World Social Justice Day: reflections on care work and dignity

Interview with Dr Sreerekha Sathi
Photo of Accredited Social Health Activists (ASHAs) speaking with a man and young girl about vaccines

Can the world offer dignity and recognition to care workers? In this interview dedicated to World Social Justice, Dr Sreerekha Sathi, Assistant Professor in Gender and Political Economy, sheds light on the experiences of women welfare workers in South Asia, particularly in the health sector. She shares her journey from activism to academia, emphasizing the devaluation of women’s work and the challenges health workers face in South Asia. This year's World Social Justice Day theme is about prioritising social justice in national and international policies, encompassing decent work, fair globalisation and and fair wages addressing increasing inequalities. Read along as Dr Sathi reflects on the intersections of labour relations, gender politics and social justice.

Why were you interested in researching the experiences of women health workers in the Indian context?

‘I identify as a feminist. In my younger days, the term care work was more of a western term. But today, I think the term and the conversation around care work is more globally accepted. There was a time in my youth where I focused on combining activism and academic work. In 2006, I witnessed a massive protest in Delhi; health workers were demanding a living wage, better contracts and benefits as workers. I was part of some autonomous, voluntary women's groups and civil rights groups and was interested in knowing about health worker’s struggles. 

At that time, I realised there was not much academic work done on the category of women welfare workers. They were and are still not even legally identified as workers by the government, because welfare workers, in the Indian context, are termed as honorary workers and honorary workers are classified as social workers and have no right to worker’s rights. I was interested in broadly connecting this issue to how women’s work is devalued and the role the state plays in that process.’

Health systems struggled to bear the brunt at height of the Covid-19 pandemic. India was particularly hit hard. How crucial were women health workers?

‘I recently explored the question of how we acknowledge the efforts of a specific group of women workers in the health sector, known as the Accredited Social Health Activists (ASHA). These women workers labelled by the government as ‘activists’, receive a minimal government stipend and have no regular contract, have played a vital role during the COVID crisis, addressing health issues especially in India’s rural areas. The severity of the pandemic varied across Indian states. However, despite the challenging experiences these health workers faced, from making sure that help reached to urban slums or remote areas of villages to dealing with dead bodies to addressing the aftermath of death, there has been a lack of discussion or recognition on these aspects their contribution.'

Gautam Ramuvel

Did this strike a chord with you?

‘What struck me was how, in times of crisis like the pandemic, the heavy burden placed on marginalised women and men in the informal sector. They are expected to care for their communities, including both marginalised and middle-class populations. However, the acknowledgment and recognition for their efforts are minimal. Once the crisis subsides, it's almost as if we completely forget what we went through. The cycle repeats or will repeat in the next crisis, with little reflection or memory of the contributions of marginalized workers. This aspect troubles me – the lack of learning from these experiences, the rush to move on, and the disregard for the possibility of such crises occurring again. It's a pattern that we should pause and reflect upon instead of hastily consigning it to the past.’

You also undercut how caste barriers severely influence the rights and perceptions of women health workers. 

‘Caste politics and practices are deeply ingrained in the foundation of Indian society, making it essential to comprehend them to understand the country. In the context of Indian women workers, those seeking daily wage work often hail from lower caste or Dalit communities, akin to marginalised black women in the US or native women communities in many parts of the world. These individuals form much of the workforce involved in daily wage tasks, social welfare tasks or many other menial jobs in India. 

Among these workforce too, there exists a hierarchy, with the most marginalised sections, like Dalit women performing physically demanding tasks such as walking in communities, cleaning, cooking and other labor-intensive roles. The combination of class, caste, and gender dynamics influences these roles. Despite the heavy gendering and casteization of these sectors, discussions about caste remain silenced within Indian society. Recognising and addressing caste as a problem is crucial, yet there is a historical invisibilisation and effacement associated with it. Conversations on caste is an important area that requires further attention and work.’

Absolutely. You reflected on the compounding challenge of globalisation on India’s health sector. Has the increase of privatised health services been impactful for Indian society and care workers at large?

‘In the context of India and South Asia, it's evident that these entities have fueled growing inequalities and heightened exploitation at the workplace. The impact is not confined to Asia alone but extends globally. In India, we witness the rise of large corporate hospitals where allocated quotas, if any, for marginalised communities often prove ineffective. Simultaneously, public hospitals face significant budget cuts, resulting in critical shortages of medical staff, essential medications, and life-saving resources. The stark disparities in resource allocation contribute to failures such as the lack of oxygen during the covid-19 crisis, leading to unnecessary deaths.

This unequal distribution of resources also places immense challenges on workers. The reality now is that many individuals, especially in the private and informal sectors, endure much longer work hours – 12 to 14 hours or even more. The question arises: are we progressing or regressing? The pressure on marginalised women and men in the globalised neoliberal world is palpable, with expectations to conform to a system that disproportionately benefits a small, obscenely wealthy minority while leaving over a billion people in poverty.’

You teach within the Human Rights, Gender and Conflict Studies: Social Justice Perspectives (SJP). How do you explore these topics — from intersections of labour rights and gender politics— with your students? 

'I bring these topics into my teaching to keep students informed and inspire them to work on relevant issues they'll likely encounter in their lifetime. ISS provides an ideal environment with diverse students from different regions, allowing them to learn from each other's experiences. While we might always feel like we're in a crisis, knowing the impact of such histories on ordinary people's lives, remains crucial. Teaching courses on gender and political economy at ISS is both interesting and worthwhile, enabling me to explore a variety of issues.'

I’m sure students feel inspired! As today marks World Social Justice Day, do you see social justice informing or transforming policy within the Indian health sector? 

'I do. Post-COVID, there's increased community awareness about the importance of public health and welfare. However, despite the pandemic's lessons, uncertainty persists about translating awareness into effective policies. The rush to move forward is evident, overshadowing the vulnerabilities exposed during the crisis. Recognition for health workers fades further, replaced by benefit cuts in health, social welfare and education. Globally, spending priorities continually shift when crises arise due to increasing number of wars and other conflicts that impact workers in the informal sector, neglecting the crucial role of care workers. Developments in the field of care work is an extremely important space to understand where we're headed.'

Thanks for chatting with us!

Assistant professor
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