This case study was conducted for the Pakistan Institute of Labour Education and Research (PILER), with the financial support of ActionAid France in 2017. It was published in both English and French.
The Lady Health Workers (LHW) Programme, instituted in 1994, is considered one of the largest and successful community based primary healthcare initiatives in the world. The lady health workers’ role has received recognition by the global health bodies in improving Pakistan’s maternal and child health indicators. Currently more than 130,000 lady health workers reach out to 60 to 70 per cent of the country’s population residing in rural and low-income urban areas.
Perhaps if it was not a collective struggle for their rights, the lady health workers would have continued to suffer injustice in silence: a low wage, no benefits and insecure job. It was death of a health worker at child birth that compelled Bushra Arain, a Lady Health Supervisor, to rebel against the irony: health providers’ own deprivation of health facilities and lack of decent work conditions. She and several other lady health supervisors mobilised the workers and founded the union, the All Pakistan Lady Health Workers’ Welfare Association, in December 2008. By early 2009, each district had a Baji (elder sister), a dynamic activist health worker to prepare the cadre for struggle. The union took to legal intervention and street power to claim their due rights at work place. The phenomenon was unique: never before in Pakistan’s history had women workers exercised the right to ‘collective bargaining’ in any sector, much less in the low-paid care economy.
The case study aims to document the LHWs’ struggle, review the constraints they faced as women workers in a public sector health programme and as caregivers, identify the union’s strategies and highlight the achievements of their eight-year long battle.
Click here to access the full report in English.
HOW do you deal with deceit, dishonesty and debasement in your day-to-day life? Sounds like an existential question. Substitute the three D’s with a single word, ‘corruption’, and the question loses its dimensions and sounds almost clichéd.
Inducted into the Urdu lexicon and used ad nauseam in our popular political discourse, the word when deconstructed in a specific context holds a mirror up to ordinary lives made difficult through avarice and misuse of entrusted power. A look at ‘corruption’ through the perspective of Lady Health Workers (LHWs) explains why corruption is termed by the UN on the International Anti-Corruption Day (observed two weeks ago) as one of the biggest obstacles to achieving the Sustainable Development Goals and a formidable hurdle in the path of “development, peace and security”.
Published in Dawn, May 1st, 2016
The old world is dying and the new world struggles to be born. — Antonio Gramsci
THE old world of the labour movement started unravelling in the 1990s when finance and production went global, kicked up by unbridled capitalism. In the new system of production, traditional labour relations — characterised by long-term employment, job security and workers’ representation — fell apart. In developing countries, union density plummeted. Was it the end of organised labour? Or, have new forms of labour solidarity started filling the vacuum?
Published in Dawn, March 30th, 2016
ONE of the many contradictions of our society is between its loud avowal of its love of the ‘family’ institution and its devaluation of woman, the pivotal figure in the family. Not only do we look down on women inside the family, we give two hoots about women who commit themselves to door-to-door healthcare services for the women and children of the family. No wonder the issues being faced by lady health workers — job security, timely payment of wages and supplies of kits and medicines —remain to be addressed fully by the state.