My name is Santosh Charan, and I’ve been an ASHA sahyogini (ASHA worker) for the last 14 years. I live in Kapasan, a municipality in Rajasthan’s Chittorgarh district, with my husband and two sons. I have been working on the ground in the village of Hapakhedi since 2004. Having started out as an Anganwadi helper, I became an ASHA sahyogini in 2008. This role involves connecting pregnant women to government healthcare facilities and policies, and assisting them throughout the course of their pregnancy. I also help run vaccination drives for infants and children in the village, along with conducting regular healthcare surveys to better understand and address the community’s health needs.
4 AM: I’m the first to wake up in my house every morning, and then I pray and go to the temple. A few years ago, I moved to Kapasan from the village of Hapakhedi located 2 kilometres away, where I used to live with my in-laws. At Hapakhedi, I would wake up at 4 am every day to feed our cows, clean the stable, and make cow-dung cakes to use as cooking fuel and fertiliser. I learned to do this after I married my husband in 1998. Even now, while I no longer have cows to tend to in Kapasan, I continue to wake up at 4 am. When I first started working at an Anganwadi, my in-laws were worried that I would no longer be able to attend to these responsibilities, which led to frequent arguments. They were concerned about who would take care of the cattle and look after the household if I started working outside the home. Despite their disapproval, I started working at an Anganwadi centre in Hapakhedi village in 2004.
Back then, I used to drop my sons at the Anganwadi centre every morning. My friend’s father-in-law worked at the centre; we would speak frequently and I learned more about the Anganwadi system. I would sometimes help him with chores. He was the one who asked me to apply for the role of a helper. My husband supported my decision, but my in-laws soon stopped speaking to me. They were not happy about a woman from their household going out in the village and talking to strangers. Eventually, these issues led me to move to Kapasan with my husband and two children.
I was determined to work because I wanted to send my children to a private school. I used to cook meals at the Anganwadi for INR 500 and would get paid another INR 500 in my role as a helper. With this money, the first thing I did was enrol one of my children in a private school. But I couldn’t afford to enrol my second son. I pleaded with the headmaster, and he finally agreed to let him study for free if I could get five more students to enrol. I convinced several parents in the village and got eight children enrolled. Both my sons are now college-educated.
By the time I come back home from the temple in the morning, my husband is awake. I make breakfast for him, and then leave for the bus stop to go to Hapakhedi.
7 AM: The bus drops me at a little distance from the main village. Sometimes I take a rickshaw to the village, and other times I walk. On these walks, I frequently encounter women from the surrounding villages going to their agricultural fields, and we chat about our lives. I often ask them if they are facing any health-related issues and make a note of them.
As an ASHA sahyogini, I help people—particularly women—avail of various healthcare services. Today, I’m helping people file for Ayushman cards, which allows them access to free healthcare in Rajasthan.
Deliveries are completely free of cost at government centres. However, a few years ago we had a doctor who would charge the families.
I accompany pregnant women to the healthcare centre for their deliveries. Deliveries are completely free of cost at government centres in Rajasthan. However, a few years ago we had a doctor in the area who would charge the families INR 500 for each delivery. All the ASHA workers reluctantly paid him since we didn’t want any complications in the deliveries. The doctor also used to approve the INR 1,400 that the mother would receive under the Janani Suraksha Yojana scheme, and would at times refuse to sign this if we didn’t give him the money. This went on for a long time.
Once, I brought in a woman whose family could not afford to pay more than INR 300 to the doctor. When I took that money to the doctor in his private quarters, he refused to accept anything less than INR 500. I went back to the family asking them for INR 200 more, and the husband said he’d have to go back home to sell some grain for the money. After hearing this, I decided to plead with the doctor to accept a payment of INR 300. When I went back to his quarters with this request, he was furious and held my collar and pushed me. I was enraged. I grabbed his shirt and pulled him out of the room. I then called Navachar, a Kapasan-based nonprofit I have been associated with since 2008, and soon a lot of people, including the subdivisional magistrate, had gathered. The news about the incident reached Jaipur and the state decided to launch an inquiry into the matter. I was called to Jaipur to speak in front of the legislative assembly. I had never experienced something like that before; I could only see myself on all of the screens. All the other ASHA workers also came forward to talk about their experience with corruption in the healthcare sector, which led to an investigation. The doctor has now retired and his pension has been withheld.
