Lives in balance as Aarogya mitras continue indefinite strike

MUMBAI: It’s been only 48 hours but the indefinite agitation launched by aarogya mitras is already impacting lives. Shardadevi Saroj, 57, urgently sought to register herself under the government’s free MJPJAY scheme for dialysis but was turned away because there was no one to do the paperwork.

Her son, Ankit, said his mother had been told she needed dialysis only on Sunday. “We don’t have the money for treatment—my father is a tailor, and the hospital is 3 km away. On Monday, and again today, we went to the centre in Kalwa but they sent us back because there was no one to register us for free services. If dialysis doesn’t start soon, my mother’s health will deteriorate quickly. We don’t know what to do.”

The Sarojes are among thousands of patients whose cases cannot be processed as the aarogya mitras launched an indefinite strike on Tuesday. These are frontline field staff who implement state health insurance schemes – Integrated Ayushman Bharat-Pradhan Mantri Jan Aarogya Yojana (PMJAY) and Mahatma Jyotirao Phule Jan Aarogya Yojana (MJPJAY). These schemes provide insurance cover up to 1.5 lakh to all families in the state seeking medical treatment.

There are 1,600-odd aarogya mitras employed in Maharashtra, in 104 network hospitals in Thane, and 75 public and private network hospitals in Mumbai. Their demands include fair wages, annual salary increments and proper leave policies.

Major hospitals in Mumbai have recruited temporary staff to avoid overcrowding at desks and to streamline the treatment process. However, aarogya mitras say it hasn’t really helped. All dialysis and chemotherapy patients have to be discharged and readmitted at an interval of one and half months. “The process is lengthy and we are trained to operate the portal and execute the process. Temporary staff cannot do what we do,” said Ganesh Shinde, vice-president of the Maharashtra Aarogya Workers’ Union. “If our work is so important on a day-to-day basis, then we should be considered an integral part of the state healthcare system,” Shinde pointed out.

The union met with state health minister Prakash Abitkar on Thursday. “He has assured us that most of our demands will be fulfilled,” said Dr Karad, president of the union.

The aarogya mitras are pushing for a 12-point agenda, which they say are “basic rights”. The administration of the insurance scheme is executed by three third party administrators (TPA), namely MD India Healthcare Services, Medi Assist Healthcare Services, and Paramount Health Services and Insurance TPA, who hire the aarogya mitras, train them and oversee their work.

According to Dr Karad, “These TPAs pay less than minimum wage and don’t give basic leave. Under the Minimum Wages Act for skilled labour employed in hospitals, aarogya mitras should get about ₹14,700 as their basic monthly salary but they only get ₹11,000. When there was a change in the contract, the TPAs gave them a salary cut! We are currently demanding basic wages and an additional ₹10,000 because many aarogya mitras have been working for over 10 years at less than minimum wage.”

Aarogya mitras also want to be included in the State Health Assurance Society (SHAS), which would provide them job security, Annasaheb Chavan, CEO of MJPJAY said, “This is a matter between the workers and their employers, the state has nothing to do with it. However, we are intervening for the proper working of the state scheme.”