Karnataka's sex workers raise pitch to take their successful telemedicine-based healthcare service national

The 'Phone Maadu' initiative that helped sex workers in parts of Karnataka get easy access to doctor and quality health care during COVID-19 times without being stigmatised and ensuring anonymity is now sought to be scaled up further leveraging technology and expanded to benefit other marginalised sections.

'Phone Maadu' (or Phonehealth Clinic) is a telehealth initiative by 'Ashodaya Samithi', a sex worker-led organisation located in Mysuru, with the system organically evolving from the need expressed by the community during the COVID-19 lockdown and lack of accessibility to health care services.

Karnataka Home Minister Araga Jnanendra on Monday launched the 'Phone Maadu' report which documents how Ashodaya's innovation promoted and provided for changes in the way health care was meted out to the sex workers.

"With Phone Maadu (conceived by and for the community), we can speak whole-heartedly and it is all confidential", Devika, a female sex worker, was quoted as saying.

'Phone Maadu' is a telemedicine-based approach to connect the community members to doctors, using phone calls, WhatsApp, and SMS to send and seek information.

Many sex workers preferred 'Phone Maadu' over face-to-face doctor visits as they enjoyed the confidentiality it provided and the comfort of expressing themselves openly on the mobile phone.

Among the benefits of the system that were mentioned by the community is: "Non-stigmatising; they can speak openly without feeling shy, whereas when they go to government/private facility, the odds are that they might face some degree of stigma because of their identity".

While Ashodaya introducing 'Phone Maadu' health service and making it such a success among the sex workers may be seen as a "one off" initiative, it could be implemented in two or three other places, like Gujarat, West Bengal and Maharashtra, before going to "national scale", says the Ashodaya team.

While Ashodaya, a community of over 8,000 sex workers, said it is committed to continuing the programme, it's worried about how this can be funded and is looking for support.

"The perception within the community is that 'Phone Maadu' provided them with a ready access to health care, minimising the hardship of travel, its expense and loss of income that comes with conventional health care", the report said.

The pivot on which the 'Phone Maadu' rests is the doctor. The doctors with the programme have had experience of working with Ashodaya previously.

"Successful rolling out of this programme among sex worker community-based programmes could have a transformational impact", an Ashodaya team official said.

Ashodaya says it is now looking at scaling up the programme leveraging technology to make it more optimised and efficient.

It has recommended creation of a model which can be deployed in other parts of the country and for the benefit of other communities.

Ashodaya will keep 'Phone Maadu' as an ongoing activity, and it is also looking at raising funds locally or from doctors to use technology to take away the repetitive tasks and make scheduling easier, a team member said.

Ashodaya has proposed a new system to remove the dependency on the middleman to schedule doctor's appointments, and giving all the power in the user's hand, providing doctor's consultation service 24X7 which can be used by anyone and everyone.