Being an Indian, it is shameful and poignant to say that Indians do not get free access to healthcare even today. Even in the twenty-first century, healthcare in India has been largely in favor of the privileged; the marginalized and disenfranchised gender and caste identities in India are discriminated against in the healthcare sectors to a large extent.
How many times have we seen that poor Dalits have been denied proper medicines and medical attention in the villages and even in the so-called egalitarian metropolitan cities of India? Movies like “Article 15” do give us a blurred picture of what happens in the lives of untouchables but there is more than what meets the eye.
It is indeed true that Indians are known for their superstitions that stinks of the casteism they bear with them everywhere they go. Certainly, even the primary healthcare sectors that are customary necessities in a human’s life, are also littered by caste discriminations in many parts of India. Dalit patients are given the poorest medical facilities, while the non- Dalits and upper castes are given more consultations and better medicines (George 2015).
Social health activists were the group of people designated by the Manmohan Singh government who acted as community health workers with a mission to eradicate discrimination in the healthcare sector and see to it that all Indians receive the necessary healthcare they deserve (Dasgupta and Qadeer 2005). Even though the Accredited Social health activists were able to fight corruption, improve immunization, and enhanced maternity care in many parts of India, yet there are miles to go for an all-over development of healthcare sectors in India.
In Uttar Pradesh, untouchability is practiced in such an intense way that many community health workers are often denied or discriminated against in giving healthcare facilities to pregnant Dalit women leading the mothers to give birth to children without the presence of expert health workers/ midwives. Such actions are dangerous for the mother as well as the child, especially in case of complexities in labor.
Rape cases in rural areas of India are seldom reported. Moreover, when Dalit women are raped, such incidents are not reported at all. Rape victims belonging to the “untouchable” category are denied medical attention and justice. Community health workers sometimes find themselves in a difficult position amidst the regressive and inhuman subcultures of untouchability and misogyny. Often the community health workers who show dissent attitude towards the injustice fall prey to the ogling eyes of the treacherous political leaders who are often the support behind such injustice.
It would be disgraceful to know that Dalit women and children (especially the girl child) have a low nutritional status due to their low social and economic status in the households. The Lady Health volunteers and community health workers are, however, paying fewer visits to the households of malnutrition children and impoverished pregnant mothers, broadly belonging to the Scheduled Castes categories (Downtoearth.org.in.2015).
Such inhuman discriminatory practices in healthcare sectors by the community healthcare workers are disturbing. The discrimination is mainly done by the front-line staff of the community health workers who generally belong to the general categories and tend to be prejudiced with casteist mentality. The most important outcome of the various researches that have been done is that the community health workers themselves are not freed from casteist prejudices and mentality.
Why is then the accredited social health workers and activists do not give the desired results to the government? What can be the reasons for such unprofessionalism? The reasons are way too complicated and perturbing. Social health workers often face dangers in their workplace. Every Indian has gone through the poignant news of a Mumbai-based nurse Aruna Shaunbag’s treacherous rape and assaults in the hospital itself where she worked that left her completely in a vegetative state till she attained the age of 66 and took the reward of death, euthanasia. It indicates that social health workers are not safe in their work areas.
Many community health workers struggle to meet their ends because they are denied their deserved salaries (Timesofindia.com.2015). Many are overworked and underpaid. If the government sees to it that the ASHA (Accredited Social Health Workers) workers are given a proper salary, working conditions, and respect in the society, we might see improvements in rural healthcare sectors. The ASHA workers are the rays of hope for a country like India that is often plagued by health crises. It is high time that the nation recognizes the healthcare needs of the country and shapes the health sector in a flexible way for a better future.
Dasgupta, R. and Qadeer, I., 2005. The national rural health mission (NRHM): a critical overview. Indian J Public Health, 49(3), pp.138-40.
Downtoearth.org.in.(2015). Available at: https://www.downtoearth.org.in/blog/dalits-and-nutrition-where-is-the-catch-up-45263
George, S., 2015. Caste and Care: Is Indian Healthcare Delivery System Favourable for Dalits?. Institute for Social and Economic Change.
Hrw.org.(2007). Available at: https://www.hrw.org/report/2007/02/12/hidden-apartheid/caste-discrimination-against-indias-untouchables
Timesofindia.com.(2015). Available at: https://timesofindia.indiatimes.com/city/vijayawada/Vijayawada-Municipal-Corporations-Asha-workers-losing-hope/articleshow/47610545.cms