Rights of Community Aid and Health Workers: Humanitarian workers of COVID-19

The worldwide pandemic and almost six months of being trapped inside houses have made us realise the value of the essential workers who provide for the daily needs in our community. For most of us, it is a time to take rest, remain inside the house with all comforts and luxuries, avoiding outside contact as much as we can. But a few other professions have seen a considerable rise in the demand for their work and services they provide, one of them being the healthcare workers. The entire world unanimously considers them as an angelic host saving us from perils of the deadly virus. However, recently there was a mixed attitude and a noticeable change in the behaviour towards the health workers around the world. Assault on health-workers in Mexico, punching in a Chicago bus, stone-pelting in India’s Indore district, dousing with bleach in the Philippines became controversial news headlines.(( Health workers become unexpected targets during covid-19, Economist 11 May 2020. Available at: https://www.economist.com/international/2020/05/11/health-workers-become-unexpected-targets-during-covid-19))1 Apart from these violent incidents, sudden and urgent eviction of health workers by tenants, refusing access to public transport, denying entry to uniformed-nurses in supermarkets and various other instances of public stigmatisation were observed across the world.((Julian Sheather, Serious violations of health workers’ rights during pandemic, 14 July 2020. Available at: https://www.bmj.com/content/370/bmj.m2824))2 Amidst all these mishaps, it becomes essential that we start respecting the rights of the community aid and health workers who have been continuously working in mitigating the impact of coronavirus.

Rights vis-a-vis employers and managers

The World Health Organisation (WHO) released a document enlisting the rights, roles and responsibilities of a health worker.((World Health Organisation, Coronavirus Disease (Covid-19) Outbreak: Rights, Roles And Responsibilities Of Health Workers, Including Key Considerations For Occupational Safety And Health, 19 March 2020. Available at: https://www.who.int/docs/default-source/coronaviruse/who-rights-roles-respon-hw-covid-19.pdf?sfvrsn=bcabd401_0))3 This document enlists the rights of a health worker to ensure proper health facilities from their employers and managers. According to this, the responsibility of the employers and managers is to ensure that they take all necessary preventive and protective measures to minimise occupational safety and health risks. They are required to provide information, instruction and training on occupational safety and health. Additional duties include that employers and managers:

• provide adequate Personal Protective Equipment (PPE) supplies to healthcare or other staff caring for suspected or confirmed COVID-19 patients

• familiarise personnel with technical updates on COVID-19 and provide appropriate tools to assess, triage, test and treat patients and to share infection prevention and control information with patients and the public;

• provide a blame-free environment for workers to report on incidents, enable co-operation between management and workers and/or their representatives and provide access to mental health and counselling resources;

• advise workers on self-assessment, symptom reporting and staying home when ill;

• maintain appropriate working hours with breaks;

• consult with health workers on occupational safety and health aspects of their work and notify the labour inspectorate of cases of occupational diseases; and,

• honour the right to compensation, rehabilitation and curative services if infected with COVID-19 following exposure in the workplace.

Such measures ensure that the workers do not have to incur additional expenditure for occupational safety and health requirements or any disease due to occupational exposure. They are at liberty to remove themselves from situations where continuing danger to life or health exists and should be protected from undue consequences following from such action.

Responsibilities of Health Workers

A job of a healthcare worker does not come easy as there are certain responsibilities and duties that they owe towards their patients and broadly towards society. The element of risk and uncertainty in their job requires them to adhere to a stricter set of rules and regulations. During pandemics like COVID-19, health care workers are exposed to maximum risk as they come in proximity with the infected patients compared to those working in non-acute environments. Regardless, they have a moral obligation to help patients without any form of discrimination.((Adaeze Aniodoh, COVID-19 and health workers’ rights in Africa: the duty to treat or not to treat? May 5, 2020 Available at: https://blogs.bmj.com/medical-ethics/2020/05/05/covid-19-and-health-workers-rights-in-africa-the-duty-to-treat-or-not-to-treat))4. The WHO interim guidance document also mentions the responsibilities of health workers. Health workers should:

