Sukumar Shinde, 52, who sells food items and snacks in rural fairs, said, “Because of the lockdown, I had to throw away several food items as they have a shorter shelf life.” / credit: Sanket Jain
Balu Jadhav usually journeys through 60 villages 300 days a year, selling toys and artificial jewelry in India’s “jatras,” or rural village fairs.
So if Jadhav travels less than 1,000 miles a year, that’s a sign of distress.
“In the past two years, I covered only 150 miles,” he said.
His two-decade-long routine was broken in March 2020 when far-right Indian Prime Minister Narendra Modi announced a 21-day nationwide lockdown to curb a pandemic caused by COVID-19, the novel coronavirus. The lockdown was extended to 67 days, causing 121 million people to lose their jobs within the first month. Yet, with this lockdown, India couldn’t contain the coronavirus. Meanwhile, because case numbers ebbed and flowed for two years, district administrators banned fairs.
With a history of over 150 years, these fairs remain an important source of income for marginalized people. In Jadhav’s home state of Maharashtra, located on India’s Arabian Sea coast, almost every village hosts an annual fair for a couple of days. Jatras are held in reverence of local deities. Rural vendors sell a variety of items, including toys, posters of regional deities, local books, footwear, artificial jewelry, balloons and household items. “A fair is like a festival and a holiday season for rural people,” said Gangabai, Jadhav’s wife. “Everyone prepares good food, dresses up and relatives from different villages attend the fair.”
With no option for selling goods, the Jadhavs were forced to work in 10 other occupations. They labored as farmworkers and masons, and in factories, but nothing helped them earn enough to survive. “There was no regular work because COVID devastated the rural economy,” she said.
The 2022 World Inequality Report states India is one of the most unequal countries in the world. Oxfam’s Inequality Kills report mentions, “The wealth of the 10 richest men has doubled, while the incomes of 99 percent of humanity are worse off, because of COVID-19.” Further, it found that a new billionaire was created every 26 hours since the pandemic began. Meanwhile, millions like Jadhav could barely find 26 hours of work per month during the peak of the pandemic.
After two years, local administrators in the village of Jambhali in Maharashtra’s Kolhapur district were permitted to arrange a fair that would be held January 1-2. Unfortunately, while the Jadhavs assumed it would help them sail, it was far from reality.
With rising coronavirus cases in January, reporting as high as 347,254 cases one day, several COVID restrictions were implemented again.
“We earned about 3,000 rupees ($40) from every fair before the pandemic. Now we are finding it difficult even to recover the transportation cost,” Balu Jadhav said. “Ever since COVID, people have stopped spending money because of dwindling wages.”
Hundreds of vendors in the Kolhapur district protested several times outside the local administrator’s office, demanding revocation of the ban on fairs. “Despite writing hundreds of letters, nothing concretized,” Jadhav said.
Anusuya Chavan, who lives in the same village as the Jadhav family, is in her mid-40s and sells toys. “This occupation forced us to never send the children to school, and with COVID, there’s no possibility that four of my children will ever see the school.” Her children, all below 18, are busy looking for work. “Earlier, we took loans to support our business, but now we are forced to take loans for eating food twice a day. It’s that bad.” Chavan has 13 members in her joint family and is in $670 debt. Her husband, Yuvraj, 50, has spent four decades traveling to sell at fairs. “My entire life has gone sleeping on roads,” he said. “But with lockdowns and curfews, we don’t even have roads on which to sleep.”
Vendors rely on informal loans to buy items to sell and pay them off immediately after fairs. “The moneylenders send their goons for collection, and we always pay on time,” Yuvraj said. However, with no sales, several vendors have been caught in debts of at least $3,350 each. High interest-rate fees have caused those debts to amass.
Meanwhile, fear, anger and frustration pile up, with another generation missing out on obtaining an education. That leaves Jadhav to vent.
“Even our children will have to live the same cursed life now.”
