“…the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being…”– The WHO Constitution 1946.
The WHO constitution envisaged heath as a fundamental right; meaning that everyone should have access to good health which is “…a state of complete physical, mental and social well being and not merely the absence of disease or infirmity”. Good health has various underlying determinants; Safe working condition is one of them. In the year 2020, the year of nurses and midwives, this vision of health as a fundamental right is more relevant than ever.
India has been three months down, battling the epidemic called COVID-19. Since February, the number of nurses has been infected; send to quarantine and some even lost their lives. Most of the nurses contracted the infection through patients within their work environment resulting in the partial or complete shutting of the hospitals. By May, this disease had infected 548 health workers including doctors, nurses and paramedics. This data includes only nurses from the centre or government-run facilities across India. There is hardly a record of nurses working in the private sector that got infected or died due to COVID-19.
The media report indicates toward complete mismanagement, non-compliance and disregard of the Central and State guidelines for COVID-19 management by the hospitals (mostly private but public hospitals are no exception). Addressing issues such as the supply of PPE (adequate, quality and availability), regular testing, duty hours, rest/recuperation, accommodation, nutrition, travel and compensation for nurses engaged in direct management of COVID-19 cases is imperative. On the other hand salary (appropriate and regular disposal), duty hour, workload, safe working environment, occupational safety (including appropriate PPE) and health, leave, transport, sanitation and hygiene facility, health and medical insurance and other non-salary benefits to nurses irrespective of their location (COVID, Non-COVID facility) need to be regulated. The frontline health workers (FHWs; ASHA, ANM, LHV) and nursing students are serving as ‘volunteers’ and ‘COVID workers’; the Centre and State government is banking on them for community tracing and management. The FHWs are delivering regular community health care services and awareness generation, tracing and monitoring of symptomatic, asymptomatic and suspected cases. There is ample media coverage on inadequate compensation, occupational safety, work pressure and lack of insurance coverage these workers are bearing across the country while waiting for recognition and appointment as regular government health employees. It is time India rises above the ‘either-or’ decision and takes corrective measures to address term of employment and work of nurses irrespective of cadre or location of occupation.