• follow established occupational safety and health procedures, avoid exposing others to health and safety risks, and participate in employer-provided occupational safety and health training;

• use provided protocols to assess, triage, and treat patients;

• treat patients with respect, compassion, and dignity;

• maintain patient confidentiality;

• swiftly follow established public health reporting procedures of suspected and confirmed cases;

• provide or reinforce accurate infection prevention and control (IPC) and public health information, including to concerned people who have neither symptoms nor risk;

• put on, use, take off, and dispose of PPE properly;

• self-monitor for signs of illness and self-isolate and report illness to managers, if it occurs;

• advise management if they are experiencing signs of undue stress or mental health challenges that require supportive interventions; and

• report to their immediate supervisor any situation which they have reasonable justification for believing presents an imminent and serious danger to life or health.

Safety of health workers in India during COVID-19

Before the global spread of the COVID19 virus, in January 2020, Ministry of Health and Family Welfare (MoHFW) released National Guidelines For Infection Prevention And Control In Healthcare Facilities((National Guidelines For Infection Prevention And Control In Healthcare Facilities, Ministry of Health and Family Welfare, January 2020. Available at: https://www.mohfw.gov.in/pdf/National%20Guidelines%20for%20IPC%20in%20HCF%20-%20final%281%29.pdf))5, which touched upon the protection of healthcare workers. It recognised stress and fatigue as factors affecting their safety. It gave importance to training and education, so they understand the principles and procedures of IPC. But soon after the coronavirus was declared as a global health emergency, MoHFW issued a notice stating the measures to be adopted for the protection of health workers during COVID-19 services.((Measures Undertaken to Ensure Safety of Health Workers Drafted for COVID-19 services, Department of Health and Family Welfare, Ministry of Health and Family Welfare, 20 April 2020. Available at: https://www.mohfw.gov.in/pdf/MeasuresUndertakenToEnsureSafetyOfHealthWorkersDraftedForCOVID19Services.pdf[))6 The highlights of the notice are:-

• Staffing guidelines and timely payments- Payments to be made to all frontline workers such as Accredited Social Health Workers (ASHA) and service providers, including those hired outside the government sector.

• Psychological Support- The Government is encouraging health professionals to practice stress management techniques. In furtherance of developing a toll-free helpline (0804611007), training modules are also designed in this regard.

• Training/Capacity Building– An advisory has been issued to provide guidance to states/UTs on building the human resources in medical workforce including workers employed in hospitals as well as non-medical personnel, front line workers and those who are involved in logistics and surveillance for COVID-19 management. Training resources on IPC, clinical management are updated regularly. Online courses, training and webinar sessions are conducted by AIIMS Delhi, which guide about the management of patients and providing them with psychological care, medical procedures, IPC practices, etc.

• Life Insurance Cover– Government has announced an Accidental insurance cover Rs. 50 Lakhs for 22.12 Lakh healthcare workers who may be drafted for services for COVID-19 patients. This amount is declared under the Pradhan Mantri Gareeb Kalyan Package where the claimant of any person providing services for COVID-19 can claim compensation if service providers sustain a loss of life due to COVID-19 or related duty. Government has paid the premium amount, and the insurance is free for the beneficiaries.

These measures are necessary in light of the disastrous impact coronavirus has on the health of a person and increases the sufferings of their family. The courses and webinars are receiving enrolments and viewership in huge numbers, thus sensing a positive attitude of workers by devoting time towards learning safety measures from the virus. Though such measures are undoubtedly a big step towards improving the safety of health workers, timely implementation of them in our country still remains a major issue. It will benefit not only the workers but also the society if the government considers the safety of healthcare workers also as a priority during this pandemic. Ultimately, better healthcare workers will ensure better recovery of COVID-19 patients. Soumya Gupta is a student at NUJS, Kolkata and a member of Kautilya Society, an initiative of Vidhi Centre for Legal Policy. Views are personal.