A view of the Jambhali fair at night. Vendors said they had never before seen such a low turnout / credit: Sanket JainVendors sell a variety of items, including toys, posters of regional deities, local books, footwear, artificial jewelry, balloons, household items, and much more in India’s rural fairs / credit: Sanket Jain“I’ve taken both the doses of the vaccine and even follow COVID norms, yet the government hasn’t given permission for fairs,” said toyseller Yuvraj Chavan / credit: Sanket JainKanthinath Ghotane traveled from the neighboring Indian state of Karnataka state to sell keychains in the Jambhali fair of Maharashtra’s Kolhapur district / credit: Sanket JainFairs are more like festivals, and are special occasions for rural people. During these fairs, every household creates in front of their homes rangolis, a traditional Indian art form, in which patterns are created on the floor using powder, flower petals, colors, colored sand and limestone / credit: Sanket JainEveryone (irrespective of religion) first offers coconut and incense sticks in Jambhali’s Khwajaso dargah, a Muslim shrine, before entering the jatra. “These fairs are a sign of communal harmony,” said Sikandar Attar, a coconut and incense stick vendor / credit: Sanket JainSikandar Attar, 69, who travels to more than 100 villages every year, sells incense sticks and coconuts offered to regional deities. He began working at farms during the COVID-19 lockdown. Even today, he hasn’t been able to find his way through to make ends meet / credit: Sanket JainCredit: Sanket JainColorful LED-based toys are selling at a higher rate than other items / credit: Sanket JainRiyaz Latkar, 32, has been selling artificial jewelry for over a decade and said he has never seen a crisis like this / credit: Sanket JainDuring these two- to three-day fairs, vendors sleep and cook on the roadside. Kamalaxmi Bahurupi said, “I’ve spent my entire life cooking food on roadsides. I don’t know how long we will live like this.” / credit: Sanket JainArtificial jewelry is usually in high demand in the village fairs of Maharashtra. However, with people losing their livelihoods because of the pandemic lockdown, vendors have reported a steep decline in sales / credit: Sanket JainIn this stall, every item is sold for a fixed rate of Rs 10 (13 U.S. cents) / credit: Sanket JainBalu and Gangabai Jadhav were forced to work 10 different occupations as the fairs remained banned. “If there’s another lockdown, we’ll all die of starvation,” Balu said / credit: Sanket JainAs much as 70 percent of rural India lacks an internet connection. With schools shut because of the coronavirus pandemic, several children have been forced to pick this line of work to make ends meet and support their families / credit: Sanket JainHorse and bullock cart races remain a major attraction during these fairs. Here, a horse is getting ready for a race / credit: Sanket JainCredit: Sanket Jain
Sanket Jain is an independent journalist based in the Kolhapur district of the western Indian state of Maharashtra. He was a 2019 People’s Archive of Rural India fellow, for which he documented vanishing art forms in the Indian countryside. He has written for Baffler, Progressive Magazine, Counterpunch, Byline Times, The National, Popula, Media Co-op, Indian Express and several other publications.
Prime Minister Narendra Modi walking towards the dais to address the nation at Red Fort in Delhi, on the occasion of 75th Independence Day on August 15, 2021 / Indian Prime Minister’s Office
Editor’s Note: The following analysis was produced in partnership by Newsclick and Globetrotter.
The recent Quad leaders meeting in the White House on September 24 appears to have shifted focus away from its original framing as a security dialogue between four countries, the United States, India, Japan and Australia. Instead, the United States seems to be moving much closer to Australia as a strategic partner and providing it with nuclear submarines.
Supplying Australia with U.S. nuclear submarines that use bomb-grade uranium can violate the Nuclear Non-Proliferation Treaty (NPT) and International Atomic Energy Agency (IAEA) protocols. Considering that the United States wants Iran not to enrich uranium beyond 3.67 percent, this is blowing a big hole in its so-called rule-based international order—unless we all agree that the rule-based international order is essentially the United States and its allies making up all the rules.
Japanese Prime Minister Shinzo Abe had initiated the idea of the Quad in 2007 as a security dialogue. In the statement issued after the first formal meeting of the Quad countries dated March 12, 2021, “security” was used in the sense of strategic security. Before the recent meeting of the Quad, both the United States and the Indian sides denied that it was a military alliance, even though the Quad countries conduct joint naval exercises—the Malabar exercises—and have signed various military agreements. The September 24 Quad joint statement focuses more on other “security” issues: health security, supply chain and cybersecurity.
Has India decided that it still needs to retain strategic autonomy even if it has serious differences with China on its northern borders and therefore stepped away from the Quad as an Asian NATO? Or has the United States itself downgraded the Quad now that Australia has joined its geostrategic game of containing China?
