Police crack down on Tunisian protesters on July 22 / credit: People’s Dispatch
Editor’s Note: This article was originally published by People’s Dispatch.
Tunisian security forces violently repressed a massive protest in the country’s capital on July 22 against the moves by President Kais Saied to further undermine democratic institutions in the country. According to human rights organizations, police repressed protesters who had gathered at the emblematic Habib Bourguiba Street in the center of Tunis by hitting them with batons and launching tear gas at them. Several people injured during the repression were hospitalized, and police arrested nine people.
Among those arrested are feminist rights activist Olfa Baazaoui of the Workers’ Party of Tunisia, human rights and LGBTQ+ rights defender Saif Ayedi of Damj, Aziz Ben Jemaa of the Workers’ Party of Tunisia, and other progressive activists.
Their arrests were widely condemned by diverse civil society organizations. Damj, the Tunisian Association for Justice and Equality, released a joint statement with organizations such as the Tunisian Association of Young Doctors, the Tunisian Organization Against Torture, and others, condemning the repression and demanding the immediate release of the protesters.
Denouncing the repression, they stated that “police repression had replaced democratic mechanisms” and emphasized their support “for all forms of demonstration, protest, assembly and expression, which they consider one of the most important gains of the revolution.” They added that protest is the central mechanism to exert pressure on the ruling system in order to “review development policies, combat corruption, terrorism and all the elements of tyranny, and guarantee respect for rights and freedoms.”
Egalité, the women’s organization to which detained activist Baazaoui also pertains, wrote in a statement that they hold President Saied responsible for the wellbeing of the detained activists. They also called on all female citizens “to boycott the referendum on a constitution that threatens rights and freedoms and dedicates it to the dictatorship of the individual and the return of the police state with force, which has been clearly and tangibly proven today.”
In a statement released by the Workers’ Party of Tunisia shortly following the arrests, they called for the protester’s immediate release and alerted that the detainees had been deprived of visits from their lawyers and some had been denied medical treatment.
The protest action was held three days ahead of the national referendum wherein Tunisians will vote on a draft constitution presented by Saied. A large number of opposition parties have called for a boycott of the referendum in rejection of the undemocratic nature of the new constitution’s writing process, as well as its proposals. The current constitution, which was adopted in 2014, is seen as a significant achievement of the revolution that overthrew dictator Zine El Abidine Ben Ali in 2011. A major objection to the draft presented by Saied is the proposal to do away with the division of executive power between the president and prime minister, concentrating power solely in the hands of the president.
The referendum on the constitution comes after several other moves by Saied which opposition parties have alleged undermine the democratic institutions in the country. These include the dissolution of judicial bodies, dissolution of the parliament, the persecution of leaders from major opposition parties, and the dissolution of other state institutions. These measures which began with the dissolution of parliament on July 25, 2021 have been met with constant protest from diverse civil society organizations and political parties.
More than 15,000 people participated in a November 22, 2021, protest at the White House to express their disappointment with the Biden administration’s coercive diplomatic policy toward the democratically elected government of Ethiopia / credit: Twitter/Gennet Negussie
Editor’s Note: The following is the writer’s opinion and was first published in Black Agenda Report.
Correction: A previous version of this article erroneously connected Lausan Collective to the National Endowment for Democracy (NED). A member of Lausan Collective had served as a fellow at the Taiwan Foundation for Democracy, an organization that has collaborated with the NED.
In the last few months, the left media outlets from various camps, in their sincere attempts to demonstrate solidarity and spotlight conflict in the Horn of Africa and internal developments in Ethiopia, got it wrong. They have been uncritically centering active ideological players on two opposing camps. The significant focus on the Tigray People’s Liberation Front (TPLF) attacks on Eritrea, its invasion of Afar and the Amhara region, and its existence as a willing proxy actor of Washington was correct. They got it wrong, however, in their uncritical framing of neoliberal Ethiopian President Abiy Ahmed. They have chosen to over-amplify the Abiy camp’s reactionary narrative on the long ideological internal struggle concerning the path forward for Ethiopia and the Horn.
In 1915, Lenin gracefully asserted:
“We demand freedom of self-determination, i.e., independence, i.e., freedom of secession for the oppressed nations, not because we have dreamt of splitting up the country economically, or of the ideal of small states, but, on the contrary, because we want large states and the closer unity and even fusion of nations, only on a truly democratic, truly internationalist basis, which is inconceivable without the freedom to secede.”
