Updated: Oct 12
Q: During the past several months, you have been involved with pandemic-related work. Can you give a brief overview of what your pandemic and non-pandemic duties were?
Auxiliary Nurse Midwife (ANM): Since May 2020, the workload has increased a lot. I have mostly been doing surveys. I have a population of 3,000 under me. I go door-to-door and do check-ups for them the entire day.
I have to manage this with my regular work and hence we have a system wherein five days of the week are dedicated to COVID-19 work, and the sixth day is only for routine immunisations.
I have also been carrying out awareness work. Whenever I go for surveys or am doing routine immunisation, I keep telling people about COVID-19 norms, social distancing, the importance of masks and sanitisers, and how to use them effectively.
Q: Did you receive any support from your immediate supervisor to carry out these activities?
ANM: There wasn’t much supervision in the first place. One of my supervisors tested COVID-19 positive very early on and took really long to recover. As soon as she returned, she retired. My other supervisor is swamped with work; has more than 10 centres to handle, and so it is difficult for them to guide us. We were on our own the entire time.
Even during the times when they checked in, they were not supportive at all. This one time I was on a bus, coming back to the Primary Health Centre (PHC), and my supervisor called me. She asked to send the report for the cases of the day. I explained that I would send the report after reaching the PHC but I wasn’t allowed to do that.
Our supervisors gave us daily goals. While these goals helped in scheduling my day, they were way more than what one could achieve in a day. They asked us to survey 20 houses in a day without accounting for the travel time. I don’t have a transport of my own so I had to walk everywhere. Many of my fellow ASHAs and ANMs were frustrated because we could never complete these goals. The supervisors were strict and rude and that made things very stressful for us.
Q: What has motivated you to come to work and carry out your activities during the pandemic?
ANM: I have been in this field for 13 years, and my only motivation is my compulsion to do this job. I have to do it for money.
After so many years of experience, I am also familiar with the people now. They are comfortable with me. They want my advice; they prefer me over other healthcare workers because of my expertise. This is something that I like and it has kept me invested in my work.
There are also many letdowns in this field. The biggest one is the people themselves. During COVID-19, due to the increase in work, I needed motivation. But people responded badly. Whenever we would go door-to-door to conduct surveys, some would abuse us. Walking on the roads after 4 PM felt unsafe as we received unpleasant stares from people. I kept doing my work because I had to, but if I could, I would just retire and leave this job.
COVID-19 only made me realise why I need to leave this work. Every day I just wait for my duty hours to get over, and I am looking forward to my retirement order.
Q: Have there been challenges to carrying out your work?
ANM: People want everything at home be it check-ups or medicines. They want me to be available for them 24x7. This one time, someone tested positive and asked me to get them medicines, but I wasn’t able to do that immediately because I was on duty in some other area. I requested them if I could instead ask another ASHA worker to get them medicines first thing the next morning. To this, I received abuses; they made judgements on my character and were very rude to me.
We were under strict instructions to test only those who have symptoms of cough, and most of the time people would just lie about not having any symptoms because they were scared of testing positive.
Another problem, and a major one, is my age. I am diabetic, I have knee pain, my back is weak, and I am not that strong anymore to keep working the entire day.
My area is very large so sometimes I have to walk around 18 kms, and it is very difficult for me to do that, especially because COVID-19 work doesn’t allow for planning in advance. Sometimes, in emergency situations, I take the bus, for which I pay on my own.
There are also no incentives or insurances for elderly people like me. ASHA workers told me that they were getting incentives for their COVID-19 related work, but there was no incentive for ANMs. Even for medical insurance, they tell me that my family will get Rs. 50,000 if I die, but I am not sure about that.
Many news channels said that elderly frontline workers are allowed to take leaves, so I tried that. I took 10 days of leave, but on the third day, my supervisor called me and said that my leave had been cancelled. Recently, my cousin’s mother died, and I didn’t get to take a leave to attend to this personal matter.
This interview was conducted as a part of a research study funded by the Azim Premji University under the COVID-19 Research Funding Programme 2020. The study delves into the experiences of frontline workers in Rajasthan and Himachal Pradesh during the COVID-19 pandemic.
It was conducted with an Auxiliary Nurse Midwife in Solan, Himachal Pradesh on 6 January 2021 in Hindi, and has been translated.