Naval ships from India, Australia, Japan, Singapore, and the United States steam in formation in the Bay of Bengal on September 5, 2007, during Exercise Malabar 07-2. The formation included USS Kitty Hawk, USS Nimitz, INS Viraat, JS Yuudachi, JS Ohnami, RSS Formidable, HMAS Adelaide, INS Ranvijay, INS Brahmaputra, INS Ranjit, USS Chicago and USS Higgins / credit: U.S. Navy photo by Mass Communication Specialist Seaman Stephen W. Rowe
Before the Quad meeting in Washington, the United States and the UK signed an agreement with Australia to supply eight nuclear submarines—the AUKUS agreement. Earlier, the United States had transferred nuclear submarine technology to the UK, and it may have some subcontracting role here. Nuclear submarines, unlike diesel-powered submarines, are not meant for defensive purposes. They are for force projection far away from home. Their ability to travel large distances and remain submerged for long periods makes them effective strike weapons against other countries.
The AUKUS agreement means that Australia is canceling its earlier French contract to supply 12 diesel-powered submarines. The French are livid that they, one of NATO’s lynchpins, have been treated this way with no consultation by the United States or Australia on the cancellation. The U.S. administration has followed it up with “discreet disclosures” to the media and U.S. think tanks that the agreement to supply nuclear submarines also includes Australia providing naval and air bases to the United States. In other words, Australia is joining the United States and the UK in a military alliance in the “Indo-Pacific.”
Earlier, President Macron had been fully on board with the U.S. policy of containing China and participated in Freedom of Navigation exercises in the South China Sea. France had even offered its Pacific Island colonies—and yes, France still has colonies—and its navy for the U.S. project of containing China in the Indo-Pacific. France has two sets of island chains in the Pacific Ocean that the United Nations terms as non-self-governing territories—read colonies—giving France a vast exclusive economic zone, larger even than that of the United States. The United States considers these islands less strategically valuable than Australia, which explains its willingness to face France’s anger. In the U.S. worldview, NATO and the Quad are both being downgraded for a new military strategy of a naval thrust against China.
Australia has very little manufacturing capacity. If the eight nuclear submarines are to be manufactured partially in Australia, the infrastructure required for manufacturing nuclear submarines and producing/handling of highly enriched uranium that the U.S. submarines use will probably require a minimum time of 20 years. That is the reason behind the talk of U.S. naval and air bases in Australia, with the United States providing the nuclear submarines and fighter-bomber aircraft either on lease, or simply locating them in Australia.
I have previously argued that the term Indo-Pacific may make sense to the United States, the UK or even Australia, which are essentially maritime nations. The optics of three maritime powers, two of which are settler-colonial, while the other, the erstwhile largest colonial power, talking about a rule-based international order do not appeal to most of the world. Oceans are important to maritime powers, who have used naval dominance to create colonies. This was the basis of the dominance of British, French and later U.S. imperial powers. That is why they all have large aircraft carriers: they are naval powers who believe that the gunboat diplomacy through which they built their empires still works. The United States has 700-800 military bases spread worldwide; Russia has about 10; and China has only one base in Djibouti, Africa.
Behind the rhetoric about the Indo-Pacific and open seas is the U.S. play in Southeast Asia. Here, the talk of the Indo-Pacific has little resonance for most people. Its main interest is in the Regional Comprehensive Economic Partnership (RCEP), which was spearheaded by the ASEAN countries. Even with the United States and India walking out of the RCEP negotiations, the 15-member trading bloc is the largest trading bloc in the world, with nearly 30 percent of the world’s GDP and population. Two of the Quad partners—Japan and Australia—are in the RCEP.
The U.S. strategic vision is to project its maritime power against China and contest for control over even Chinese waters and economic zones. This is the 2018 U.S. Pacific strategy doctrine that it has itself put forward, which it de-classified recently. The doctrine states that the U.S. naval strategy is to deny China sustained air and sea dominance even inside the first island chain and dominate all domains outside the first island chain. For those interested in how the U.S. views the Quad and India’s role in it, this document is a good education.
The United States wants to use the disputes that Vietnam, the Philippines, Indonesia, Thailand and Malaysia have with China over the boundaries of their respective exclusive economic zones. While some of them may look to the United States for support against China, none of these Southeast Asian countries supports the U.S. interpretation of the Freedom of Navigation, under which it carries out its Freedom of Navigation Operations, or FONOPS. As India found to its cost in Lakshadweep, the U.S. definition of the freedom of navigation does not square with India’s either. For all its talk about rule-based world order, the United States has not signed the UN Convention on the Law of the Sea (UNCLOS) either. So when India and other partners of the United States sign on to Freedom of Navigation statements of the United States, they are signing on to the U.S. understanding of the freedom of navigation, which is at variance with theirs.