It is in the same framework that the principled Ethiopian and Eritrean revolutionaries during the 1960 and 70s warmly embraced this materialist line on the National Question. One of the most noted and often quoted Ethiopian Marxist is Wallelign Mekonnen. Mekonnen, who is of Amhara background, is famous for this 1969 article, “On the Question of Nationalities in Ethiopia.” This article is very relevant for today, and offers an effective ideological compass to navigate around the war of narratives taking shape, particularly on social media. Mekonnen specifies the basis of the Ethiopian settler state and its class foundation, which operated to benefit the Abyssinian ruling class in both Amhara and Tigray regions. The oppressed nations were not Amhara or those in the Tigray region, but the other non-Abyssinian nations in the south, who were conquered, colonized, and their names erased for the creation of Ethiopia. Mekonnen writes:
“To anybody who has got a nodding acquaintance with Marxism, culture is nothing more than the superstructure of an economic basis. So cultural domination always presupposes economic subjugation. A clear example of economic subjugation would be the Amhara and to a certain extent Tigray Neftegna system in the South and the Amhara Tigray Coalition in the urban areas. The usual pseudo-refutation of this analysis is the reference to the large Amhara and Tigray masses wallowing in poverty in the countryside.”
Following Mekonnen, I argue that the left must cautiously navigate around the two opposing ideological battlegrounds that have co-opted the language and performativity of “anti-imperialism” or “decolonization.” This language works to impede wider radical investigation of the Horn of Africa and its various contradictions.
As Lenin and the elder Eritrean and Ethiopian revolutionaries from the 1960 and 1970s advocated a dialectical understanding of the National Question, so must the left as they seek to understand Ethiopia and the Horn. What is the national question of Ethiopia? Voices from the revolutionary Ethiopian student movement of the 1960s and 1970s echoed much of V. I. Lenin’s point on the National Question that nation-states should be based on “voluntary ties, never compulsory ties.” Lenin insisted upon the “right of every nation to political self-determination,” which includes the right to secession. Following Lenin, Tilahun Takele (pseudonym name for a member of the Ethiopian People’s Revolutionary Party (EPRP)), argued:
“How could Marx, Engels, Lenin and Stalin, of all people support the right of nations to secession when they were, on the other hand, the most committed advocates of the unity and integration of the world proletariat? The answer is simple. Briefly, it is precisely because they wanted to promote the genuine, equality and fraternal unity of the proletariat of all nations, the general unity of the oppressed toiling masses of all nations.”
What are examples of the two opposing voices on The National Question that are attempting to get leftist legitimacy and credibility online? The first example uses the facade of decolonial positioning to cover for the attempted imperialist intervention against Ethiopia and also absolve TPLF of its violent aims to continue the settler-colonial legacy of Abyssinian king Yohaness of Tigray. The second one gives cover to neoliberal Abiy’s vision, a vision that aims to continue the settler-colonial legacy of Abyssinian king Menelik of Amhara without addressing the grievances of the oppressed nationalities.
We can see an example of the first camp in a popular event that occurred on December 8, 2021. Haymarket hosted a webinar called, “What’s Happening in Ethiopia,” with panelists Ayantu Tibeso and J. Khadijah Abdurahman, and facilitated by an anti-China Hong Kong “leftist,” Promise Li, who is a member of Lausan Collective.
Haymarket attracts pro-TPLF academics, such as Andom Ghebreghiorgis, with similar pro-Amnesty International politics and NED connections. One of the panelists referenced Wallelign Mekonnen by aiming to manipulate the “Nations and Nationalities” discussion toward vilifying the Amharas and the Eritrean state, while simultaneously giving cover to the Washington-backed TPLF as the vanguard of the oppressed nationalities. In other words, the discussion was intellectually dishonest, both in its inability to acknowledge Ethiopia as a settler state that has primarily benefited the Amhara and Tigray ruling classes, and in its echoing the U.S. State Department propaganda that is running interference for the TPLF while demonizing the Eritrean state.
