Lata Kumari works as a community midwife in Tharparkar district. She is appointed at the government dispensary in Jhdhiyar Somra. Although this dispensary is not far from their settlement (Dhani), she is highly disappointed in the health department.

She says that it has been three years since she started her job. When the contract was given, the District Health Officer assured her of her job’s permanency, but now the department is making her rounds and rounds, even for the salaries.

“We have been continuously on duty, but the salaries for the first nine months were combined. Now, for the past six months, the salaries have been stopped. Before this, the department officials collectively deprived us of our one-year salary.”

The Sindh government initiated a program to improve the state of ‘Mother and Child Health’ in the Tharparkar district. Community Midwives (CMWs) were recruited in five sections for this initiative.

Under the program, 65 women were recruited in Tharparkar in November 2020. In the other four districts – Thatta, Sajawal, Badin, and Dadu – 20 to 30 CMWs were appointed. Prospective female candidates were required to have at least a matriculation education and a midwifery course.

After government advertisements and interviews in Tharparkar, these women were placed on a one-year contract.

The District Health Officer issued offer letters. The ceremony occurred at the district presidency office in Mithi, where the Parliamentary Secretary of Health, Qasim Soomro, was also present.

The work of the Community Midwives (CMWs) was to raise awareness among pregnant women in rural areas about their health and the nutrition and care of their children. The salary for CMWs was Rs 25,000, but they were not paid for the first six months since the start of the program.

When the CMWs began to protest in June 2021, the district in-charge, Tharparkar, said their offer letters were fake. In response, a lawyer named Sandeep Kumar filed a writ in the Sindh High Court.

After hearing the case, a two-member bench consisting of Justice Muhammad Iqbal Kalhoro and Justice Adnan Kareem decided that the Community Midwives should undergo a test conducted by the Institute of Business Administration (IBA). However, due to non-payment of salaries until then, several CMWs had already resigned.

In December 2021, 52 Community Midwives cleared the Institute of Business Administration (IBA) test, and the Health Department rehired them. Four women left their jobs after finding employment in the education department, while another girl joined the NGO sector.

According to the Health Department, the number of community midwives in the Tharparkar district has now been reduced to 47.

Lata says that she was not paid during the period of the case in court. When she rejoined, she was once again promised regularisation.

“It has been six months, and our salaries have again stopped. When we go to the district office, we are told that your salaries will be paid soon, but we have received nothing so far. We perform duties in remote areas where officers don’t even visit. Instead of that, we are being tortured on the roads.”

According to the Fact Sheet released by the World Bank in December of last year, the maternal mortality rate related to childbirth in Sindh is 345 per hundred thousand, while in Punjab, it is reported at 219 per hundred thousand.

In the hospitals of Tharparkar district, 862 child deaths were reported last year. So far this year, 715 child deaths have been reported in the district.

Due to the alarming maternal and child health situation, the provincial government initiated an awareness program and allocated a budget for it. However, there seems to be negligence by the Health Department in Tharparkar.
Meanwhile, in other districts, the Community Midwives are receiving their salaries.

Due to the alarming maternal and child health situation, the provincial government initiated an awareness program and allocated a budget. However, there seems to be negligence by the Health Department in Tharparkar.
Meanwhile, in other districts, the Community Midwives are receiving their salaries.

Regarding the maternal and child health program in Tharparkar, the District in charge and Deputy District Health Officer, Dr Bhagwan Das, acknowledges that the non-payment of salaries is a real issue for Community Midwives.

He says that the salaries are issued to contract employees only after the approval of the department. If their contracts are confirmed, they may receive salaries regularly.

“The issue of regularising Community Midwives can be resolved through the provincial cabinet. However, we are also writing formal letters from here. We have also sent a letter to the department regarding salaries, and our efforts aim to ensure prompt payments.”

A 35-year-old Shabana from the village Chhachhro in Tharparkar works at Junijo Hospital. She says that she leaves her children behind to go to work, but for her salaries, she has to travel a distance of a hundred kilometers to Mithi repeatedly. The Health Department officials are reportedly not responsive to her concerns.

“We protest outside the press clubs every month. On October 10, we also held a demonstration in Mithi. We fulfil our duties with honesty. If it was known that these people won’t pay salaries, we wouldn’t even take up these jobs.”

Contact was made with the Director General Health Sindh, Dr Irshad Memon, but he declined to take a position on this matter, stating that the Health Department officials of Tharparkar district would provide information regarding this issue.