The 1973 Nuclear Non-Proliferation Treaty created two classes of countries, ones who would be allowed to a set of technologies that could lead to bomb-grade uranium or plutonium, and others who would be denied these technologies. There was, however, a submarine loophole in the NPT and its complementary IAEA Safeguards for the peaceful use of atomic energy. Under the NPT, non-nuclear-weapon-state parties must place all nuclear materials under International Atomic Energy Agency safeguards, except nuclear materials for nonexplosive military purposes. No country until now has utilized this submarine loophole to withdraw weapon-grade uranium from safeguards. If this exception is utilized by Australia, how will the United States continue to argue against Iran’s right to enrich uranium, say for nuclear submarines, which is within its right to develop under the NPT?
India was never a signatory to the NPT, and therefore is a different case than that of Australia. If Australia, a signatory, is allowed to use the submarine loophole, what prevents other countries from doing so as well?
Australia did not have to travel this route if it wanted nuclear submarines. The French submarines that they were buying were originally nuclear submarines but using low-enriched uranium. It is retrofitting diesel engines that has created delays in their supplies to Australia. It appears that under the current Australian leadership of Prime Minister Scott Morrison, Australia wants to flex its muscles in the neighborhood, therefore tying up with Big Brother, the United States.
For the United States, if Southeast Asia is the terrain of struggle against China, Australia is a very useful springboard. It also substantiates what has been apparent for some time now—that the Indo-Pacific is only cover for a geostrategic competition between the United States and China over Southeast Asia. And unfortunately for the United States, East Asia and Southeast Asia have reciprocal economic interests that bring them closer to each other. And Australia, with its brutal settler-colonial past of genocide and neocolonial interventions in Southeast Asia, is not seen as a natural partner by countries there.
India under Prime Minister Narendra Modi seems to have lost the plot completely. Does it want strategic autonomy, as was its policy post-independence? Or does it want to tie itself to a waning imperial power, the United States? The first gave it respect well beyond its economic or military clout. The current path seems more and more a path toward losing its stature as an independent player.
Prabir Purkayastha is the founding editor of Newsclick.in, a digital media platform. He is an activist for science and the free software movement.
Instagram application on iPhone / credit NeONBRAND via Unsplash
On May 6 and 7, Instagram users in India noticed that some of their posts were starting to vanish. Gone were their COVID-19-related posts that demanded improved conditions for overworked crematorium workers, publicized volunteer-led relief efforts, and linked coronavirus deaths in the country to “abject callousness” of the government. Stranger still was the removal of private chats on the matter.
“There is a growing trend of internet shutdowns, takedown of social media content, particularly around political speech in India over the last few years,” said Vidushi Marda, global AI research and advocacy lead at ARTICLE 19, an international freedom of expression organization that has been tracking the deleted content.
In India right now, whether or not people have access to COVID-19 information on social media is a matter of life and death. Such censorship, however, is not unique to the country. Over the past month, activists and researchers have also collected numerous examples of suppressed content related to unrest in Palestine and Colombia, as well as posts related to the National Day of Awareness of Murdered and Missing Indigenous Women in the U.S. and Canada.
On May 7, Instagram said that “this is a widespread global technical issue not related to any particular topic” and that the issue had been “fixed.”
But the following day, the company acknowledged that there were issues with posts relating to unrest in Colombia and Palestine.
“We are so sorry this happened,” Instagram noted in a statement. “Especially to those in Colombia, East Jerusalem, and Indigenous communities who felt this was an intentional suppression of their voices and stories — that was not our intent whatsoever.”
But Instagram failed to acknowledge reports of censorship in India.
A representative of Facebook, which owns Instagram, wrote in response to questions about why dissent in India, Colombia, and Palestine seemed to have been disproportionately impacted: “This was a widespread global technical issue that affected users around the world, regardless of the topic of their Stories. We fixed it as fast as we could so users around the world could continue expressing themselves and connecting with each other through Stories.”
Despite the company’s claims that the takedowns were automatic and universal, Marda said there was “overwhelming evidence of the disproportionate impact these takedowns have had on political speech and dissent.”
In India, she noted that ARTICLE 19 observed “significant overlap between posts about activism, COVID-19 relief and government critique.” All of this, she said, points to “a significantly larger problem than just a single automation tool,” and noted “the opacity of content moderation practices” means that there are gaps in accountability.
Such digital suppression isn’t simply a matter of being able to speak freely. In each of these countries, thanks to government failures and limited media coverage, people have come to rely on social media to share information, track resources, and protect themselves from violence.
