(This article has been republished in light of the protests by ASHA workers escalating in Kerala. It was first published on 5 March.)
Thousands of ASHA workers in Kerala have taken to the streets, demanding minimum wages, recognition as workers, dignity, and retirement benefits. They are facing off with the very forces that claim to champion labour rights—the Centre of Indian Trade Unions (CITU) and representatives of the Left government. The latter have left no stone unturned to dismiss and ridicule the workers' fight.
This betrayal exposes the hypocrisy of those who built their political legitimacy on working-class solidarity but now turn their backs on some of the most underpaid and overworked women in the state.
After 18 days of relentless protest, the state government released the unpaid honorarium and incentives but continues to blatantly ignore the other critical demands made by the workers. Adding insult to injury, Veena George, a journalist-turned-Communist Party of India (Marxist) [CPI(M)] MLA and Kerala Health Minister, has conveniently shifted the blame to the central government.
In an attempt to deflect responsibility, George declared that she stands "with the ASHA workers to fight against the Centre in Delhi", even as her own government fails to address the workers' rightful demands.
Why ASHA Workers are Protesting in Kerala
ASHA workers had been protesting in front of the Kerala Secretariat in the capital city, demanding the immediate disbursal of their unpaid honorarium for the past three months. Their key demands included receiving their honorarium by the 5th of every month, a minimum monthly wage of Rs 21,000, an end-of-service benefit of Rs 5,00,000, and access to a pension scheme.
Currently, ASHA workers are promised a little over Rs 13,000, which includes contributions from both the state government and central government incentives. However, due to multiple eligibility conditions, the majority receive only Rs 6,000 to Rs 7,000 per month—that too, with delays. This effectively means their daily wage is just around Rs 230.
According to data collected by the leading Malayalam daily Malayalam Manorama:
Only 963 ASHA workers out of the total 6,000 in Kerala received Rs 13,000 in January
Around 21,000 workers received between Rs 10,000 and Rs 13,000
1,673 workers got only Rs 7,000 to Rs 9,000
75 ASHA workers received less than Rs 7,000
The variation in incentives is a major issue. A simple example illustrates this: if a pregnant woman is admitted to a private hospital instead of a government hospital, the ASHA worker loses the incentive associated with that case.
Such conditions significantly impact their earnings, making their income highly unpredictable and inadequate.
In contrast, even an internal migrant worker in Kerala earns between Rs 800 and Rs 1,000 per day. As per the October 2023 minimum wage notification, workers in various categories in Kerala are entitled to wages ranging from Rs 500 to Rs 1,025 per day—highlighting the stark injustice faced by ASHA workers.
Although the government cleared the unpaid honorarium and incentives after realising that the protest was gaining support from the public, social activists, and the media, ASHA workers and their leaders faced ridicule from the CITU in various ways.
Discrediting ASHA Workers
CITU national leader and Keralite Elamaram Kareem, a former legislator and parliamentarian, claimed that the ASHA workers protesting in front of the Kerala Secretariat were being misled.
He asserted that only a few were actually participating in the protest, led by some tiny organisations. He alleged the involvement of 'anarchist' forces and dismissed the protest leaders as “paatta kulukki” (tin-can fund collectors). He also suggested that the protesters were emboldened by media support.
The remark drew criticism from different sections, as he, along with CITU and the Left parties in Kerala, has long been associated with the system of “bucket pirivu” (fundraising through bucket collections).
Responding to Elamaram’s mockery, Mini S, an SUCI leader at the forefront of the ASHA workers' protest, wondered since when he and the Left began measuring the strength of a workers’ protest by counting heads.
Elamaram didn’t stop there. He also wrote a detailed editorial in Deshabhimani, the Malayalam mouthpiece of the CPI(M), titled "Protest Drama." In the article, he ridiculed the protest, claiming it was led by only a handful of workers who were being misled. He further argued that ASHA workers could not be considered workers since the central government does not recognise them as such, making them ineligible for minimum wages.
In essence, he dismissed the protest of the very workers who form the backbone of Kerala’s healthcare system.
