How Covid-19 Impacted Pregnant Women And ASHA Workers In Uttarakhand

Whether it's accessing health services or travelling during the lockdown, pregnant women have undergone immense difficulty to get what they are entitled to.

In April 2021, during the second wave of Covid-19, a curfew was imposed in the state of Uttarakhand, just a month before Laxmi Devi, 26, delivered her first child. Laxmi, a resident of Pipaleth village in Narendra Nagar block in Tehri Garhwal district of Uttarakhand, was one among several new mothers in this hilly region, for whom availing maternity services had become quite a task during the pandemic.

Difficulties faced by pregnant women during the lockdown

Laxmi could not undergo her fourth prenatal test as the nearest health sub-centre in Jajal, which was about 2 km away from her village, had been converted into a Covid-19 centre.

These sub-centres are health checkpoints located at the village level, comprising of approximately 15 villages and serve as the primary place for maternal care, pre and post-natal check-ups for mothers and immunisation of infants.

Laxmi’s struggle did not end there. “For the delivery, I had to get admitted to the Primary Health Centre (PHC) in Fakot, 15 km from my village. We had to book a cab as the ambulance service was unavailable during that time. Within a few hours of delivering a child, I was discharged. Usually, after the delivery, the mother is supposed to be in the hospital for a day or two, but due to Covid-19, I was discharged quite early. It did affect my health as I had not fully recovered. I needed more rest,” Laxmi expressed.

Reflecting on the present scenario, Laxmi believes that accessing healthcare during pregnancy has become much easier and better after the lockdown. Now that the sub-centre is no longer a Covid-19 centre, she takes her 11-month-old daughter for routine immunisations there.

Similar was the situation in Than village, which is 12 km from Pipaleth. In April 2020, Seema Rawat, 23, delivered her first child at PHC, Fakot, which is nearly one hour away from Than.

Just like Laxmi’s, her family also had to book a private car as ambulance services were not available. While on the way to the PHC, they were fined by the traffic police.

“When we left our house for the delivery, I was uncomfortable and scared. On our way, the police stopped and challaned us for having an extra passenger in the vehicle. As per the Covid-19 protocol, only two passengers were allowed in a car. How was I supposed to go for such a crucial task with just one person? I would have needed people in case of an emergency,” Seema expressed.

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Accredited Social Health Activists to the rescue

Whether it’s accessing health services or travelling during the lockdown, these women have undergone immense difficulty to get what they are entitled to. However, to assist and support the pregnant women in rural areas, the Accredited Social Health Activists (ASHA), were always on their toes despite having additional duties related to Covid-19. They attended the pregnant women, visited the quarantine centres and performed other Covid-19 work. At times, they had to be quarantined too after visiting these quarantine centres.

“Once I had to visit a person who was in a quarantine centre. Later, when he tested positive, I had to quarantine for 15 days. During this time, I could not undertake any tasks,” shared Rumna, 39, an ASHA worker from Tipli in Narendra Nagar.

Rumna has been working as an ASHA worker since 2011. In the eleven years of her service, she had never encountered a situation like Covid-19. “Even though we had to work overtime, we did it because it was our responsibility. We tried our best to continue supporting pregnancy cases as much as we could. There were times when we had to visit multiple quarantine centres during the day and at night, accompany the family of a pregnant woman to the hospital,” said Rumna.

As informed by her, when the sub-centre in Jajal was converted into Covid-19 facility, she took the pregnant women in the village for check-ups to the PHC in Fakot, which is 25 km from Tipli. “I would arrange a car and take all of them,” she said.

Further, she also stressed how difficult it was for her to get doctors at the PHC for delivery during the lockdown. “It was in May 2021, when I took a pregnant woman for delivery to the PHC in Fakot. As there were no doctors available, the nurse referred us to Sri Dev Suman Base Hospital, a government hospital in Narendra Nagar. Even there, the hospital authorities refused to take the case forcing us to take the patient to a private hospital in Rishikesh, which is about 21 km from Narendra Nagar. I stayed in the hospital for three days with the family as there was no vehicle available due to the lockdown,” narrated Rumna.

Despite several hurdles, ASHA workers across the country continued to support the communities. However, Covid-19 did bring to light the flaws in our health care system that had put the entire onus of Covid-19 interventions on ASHA workers.

The writer is a development worker based in Delhi. Share your feedback on [email protected]

Published here first.

Image source: YouTube

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