Part of the problem is automated content moderation, which uses machine learning to filter content. The systems are blunt instruments that often misunderstand context and remove too much or too little content, noted a report by the New Delhi-based Observer Research Foundation. These developments, adds the report, can negatively impact minority groups because these tools are often trained on English-language datasets, so they have trouble properly parsing dialects and rarely-used languages.
“[There is] overwhelming evidence of the disproportionate impact these takedowns have had on political speech and dissent,” said Marda. “[This is] precisely why… human rights organizations and defenders around the world have pointed to the dangers of automated content moderation for years.”
India’s History Of Digital Censorship
Because of the Indian government’s monumental failure in tackling the coronavirus, people in the country have come to rely on social media to seek and provide COVID-related help like oxygen supplies and vaccinations. Many people have also used social media to collate lists of supplies into a larger, searchable database.
Silicon Valley-driven censorship in India, therefore, has become a matter of survival, despite the fact that Instagram has yet to acknowledge it.
“Despite documented instances of censorship [in India] and Instagram users highlighting them very prominently, there was a complete lack of recognition [by Instagram] of what’s happening in India,” said Apar Gupta, Executive Director, Internet Freedom Foundation (IFF), a New Delhi-based organization that seeks to ensure that technology respects fundamental rights.
Digital suppression in the country isn’t new, despite the fact that the Indian Constitution guarantees the right to freedom of speech and expression.
On April 28, Facebook temporarily hid posts critical of Indian Prime Minister Narendra Modi that included the hashtag #ResignModi for “violating its community standards.” A Facebook spokesperson later said that the posts were hidden “by mistake, not because the Indian government asked us to.”
“Silicon Valley platforms have a very natural interest in keeping governments happy in the regions that they operate,” Gupta said, pointing to the fact that India is Facebook’s biggest market.
The lack of institutionalized free speech protections is further compounded by laws and regulations in India that allow the Ministry of Electronics and Information to not disclose censorship orders sent to social media companies, said Gupta.
Users are therefore often given no official explanation why their posts were suppressed.
Content Moderation In Colombia
There have also been numerous reports of censorship related to ongoing protests in Colombia over proposed tax increases and the resulting police crackdowns.
“We identified a specific problem with Instagram,” said Carolina Botero Cabrera, a researcher with Karisma, a Bogotá based civil society organization that works on technology and human rights. “We have over 1,000 reports of censorship, around 90 percent of it was by Instagram and the content was overwhelmingly about the [ongoing] protests,” she added.
Deleted posts reportedly related to the national unrest, unemployment numbers in the country, and the death of a protester.
For Colombia, a country with a long-lasting civil war, such automated content moderation is all the more contentious because journalists and human rights activists often find that their content is removed, their reach is diminished, or their accounts are blocked because their content is deemed too violent.
Jesus Abad Colorado, an experienced Colombian photojournalist, recently had his Twitter account blocked after he posted photographs of an armed dispute in the Chocó Department in Western Colombia. A few days later, when an independent media outlet livestreamed an interview with Colorado about the dispute, their account was blocked, too.
Another challenge, said Botero, is that the Revolutionary Armed Forces of Colombia — People’s Army (FARC), the longtime leftist guerilla group that disarmed and became a political party in 2017, “was flagged as a terrorist organization [by social media companies at the time] even though they were in peace negotiations.”
The peace process spanned about four years, culminating in a peace agreement in 2016. “Any research about the peace process will have to deal with important problems to [understand] FARC’s position, actions, and voice,” said Botero, noting that blocked social media accounts and deleted content hamper documentation of the process.
Suppressing Palestinian Voices
As tensions escalated in Israel and Palestine, digital suppression in the region also appeared to increase.
“We have over 100 reports of censorship on Instagram,” said Alison Carmel Ramer, a researcher at 7amleh, a Haifa-based digital rights organization based in Haifa, Israel.
Muslim, a media publication, also documented blocks on Instagram livestreams related to Palestine.
According to ِRamer, Facebook told 7amleh that a majority of the Instagram takedowns were mistakes because they did not violate community standards and that they have restored the content.
“This means there is a problem in the way content is moderated,” said Ramer. “Why is content which is not against community standards being taken down? [Facebook] also did not tell users under which policy the content was taken down.”
