Photo Essay: India’s Rural Health Workers Fell Ill As Workload Spiked During Pandemic

Sanket Jain April 19, 2022 Sanket Jain Admin, Archives, Asia
More than 3,000 Accredited Social Health Activists (ASHAs) protested in the city of Kolhapur 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
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 from Maharashtra’s Tardal village shows the COVID records she has to fill every day by visiting her community of over 1000 members / credit: Sanket Jain
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 Jain
ASHA workers Rekha Dorugade and Mandakini Kodak trekking the Dhangarwada hill to complete their survey, a steep patch of five kilometers in Kolhapur’s Pernoli village / credit: Sanket Jain
ASHA 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 Jain
An ASHA worker took a selfie as part of their protest on 21 July 2021 in Maharashtra’s Kolhapur city / credit: Sanket Jain
An ASHA worker took a selfie as part of their protest on July 21 in Maharashtra’s Kolhapur city / credit: Sanket Jain
ASHA workers protesting outside the district collector’s office in Kolhapur city with placards mentioning their workload. In the center with a red saree is ASHA union leader Netradipa Patil, who has been fighting for better working conditions for over a decade / credit: Sanket Jain
ASHA 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 Jain
ASHAs across India have been protesting for better pay, the status of full-time workers, and proper working conditions. However, their protests haven’t seen concrete results yet / credit: Sanket Jain
ASHAs across India have been protesting for better pay, full-time worker status and proper working conditions / credit: Sanket Jain
India merely 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 Jain
India 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 Jain
An ASHA worker explains breastfeeding and taking care of the newborn to a community woman in Maharashtra’s Khutwad village / credit: Sanket Jain
An ASHA worker explains breastfeeding and taking care of a newborn to a community woman in Maharashtra’s Khutwad village / credit: Sanket Jain
In Kolhapur’s Khutwad village, ASHA Maya Patil informs a migrant sugarcane cutter whose relative gave birth to a child a month ago about postnatal care and how they can avail of the public healthcare facilities / credit: Sanket Jain
In 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 Jain
To 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 Jain
To 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 Jain
ASHAs also distribute iron, calcium, and vitamin tablets, among others, to the community women and children every month. “For distributing these medicines, we’re merely paid Rs 100 (USD 1.3),” says ASHA Netradipa Patil / credit: Sanket Jain
ASHAs 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 Jain
ASHA Prajakta Khade collected the sputum of a patient she suspects to be a Tuberculosis patient / credit: Sanket Jain
ASHA 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 Prajakta Khade, who has been an ASHA since 2009 / 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 Jain
Women often share their health and mental issues with ASHA workers as they have built a safe bond over the past decade / credit: Sanket Jain
Women often share their health and mental issues with ASHA workers, as they have built a safe bond over the past decade / credit: Sanket Jain
As part of the Health Ministry’s program of alleviating Non-communicable diseases, ASHAs across Maharashtra are tasked with surveying communities by asking them over 60 questions. “We will merely be paid Rs 5 (0.06 USD) per form for collecting and filling in all the details,” says Khade / credit: Sanket Jain
As 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 Jain
A significant part of ASHA Prajakta Khade’s time goes into writing the medical records. “If any record is incomplete, our seniors immediately probe an inquiry, and even the pay is deducted,” she says / credit: Sanket Jain
A 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 Jain
So far, Prajakta Khade has spent over Rs 10000 (USD 131) on doctors, medical tests, and medicines, 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 Jain
So 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 Jain
ASHA Jayashree Khade from Kolhapur’s Vhannur village tested positive for COVID 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 Jain
ASHA 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 Jain
Prajakta Khade gives a plastic bottle to a community woman asking her to submit the sputum for tuberculosis detection / credit: Sanket Jain
Prajakta Khade gives a plastic bottle to a community woman asking her to submit sputum for tuberculosis detection / credit: Sanket Jain
Pushpavati Sutar, as part of postnatal visits, often counsels the women on breastfeeding, seeks constant updates on the mother and newborn’s health, and provides them the required medicines / credit: Sanket Jain
Pushpavati 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 Jain
An ASHA worker filling the health records of a newborn in Kolhapur’s Shirol region, noting down important details / credit: Sanket Jain
An ASHA worker filling out health records of a newborn in Kolhapur’s Shirol region, noting important details / credit: Sanket Jain
Pushpavati distributes iron and folic acid tablets to her community members / credit: Sanket Jain
Sutar distributes iron and folic acid tablets to her community members / credit: Sanket Jain
To make sure the community members take medicines as per the schedule, ASHAs often write instructions on the box / credit: Sanket Jain
To ensure community members take medications and supplements on a schedule, ASHAs often write instructions in the native language on the box / credit: Sanket Jain
Pushpatai ignored her hypotension symptoms for several months and continued the survey because of the tremendous workload / credit: Sanket Jain
Sutar ignored her hypotension symptoms for several months and continued the survey because of the tremendous workload / credit: Sanket Jain
ASHA workers always counsel the community members on proper healthcare. Here Pushpatai is talking to a woman about early childhood health in Kolhapur’s Shirol region / credit: Sanket Jain
ASHA 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 Jain
As part of the health ministry’s Anemia free India program, ASHAs are given a long notebook to maintain the records of 6-51 week old infants and 5-10-year-old children from their community. ASHAs regularly provide them with adequate medicines to prevent Anemia / credit: Sanket Jain
As 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 Jain
ASHAs’ role doesn’t end with distributing medicines. People ask them several doubts about medicines, and they patiently answer all of them / credit: Sanket Jain
ASHAs’ role doesn’t end with distributing medications. They answer questions people raise / credit: Sanket Jain
ASHA Rani Koli from Kolhapur’s flood-affected Bhendavade village surveying her community after the July 2021 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 Jain
ASHA 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 Jain
ASHA Kavita Patil talking to senior citizens in Kolhapur’s Bhendavade village to understand the mental toll of two floods / credit: Sanket Jain
ASHA Kavita Patil talking to senior citizens in Kolhapur’s Bhendavade village to understand the mental toll of living through two floods / credit: Sanket Jain
ASHA 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
ASHA 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.

