Covering Deprivation, Government, Health

Anganwadi workers ask for dignity of labour

CHENNAI, Mar 28: Anganwadi workers in the neighbouring territory of Puducherry receive a pension of Rs. 7,500 per month whereas those in Tamil Nadu get Rs. 1,500 per month.

Following a protest on March 26, the anganwadi workers and helpers will protest yet again on April 5 for fulfilment of their demands: raise in pension, recognition as government workers, increase in salaries, and above all, “for workers’ rights and dignity of labour”.

Several protesters are the first generation of workers who joined as ‘scheme workers’ under Integrated Child Development Services (ICDS) scheme in the 1980s. Most of them have served for nearly 35 years. As per the pension pay-out standards, a worker must receive 50 per cent of the last drawn salary as pension. A retired anganwadi worker receives Rs. 1,500 per month as against Rs. 5,000, which is 50 per cent of their Rs. 10,000 per month salary at the time of retirement.

Although their salaries are comparably higher than those in Bihar, the pension given to them is one of the lowest in the country, said R Karumalayan, General Secretary, Tamil Nadu state committee, Centre of Indian Trade Unions (CITU). Anganwadi workers in the neighbouring territory of Puducherry receive a pension of Rs. 7,500 per month.

Since ICDS is a centrally-funded scheme, the government recognises anganwadi workers and helpers as scheme workers and not as government employees. Most of these workers are underpaid and excluded from the revision of pay under the seventh pay commission, said M Anbarasu, General Secretary, Tamil Nadu Government Employees Association (TNGEA). In Tamil Nadu, over the last four decades, their salaries have increased by Rs. 1,000 per decade.

The government officials compare the salaries of anganwadi workers in Tamil Nadu with those of underdeveloped states but these workers anywhere need social security after retirement as they hardly have any savings, said Karumalayan.

A majority of the protesters were widows and single mothers – several of whom were destitute.

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Covering Deprivation, Government, Health, Profile

How one hardy lady brings kids to school

The government hopes to keep more and more kids in class. And, a resilient tribal woman is fulfilling that hope in her tiny village in H D Kote district, Karnataka. 

 

Every morning, Lalitha rushes from house to house in her village calling out  each Anganwadi kid by name, promising payasa – sweet porridge – on the condition that the kid step out of the hiding place, hold her hand, and march to school.

The kids hide in the newly built toilet, under the hay in the cowshed, on the roof, amidst goats– but, Lalitha wins. She beats the kids at their own game. She pursues a giggle to the giggler with joy, but follows a sob with heavy feet when it beckons her to a corner.

Some mornings, Lalitha begins her day, to her disappointment, by fighting with a parent. “Screams! Shouts! I employ them all to put it in their mind that their child must go up to higher classes,” she said.

Earlier, the parents would take their children to Coorg and enrol them as helping hands on a coffee plantation. Now, the owners fear the loss of reputation and the parents fear the police. Kids stay back in the village, and Lalitha is glad to fetch them every morning to school and accompany them back and forth whenever they want to use the toilet. She stands waiting, like a guard, to stop the kids from running away.

Rising aspirations in the village have reduced her tiffs with parents. Lalitha explained that the failure of the monsoon and non-availability of work convinced the parents that education is necessary.

Lalitha’s parents worked as coolies and farm labourers all their life and as soon as she was strong enough, they pushed her into coolie work. She spent her childhood in coffee plantations far away from her tribal settlement in Nagarahole.

Her pride in the kids she brought to school surges forth, especially when she sees girls going to college. She identifies them by name, and her questions to them, are mostly about their travel to town.

 

“A young mother standing at the door and wilfully sending her child to school is both heart-breaking and encouraging,” she said. “There are no jobs here, and you see boys loitering on the streets after failing their class 10 exams.”

Teachers from the school visit the village in search of the boys, trying to take them back to school. But, the boys run away. A boy, who doesn’t go to school or college, roams the streets for a few years until his parents decide to marry him off, saying, ‘that a wife and a child will set him right, instil responsibility, and send him in search of a job.’

Lalitha was herself a child-bride – married at 15, and soon a mother of three – two girls, one boy – about whom, she said, “Life here is much better for the kids than it was in the forests. They are seeing the world.”

In the afternoon, as soon as she finishes her rounds of dropping kids back at their home, she runs home, releases her flock of goat and lets them graze in the periphery of the forest while she takes a long, relaxing walk.

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Covering Deprivation, Government, Health

Government’s ‘Delivery’ issues

Hunsur: Field workers such as the auxiliary nursing midwives (ANM) are limping from village to village in Hunsur taluk, covering its 296 villages; there are only 47 ANMs against a sanctioned strength of 76.

“Policy makers must understand that vacancies result in decreased reach of the health department and the reduction in coverage affects health awareness activities and services indirectly. Plus, the community here needs continuous assessments. ANMs and Asha workers bring field reports to the Taluk Health Officer’s table. Fewer field workers means fewer assessment reports,” said Rajeshwari H M, Block Health and Education Officer, Hunsur.

