Protection and Protest by "Voluntary" Community Health Workers: COVID-19 Authoritarianism in India

Abstract

During the COVID-19 crisis, the Indian state assigned an outstanding role in the containment of the pandemic to ASHAs, "voluntary" community healthcare workers. Local women were recruited as "honorary" workers receiving only a small honorarium or piece rate "incentives." The feminisation, casualisation, and informalisation of work in state-funded social welfare schemes are examples of care extractivism. ASHAs had to spearhead awareness-raising, identify infections, and organise vaccinations in rural areas, often without proper protective equipment and always without fair payment. Despite such care extractivism, these caregivers were celebrated by the middle classes as frontline fighters of the nation amidst a masculinist discourse of "war," "warriors," "heroes," and "sacrifice." Yet, at the height of the crisis in 2020 when thousands of ASHAs contracted COVID-19, they went on strike. Having gained confidence in earlier struggles, they complained about extreme exhaustion, increased vulnerability, and the depletion of caring capacities. Their efforts reflect a feminisation of labour struggles that focuses on care work with an emphasis on both the care-recognition-gap and the care-pay-gap.