Intimate Labor at Biomedical Frontlines: Situated Knowledges of Female Community Health Workers in the Management of COVID-19 in India

Media reports of the COVID-19 pandemic in India have highlighted the important role that India’s female community health workers, the Accredited Social Health Activists (ASHAs), have played in managing COVID infections in India. This paper explores the epistemic basis of ASHA work to understand the significance of their role. Through a discourse analysis of textual media articles, we show that the ASHAs’ routine and COVID-related caregiving practices are a form of embodied, intimate labor rooted in their situated, community-oriented knowledge. This labor is devalued as emotional and feminized care work, which denies the ASHAs professional status in the public healthcare system of India and, in turn, reflects a hierarchy among health practitioners that stems from the status of objectivity/disembodiment in biomedicine. We find that, despite their low status in the public health system, ASHA workers develop a self-concept that enables them to self-identify as healthcare professionals, motivating them to continue providing essential healthcare services during the pandemic. We argue that an official recognition of the epistemic value of ASHA work would help to overcome the age-old nature/culture dichotomy that informs what counts as valuable, legitimate, formal medical knowledge. Furthermore, our analysis provides a critique of the gendered devaluation of care work within a political economy of health increasingly dictated by a neoliberal logic