Multi-Purpose Health Workers (MPHW)in Haryana, who are responsible for delivery of preventive and promotive health care services to the community, struck work across various districts of the state on 27th August. MPH workers are responsible for several critical aspects of health care including case finding through home visits, community mobilization, epidemic notification and control, referrals, record keeping, meeting targets for immunization, MCHN, limited diagnosis (malaria, TB, for e.g.), follow up of patients undergoing treatment for communicable diseases, enumeration, organizing mass campaigns, record keeping, reporting, etc
The striking workers defied all attempts to cow them down. On 29th August, the state government invoked the Essential Services Maintenance Act, 1974 (ESMA) for six months. Following this, on the night of 6th September, Hissar district registered a case against 11 MPHW union leaders and an Auxiliary Nurse Midwife (ANM) under ESMA. In some districts, the protesting workers received notices from the authorities seeking an explanation for their absence from work.
However, despite all this intimidation the striking workers carried on with their strike. “We are not afraid of the black laws like ESMA. We will continue our struggle till our demands are met” was their response. On the 10th day of their ongoing indefinite strike, some of the multipurpose health workers (MPHW) on Wednesday tonsured their heads in support of their long-pending demands.
The main demands raised by the MPHW are-
regularisation of services of contractual workers and an end to outsourcing policy
equal pay for equal work till regularisation
technical status for the post of MPH workers
implementation of the grade pay of Rs. 4,200
fixed travel allowance of Rs.1000
enforcement of uniform allowance for the employees of Reproductive and Child Health (RCH),
scraping of the National Pension Scheme,
removal of pay commission anomalies, cashless medical facilities.
These demands have been raised by the MPHW year after year since 2010. Irked over the lack of response from the state government towards their demands, Multi-Purpose Health Workers (MPHW) staged a four-day dharna 19th-23rd November under the aegis of the Multi-Purpose Health Workers’ Association in front of the local residence of Haryana Education and Health Minister at Jhajjar district.
State president and secretary of the Association said they had appealed to the authorities several times, but to no avail.
“The health workers have not got anything except hollow assurance from the state government. The association had been demanding regularisation of those health workers, who had been working on contractual basis, and removal of salary discrepancies. So these demands have been continuing since 2010!”
Thereafter, following their strike in August 2015, the government had accepted their demands, but there has been no implementation to date.
In December 2017, hundreds of multipurpose health workers from across the state held a protest in support of their long-pending demands. The workers were forced to take to the streets due to lack of concern in the attitude of senior officials of the Health Department. The authorities had promised to resolve the issues and work on the already accepted demands, but to no avail.
The attitude of the Indian state towards public health workers, be they ASHAs, Anganwadi Workers, Multipurpose Health Workers is condemnable. Their scope of work keeps expanding with every health scheme announced by one government after another. They are not given regular contracts and are kept as temporary or contract workers and paid less than regular staff for the same work. Temporary workers get only Rs.4000-Rs.8000 a month.
The struggle of the Haryana MPHW is just. The response of the government in invoking ESMA must be condemned. The Haryana government was claiming that it had to invoke ESMA as the public would have suffered if the strike continued. If a government thinks that public’s access to health services is critical, then it must ensure fair treatment of the actual service providers on the ground with respect to their appointments, grades of pay, designations and remuneration.