India, home to 1.3 billion, is aiming to inoculate about 300 million people by July.
Jyoti Bhambure is usually the one dispensing medicine – this week she was at the receiving end, among the first in India’s million-strong force of women health workers to win a COVID-19 vaccine.
Dressed in a bright green sari with a gold border, Bhambure visited the small, rural hospital in western India at the time allotted and said the jab had lifted a weight off her shoulders.
“I no longer fear the coronavirus,” said Bhambure, after getting her initial dose on Tuesday, one of the first tranche of front line workers to win protection in the pandemic.
“We handle children and interact with mothers,” she said. “So I am glad I am vaccinated. I have no fear left in my mind.”
India has suffered 152,000 deaths due to the virus and has prioritised about 30 million front-line workers in the first phase of an inoculation drive that began on January 16.
More than 800,000 people have been vaccinated so far, according to government data.
For health workers like Bhambure, a place on the priority list felt like a long-overdue validation for all the women who work as Accredited Social Health Activists – or ASHA for short.
“I was the first to get vaccinated in my village. It felt good. They recognised the work we have done,” she told the Thomson Reuters Foundation by phone from Khed village in western Maharashtra state.
“The recognition came late – but it came finally.”
In the last, long year, ASHA workers – a million women all in uniform pink saris – have worked frantically on the rural front line to rein in an ever-worsening pandemic as millions of migrants headed home after urban jobs vanished in lockdown.
Multi-tasking does not begin to describe their work.
From offering advice on COVID-19 to recording all village arrivals, the women were simultaneously tasked with quarantining newcomers while keeping up with their traditional duties of caring for newborns and the mothers, too.
ASHA workers saw their work hours and duties stretch ever further and fought even to be recognised as government employees eligible for benefits, rather than just volunteers.
For if ASHA workers did not step up, it was not clear who else could, as the 15-year-old force is sole health provider in many villages where healthcare facilities are distant or non-existent, with 1,000 to 1,500 people in each worker’s care.
Eighteen ASHA workers have died on COVID duty, the government told the parliament last year.
The women take all precautions – masks, sanitiser, some even wear protective equipment – but the fear of infection remains.
“I have taken care of 34 coronavirus patients in my village and am still on the job. I do wear a mask but getting vaccinated was important,” said Sharda Sachin Patarne, an ASHA worker in Khed village in Pune district, who also got a shot on Tuesday.
ASHA was born in 2005 to improve the health of vast swathes of rural India cut off from doctors, clinics and hospitals.
Be it heading up village maternal care or running area-wide vaccination drives, ASHA workers are a linchpin yet say they are treated like volunteers, not even entitled to the minimum wage.
Paid about 4,000 Indian rupees ($54.83) a month – half of the average minimum monthly wage – the women also get payouts of 50 to 500 rupees linked to specific duties they perform.
Last year, they went on strike for better pay, protective equipment and job recognition. They were offered a wage hike for their COVID-19 duties, but many complained of irregular payouts.
So when government rolled out its plans to safeguard the health front line – doctors, nurses, hospital cooks and cleaners – extending that cover to ASHA workers was only logical.
It sent a “good signal”, said Sejaj Dand, founder of women’s rights non-profit organisation, Anandi, saying the front line would after all not be secure if ASHA were left out.
Next stop, she said, is giving the million women an advocate in government and fair terms to reflect their front-line role.
“This should lead to creating a cadre for them in government services and ensuring all their social security rights are covered,” Dand said.
“It is only fitting their employment is regularised now.”