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Israeli military personnel push a U.S. solidarity activist / credit: Emily Glick
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Displacement Looms for 1,000+ Palestinians After Israel’s Supreme Court Sides with Army

Jessica Buxbaum June 22, 2022 Jessica Buxbaum Admin, Archives, West Asia
Israeli military personnel push a U.S. solidarity activist / credit: Emily Glick
Israeli military personnel push a Jewish activist from the United States amid a Palestinian-led protest on June 10 against the seizure of the Masafer Yatta region in the West Bank / credit: Emily Glick

MASAFER YATTA, OCCUPIED WEST BANK—On Tuesday, the Israeli military started training in Masafer Yatta, a rural, arid enclave south of the occupied West Bank city of Hebron. This comes after more than two decades of Palestinians using legal avenues to try to stop the seizure of their land.

The military training has involved the army sticking shooting targets onto tractors, windows and barrels of hay.

They also have driven war tanks over cultivated fields.

Expected to last a whole month, this is the first such military training exercise in the Palestinian community in 20 years, and comes as Masafer Yatta is experiencing the largest mass expulsion of Palestinians since 1967.

Demonstrations—regularly met with violence from soldiers and Israeli settlers—have occurred almost weekly since Israel’s Supreme Court rejected a petition in May against the expulsion of more than 1,000 Palestinians.

For example, on June 10, the Israeli army attacked a Palestinian-led protest. Soldiers beat protesters, fired tear gas that burned demonstrators, threw stun grenades and detained Israeli solidarity activists. More than 200 Palestinians, Israelis, and Jews from both the United States and the United Kingdom protested as part of the “Save Masafer Yatta” campaign.

“Our protests show the racism in how the Israeli army treats us,” said Basil Adra, an activist from the village of Tuwani in Masafer Yatta. “Soldiers who claim that they are not allowed to stop settlers from committing violence against us are then very aggressive towards protesters.”

Israeli military personnel push activists protesting the seizure of the rural West Bank enclave of Masafer Yatta / credit: Emily Glick
Israeli military personnel push Palestinians and solidarity activists protesting on June 10 the seizure of the rural West Bank enclave of Masafer Yatta / credit: Emily Glick

The Culmination of a Decades-Long Legal Battle

In the 1980s, the Israeli army declared all 19 villages in Masafer Yatta as “Firing Zone 918,” a closed military training site. By 1999, the Israeli military rounded up more than 700 residents into trucks and expelled them off land they had cultivated for generations.

In response to the forcible transfer, the Association for Civil Rights in Israel (ACRI) in the year 2000 filed petitions with the Israeli Supreme Court on behalf of residents. The court then granted an interim injunction, permitting residents to temporarily return to their homes.

A 2012 state attorney decision allowed four villages—Tuba, Sirat ‘Awad Ibrahim, Sarura and Mufaqara—to remain based upon the Israeli Defense Ministry’s position that the land wasn’t needed for military training. Despite the decision, settler violence and land theft have plagued these villages.

