At the height of the second wave this year, the state government hired thousands of doctors and nurses as Covid Consultants and Covid Health Assistants. Five months later, they still haven't been paid, and confusion reigns about who they report to and what their duties are. 

Hanumangarh: Dhruv Bishnoi has been doing the tough job of a Covid Health Assistant (CHA) in Rasuwala village in Rajasthan for five gruelling months. He was promised a monthly honorarium of Rs 7,900 by the state government. But Bishnoi’s hard-earned money is nowhere in sight. And neither is the end of his duties.

“I requested the in-charge of the Primary Health Centre to pay the honorarium, but he said the payment will be given by the gram panchayat. When I went to the village development officer, he refused to pay, saying no government order had been issued in this regard,” said Bishnoi.

He is not the only one grappling with this problem.

Thousands of youth like him were hired as CHAs in various districts in Rajasthan on the orders of the state government, but no arrangement was made to actually pay them.

Spiralling responsibilities 

In May this year, when Covid cases were surging in the state, the government appointed 1,000 MBBS doctors as Covid Consultants and 25,000 nursing diploma/degree holders as CHAs to speed up door-to-door surveys and drug distribution in the villages and towns of all 33 districts. The objective was to break the chain of infection, provide proper treatment to Covid patients and minimise the mortality rate.

These appointments were first made in Hanumangarh, and 860 candidates were selected as CHAs in the first week of June. Bishnoi was among them and they were asked to start work right away.

Kashish Kachhwa, State Convener of the Rajasthan Nurses Association, said, “Even after five months, the CHAs have not received their honorarium anywhere in the state and neither have the doctors hired as Covid Consultants. Meanwhile, the workload on us is increasing even as we are facing a financial crisis.”

On May 18 this year, Akhil Arora, Principal Secretary at the Medical, Health & Family Welfare Department, ordered the hiring of Covid Consultants and CHAs as volunteers. These people were to be employed only till July 31. In some districts, the hiring was done in a fortnight, while in many others, the process has not been completed even till date.

According to Ravi Chawla, Vice-President of the Rajasthan Nurses Association, the recruitment in Jodhpur, Kota and Dholpur districts has not been completed even after five months.

There is also no clarity on the work profile of the CHAs and Covid Consultants, who have been tasked with various non-Covid duties over the months by the state administration.

Covid Health Assistants demonstrating in front of the District Collectorate of Hanumangarh, demanding the payment of honorariums (Picture sourced by Amarpal Singh Verma) 

Two months after the CHAs were hired In Hanumangarh, their services were extended till October 31 across the entire state. In the meantime, the State Health Assurance Agency issued an order on September 9 to appoint these CHAs as ‘Chiranjeevi Mitra’ for the implementation of the Mukhyamantri Chiranjeevi Swasthya Bima Yojana in private hospitals till March 31, 2022.

Then, on October 16, principal secretary Arora directed that the services of these new hires be employed for door-to-door surveys and for prevention of seasonal diseases like dengue and malaria, including conducting anti-larval activities.

Mahendra Singh Godara, District President of the Rajasthan Nurses Association, said, “The government and its departments are not able to decide what work to extract from them and for how long.”

He alleged that “instead of Covid surveys and drug distribution, tasks such as collection of blood samples, vaccinations, and even night duty at wards is being imposed on us. The Chiranjeevi Mitra job has been foisted on us and the latest orders are related to seasonal diseases!”

Passing the buck

The aggrieved CHAs are now agitating for their pay, holding dharnas and demonstrations across all districts of Rajasthan. 

Many nursing diploma and degree holders were compelled to accept the job despite the paltry honorarium, even as very few doctors came forward to take up the task. In Hanumangarh, 25 MBBS doctors were to be hired for this job, but only three applied, of which only two actually joined. They too have not received their honorarium in five months.

Chawla cited the example of Madhya Pradesh where the state had hired CHAs a year and a half ago. They have been paid Rs 20,000 a month, and the state government has also decided to award 10 per cent bonus marks in government examinations to CHAs who have completed 90 days of duty.

"On the contrary", Chawla said, “officials in Rajasthan are not even willing to give us an experience certificate.”

“Forget the honorarium, it is not even clear where our attendance is being recorded. District administration officials asked us to register our attendance in the respective municipalities and gram panchayats, but the municipality and panchayat officials asked us to mark our attendance in the medical department,” Chawla complained.

Dr Devendra Chaudhary, Joint Director at the state medical department's Bikaner divisional headquarters, said that payments were not just a problem in the four districts of Bikaner. The honorariums have not been paid anywhere in the state as the government has not issued any guidelines in this regard, he said.

There is no clarity within the medical department either. Hanumangarh's Chief Medical and Health Officer, Dr Navneet Sharma, said, “We are trying to get the money disbursed. The state government had directed that the municipalities in urban areas and the gram panchayats in the villages would pay the honorariums out of the funds received by the State Finance Commission. If the panchayats and municipalities do not pay, then we will think about it.”