AFTER days of protests, a number of lady health workers have threatened to commit suicide in front of the Bhutto mausoleum at Garhi Khuda Bux on April 4, the death anniversary of Zulfiqar Ali Bhutto. The extreme nature of the threat indicates the manner in which the state administration has mismanaged, even worsened, the situation and failed to take cognisance of the issues being faced by the workers. The protests started on March 23 when over 2,500 LHWs gathered on the National Highway at the Sindh-Punjab border to press for the regularisation of their services. After the sit-in continued for 16 hours, police resorted to the unnecessary use of batons and teargas to break up the gathering. Hundreds of LHWs were rounded up; the whereabouts of some are still unknown. Given such use of force, it was only to be expected that other LHWs, joined by activists of social and political organisations, would stage further sit-ins and protests.

While the government engages in a power struggle with the workers, the latter’s duties remain unattended to. The situation is symptomatic of the manner in which the state administration fails to capitalise on initial gains. The LHW scheme was a notable success in a country where providing access to healthcare, particularly for women and children in remote areas, remains a challenge. Since 1994, when the scheme was launched, LHWs have formed the backbone of the primary healthcare system. With an army of over 100,000 workers, it is amongst the biggest outreach interventions in South Asia and covers 60 per cent of the population. Over the years, the duties of these workers, responsible for dozens of households in their areas, have expanded from reproductive health and family planning to include campaigns such as polio vaccine administration, and tuberculosis and malaria control. The programme is funded by the Public Sector Development Programme, whose resources have suffered continual clipping over the years. In terms of the LHW programme, this means ill health and even loss of lives that could have been prevented. Pakistan’s healthcare indicators are grim enough; the administration must address the LHWs’ issue so that their contribution continues.