A new Measles and Rubella (MR) vaccine campaign is set to begin on Feb 7. A Junior Health Inspector is worried that there will be no supply at the PHC just as it happened when pregnant women who had queued up in front of a health camp at an Anganwadi were sent away since their tablets and injections were yet to arrive. Sometimes these pregnant women were also made to wait for hours as there was a shortage of staff to conduct blood tests and distribute nutritional supplies.

“At Nerlukuppe, there are two positions that are vacant at the PHC. At Doddahejjuru, there are two sub-centres that are empty. There areas are provided services through camps and deputations,” said MB Juby, Junior Health Assistant, Hunsur Hobli PHC.

Sitamma, mother of a pregnant woman sitting in the check-up room at an Anganwadi, revealed that when Meenakshi, a nurse who use used to check her daughter, quit two months ago, a complaint was made at the local PHC since no midwife or nurse was available. She then took her daughter to a former government doctor who had opened a private clinic in her area.

“If they say there are no nurses, what do I do? If they are not there when the time comes for my daughter to deliver, I have to take her to Mysore,” she said.

Government’s Delivery Issues

“Government funds, allotments, and policies are always a problem,” said BHEO Rajeshwari.

Under the National Rural Health Mission’s Janani Suraksha Yojana, pregnant women with a Below Poverty Line (BPL) card were to receive Rs.1000 in their 3rd to 6th month pregnancy, essentially, to procure locally available nutritious food.

“Pregnant women haven’t received the money for the last three years,” she said.

Under the State Prasuti Aarayke scheme, all tests at the Government Hospital are free for pregnant women and they also receive free ration. It is given to the pregnant woman but other members in the house consume it.

Use a SIM without a Phone?

Under the Mother and Child Tracking System (MCTS) and digitisation drive, field workers were given a free SIM. The data-entry system was modernised and hosted online. The field worker had to open the App, and enter the information. Earlier, entries were made in a ledger that was carried in the field kit.

Only a free SIM was given but not a smartphone. With meagre salaries, field workers couldn’t afford a quality smartphone.

Soon, the data-entry system reverted to its earlier process of field workers coming back to the PHC to enter the data manually.

“Technology was supposed to cut down the time between request and delivery but it has remained the same,” said BHEO Rajeshwari.

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Covering Deprivation, Government, Health

Women face the scalpel but men run away

In 2016, only two men underwent vasectomy, whereas 1257 women underwent tubectomy, says Taluk Health Officer

Hunsur: On a recent Village Health and Nutrition Day (VHND), a sterilization camp was organised in Hunsur taluk mostly by female staff and only women were approached to attend the meet because men were either at work or had locked themselves in refusing to attend the meeting.

Earlier, when general health camps were held in villages, men were invited too. But, women were always in greater attendance than men. Men and women hardly came to health camps together and even if they did, their awkwardness with a subject like sterilization would make them flinch and quit the camp.

Since, participation of men was negligible, specific campaigns were directed at couples, women, pregnant women, and also for men, especially to explain the No Scalpel Vasectomy (NSV) procedure.

“When specific camps for men were organised, we went from door to door and invited men to assemble for the awareness talk. But, once the news of our arrival reached a man, he would instruct his wife to say, ‘He is not at home,’ ” said MB Juby, Junior Health Assistant, Hangudu Primary Health Centre (PHC).

A man who had undergone vasectomy was also taken in front of men during a camp. Men attend such camps, say yes, express their fears, sign up for further tests and then, fail to turn up.

“The work men do in the area is strenuous, with long hours of standing, squatting, and lifting. Many work as coolies or coffee plantation labourers in Coorg, especially tribals. Even though men are told that it doesn’t affect their physiological functions, they refuse to undergo the procedure. They fear loss of wages,” said Taluk Health Officer Dr. Devatha Lakshmi.

For those below poverty line, the incentive to undergo the operation is Rs.1100 for women and Rs.1250 for men. And, for those above the poverty line, it is Rs.650 for both men and women. But, along with economic concerns, societal pressures restrain men from stepping into a sterilization clinic.

Scalpel razes rubber and powders pill?

Dr. Lakshmi argued that sterilization beats temporary measures such as condoms and contraception, which are not 100 per cent effective.

“Women forget to take contracepives. Non-availability of condoms or unwillingness to use a condom or to procure it leads to unprotected sex. More failures happen due to temporary measures than permanent methods,” she said.

Answering the question whether sterilization was the only method to help family planning or condoms and contraceptives can also be used, Senior Health Inspector Shivananjay said that although condoms are supplied for free, the decision to use it is between husband and wife, and ‘often, they decide not to use it.’

“We can’t rely on people’s self-control. Can we?” he added.

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