There are a little over 26,000 ASHA workers in Kerala and they perform around 35 essential tasks, including caring for pregnant women and newborns and raising awareness about contagious diseases.
During the COVID-19 outbreak, they worked tirelessly to contain the spread and minimise casualties.
Amid the protest, when ASHA workers attempted to meet Health Minister George at her official residence, they were reportedly turned away. Later, when they were finally granted a meeting at her office, they went in with high hopes but left disappointed as the discussion yielded no positive outcome. This only strengthened their resolve to intensify the agitation.
Meanwhile, CITU launched a parallel ASHA workers' protest, staging a demonstration with its own members.
The CITU-led ASHA Workers Federation staged a protest, arguing that it is the central government—not the state—that must resolve the issues.
"The state government has already agreed to increase the honorarium. However, it is facing a hurdle as the Centre has yet to release the Rs 484 crore owed to Kerala. Given this situation, ASHA workers should be protesting in front of central government institutions, not the State Secretariat," said the Workers Federation's General Secretary PP Prema.
Prema also issued a veiled threat, warning that those protesting at the Kerala Secretariat should stop, or they risk losing their jobs.
Interestingly, a response obtained by Kerala MP NK Premachandran from the Ministry of Health and Family Welfare on 5 February revealed that the central government had already released Rs 815.73 crore out of the allocated Rs 913.24 crore for the 2024-25 financial year under the National Health Mission, which also funds ASHA workers.
This directly contradicts the claims made by CITU leaders and their supporters, exposing their narrative as misleading.
Meanwhile, on Friday, another CITU leader labelled Mini S as a "worm, spreading contagious diseases." However, CPI(M) State Secretary acknowledged the remark, stating that derogatory language should not be used for criticism.
Why Left is Torpedoing a Workers' Movement
While CITU attempted to sabotage the protest, the Left-led state government also deployed the police to suppress it. Using state machinery, the police systematically filed FIRs against protesters, accusing them of disrupting traffic and unlawful assembly.
Responding to questions about the future of the protest, SUCI leader Bindu MA at the forefront of the movement stated that they would continue until their demands—including minimum wages, official recognition as workers, pensions, and end-of-service benefits—are met.
A bill to recognise ASHA workers has been tabled in Parliament and is awaiting approval. If passed, it will grant ASHA workers official worker status, ensuring minimum wages and other benefits.
The ASHA programme was launched in 2005 as part of the National Rural Health Mission (NRHM) (now known as the National Health Mission or NHM). The initiative was introduced by the health ministry, to provide essential healthcare services at the grassroots level, especially in rural areas where access to medical facilities is limited.
Ironically, the Left parties and trade unions in Kerala are ignoring a crucial historical lesson. Chairman Mao Zedong, the ideological beacon of communists worldwide, mobilised an army of Barefoot Doctors—trained rural health workers—to empower peasants and support his Great Leap Forward. These workers played a vital role in combating the Big Belly Disease that plagued rural China.
If we look closely, today’s ASHA workers in India perform the same responsibilities as Mao’s Barefoot Doctors, providing essential healthcare to marginalised communities. Yet, the same Left forces that idolise Mao and his revolution fail to recognise the significance of ASHA workers and their struggle for dignity, fair wages, and recognition.
Even Che Guevara, the Cuban revolutionary and minister, sought to replicate Mao’s model in Cuba, recognising the power of community health workers in transforming societies.
Yet, despite their admiration for both Mao and Che, Kerala’s communists are undermining the struggle of ASHA workers, conveniently ignoring the very revolutionary principles they claim to uphold.
But why is the Left torpedoing the ASHA workers’ strike? The answer lies in politics, not principles.
First, the Left sees the ASHA workers' protest as an attack on the government’s image, a threat to its carefully crafted narrative.
Second, the Left believes that workers' movements should remain under its control—only they have the authority to lead agitations, and any independent uprising is a challenge to their dominance.
(Rejimon Kuttappan in a workers’ rights researcher, forced labour investigator and author of Undocumented-Penguin 2021. This is an opinion piece. All views expressed are the author’s own. The Quint neither endorses nor is responsible for them.) )