As administrative tasks and overlapping responsibilities overwhelm community health officers and ANMs, their mental health risks being overlooked. There is a need for compassionate reforms to sustain the fragile health infrastructure in remote Ladakh.
By Dr Fazlul Haq Wani
In the Union Territory of Ladakh, Community Health Officers (CHOs), ANMs, and other frontline workers form the backbone of the health system in remote and difficult terrains. Yet, the increasing workload and overlapping responsibilities are silently taking a toll on their mental health.
Every day brings a new directive. One day, they are tasked with preparing detailed data of elderly populations, the next, they are told to organise a camp under a health initiative. Another day demands a campaign for women’s health, followed quickly by pressure to submit reports for non-communicable diseases (NCDs). Amidst all this, they are expected to maintain routine patient care at their health centres.
Adding to this burden, many health workers are assigned duties that do not even fall under their core responsibilities. For instance, the creation of Golden Cards under health insurance schemes is often handed to them. While related to healthcare in principle, the technical and administrative process of card creation should ideally rest with technical or social welfare staff, not with already overburdened health workers. Despite knowing the heavy workload these workers carry, more and more such tasks keep getting pushed onto them.
For patients, these workers are a lifeline. But for the workers themselves, the burden is becoming overwhelming. Many of them admit, though quietly, for fear of job loss, that they feel mentally drained. “Some days we feel like crying,” confided a health worker, reflecting the deep emotional impact of the constant pressure.
It is natural and acceptable when staff are overwhelmed with patients, after all, that is their core responsibility. But the problem lies in the fragmented and ever-increasing administrative tasks. Each programme, whether Swasthya Nari, NCD screenings, or vaccination drives, is important in itself. However, when programs are run one after another in quick succession, without proper planning or breathing space, how can they ever be impactful or successful? Yes, if higher authorities need only numbers and data to show that they are on top of the table with respect to other states, then perhaps that target is achieved, but the true purpose of these programs, which is to bring real change on the ground, gets lost in the process.
Part of the problem lies in the chain of command. In meetings with higher authorities, our officers have become silent “yes-men”. Instead of voicing the ground realities, such as the impossibility of collecting accurate data within unrealistic deadlines, they simply agree to every directive. The burden then rolls downhill, and it is the frontline staff who are forced to carry out orders, no matter how impractical they may be. This culture of compliance, rather than constructive feedback, deepens the crisis.
If this continues unchecked, there is a growing fear that many health workers may be forced to resign simply to protect their mental health. This would not only be a personal tragedy for the workers but also a serious blow to the fragile health system of Ladakh.
Ladakh UT, with its unique geographical challenges, requires a more compassionate and practical approach in health program implementation. Instead of burdening the same staff with multiple overlapping responsibilities and non-core tasks, authorities must prioritise programmes, phase them wisely, and strengthen the workforce.
The health staff of Ladakh have shown immense dedication and resilience. What they need now is recognition of their struggles, not silence. Their mental well-being is as important as the physical health of the patients they serve. If we truly want a healthy Ladakh, we must begin by taking care of those who care for us.
The writer is a Medical Officer at the PHC Shargole
wa*******@***il.com