Giving her a choice

Written by Evans Rebello and Rashmita Redkar, Dasra

“Bholi, a 12 year old girl from the Dindori district in Madhya Pradesh, was playing in the backyard of her house when she got her first period. Horrified at the sight of blood, she ran to her mother.

Pulling her outside the house, her mother gave her some hay to absorb the blood and told her that she would have to spend the next five days in the shed where the family buffaloes lived.

Confused, Bholi cried at first, but soon realized that her mother and sisters did the same every month as it was an essential part of ‘becoming a woman’. She spent the next 5 days in a corner of the shed where she ate and slept with the animals, smeared in dung, dust, and blood.

Three months later…

Bholi picked up hay as usual to manage her period, not noticing an insect in the hay. Soon after, she experienced severe stomach pain, which continued even after her menstrual cycle had ended. When the pain became unbearable, she was finally taken to a doctor. But the insect, which had entered through her vagina, had severely infected her uterus, and removing it was the only option. Bholi would never bear a child.”

While Bholi’s story is an extreme case, it captures the circumstances that most of the 355 million menstruating girls and women in India face every month, and for most of these women, especially in rural India, these incidents are just a “way of life.”

A natural biological process, menstruation has strong religious and socio-cultural connotations in India. A myriad of misconceptions, social protocols and cultural barriers are associated with this transition, which form the basis for poor menstrual hygiene practices. Apart from the socio-cultural restrictions, the problem of Menstrual Hygiene Management (MHM) in India is essentially a problem of Awareness, Availability and Access.

In recent years, there has been an increasing focus on addressing the three gaps of access, awareness, and availability. However, an area that is often overlooked is creating solutions that are sustainable over the long run. MHM has become synonymous with using disposable sanitary napkins to manage the monthly period. As a result, commercially-available disposable sanitary napkins are promoted as ‘the solution’ to the problem at hand. While it temporarily addresses the issue of availability of material, lack of education on and minimal investment in disposal mechanisms hamper the long-term viability of this solution. Sanitary napkins are unavailable to the vast majority, and 70% of women cannot afford sanitary napkins. Moreover, commercially marketed sanitary pads are non-biodegradable, and waste management infrastructure is severely-lacking.

A woman throws away 125 to 150 kilograms of absorbents used during menstruation in her lifetime, if every woman of reproductive age in India started using disposable sanitary napkins, the estimated waste generated would be 58,500 million pads each year

Through extensive research and expert engagement, Dasra has come to the conclusion that the key to effective and sustainable menstrual hygiene management is giving girls and women ‘options’ and supplementing these options with the necessary awareness generation and behavior change communication. Experts suggest that it is not about promoting one material over the other, it is about teaching girls and women to use readily-available local material in a hygienic manner.

Cloth, if washed and dried properly is not bad at all

“Cloth is cheap, accessible and the most familiar and preferred sanitary material for most women in India. Development agencies such as UNICEF and WaterAid endorse cotton cloth as an acceptable and safe sanitary material, if washed and dried properly.”

Using cloth appropriately can also preclude health problems sometimes caused by disposable sanitary napkins. Anecdotal evidence suggests that women who suffer from irritations sometimes experience a worsening of symptoms around their period, usually due to exposure to synthetic products. Cloth menstrual pads inhibit fungal and bacterial growth thereby reducing irritation, infection and PMS symptoms.” In promoting cloth, it is critical to create awareness about the right fabric to be used, hygienic methods to be adopted (washing and drying), and frequency of replacement. Being biodegradable, cloth is also more easily disposable than commercial sanitary napkins.

“Most women and girls I interacted with (around 5000 in the last 3 years) across rural Karnataka, use cloth (cotton) to absorb menstrual flow. And unlike my own earlier assumption, the reason isn’t always that cloth is cheaper. But rather, that cloth is a familiar, comfortable option. And why not? It absorbs blood quite well, can be procured easily without the embarrassment of asking a shop-keeper, can be washed and re-used and thereby eliminating the problem of disposal and environmental damage.”                       —Sinu Joseph Mythri Project, non-profit Youth for Seva

Locally-produced sanitary materials are good alternatives too

There are several other innovative solutions in the developing world including India that make use of locally grown materials such as bamboo, banana stem fiber, sugarcane waste and cotton knitwear waste to produce sanitary napkins. Promoting such alternatives, along with cloth, will ensure greater access and long-term availability of sanitary materials.

Beyond the Sanitary Pad
 Sugarcane waste is used to make pads in some parts of Uttar Pradesh
 Bamboo pulp is being used as a popular raw material in Karnataka and some other north-eastern states of India
 In parts of India, banana stem pulp and water hyacinth are being researched as

The MHM sector in India is gradually recognizing the need to promote sustainable alternatives to the disposable Eco Femmesanitary napkin. Several organizations have emerged as champions for the cause.  Eco Femme is one such organization that Dasra works closely with. Its model is simple: Educate and provide women with a sustainable and hygiene option. Eco Femme designs and manufactures premium cloth washable pads and promotes menstrual practices that are safe, clean and eco-friendly. And with their “Pad for Pad” program providing girls from economically disadvantaged communities in India to allow them to fully manage their menstrual cycle.

–Evans Rebello and Rashmita Redkar

This post is part of Period Of Change, a 5-week campaign organized by The Kachra Project along with Earth&us that aims to mobilize people (both men and women) around menstrual waste as a starting point to lobby for change in current practices in MH waste management.

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