New Delhi: In Laujora Kalan village of Jharkhand, an Adivasi area, there is a belief that lactating women should eat only once a day. They get food early in the morning and feed their child throughout the day while also managing household chores. So the job is cut out for 28-year-old Masuri Gagrai as she goes door-to-door to shatter age-old traditions and bring about a change in the community. Masuri Gagrai works as an ASHA (meaning hope in Hindi) for the 1,446 people of the village. ASHA or Accredited Social Health Activists are the grassroot healthcare workers delivering primary healthcare, particularly for women and children.
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Masuri, a Class 12 pass out was always inclined to serve her community and help underprivileged people. Talking to NDTV about how she became an ASHA worker, Masuri said,
I was a part of a self-help group, majorly involved in saving money. Every week, we, a group of 10-15 women, would gather and discuss things. During these discussions, we would also get training on various health issues. Back in 2019, on one such Sunday, we were sitting together when I learnt that Rajini, a fellow woman, who has been pregnant, is in pain and nobody in her family was willing to take her to the hospital as they believed that home delivery was the tried and tested option. We visited her and I called for an ambulance to take Rajini to the hospital. After much struggle, Rajini delivered a baby who was declared dead. But when I went to see the baby, his body had turned bluish-green but his navel was moving and that gave me hope.
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On the advice of the doctor, Masuri rushed the child to the district hospital and got him admitted to NICU (newborn intensive care unit). Today, the child is hale and hearty, all because of Masuri’s presence of mind. She said,
There was no one to talk to the doctor and run around to save the child. It is then I stepped up. Even today, Rajini thanks me for it. I feel happy and proud for managing to save a life.
This one incident changed the course of Masuri’s life and she dedicated herself to focusing on the health issues prevalent in her village. In a Gram Sabha meeting in September 2019, Masuri was chosen to be an ASHA worker. She got the training from volunteers of Ekjut, a non-profit voluntary organisation. Ekjut provides support to National Health Mission and works toward the improvement of maternal, newborn and child health and nutrition.
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As an ASHA worker, Masuri’s day starts at 9am. She goes around the village, checking on people and educating women about breastfeeding, how to take care of a child after birth, and why institutional delivery and immunisation are important. Masuri is herself a mother to a seven-year-old boy. She explained,
Older women of the village are often against women going to the hospital for delivery. They believe in at-home delivery. We educate them about the facilities available at a hospital. We ask them, ‘who will take care of your daughter if she bleeds excessively after delivery or if any complications occur?’ When women of the house or the mother-in-law agree, the father-in-law turns around and opposes. Nevertheless, our job is to try. Ekjut has provided me pictorial cards which I use to make women aware of when and how to breastfeed, the kind of nutritious food they should have as lactating mothers, among other things.
When the first wave of Novel Coronavirus hit India in March 2020 resulting in a lockdown, migrant labourers moved back to their villages from cities. Many came back to Laujora Kalan village as well and at that time, Masuri had an additional task to ensure that people coming from cities quarantine themselves and take the test. Masuri maintained everyone’s record. Elaborating on the challenges in ensuring social distancing, she said,
We don’t have big houses like those in cities where you can lock yourself in your room and completely isolate yourself from the outside world. In villages, we share resources like we fetch water from the same well. Women gather around a well to collect water and chat. People would say, ‘what kind of disease is this that you can’t meet each other’ and if we will ever be able to go back to being normal. I would tell them that if there is a problem, there is a solution as well – that is to follow COVID protocols.
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Villagers would ask for medicine against COVID-19 but when the vaccination began, Masuri and other healthcare workers faced resistance from villagers. People were scared and there was a wrong notion that vaccines could cause death. She said,
In the first round of COVID vaccination, healthcare workers including ASHAs were given the vaccine and that helped me build confidence among people. I showed them that I have taken the vaccine, I have the certificate for it and I am completely fine. These vaccines have been developed for our protection. I went to teachers in the village and asked them to join us in this fight against COVID-19.
In her three years of service, Masuri has managed to bring about some change. Now women do come to her and seek guidance. In fact, people’s perspective towards her work has undergone a transformation. She said,
Initially, no one would recognise our work. People would say, ‘we don’t know what ASHA didis do. Their job is to roam around the village all day long’. However, today, everyone in the village – from children to elders – knows us, our work and that we take care of their healthcare needs. It makes me happy. I feel like I am a leader of the village.
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About ASHA Workers
ASHA (which means hope in Hindi) is an acronym for Accredited Social Health Activist. ASHAs are the grassroot health workers assisting the Ministry of Health and Family Welfare (MoHFW) in delivering primary healthcare, particularly for women and children, in both rural and urban areas since 2005. There are over 10 lakh ASHA workers in the country. In May 2022, the World Health Organisation’s Director-General Dr Tedros Adhanom Ghebreyesus honoured ASHA workers for their crucial role in linking the community with the health system, to ensure those living in rural poverty can access primary health care services, as shown throughout the COVID-19 pandemic. India’s ASHAs are among the six recipients of the WHO Director-General’s Global Health Leaders Award. The award ceremony was part of the live-streamed high-level opening session of the 75th World Health Assembly.
NDTV – Dettol have been working towards a clean and healthy India since 2014 via the Banega Swachh India initiative, which is helmed by Campaign Ambassador Amitabh Bachchan. The campaign aims to highlight the inter-dependency of humans and the environment, and of humans on one another with the focus on One Health, One Planet, One Future – Leaving No One Behind. It stresses on the need to take care of, and consider, everyone’s health in India – especially vulnerable communities – the LGBTQ population, indigenous people, India’s different tribes, ethnic and linguistic minorities, people with disabilities, migrants, geographically remote populations, gender and sexual minorities. In wake of the current COVID-19 pandemic, the need for WASH (Water, Sanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign will continue to raise awareness on the same along with focussing on the importance of nutrition and healthcare for women and children, fight malnutrition, mental wellbeing, self care, science and health, adolescent health & gender awareness. Along with the health of people, the campaign has realised the need to also take care of the health of the eco-system. Our environment is fragile due to human activity, which is not only over-exploiting available resources, but also generating immense pollution as a result of using and extracting those resources. The imbalance has also led to immense biodiversity loss that has caused one of the biggest threats to human survival – climate change. It has now been described as a “code red for humanity.” The campaign will continue to cover issues like air pollution, waste management, plastic ban, manual scavenging and sanitation workers and menstrual hygiene. Banega Swasth India will also be taking forward the dream of Swasth Bharat, the campaign feels that only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and the country can become a Swasth or healthy India.