Kerala, often touted as the most progressive state in India, is experiencing a wave of resistance that could potentially tarnish its carefully built image. Tens of thousands of Accredited Social Health Activists (ASHA) who make up the core of the state’s healthcare delivery system have been on a protest for nearly three weeks at the Secretariat in Thiruvananthapuram. Their list of demands—decent pay, pension rights and job security—are fair and non-negotiable.
In some ways, their struggle is not limited to financial grievances; they are a feminist declaration of resistance against Kerala’s ruling elite, pushing them to acknowledge a grim reality: ie; their “revolutionary” dream fades away when exposed to the intersecting axes of caste, class, and gender.
Consequently, this incident has laid bare the contradictions of a welfare model structured around the unpaid and poorly paid work of women. In some ways, their struggle is not limited to financial grievances; they are a feminist declaration of resistance against Kerala’s ruling elite, pushing them to acknowledge a grim reality: ie; their “revolutionary” dream fades away when exposed to the intersecting axes of caste, class, and gender.
Care work is labour: how Kerala’s welfare state thrives on women’s invisible toil
ASHA workers are the living framework of Kerala’s robust healthcare system. They foster inclusivity in healthcare access and close the divide between local communities and medical establishments. From hosting health-oriented community drives to aiding people in understanding and utilising public health services, their contributions are invaluable. During the Covid crisis, they took the lead in frontline care—providing medical supplies, identifying high-risk contacts and countering vaccine misinformation in skeptical communities. Their efforts are, therefore, physically demanding and socially irreplaceable yet politically invisible.
Officially, they are regarded as “volunteers”—a red tape rhetoric that nullifies the meaning of their work. They earn a modest ₹7000 monthly honorarium with no pensions, no stability and unpaid dues. The state’s rationale that ‘this is among the most substantial honorariums in India‘ is a sharp rebuke and it reveals a morally bankrupt premise: exploitation is justified if others do it more.
When ASHA workers seek an increase in their monthly honorarium to ₹21000, they are pursuing parity with the state’s own benchmarks. Interestingly, Kerala has recently revised and raised the salaries of Public Service Commission officials to ₹2.25 lakh per month and sanctioned high-end travel benefits for executive nominees. The subtext is pretty obvious: office-bound roles are compensated while care work is shunted aside.
This disparity is not merely a mistake—it is a systemic flaw. Kerala’s social welfare framework, mirroring the outline of many Indian policies, relies heavily on women’s underpaid work to invest in developmental activities. Anganwadi staff, midday meal providers and ASHA workers are designated as “part-time” employees, thus stripping them of their labour rights. Their work is viewed as “service,” a patriarchal misnomer where care is equated with that of charity. More importantly, the state’s reluctance to formalise their positions—despite their essential contributions—underscores a persistent and pernicious prejudice: women’s work—particularly from underrepresented communities—is treated as a “natural” talent rather than a refined skill.
More importantly, the state’s reluctance to formalise their positions—despite their essential contributions—underscores a persistent and pernicious prejudice: women’s work—particularly from underrepresented communities—is treated as a “natural” talent rather than a refined skill.
The Covid-19 pandemic threw open this hypocrisy. As Kerala garnered international recognition for its pandemic efforts, ASHA workers were overworked and underappreciated with an unassured financial future. ‘How can we support those in need if we are struggling to put food on our table?‘ a worker spoke up.
The state’s allegation of overdue central government funds (₹468 crore under the National Health Mission) lacks sincerity. If Kerala can earmark huge sums for VIP privileges, why not reallocate its funds to those who keep its healthcare running?
ASHA workers: underpaid, overworked and fighting back!
The state’s reaction towards the protest has embodied the worst of patriarchal arrogance. When Elamaram Kareem, a CPM leader, made accusations of “anarchist groups” co-opting the movement, he exploited a familiar trope: women protesters are either illogical or pawns of unseen powers. His attempt to equate ASHA workers’ protest with that of Pembilai Orumai Agitation (2015)—where women tea labourers in Munnar challenged the unions—was striking. Both movements disrupted Kerala’s male-centric labour politics by defying conventional unions and taking control of their own movement.
Moreover, ASHA workers have openly rejected ties to any political parties. ‘There are no flags here,’ they assert. Their protest creates solidarity among women across social, religious and party affiliations—a revolutionary gesture in Kerala’s polarised sociopolitical climate. Their collective action plan—focused on unity through issue driven activism—marks an extension of the democratic principles in the state instead of deviating from it. By establishing platforms for self-representation, these women are not forsaking Kerala’s legacy of strong labour-oriented politics but are tackling its neglect in giving credence to caregiving work.
They shed light on the structural inadequacies that have been sidelined for far too long—gaps that are not indicative of a falling system but of a framework that must evolve to honour its own ideals.
They shed light on the structural inadequacies that have been sidelined for far too long—gaps that are not indicative of a falling system but of a framework that must evolve to honour its own ideals. The differing language used to describe various forms of protest (“transformative” versus “anarchic”) opens up a new avenue to understand the role of gender in shaping labour experience and organisations. The ASHA workers mobilisation, therefore, is not a rejection of Kerala progressive reforms but a rational continuation to it.
However, Chief Minister Pinarayi Vijayan’s lack of response, meanwhile, exposes the fault lines of Kerala’s political consciousness. His nod to the state’s “renaissance” legacy—a landmark resistance to patriarchal and caste-based oppression—lacks conviction as ASHA workers protest beneath the shadow of his office. Unless Kerala confronts this contradiction, its rhetoric of justice will stay as a superficial illusion.
A dignity revolt: what ASHAs mean for Kerala’s future
The ASHA workers’ protests speak to more than just a labour issue—they represent a feminist uprising. By not submitting to silence—these women are breaking down Kerala’s myths and legends one by one. The first myth is that “development” eliminates gender-based exploitation.
Kerala’s impressive literacy and health statistics are widely praised, but seldom does anyone ask: “whose labour is hidden behind these achievements?” The second myth is that gender justice is central to progressive politics. However, the Left’s reluctance to support ASHA workers illustrates the ways in which male-dominated unions overlook informal women workers.
Establish ASHA workers as formal healthcare providers, secure fair wages, offer retirement benefits and discard the “volunteer” mask.
Yet, the solution is self-evident in itself: acknowledge the economic value of care work. Establish ASHA workers as formal healthcare providers, secure fair wages, offer retirement benefits and discard the “volunteer” mask. These demands, however, require a willingness to go beyond the status quo and a commitment to value women’s dignity above everything else.
Ultimately, Kerala’s ASHA workers form a part of the global tide of women-led protests— ranging from Kenya to Argentina—calling for recognition of care work across economies. Their protest serves as a cautionary signal: a welfare state that thrives on women’s underpaid work is not a “welfare” state. Until Kerala takes heed of this plea, its “renaissance” is nothing more than a myth—one built upon the labour of unseen women.
About the author(s)
Akhila holds a Masters' degree in Society and Culture from IIT Gandhinagar. With a passion for exploring ideas through words, she enjoys writing and reading, often diving into books and essays that challenge perspectives. When not immersed in her academic or creative pursuits, she finds joy in watching movies and engaging in thoughtful conversations.