In general, Palestinian content is “over-moderated” Ramer added, noting posts are often suppressed either because they are considered hate speech, or the posts appear to be connected to terrorist organizations. Many Palestinian leaders are designed as terrorists by the United States, meaning Facebook censors content related to them. Ramer also explained how hate speech in the region written in Hebrew is not censored to the same extent as hate speech in Arabic.
A March 2021 report by 7amleh which analysed 574,000 social media conversations in 2020 showed that one out of every 10 Israeli posts about Palestinians and Arabs contained violent speech, a 16 percent increase compared to 2019. “We have sent reports like this one to Facebook for several years and every year, [but] we find that this content just remains online,” Ramer said, adding that Facebook has not informed them of what, if any, actions it intends to take.
“Zionism is a political ideology,” Ramer said. “Political speech must be protected. Words like ‘Zionist’ and ‘shahid’ [martyr in Arabic] should be protected.” Censorship in the region is especially concerning because of the longstanding lack of transparency around Israel’s treatment of Palestinians, political activist Noam Chomsky told The Daily Poster.
“Israel’s brutal repression of Palestinians for many years, with strong support from the U.S. particularly, is a shocking crime in itself and has ominous international repercussions as well,” said Chomsky. “There have been extensive efforts to block efforts to bring the facts and their significance to the general public. These efforts amount to direct participation in the crimes.”
When asked about social media companies’ ability to freely censor content, Chomsky replied, “Their enormous power should not be tolerated.”
The Path Ahead
At ARTICLE 19, Marda said that in order to align itself with international human rights standards, Facebook “must publicly and transparently acknowledge the reasons for recent takedowns” and “provide information for the substantive and legal reasons for takedown.”
Marda added that Facebook should also “restore all blocked content” and “publicly commit to not bowing to governmental or judicial pressure that requires it to act in violation of international human rights standards and jurisdiction-specific standards on freedom of expression.”
More than 3,000 Accredited Social Health Activists (ASHAs) protested in the city of Kolhapur in India’s Maharashtra state on October 26 after several of their demands, such as the legal status of full-time workers, better working conditions, adequate pay, medical insurance, and others, weren’t met / credit: Sanket Jain
Prajakta Khade walked into a public health center daily for three months in early 2021, without ever receiving medical care. The healthcare worker’s 26 notebooks—containing more than 3,000 pages of community health records—point to why she couldn’t seek treatment for her ailments. She was simply too busy.
In March 2020, India’s health ministry tasked 1 million Accredited Social Health Activists (ASHAs) like Khade with COVID-19 duty in rural areas. This, in a country where 65 percent of its 1.38 billion people live outside cities. Suddenly, ASHAs’ workload increased exponentially. Yet, they remain underpaid and now suffer stress-related chronic ailments.
“If a positive case was found in the area, we had to visit the patient, contact trace, arrange medical facilities, measure their oxygen and temperature levels daily, and ensure they complete quarantine,” Khade explained about the added duties to treat the infectious respiratory disease. But all Khade was given to do her job in the assigned area in India’s Maharashtra state was a single N95 mask and 200 milliliters of sanitizer.
ASHAs, an all-women healthcare cadre, remain the foot soldiers of India’s rural healthcare. One worker is appointed for every 1,000 citizens under India’s 2005 National Rural Health Mission. ASHAs are responsible for more than 70 tasks, including providing first-contact healthcare, counsel regarding birth preparedness, and pre- and post-natal care. Plus, they help the population access public healthcare and ensure universal immunization, among other things.
The World Health Organization announced a pandemic in March 2020. But in many countries, lack of adequate healthcare and no social safety nets amid lockdowns wrecked the lives of ordinary people. In India, for example, an additional 150 million to 199 million people are expected to enter poverty in 2021 and 2022.
Chronic Illnesses Spike
One day about a year ago, while surveying people in her village of Vhannur in India’s Maharashtra state, 40-year-old Khade felt dizzy. But she couldn’t take a break. “At one point, my face was swollen, and I could barely see anything.” It turned out her blood pressure level had surged to 252/180 mmHg (millimeter of Mercury), much higher than the standard limit of 120/80. That is how she got diagnosed with hypertension.
However, a month’s worth of medications didn’t help because she continued to experience stress as her workload increased. Senior officials at the health center had early on issued an order to submit patient records daily by noon.
ASHAs, who aren’t considered full-time workers, receive performance-based incentives paid on the number of tasks completed. “For COVID duty, the government decided our worth as merely 33 Indian Rupees per day (43 U.S. cents),” she said. “We received this amount only for three months in the past two years.”