From there, the high court continued hearings on various petitions for years. But last month, the court dismissed residents’ petitions. In its ruling, the court determined the Palestinian inhabitants—who live nomadically and depend on shepherding for their livelihoods—were not permanent residents when the military declared the area a firing zone.

The recent court opinion has given the army the green light to demolish eight villages and displace the Masafer Yatta residents once again.

The residents, along with ACRI, petitioned the Supreme Court on Sunday for an additional hearing and interim order to stop military training in Masafer Yatta.

“It is to be hoped that the high court will accept the request for additional hearing and reverse the ruling that war crimes can be committed under the court’s purview,” ACRI attorneys Dan Yakir and Roni Pelli said.

Israeli military personnel push solidarity activists / credit: Emily Glick
Israeli military personnel push solidarity activists on June 10 amid the Palestinian-led protest in the West Bank enclave of Masafer Yatta / credit: Emily Glick

From Quiet Grazing Lands to an ‘Army Base’

Since the court ruling, residents say Masafer Yatta feels like it has transformed into the equivalent of a military base. Temporary army checkpoints have been established at entrances of the area’s eight villages deemed the firing zone. Soldiers with assault rifles strapped to their chests patrol the area daily—delivering demolition orders, as well as carrying out arrests and nightly raids. Military jeeps packed with soldiers roam the rocky terrain.

The Israeli military has already started carrying out demolitions since the court ruling.

In May, 19 structures such as houses, tents, animal pens and water tanks were demolished. That left 45 people homeless in the villages of Al-Fakheit and Al-Mirkez. This month, the army bulldozed tents belonging to 21 residents of these villages, which they had set up after their homes were destroyed. On Thursday, all but three buildings in the village of Khalet a-Thab’a received demolition orders that can be enacted beginning Sunday.

Even areas of Masafer Yatta not part of the firing zone are at risk of being razed. The Israeli Civil Administration, which governs activities in the West Bank, issued on Thursday a demolition order for Palestinian activist group Youth of Sumud’s guest house and community center.

“This center, which we worked for years to complete, is a big step for the people of Masafer Yatta to organize and protect our lands. We use this place to host internationals, hold meetings and organize community gatherings,” Sami Huraini of Youth of Sumud told Toward Freedom. “This demolition order isn’t just about the Youth of Sumud—it is about crushing organizing efforts in solidarity with the vulnerable communities in the 918 firing zone.”

The center is located in Tuwani—the only village in Masafer Yatta with a zoning plan—meaning the law protects it from demolition. Sameeha Huraini, Sami’s sister who also is involved with Youth of Sumud, explained the Civil Administration gave the demolition order on the grounds the center is located outside of the zoning plan and on an archeological site—both claims are false, she said. The Israeli military and Coordinator of Government Activities in the Territories, which oversees the Civil Administration, did not respond to requests for comment by the time of publication.

A stun grenade burnt the pants and leg of an activist during a protest against the seizure of the Palestinian rural enclave of Masafer Yatta in the West Bank / credit: Emily Glick
A stun grenade burned the pants and leg of an activist during a June 10 Palestinian-led protest against the seizure of the rural enclave of Masafer Yatta in the West Bank / credit: Emily Glick

‘Our Rights Have Become Dreams’

Army-enforced eviction isn’t Masafer Yatta’s only struggle. Several illegal, Jewish-only settlements encircle the region.

“Israeli illegal outposts inside Masafer Yatta are connected to resources and are not under imminent eviction,” said Ali Awad, a Palestinian activist from the village of Tuba. “Settlers in these outposts commit violence against neighboring Palestinians and work in tandem with the Israeli military to steal our resources and expel us from our homes.”

While the Palestinian villages are not connected to the electrical grid and water system, the illegal settlements are. Without these hookups, Palestinians are forced to survive on NGO-donated solar panels and expensive water tanks, which settlers often destroy and soldiers confiscate.

Israeli military personnel on June 10 mingle with settlers from the colony of Mitzpeh Yair / credit: Emily Glick
Israeli military personnel mingle on June 10 with settlers from the colony of Mitzpeh Yair / credit: Emily Glick

Awdah Hathaleen, a Palestinian activist from the village of Umm al-Khair in Masafer Yatta, lamented what will happen to his community if the army is successful in dismantling the eight villages.

“After that, what will be [the army’s] next mission? The other villages [in Masafer Yatta], and, unfortunately, my village will be one of them. Because if they succeed in this, they will just keep going,” Hathaleen told Toward Freedom. “We are humans. Humans who deserve basic rights. But our rights have become dreams. And now we have to work to make those dreams become reality.”

