“People don’t take us seriously. Why would they, when I cannot even record their temperature and oxygen level for them,” says Veermati Singh, standing at her door in Nindemau, a village in Unnao.
An Asha worker, among the thousands of frontline workers tasked with surveillance and monitoring of COVID-19 in rural Uttar Pradesh, Ms. Singh speaks of the obstacles faced by her in the absence of proper protective gear and equipment.
In addition to its ongoing routine surveillance, the State government from May 5 to May 9 reportedly carried out a special drive for identifying symptomatic patients and testing them through village-level over 60,000 nigrani samiti or surveillance committees. Asha workers and anganwadi workers are an integral part of the samiti , which includes the village headman, and other local functionaries.
Ms. Singh has neither a thermal scanner nor a pulse oximeter nor has she been provided with sanitizers. All she was provided was a medicine kit with some strips of tablets, mainly for fever, a face mask and a pair of gloves for the surveillance work. Her task requires her to go door-to-door and record the temperature and oxygen levels of residents, and send those with symptoms for self-isolation or testing to the local community health centre. She checks on 20-25 households in a day.
Personal risk
“How do I save myself with one mask? I can’t wear the same gloves daily when I go door-to-door. If I do, I would be bringing COVID to my house,” she says. Ms. Singh is particularly worried about her infant grandson.
Besides the personal risk of coming in contact with a lot of untested people, Ms. Singh says the Asha workers do not get much cooperation from villagers as they lack the authority and resources, and also because many in rural U.P. are hesitant to reveal their symptoms. “Due to some fear, they say they are all normal even if they have cough, cold and chest infection,” Ms. Singh says.
In Khapura Bhatt village, anganwadi worker Suman Sharma and Asha worker Manorama also lack thermal scanners and pulse oximeters. The one they used last year was taken back by the former village pradhan (village headmen) after a couple of days this year and they do not have replacement, they say.
Pointing to the difficulty in locating symptomatic patients without proper equipment, Ms. Manorama says during the special drive she could identify only one person in the two villages she was asked to monitor. That person in turn, begged her to not reveal his symptoms. As a result while the man is under self-isolation with lung infection, he is yet to be officially tested.
Rama Kanti, a ‘Super Asha’ who has 20 Asha workers under her in Hasanganj block, says that last July, COVID-19 kits were provided to the workers but some pradhans took the equipment back and did not provide anything this year. While a village may have 3-4 Asha workers — one for every 1,000 residents — only one of them gets the thermal scanner and oximeter, said Ms Kanti, admitting that if each Asha worker was provided a kit, the surveillance work would be more efficient and quicker.
“When the Ashas themselves have a single kit, what will they distribute to people if they ask for help or medicine,” she asked. Ms Kanti also claims that Asha workers are yet to get paid for last year’s surveillance work. “We are working with a lot of risks. What will happen to our families if something happens to us,” she asked.
Geetanjali Maurya, State head of the Anganwadi Karmachari Association Uttar Pradesh, also says her workers were not provided any kit or equipment during the second wave.
“No pulse oximeter, no sanitizer, no thermal scanner. We need it for the people whose houses we are visiting. Why should we go to their homes if we can’t even check their temperature? They already get all the information about precautions from social media and barely listen to us,” she said.
Additional Development Officer (Industry, service and business) of Hasanganj, Lal Madhav Singh, a district block official, said all villages had already been provided one thermal scanner and oximeter each last year. But he pointed out that not all Ashas in the village are given the tools. “Only one of them gets it,” he said.
The equipment from some villages was borrowed for the recently-concluded panchayat polls but were soon returned, he added.
Mr. Singh said there were control rooms at the block and district levels to educate the Asha and anganwadi workers about spreading awareness. The government on May 11 informed the Allahabad High Court that under the special drive since May 5, a survey was done of 2.92 crore houses in the whole State, out of which 4.24 lakh persons were found with certain symptoms and considered as “suspected” cases and provided with medicine kits.
The World Health Organisation, which is supporting the State government in training and micro planning for the drive, said the State has deployed 141,610 teams and 21,242 supervisors from the Health Department to ensure all rural areas are covered.
Swatanshu, a WHO official working in Unnao, said they had 17 members in Unnao. The WHO teams train the nigrani samiti members on how to cover the containment zones and also monitor their work, he said.
Additional chief secretary health Amit Mohan Prasad said apart from the special drive, under the routine surveillance in the State, they had contacted over 16.80 crore people in over 3 crore households.
