and pregnant women as per the required ICDS manual. But added responsibilities make these workers work beyond their shift and often, they stay the whole night to wrap up their work along with maintaining at least twenty registers. “We spend day in and day out looking after the nourishment of these children. We are responsible for their health. But we have no time for our nourishment,” said Sahida. “Even if we fall sick, we neither have the money nor the time to see a doctor.” The Poshan tracker app installed in smartphones given by the government also largely contributes to making their work toilsome as the app in smartphones from two brands — Lava and Panasonic — crashes and often malfunctions. Most have to buy mid-range smartphones to continue their routine work. “These phones are useless. We call them ghost phones because they turn on and turn off on their own,” Pratima Saha Roy, an AWW, said. 

Overnight retirement and a bleak future

In 2021, Chief Minister Himanta Biswa Sarma announced a one-time financial assistance for all AWWs and AWHs retiring at the age of 60. As of May this year, there are more than 3,000 retired Anganwadi Workers and Helpers in the state, according to Indira Newa, General Secretary, ASAWHA. Of this, so far close to 800 AWWs and AWHs have received the benefits with most still awaiting the promised benefit. Manju Cooch, a retired AWW from Biswanath Charali who has not received the benefit yet finds her future hanging in the balance as she is unmarried and has no one to look after her. She doesn’t know how to earn a living now. What was also shocking for her was her retirement in April last year. She was not expecting it. “It was so sudden,” Cooch said, adding her retirement was “communicated to me in the wee hours.” The workers and helpers in the state have been pleading with the government to increase their retirement age. Newar said since they are called “voluntary workers”, the government cannot apply the same parameters of retirement for them. However, India’s apex court in May this year set aside Tripura High Court’s order to increase the retirement age of AWWs from 60 to 65 years. Cooch is now frail and keeps enquiring about if the government has announced any pension schemes, Provident Fund or gratuity for retired workers. The state government, however, has not announced any such schemes for the ICDS workers despite a Supreme Court judgement last year that held that the AWWs and AWHs are entitled to gratuity under the Payment of Gratuity Act, 1972. Mukesh Chandra Sahu, Principal Secretary to the Department of Women and Child Development, refused to comment on the issue. When asked about the protest and demand he said, “We are working under the Central Government’s directive.” Johura, Cooch, and other Anganwadi workers now feel the state government did little for them even though the state saw an increased fund transfer between 2019 to 2020.

How is this ‘honorary’?

The Ministry of Women and Child Development describes them as “honorary workers from the local community” who render their services “on a part-time basis in the area of child care and protection” even for primary healthcare and educational needs, they are not recognised as government workers. But Deepa Sinha argues that the government’s categorisation of them as “honorary workers” doesn’t do justice to them when more than 80 million Indians benefit from them. “When the ICDS started in 1975, the idea was community-based childcare by women, and that is how the name ‘Anganwadi’ came to be,” Sinha said. “But these Workers and Helpers have been entrusted with an increasing amount of additional responsibilities ever since,” she added. 

A Supreme Court judgement, however, dating back to 2006 in the case State of Karnataka & Ors vs Ameerbi & Ors also ruled against giving them the government recognition. The apex court held that “anganwadi workers do not carry on any function of the state” and that the ICDS scheme has not created any sanctioned posts for their employment. According to Sihna, this judgement belies the bulk of the services and the contribution the ICDS workers make. “Even in India, except for the ICDS workers, we don’t have people who teach in pre-schools and commit to other community services,” Sinha added. 

“The women are rendering a range of community services. It is grossly wrong to not recognise them as government employees,” said Deepanshu Mohan, director at the Centre for New Economic Studies at O.P Jindal Global University. Explaining the reasons, he said the Centre, as well as the state, is yet to give them recognition, Mohan said it could be total indifference by the Central and the state government towards the workforce of the Anganwadi workers or “it could be fiscal incapacity because the healthcare budget the government allows for at the State government or the union government level is extremely low to be able to accommodate for a large-scale workforce such as the ICDS employees.” “However the buck stops with the Centre as well as State Government to recognize them as government workers,” Mohan said. 

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