12 PM: After wrapping up my work around the village, I spend some time doing paperwork. As the Ayushman cards roll out across Rajasthan, the paperwork for ASHA workers has increased a lot. The process of collecting and uploading all the relevant documents for each individual in a household is long and tedious. We have to be very careful since any errors or delays could prevent people from accessing free healthcare. My older son has been helping me with the forms, especially since I can’t read English, which is the language used on the upload portal.
2 PM: After spending the morning doing fieldwork, I return home in the afternoon for lunch. Most days, I go back within an hour to attend to more tasks or any emergencies that may arise. Today, I will head back to Hapakhedi to finish filing the rest of the Ayushman cards. I expect that I’ll only come back home by 10 pm. Although our official working hours are from 8 am to 11 am, most ASHA sahyoginis end up working throughout the day. Sometimes, we also receive calls at night to take a woman to the hospital.
It was in 2008 that I became an ASHA sahyogini after working for four years at the Anganwadi centre. I frequently raised concerns about the working conditions of fieldworkers, and in 2009 I was appointed as an adhyaksh (secretary) of the ASHA sahyogini union. The union organises two meetings a year where we discuss the challenges that we face. These are often related to delays in payments. A while ago, we protested for our pay to be increased. At that time, we were earning INR 1,600 a month, excluding the bonuses for connecting people with various healthcare services. We went to Jaipur to protest, and the administration informed us that they would increase our pay in the next budget. However, they only increased it by INR 200.
To organise these protests more effectively, we have an online group chat with ASHA sahyoginis from each panchayat of the blocks of Kapasan and Rasni. Any updates about meetings, grievances, or protests are posted in this group, and the ASHA sahyoginis selected at the panchayat level then inform all the others in a village.
Currently, the union is trying to resolve another payment-related issue. Since much of our work—such as form submissions for Ayushman cards—takes place online, we are entitled to an allowance of INR 600 to recharge our mobile phones. However, we have not received this money since March.
This is not the only instance where I have protested against something that’s not right.
My phone is never on silent mode, even when I’m home, so that I don’t miss any deliveries or emergency calls.
My husband used to be an alcoholic; he quit six years ago. After drinking, he would often beat me. One time, for a couple of days, he didn’t eat or drink anything except alcohol and became very violent. I decided I had to find a solution to this. I learned that a government official was visiting the village in a few days and thought that this would be a good opportunity to raise my voice. I went around the village speaking to all the women who were suffering a similar fate. We held a meeting and decided to sign a petition to bring this matter to the official’s notice. When the official arrived, I waited for my turn to speak amid a crowd of people who were also eager to raise their complaints. But soon it was 10 pm and the official was about to leave. I snatched the mic, and began tearing up as I narrated my ordeal as well as that of the other women in the village. The women started crying as well.
The official was determined to take immediate action. Upon learning that liquor stores in the village were open past legally permissible hours, she decided to seize their license. All liquor stores in the village were soon shut down. While this meant my husband couldn’t buy liquor, it created another challenge for me. The men of the village, who frequently drank, were outraged. My family was concerned for my safety, since at this point I was an ASHA sahyogini and would frequently venture out into the village at night to deal with emergencies. One of the people who owned a liquor store came to my house and told me that I’m a pest that belongs in a sewage drain. I responded to this by saying that when a pest infects wood, it is ruined completely. They never got their liquor license back and I continued my work as usual.
10 PM: On some days, like today, I arrive as late as 10 pm. Despite being exhausted, I have to cook dinner for my family that has been awaiting my return. It takes me 30–45 minutes to cook food for everyone, after which I go to bed.
My phone is never on silent mode, even when I’m home, so that I don’t miss any deliveries or emergency calls. In my free time, I enjoy listening to bhajans, dancing, and singing.
A few years ago, at a meeting organised by Navachar, I was told that the oppressed also bear the responsibility of taking steps to address their own oppression. This was back when my husband was still drinking and I was living with my in-laws. In another one of these meetings, I was told that women have as much of a right to work as men do. Both these instances left an impact on me and I was determined to change my life and also of others around me. Fourteen years later, I am doing much better and my family is happy. Sometimes people in the village still talk poorly of me, but I don’t mind it any more—it took a very long time for me to become ‘me’ and I’m proud of who I am. One day, I want to be a sarpanch and help the village and the women in a bigger, better way.
As told to IDR.
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