An example of the second ideological camp can be seen at an event that occurred on September 11, 2021. The People’s Forum NYC hosted a webinar on “Imperialism, Ethiopia & Conflict in the Horn of Africa,” with panelists Simon Tesfamariam and Elias Amare, who are part of the People’s Front for Democracy and Justice (PFDJ) camp and co-leading the #NoMore social media campaign. Simon and Elias echoed the usual Abyssinian pejorative slur of “Ethnic Federalism” and discredited the Nations and Nationalities argument by attributing it to “tribalism,” and saying that “tribalism is a problem throughout Africa.” The term “ethnic federalism” is not one of facts to the current Ethiopian constitution as there is no ethnic federalism but mult-national federalism in name, which has not been implemented during the last 28 years under the TPLF regime and now under Abiy as well. They also ridiculed the radical assertion around Nations and Nationalities, equating anyone that supports that line with being a “tribalist.” In the same vein, Tesfamariam attempted to discredit the voices who put critical anti-colonial framing on the formation of Ethiopia, which challenges the mythological narrative of a 3,000-year-old independent Christian African state. Further, on his Twitter account, Tesfamariam deployed Abyssinian slurs “ethnofascist” and “tribalists” to de-legitimize the historical grievances of the oppressed nationalities.
Why are Eritreans like Simon Tesfamariam and Elias Amare, who support the People’s Front for Democracy and Justice (PFDJ), so keen on dismissing the real struggles of oppressed nationalities in Ethiopia, a position that is in contradiction to the spirit of the Eritrean revolution? Under the direction of Isaias Afwerki, the PFDJ has taken a line of concentrating on the primary contradictions, which is imperialism and the management of the region via proxy actors like TPLF. In fact, for the past 18 years, the Eritrean state had been the home of oppressed nationalities’ liberation fronts (OLF, ONLF, etc) struggling against the Washington-backed TPLF regime. However, after the 2018 peace deal, and after the re-igniting of war in the region in 2020 by the TPLF, the rhetoric in support of the oppressed nationalities has been abandoned.
The Good, the Bad and the Ugly with #NoMore
“We have the Marxist-Leninist weapon of criticism and self-criticism. We can get rid of a bad style and keep the good.” -Mao Zedong
How did the #NoMore form online and what is the social, political and class structure behind it? The #NoMore campaign is an online diaspora projection or formalization involving the PFDJ in Eritrea and the Amhara region, plus Abiy Ahmed in Addis Ababa, in political alliance against the TPLF. The sporadic social media campaign came at a time during the violent occupation of the Amhara region as TPLF was making gains militarily and attempting to advance to Addis Ababa. The Twitter accounts that support the campaign are led by the three dominant ethnic and political bases in both Eritrea and Ethiopia, represented by Hermela Aregawi (Tigraya), Simon Tesfamariam (Tigrinya) and Nebiyu Asfaw (Amhara). The #NoMore campaigns and protests have attracted very large crowds in the United States. But the large crowd is primarily Amhara because this is the main group that forms the Ethiopian diaspora in North America. The Amhara population also numbers 20 million in Ethiopia, and are the second largest group after the Oromos, who number over 40 million people.
Despite the claim to represent all of Ethiopia, the Oromos and other historically marginalized groups are hardly part of the social media campaign. The same can be said with all of the Eritreans and Somalis. Both the Amhara and Tigrayans, due to their dominant grip of Ethiopia over the century, enjoy the settler-colonial privilege with scholarships, visas and aid to live in the diaspora. This is the reason why they are the dominant voices of what we call “Ethiopia”—online and offline.
The good aspect of the #NoMore campaign is that it is significant to witness Eritreans and Ethiopians engaging each other and sharing a common struggle. That itself is historic. That the campaign focused on the crimes of the TPLF on Eritrea, Amhara and Afar region is the best thing about it. What is problematic is the shifty co-option of “anti-imperialist” rhetoric. While the leaders of the #NoMore campaign are vehemently critical of Washington’s foreign policy, if at least temporarily, their opposition seem to only demand that the leaders Isaias Afwerki and Abiy Ahmed have a seat at the table—presumably with the imperialists. They should be calling, instead, for the destruction of the table.
The bad aspect of the #NoMore campaign is its deployment of reactionary rhetoric and symbolism: The foregrounding of the imperial Abyssinia flag, the exaltation of feudal Abyssinian monarchs, the romanticization of the “Battle of Adwa” and the pushing of the propaganda that “Ethiopia is 3,000-year-old independent state.” This social media campaign has alienated the Oromos and other marginalized communities.
The ugly is that the National Question—the goal of decolonizing the settler-state of Ethiopia, and the overall need for a wider class struggle of the masses in the Horn of Africa—has taken a back seat in the #NoMore campaign. In fact, the articulated electoral strategy of “Vote Republican” should demonstrate that this is not a sincere anti-imperialist campaign.
