Considered the backbone of the healthcare system, lady health workers receive little appreciation for their efforts. DESIGN: ESSA MALIK
She is assigned a ‘constituency’ with a population of around 1,000 people. She visits each house, knows every mother and every newborn. Her advice is considered helpful but, unfortunately, is ignored. She is neglected and paid very little.
There are 22,576 lady health workers (LHWs) in Sindh. They approach each house in their allocated area, do whatever work is assigned to them by their higher-ups, which mostly involves participation in polio campaigns. The minimum qualification is a ‘middle pass’, which is equivalent to grade eight. The programme aimed at reaching rural communities using female workers was launched in 1994.
Beginning with a salary of just Rs1,200 per month, unfortunately, she can only work her way up to Rs7,000, since the government has not fixed the minimum wage.
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“I work day and night, no matter if it is raining or there is flood or any serious threat to female workers in no-go areas,” said Maryam, a senior LHW. “We are considered the backbone of the healthcare system but aren’t respected by our officials.”
“We care for mothers and their newborns but our children are always starving,” her fellow LHW, Shabana, added while protesting in the scorching heat outside the Sindh Assembly for higher salaries.
“Our basic work is to educate women and children [on health matters],” said senior worker and president of the Sindh LHW Association, Khairunisa Memon. She said that it is the primary responsibility of a LHW to take care of pregnant women and advise them on health related matters, even after the birth of their children.
Memon said that a LHW is capable of counting on her fingertips how many expecting mothers live in her area. “She keeps every bit of data. She reaches every house.”
“Ultimately LHWs will improve the healthcare system if they are paid well and regularly,” Memon predicted, saying that all the female workers are striving to get their due rights. “We are always [protesting] on the roads to get our rights,” she added.
“We face troubles while working in the field,” said another senior worker, Rukhsana. “But we aren’t respected yet. A LHW always obeys orders. She works hard but is denied her own rights,” she explained, trying to control her tears.
“She registers every pregnant woman in her area,” said Badin’s district field medical officer, Dr Mehboob Khawaja. He said that a LHW quickly refers an ill woman to a nearby hospital and is always available for medical advice, including family planning tips.
The LHWs also claim that the successful polio campaigns across the province became possible because of their untiring efforts. “We are considered the most effective health workers for all campaigns, including the nutrition support programme,” said a LHW.
The same health department that considers her a major part of the work force in the field fails to equip her with the necessary tools with which she can help the people under her care. A LHW is given between 12 to 15 months of training when she joins the healthcare system and is never considered for more courses.
Most of the LHWs don’t remember the last time they were given training or refresher courses. “I don’t think LHWs are given proper training or refresher courses since their joining, some 20 years back,” said an official who did not wish to be named. “They are treated like slaves.”
Dr Khawaja stressed the importance of repeating courses, adding that yearly training would enhance their capacity and improve the quality of their work. The females workers, committed to their tasks, say that it is crucial to regularise Sindh’s LHWs and ensure they receive at least minimum wage.
Published in The Express Tribune, September 25th, 2015.
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