Moreover, during the peak of COVID-19 cases in 2021, salaries for Maharashtra’s ASHAs were delayed by five months, according to Khade. Netradipa Patil, an ASHA from Maharashtra’s Kolhapur district and leader of a union that represents more than 3,000 ASHAs, confirmed this.
One day last year, Khade’s supervisor asked for a list of hypertension and diabetes patients from her village of about 1,200 people—at 10 o’clock at night.
“How could I survey the entire community in the night?” she asked.
Often, such orders meant skipping lunch and staying hungry for 11 hours at a stretch. ASHAs worked four hours prior to the pandemic. Now, 12-hour days are normal.
When medications didn’t help, Khade consulted two private doctors. “After six months of hassle, the doctor doubled my dose to 50 milligrams.” Khade lost over 10 kilograms (22 pounds) of weight and was placed on medications to address anxiety. Even today, she suffers from fatigue.
“I was never this weak,” she asserted.
Chronic diseases among ASHAs are rising rapidly because of the workload, says Patil. “We protect the entire community, but there’s no one to look after our health.” ASHAs in Maharashtra, she says, average a monthly income of Rs 3,500 to 5,000 ($45 to $66 USD).
This reporter spoke to ASHAs’ senior officials from Maharashtra’s Kagal block. (In India, a cluster of villages form a block and several blocks form a district. Vhannur village is in the Kagal block of Maharashtra’s Kolhapur district.) Senior officials said they are not responsible for ASHAs’ deteriorating mental and physical health, and pointed to the Indian government’s order to submit data. The officials didn’t want to be named. Instead, they relayed that they also are overworked.
“ASHAs do the majority of the health department’s work, and they are massively underpaid for their duty,” said Dr. Jessica Andrews, a medical officer at Kolhapur’s Shiroli Primary Health Center. She has been handling mental health cases. “Without them, the health system will collapse.”
‘Not Treated As Humans’
Several ASHAs across India have worked for over a year without a break. One of them is Pushpavati Sutar, 46, diagnosed with hypotension (low blood pressure) and diabetes within seven months of COVID-19 duty in November 2020. Like Khade, she experienced constant spells of dizziness.
“Often, there was fake news of community COVID transmission in my area,” she said.
Every day, senior officials at the health center hounded her to find more details about such instances.
An ASHA for 13 years, she’s never made an error in her surveys and was sure of no community transmission. “After investigating, I found that the accused was COVID negative. Instead, two of his relatives were positive.”
She had to clear such misconceptions almost every day, answer senior officials’ questions, collect records and perform her regular duty. “For several days, I couldn’t sleep,” she remembered.
Further, fearing COVID-19 guidelines and quarantine rules, community members began demanding ASHAs hide COVID-19 cases. “People even accused us of spreading COVID as we would survey the entire village,” Sutar recounted. Moreover, she said senior officials asked ASHAs to visit the families of COVID-19 patients—instead of allowing data collection over the phone—putting them at risk of infection.
“At several places, there have been instances of community violence, where ASHAs were beaten up,” said Patil, who has filed legal complaints on behalf of the assaulted workers and is helping them mentally recover.
Kolhapur’s ASHA union has written to several government authorities, including Maharashtra’s chief minister and Indian Prime Minister Narendra Modi, highlighting the mental toll of COVID-19 duty. Still, none of their letters have garnered a helpful response.
“Forget adequate pay,” said Khade, as she continued surveying, juggling between completing her task and trying to keep her mind at ease. “We are not even treated as humans.”