How Can the Left Get It Right?
It is important for Western leftists to focus on imperialism and not take a hardline position on the internal politics of Ethiopia by not being sensitive to all the contradictions. The PFDJ is able to recognize the primary contradiction being the imperialist lackey, TPLF, in Ethiopia, but fails to recognize the other internal contradictions (the National Question). This is where the TPLF has a lifeline. For the PFDJ to not acknowledge the secondary contradiction is also to not have the correct analysis on the ways that the Abyssinian ruling class exploits these contradictions to further their settler-colonial agenda. These secondary contradictions are weaponized to exacerbate the primary contradiction. We see, for example, how the TPLF is using the plight of the oppressed nationalities to mask their settler-colonial ambitions. PFDJ representatives dismiss the oppressed nationalities as just “tribalists” and “ethnofascists,” a move that alienates the historically oppressed nationalities.
Failure to actively engage the contradictions of the National Question also gives legitimacy to Abiy, who, in addition to espousing more neoliberal policies than TPLF, has denied the historical grievances of Oromos and others in Ethiopia.
The left should oppose imperialism, but without ignoring the Ethiopian National Question. Tigray was never a part of the oppressed nationalities, but benefited from the fruits of settler colonialism. Tigray region’s political struggle with the Amhara region dates back to the period of Ethiopia’s creation in the late 1800s. The ideological struggle in the present is over who is to be the face of the Ethiopian settler-colonial state.
The left or anti-colonial forces in the past also got it wrong when they gave solidarity to slave-owning Menelik with the “Battle of Adwa,” legitimizing the conquest of the oppressed nationalities; to Selassie during the fascist Italian invasion of Ethiopia by helping to restore his feudal rule; to the pseudo-Marxist Derg regime, which hijacked the revolutionary momentum in Ethiopia; and to Meles Zenawi under the banner of state developmentalism.
The modern left must not make the same historical mistake in not being sensitive to the decolonial question of Ethiopia.
The left must heed to words of the Eritrean and Ethiopian revolutionaries of the 1960s and ’70s. One noted Ethiopian voice from that time is Tilahun Takele, who stated: “We believe that the recognition and support of the right of secession by revolutionary Ethiopians, especially those from the dominant nations, will foster trust and fraternity among the various nationalities.”
Filmon Zerai is an independent blogger who provides leftist commentary on the Horn of Africa. His views have appeared on CapeTalk, Sputnik International, BBC and other outlets. Zerai also is the founder and producer of the Horn of Africa Leftists podcast.
Sudanese Foreign Minster Mariam al-Mahdi (left) and Russian Foreign Minister Sergey Lavrov answer press questions in Moscow on July 12, 2021 / Russian Foreign Ministry Press Service
Editor’s Note: The following is the writer’s analysis of Russia-Sudan relations.
Russia’s ambitious plans to establish a naval base in Sudan could soon be thwarted. The northeast African country is reportedly trying to “blackmail” Moscow by demanding a review of a deal allowing construction of a Russian naval facility on Sudan’s Red Sea coast.
In November 2020, the Kremlin announced plans to build a seaport technical facility in the city of Port Sudan, guaranteeing Russia’s first substantial military foothold in Africa since the former Soviet Union was dismantled. The two countries reached a deal that would allow Russia’s navy a 25-year lease in Port Sudan, housing up to four ships and 300 soldiers, in exchange for weapons and military equipment for the northeast African country.
A map that shows Sudan and its proximity to the Red Sea / credit: World Port Source
But now, a Russian state news agency, RIA Novosti, reports Sudan wants to re-negotiate the deal. One Russian publication went so far as to call it “blackmail.” In exchange for providing the land for a naval base to Russia, Khartoum reportedly has asked Moscow to arrange payments to the country’s central bank during the first five years of the lease, with the option of extending the deal to 25 years.
The Kremlin has not yet responded to the proposal, although Russian Deputy Foreign Minister Mikhail Bogdanov said the two countries’ militaries continue negotiations on the creation of a naval logistics base for Russian warships in the Red Sea. Sudan’s officials, on the other hand, strongly deny their country has been trying to “blackmail” Moscow.
“It is not true. This news is not true. This is groundless news. The Sudanese side is not asking for any payments in connection with the military base agreement,” said Onur Ahmad Onur, charge d’affaires of Sudan’s embassy in Moscow.