Jessica Buxbaum is a Jerusalem-based freelance journalist reporting on Palestine and the Israeli occupation. You can follow her on Twitter at @jess_buxbaum.

Murtadha Al-Sudani/Anadolu Agency
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3 Years Since 2019 Iraq Protests, Most Demands Remain Unfulfilled

Peoples Dispatch October 31, 2022 Peoples Dispatch Admin, Archives, West Asia
Murtadha Al-Sudani/Anadolu Agency
Credit: Murtadha Al-Sudani/Anadolu Agency

Editor’s Note: This article originally appeared in Peoples Dispatch.

This October marks the third anniversary of the 2019 popular protests in Iraq. On Tuesday, October 25, a large number of people gathered in the Tahrir square in capital Baghdad and paid homage to the people who were killed in the protests. They raised slogans in support of what has been termed by the protesters as the Tishreen movement.

The countrywide protests in 2019, rooted in the long-term grievances of people against successive governments, went on for months. Before the global COVID-19 outbreak forced them to end, the protests were successful in forcing the then government led by Adil Abdul Mahdi to resign, putting the ruling classes on the defensive and pressing for reforms.

Caretaker prime minister Mustafa al-Kadhimi, who came to power in May 2020 after months of uncertainty, had promised to deliver on some of the major demands raised by the protesters, including rebuilding the economy and punishing those guilty for the deaths of over 600 people including protesters and others.

Three years down the line and with a new government on the horizon, none of these promises have been met. This is likely to lead the vast majority of pro-reformers pushing for their demands in the coming days.

Economic and Political Aspects of the Protests 

The 2019 protests were one of the largest in Iraq’s history since the 2003 U.S. invasion. Long-term grievances regarding inefficiency of successive administrations and the widely perceived corruption among the ruling establishment were at the center of the public anger. In their slogans, the protesters repeatedly denounced the failure of the system created under the supervision of the US occupation in tackling the issues faced by the people, such as rising poverty, unemployment, and basic services delivery.

At the time of the protests, the official rate of poverty in the country of approximately 40 million people was rising. Even before the pandemic hit in 2020, the poverty rate had risen to above 31 percent. Oil-rich Iraq witnessed an unprecedented rise in poverty during the COVID-19 outbreak. While the government claimed that the poverty rate was coming down after the pandemic, a large number of Iraqis are still forced to live a life as paupers.

Since oil revenues make up the bulk of Iraq’s federal budget–around 96 percent–the economy remains vulnerable to market fluctuation.

Iraqi youth, who make up the majority of the population, were at the center of the 2019 protests. The unemployment rate among the youth–fresh graduates from the university and others–was above 40 percent at the time of the protests.

The majority of Iraqis were forced to live without the basic amenities such as power, sanitation, and health care. Protesters claimed that these failures on the economic front were the result of inefficiency and corruption of the ruling elite. They also pointed to structural reasons such as the system of Muhasasa or sectarian quota based on distribution of political posts for this inefficiency and corruption.

Failure to Address Demands for Structural Changes   

The protests were not limited to Baghdad but spread across all urban centers in the country, particularly in the southern regions. The protesters raised the demands of more jobs, better governance and systemic changes, including ending the sectarian quota system and all kinds of external intervention in Iraqi affairs.

Instead of taking initiatives to address the issues related to structural reforms, the ruling class announced fresh national elections in October 2021, a year before schedule.

Partial changes in the country’s electoral laws and introduction of the first past the poll system to replace the system of proportional representation were sold as fulfilling the demand for reforms in the political structure.

Earlier, amid rising tensions created by the U.S. assassination of Iranian General Qassem Soleimani in January 2020, the outgoing parliament passed a resolution mandating the complete withdrawal of all foreign forces from the country.

However, none of these addressed, even partially, the demands raised by the protesters. The U.S. troops were forced to end their operational presence but, in complete violation of the parliament’s resolution and popular demand, they still remain in the country.

The national elections of October 2021 saw a historically low participation rate with just about 40 percent of the electorate exercising their right to vote amid a call for boycott. This resulted in a situation where no political coalition or group was in a position to claim majority and form a new government for almost a year after the elections.

Mohammad Shia al-Sudani was finally approved as prime minister this week. He was designated to the post by Abdul Latif Rashid who was newly elected as president earlier this month. Al-Sudani’s appointment is expected to end the political uncertainty in the country for now. However, it may not mean an end to the political turmoil despite his promises to deliver on the economic front and tackle corruption. 

A sign of the challenges ahead is the fact that disagreements and disputes over the nature of government as well as al-Sudani’s candidacy led to the killing of dozens of people this year.