ASHA Rehana Mujawar, of Maharashtra’s Tardal village, shows COVID-19 records she is required to fill out every day by visiting her community of more than 1,000 members / credit: Sanket JainASHA workers Rekha Dorugade and Mandakini Kodak trekking the Dhangarwada hill to complete their survey, a steep patch of 5 kilometers (3.1 miles) in Kolhapur’s Pernoli village / credit: Sanket JainAn ASHA worker took a selfie as part of their protest on July 21 in Maharashtra’s Kolhapur city / credit: Sanket JainASHA workers protest outside the district collector’s office in Kolhapur city with placards mentioning their workload. In the center, wearing a red saree, is ASHA union leader Netradipa Patil, who has been fighting for better working conditions for over a decade / credit: Sanket JainASHAs across India have been protesting for better pay, full-time worker status and proper working conditions / credit: Sanket JainIndia has 810 district hospitals for 833 million rural people. In mountainous regions like Kolhapur’s Masai Pathar, ASHAs often trek, risking their lives to save pregnant women and make healthcare facilities accessible / credit: Sanket JainAn ASHA worker explains breastfeeding and taking care of a newborn to a community woman in Maharashtra’s Khutwad village / credit: Sanket JainIn Kolhapur’s Khutwad village, ASHA Maya Patil informs a migrant sugarcane cutter, whose relative gave birth to a child a month prior, about post-natal care and how they can access public healthcare facilities / credit: Sanket JainTo inspire fellow ASHAs, Netradipa Patil shares a WhatsApp status quoting lyricist and poet Gulzar: “Milta To Bahut Kuch Hai Is Zindagi Me, Bas Ham Ginti Usi Ki Karte Hain, Jo Hasil Na Ho Saka. (We get many things in life, but we only count the things we couldn’t achieve) / credit: Sanket JainASHAs also distribute iron, calcium, and vitamin tablets, among others, to community women and children every month. “For distributing these medicines, we’re merely paid Rs 100 ($1.30 USD),” says ASHA Netradipa Patil / credit: Sanket JainASHA Prajakta Khade collected the sputum of a patient she suspects to be a tuberculosis patient / credit: Sanket Jain“Be it any health record, the health department relies on our surveys and fieldwork,” says Khade, who has been an ASHA since 2009 / credit: Sanket JainWomen often share their health and mental issues with ASHA workers, as they have built a safe bond over the past decade / credit: Sanket JainAs part of the Health Ministry’s program of reducing non-communicable diseases, ASHAs across Maharashtra are tasked with surveying communities by asking them more than 60 questions. “We will merely be paid Rs 5 (6 U.S. cents) per form for collecting and filling in all the details,” says Khade / credit: Sanket JainA significant part of Khade’s time goes into filling out by hand medical records. “If any record is incomplete, our seniors immediately probe an inquiry, and even the pay is deducted,” she says / credit: Sanket JainSo far, Khade has spent over Rs 10000 ($131 USD) on doctors, medical tests, and medications, an equivalent of three months of her salary. “ASHAs don’t receive any health support system from the government, nor any medical insurance,” she says / credit: Sanket JainASHA Jayashree Khade from Kolhapur’s Vhannur village tested positive for COVID-19 in May 2021. “None of my seniors even once asked about my health. It was only the fellow ASHAs who helped me,” she says / credit: Sanket JainPrajakta Khade gives a plastic bottle to a community woman asking her to submit sputum for tuberculosis detection / credit: Sanket JainPushpavati Sutar, as part of postnatal visits, often counsels women on breastfeeding, seeks regular updates on the health of both the mother and the newborn, and provides the required medications / credit: Sanket JainAn ASHA worker filling out health records of a newborn in Kolhapur’s Shirol region, noting important details / credit: Sanket JainSutar distributes iron and folic acid tablets to her community members / credit: Sanket JainTo ensure community members take medications and supplements on a schedule, ASHAs often write instructions in the native language on the box / credit: Sanket JainSutar ignored her hypotension symptoms for several months and continued the survey because of the tremendous workload / credit: Sanket JainASHA workers always counsel community members on proper healthcare. Here, she is talking to a woman in Kolhapur’s Shirol region about early childhood health / credit: Sanket JainAs part of the health ministry’s Anemia Free India program, ASHAs are given a long notebook to maintain the records of 6- to 51-week-old children and 5- to 10-year-old children from their community. ASHAs regularly provide tablets to prevent anemia / credit: Sanket JainASHAs’ role doesn’t end with distributing medications. They answer questions people raise / credit: Sanket JainASHA Rani Koli, from Kolhapur’s flood-affected Bhendavade village, surveying her community after the July floods. “Even my house was ravaged by the 2019 and 2021 floods, but we keep working to make sure everyone remains safe,” she said / credit: Sanket JainASHA Kavita Patil talking to senior citizens in Kolhapur’s Bhendavade village to understand the mental toll of living through two floods / credit: Sanket JainASHA workers Netradipa Patil and Maya Patil surveying a community to learn more about how two floods and lockdowns affected the lives of rural community women / credit: Sanket Jain
Sanket Jain is an independent journalist based in the Kolhapur district of the western Indian state of Maharashtra. He was a 2019 People’s Archive of Rural India fellow, for which he documented vanishing art forms in the Indian countryside. He has written for Baffler, Progressive Magazine, Counterpunch, Byline Times, The National, Popula, Media Co-op, Indian Express and several other publications.