Whether or not Sudan really asked Russia for financial compensation, the Kremlin’s struggle to improve its positions in northeast Africa is unlikely to be an easy one. Back in June, it became obvious Russia could face many obstacles in its attempts to establish a material-technical support facility in the strategically important region located between the Gulf of Aden in the south and the Suez Canal in the north. Such a facility could provide material support in the form of ships and soldiers and technical support in the form of command, control, communication, computer and intelligence operations.
On June 1, Sudanese Armed Forces Chief of Staff Muhammad Usman al-Hussein announced the revision of the agreement. About three weeks later, the Sudanese Minister of Defense Yasin Ibrahim Yasin traveled to Moscow to discuss Russian-Sudanese military cooperation with his Russian counterpart, Sergey Shoigu.
In July, while Russia was preparing to ratify the agreement, Sudanese Minister of Foreign Affairs Mariam al-Mahdi arrived in the Russian capital. She said Sudanese lawmakers will “evaluate whether the agreement is a benefit to Sudan itself and the strategic goals pursued by Russia and Sudan.” She also pointed out the future of the deal will largely depend on a “positive solution to a number of issues on which Khartoum counts on Moscow’s understanding and support.”
In an interview with Russian state-owned news agency RIA Novosti, Al-Mahdi openly stressed Sudan needs Russia’s help regarding the country’s dispute with neighboring Ethiopia, which is building the Grand Ethiopian Renaissance Dam (GERD)—a hydroelectric-power gravity dam on the Blue Nile River.
“Thanks to its good relations with Ethiopia, Russia can try to convince the Ethiopian side to listen to the voice of reason and come to an agreement that will not do harm to Sudan, as was the case when the dam was first filled,” Al-Mahdi said.
Khartoum fears Ethiopia’s apparent determination to fill the GERD would “threaten the lives of half the population in central Sudan.” In addition, the two countries have a decades-old border dispute, and some analysts claim Sudan and Ethiopia are on the verge of a wide-scale confrontation. It is worth noting Russia and Ethiopia signed a military cooperation agreement in July, and Kremlin officials claim the deal “does not have any destabilizing character.” However, Sudan recently seized Russian-made weapons—72 boxes of arms and night-vision binoculars—that were reportedly smuggled to Khartoum from Ethiopia. This was seen as an “attempt to destabilize the country.” It is entirely possible Russia is trying to balance between the two regional rivals, although Moscow could attempt to indirectly pressure Sudan to give the green light for the establishment of the Russian naval base in the Red Sea.
Port Sudan / credit: Bertramz/Wikipedia
At this point, it remains uncertain if the Sudanese parliament will ratify the agreement on the Russian base in Port Sudan. Some Russian experts think the construction of a Russian military facility on the Red Sea is unlikely.
“Russia is not going to pay Sudan to host a base in Port Sudan,” said Dmitry Zakharov, head of the Eurasian Institute of Youth Initiatives. “Due to the unthinkable corruption in the African country, the Russian government has no desire to invest in such a project.”
Unlike the Kremlin, the United States seems willing to provide limited financial assistance to Sudan. On August 29, Sudan’s Ministry of Finance and the U.S. Agency for International Development (USAID) signed an agreement for a $5.5 million development grant to support “democratic transition” and to promote economic growth. This is part of a total estimated amount of $200 million to be granted by 2024.
After the Sudanese transition government recognized Israel in 2020, the Trump administration removed Sudan in December from the U.S. list of “state sponsors of terrorism” and lifted U.S. sanctions. Sanctions normally prevent food, fuel and medicine from entering a country, harming ordinary people. Three months later, the two countries held an online Business and Investment Forum, and U.S. navy ships docked in Sudan for the first time in decades. Some Russian military experts believe the United States is pressuring Sudan not to allow Russia to open a naval base in the country, although such a facility could improve Khartoum’s position with neighboring Ethiopia.
Overall, it is Russia, rather than Sudan, that seeks to strengthen its geopolitical positions in the strategically important region. Thus, the coming days and weeks will show if Russia will adopt a more proactive approach regarding this sensitive issue. One thing is for sure: The naval base on the Red Sea would be just the first step in Russia’s ambitions plans to return to Africa, a region that has ceased to be in Moscow’s geopolitical orbit in the post-Soviet years.
Nikola Mikovic is a Serbia-based contributor to CGTN, Global Comment, Byline Times, Informed Comment, and World Geostrategic Insights, among other publications. He is a geopolitical analyst for KJ Reports and Global Wonks.
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.