Healthcare workers in Kashmir’s Kulgam district stand between triumph and tragedy in the remote snowy region, putting their own well-being second to that of the people they serve. It’s time their efforts are suitably rewarded.
The snow is relentless, blanketing the narrow, winding roads of DH Pora, a remote village in South Kashmir’s Kulgam district. For most, winter here means isolation, but for a group of fearless women, it signals a call to duty.
Meet the ASHA (Accredited Social Health Activist) workers, unsung heroes of Kashmir’s healthcare system who battle deep snow and biting cold to ensure that no one in their community suffers or loses their life due to inaccessibility to medical care.
Dressed in old shawls and worn-out boots, ASHA workers navigate treacherous terrain, carrying only a small medical kit and an unbreakable resolve. They assist in childbirth, administer vaccines, and care for the elderly often in candlelit rooms when electricity fails. In villages where hospitals remain inaccessible for weeks due to heavy snowfall, these women serve as the only lifeline for healthcare.
It is difficult, but we have to keep going. I barely earn enough to feed my children, and our savings are almost gone. But when I see a mother giving birth alone, I know I have to be there.
For 42-year-old Amina Akhter, the day begins before sunrise. She wraps herself in layers, secures her medical kit, and steps into the cold, knowing the journey ahead will be perilous.
“Some days, the snow is so deep that I have to crawl on my hands and knees to reach my patients,” Amina says, adjusting her woollen scarf. “But if I don’t go, who will?”
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Like hundreds of other ASHA workers, she is often the only medical support in her village. Her responsibilities range from prenatal checkups and vaccinations to assisting in deliveries and tending to the elderly.
With hospitals cut off for months, ASHA workers become doctors, midwives, and counsellors rolled into one. However, their challenges are immense ranging from freezing conditions, delayed or meagre payments, and an absence of transport or protective gear.
“Sometimes I walk for hours in the snow to reach a patient and wonder if anyone even notices,” says ASHA worker Kulsuma, her voice filled with quiet determination. “But when I see the relief on their faces, it makes everything worth it.”
Another ASHA worker, Shahzada, adds, “We do it because people are counting on us. We can’t let them down no matter the weather or the distance.”
Despite overwhelming odds, ASHA workers have transformed healthcare in Kulgam’s remote areas. Before their presence, maternal and infant mortality rates were alarmingly high. Many women gave birth at home without medical assistance, and preventable diseases often turned fatal due to a lack of timely care.
According to a report by Frontline, Jammu and Kashmir has over 13,500 ASHA workers who act as the first point of contact for health-related needs, particularly for women and children. However, their compensation remains minimal. They receive a monthly honorarium of around Rs. 2,000 revised from Rs. 1,000 in 2019 along with task-based incentives.
In contrast, certain other states provide higher wages: Andhra Pradesh offers Rs. 10,000, Sikkim Rs. 6,000, Haryana Rs. 4,000, Karnataka Rs. 3,500, West Bengal Rs. 3,000, and Kerala Rs. 2,000, alongside additional incentives. This disparity highlights the undervaluation of ASHA workers in Jammu and Kashmir.
Nargisa, a 42-year-old ASHA worker, shares, “It is difficult, but we have to keep going. I barely earn enough to feed my children, and our savings are almost gone. But when I see a mother giving birth alone, I know I have to be there.”
These words reflect the heartbreaking reality faced by these women. They juggle financial hardships and family responsibilities while dedicating themselves to the well-being of others. Despite working long hours in extreme conditions, their own needs often remain unmet.
Beyond emergency care, they educate communities on hygiene, nutrition, and family planning. During the COVID-19 pandemic, they became frontline warriors conducting door-to-door awareness campaigns and assisting in vaccinations.
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A report by the JK Policy Institute highlights that ASHA workers frequently face discrimination due to their gender and socioeconomic status. They are burdened with multiple tasks beyond their primary responsibilities, leading to overwhelming workloads. The pandemic further intensified their duties, increasing their stress and challenges.
Despite their indispensable role, ASHA workers remain some of the most underpaid healthcare workers in India. In Kashmir, where their work is even more challenging due to conflict and harsh geography, their struggles are magnified.
When heavy snowfall isolates Kulgam’s villages, when hospitals shut their doors to remote areas, and when families have no one else to turn to, ASHA workers stand firm. They are not just healthcare providers, they are lifelines, bridging the gap between survival and tragedy. They work without recognition, fair wages, or job security. Yet, they continue to be driven by a purpose greater than themselves.
As discussions on healthcare reforms and government policies continue, one truth remains unchanged: without these women, thousands in Kashmir’s most isolated corners would be left to fend for themselves.
In a much-needed relief for healthcare workers, Sakina Yatoo, Cabinet Minister for Education, Health & Medical Education, and Social Welfare in Jammu and Kashmir, directed the release of pending salaries for National Health Mission (NHM) employees.
On February 13, 2025, she announced the decision on X (formerly Twitter), stating, “Have passed the directions for release of salaries of NHM employees. The government remains committed to the welfare of healthcare workers and ensuring timely support for their invaluable services.”
For ASHA workers in DH Pora, Kulgam, who brave harsh winters and treacherous terrains to provide maternal care, vaccinations, and emergency aid, this announcement offers a glimmer of hope. However, the larger issue remains. Many of these healthcare workers continue to receive meager salaries despite being the backbone of rural healthcare services in Jammu and Kashmir.
These women give so much of themselves to help others and deserve more than just words of appreciation. They need real recognition through better pay, job security, and proper resources for the life-saving work they do every day. ASHA workers are the backbone of their communities, and it’s time their worth is truly acknowledged.
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The lead photo at the top shows ASHA workers trekking through knee-deep snow, wrapped in layers, making their way to isolated homes where urgent medical care is needed. (Photo by Abu Bakr Maqbool)
Nahida Mushtaq and Abu Bakr Maqbool both hold a Master’s degree in Mass Communication and Journalism from the Media Education Research Centre University of Kashmir. They have contributed to local and national newspapers, focusing on social issues.
