Rahul Chakradhari is a pharmacist and permanent employee in the primary health center (PHC) in Rasel, a village in the Gariaband district in Chhattisgarh near the Odisha border. However, the current circumstances forced him to exceed the extent of his duties. Is not just a medication; In some cases, it also prescribes them.
Chakradhari says he is forced to do so due to the crisis of employees caused by a nationwide strike of more than 14,000 contractual national health missions (NHM). One of the three healthcare professionals – from doctors and nurses to pathologists and assistant nurses of midwives – do not apply for service. The strike over 10 requirements, including a key permanent job, better wages and good working conditions, entered into their 24th day, affecting medical facilities at all levels, from district hospitals to arrogya Mandirs (Health and Wellness Center).
In Rasela PHC, a registered medical assistant-two in the hierarchy after a medical officer or a doctor-and the only nurse, both NHM contractual staff, strike. PHC serves 20,000-30,000 people according to NHM and is considered the first contact point between the village community and the doctor. The doctor in Rasela PHC was pulled out to serve in the community health center elsewhere due to lack of healthcare workers.
Also read: More than 14,000 NHM contractual employees ended up as government bags of 25 agitators in Chhattisgarh
“It is a season when Spike viral fever cases come to the hospital anywhere between 60 and 70 patients. I am forced to participate in consultation with Dr. Rahul Netam over the phone sometimes.
Each health center has similar stories: stopped immunization, non -running programs, influenced by routine controls, impacts on reporting non -transferable diseases and funds on specific projects that are insufficiently used.
Demonstrators quoted 10 requirements, including permanent employment rather than employment based on contractual establishment, 27% increase in salaries and establishment of public health cadre. The Chhattisgarh government claims to meet five requirements, including a salary trip, but only 5%. NHM staff claims to be stretched in different ways, including work in difficult to reach places and does not have regular government employees of security networks.
NHM workers have been in the protest at the 18th August at the relevant district headquarters. “Samvida Matlab Shoshan (a contract means exploiting),” says the speaker at the protest of Tuta in Raipur as an enthusiastic bunch of protesters there to respond with the singing “Ladenge, Jeetege (we will fight, win)”. Through songs and acts like Jal Satyagrah, refuses to drink water, show their anxiety. In some districts, they also protest outside the Bharatiya Janata office, the party in power on Wednesday and the state.
Requirements and offers
“NHM (formerly a national rural health mission) began in 2005 under the Mission for the Reproductive and Health of the Child with 2,000 Employees. Gradually, its scope has spread to health care and roles and individual duties only increased.
Since then, it has been part of groups requiring permanent employment for contractual employees who include medical and non -medical support staff across 100 categories. The hiring occurs at the level of state and districts.
Also read: NHM Enhanced Workforce has limited some public health concerns: Cabinet Center Report
There are currently 16,000 NHM workers, most of whom district programs (coordinators) managers, some of the new Joinees and those who have motherhood or other long -term holidays, say. According to a higher government official, 60% of the funds on NHM come from the center, while the state finds the remaining 40%. Administrative control remains in the state, says the clerk.
Sinha says that immediate juice for protest came from a political commitment. “BJP promised in its manifesto that the committee would be created to regulate all contractual employees. We protested during the previous government of Congress with similar requirements and then, BJP leaders, including cabinet ministers, supported this matter,” he says. BJP created the State Government in 2023. He adds that before the start of the strike, the Association submitted to the Government of 160 Memorandums.
Demonstrators outside the BJP district office in Gariaband. Several healthcare workers said that the ruling BJP, which created a government in the state in 2023, promised to carry its work during the election campaign. | Photo Credit: SHUBHMOY SIKDAR
The effect of protest spilling is also visible. Dr. Kirtan Sahu, a block medical officer in Chhura CHC, who is an employee, says the program protested seriously because all 36 community health officers protest. At the Raipur District Hospital in the Pandri area, the nurse of the employees says she was burdened and has to do much more night shifts than they would usually do.
Amrit Bhonsle, District Chairman of the Gariyaband district in NHM Workers ‘Union’, quotes the case of a security guard who is injected on to the patient in the district hospital – the incident that the state court realizes that it is a serious violation of “medical ethics and professional standards”.
Leaders like Sinha say that other states such as manipur have absorbed NHM workers as regular. In Madhya Pradesh, they are not permanent employees, but still receive a pay, reward, jobs for compassionate reasons and have a job of employment up to the age of 62. However, a government official points out that in the case of a deputy, politics was set for all contractual workers.
People suffer
Many arrogya mandirs are locked via CariaBand and Chhattisgarh’s Capital Raipur. Some medical centers in Raipur carry a sign -off shield that expresses regrets over inconvenience, referring to the strike of contractual employees. Others, such as the Mana on the edge of Raipur, barely a few kilometers from the protest point in Nava Raipur’s tuta, neither patients nor NHM employees are locked in sight.
Some of these areas do not even have a private health care system. The report to the administrator and general auditor and auditor (CAG) submitted in the State Assembly noted last year that, in accordance with the sanctioned force (74 797), there were a total lack of human resources 34% (25 793). She also stated that the CHATTISGARH (GOCG) government did not create any human resources policy for the healthcare sector to ensure the availability of doctors, nurses and healthcare professionals in medical institutions according to Indian public health norms.
Devshree Dhruv, a physiotherapist published in the Chhura Community Center, a unit just above Rasela PHC, is on the strike. She expressed regret that she did not participate in a three -year -old girl suffering from brain palsy, because the child “decent progress contributed with regular visits and proper care”.
It is the same for Anja Sahu, in its 1950s, which recently underwent knee surgery and arrived to Walker to learn only from Dhruvo that he would not give physiotherapy because of the strike. At the previous meeting, an older woman went to Raipur almost 100 km away.
Attempts and tribulation
In centers far from PHCS, the entire population in small villages is dependent on the health services. Sangeeta Bramhhnotiya, a district program manager who works on a contract in the district of Narayanpur in the area of the rebellion of the affected Bastar, says there is another financial burden for the last mile healthcare professionals like herself.
Among the most affected by the strike are pregnant women and families living in distant villages. | Photo Credit: SHUBHMOY SIKDAR
“We have to go to schools and Anganwadi centers in distant areas walking through the jungles, rivers and mountains and staying there. If the road is, it is so rough that our vehicles are stuck, in which case our own clothes are completely dirty and joined to laundry and repair costs,” he says.
Their vehicles are usually two wheels, on which they carry basic items such as medicines, registers and health cards, he adds. “Children suffering from serious illnesses must be brought to larger hospitals, such as children in Raipur (250 km away) or Jagdalpur (120 km away) for better medical treatment, for our own expense, many times,” says Brangnotiya.
“I am a doctor, yet my monthly income of 25,000 GBP is hardly enough to meet the goals. Imagine that I am in health settings and could not afford health care for my own.
Still walking
In September in September, 25 protest leaders, including Sinha, were suspended from work. This encountered a mass resignation, with almost all demonstrators symbolically saying that everyone resigned.
Meanwhile, Secretary of Health Shyam Bihari Jaiswal has claimed that five out of 10 requirements have been accepted and refers to NHM workers to return to work.
Sinha says that while other contractual workers in the state did not receive any salary increments between 2018 and 2022, NHM workers received 5% per year on the basis of their performance review. One of the requirements is to make a transparent evaluation process.
Workers require a written order for a government announcement and intend to continue the protest until all 10 requirements are met. “We have taken a long way and we will not give up because this key point,” Sinha says.
