Jaipur: The frail
and seemingly calm Udasi Sahu manages to conceal the excitement of
her first plane journey. But the 42-year-old health worker can't
conceal the thrill of her job - trying to change the face of
maternal health in conflict-torn districts of Odisha.
Spanning a journey across the boondocks of north Odisha's
landlocked Keonjhar district, Sahu's 16 years of unflinching
passion to work for womenfolk in the Maoist heartland has landed
her the national award as one of the best auxiliary nurse midwives
(ANMs) in India.
"I always wanted to do this...Almost two decades ago, right after
my marriage, I told my husband about my wish to work for village
women who were not aware and never cared to think of their own
health," Sahu, a Class 9 dropout, said in Odiya as her colleague
translated it into English.
She travelled by an airplane for the first time to receive this
award. A well-known face in the district, not even once has she
thought of leaving her job or village due to harsh circumstances,
thanks to her husband's support.
Udasi conducts 50 to 60 deliveries a month while she maintains the
track record of zero maternal mortality rate in Childa subcentre
over the last five years.
"The villages we work in have been facing constant conflict. There
have been several indirect attacks from time to time around the
sub-centre where our staff gets injured, but that does not mean we
will leave women and children unattended," Sahu says.
In the rural healthcare system, an ANM is the key field level
functionary who interacts directly with the community and has been
the central focus of all the reproductive child health programmes.
The ANM mans the sub-centre - the first contact point between the
primary health care system and the community.
Sahu was awarded here at a two-day national consultation on safe
motherhood April 11-12. The nominations received from 10
high-focus states were judged by a team led by the ministry of
health and family welfare in collaboration with White Ribbon
Alliance and other experts on board.
"Udasi has professionally handled many emergency and complicated
cases on life-saving childbirths," Aparajita Gogoi, national
coordinator, White Ribbon Alliance India, told IANS.
A mother of two, Sahu has seen it all - being a birth attendant in
villages amid confrontation between Maoists and security forces,
helping women make an informed choice on family planning,
immunisation of babies, nutrition programmes or running a health
subcentre all by herself.
In forest fringe villages where institutional delivery was a
distant dream, Sahu managed to take hospital care to the doorstep,
even if she was called at midnight by any family.
Considered to be the pulse of the government's National Rural
Health Mission (NRHM), around 800,000 Accredited Social Health
Activists (ASHAs) and ANMs form the ground force of delivering
health services in rural parts of the country.
With nearly 150,000 sub-centres across India, the number of ANMs
at sub-centres and primary health centres increased from 130,000
in 2005 to 190,000 in 2009.
Inspite of the increase, the National Family Health Survey (2006)
puts the picture clear on lack of skilled birth attendance: only
52 percent of women receive three antenatal contacts and 42
percent receive any postnatal care. There are districts with just
one ANM per 500 population.
Unlike the ASHAs who receive a performance-based incentive, the
ANMs are given a monthly pay. However, there are times when these
health workers do not get salaries for months together, Sahu
"My children are studying, so we sometimes take loans to run the
family. Being an ANM or ASHA doesn't come easy because there is a
lot of running around and little pay," she said.
Her colleague Jaykumari Dila, a 29-year old ASHA from the same
district, took the job because the family was under heavy debt.
Dila, whose monthly earning ranges from Rs.400 to Rs.1,000,
received the national award for one of the best ASHAs among the 10
high focus states.
"I know there is no money, but our job calls us 'actvists'," Dila,
clad in her deep blue ASHA uniform, told IANS.
Sahu has even motivated her 22-year-old daughter to become an ANM.
She is all set to fly back to her state where she is popularly
known as "Udasi dai" and is seen carrying a cotton sling with
medical kit over her shoulder.
(Madhulika Sonkar can be contacted at firstname.lastname@example.org)