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Write to the AuthorGirls EducationWomens Health

02 September 2015 -

MENSTRUAL HYGIENE

Why rural girls need more than justsanitary napkinsHanding out non-biodegradable sanitary pads to rural school girls who have reachedmenarche will not address their menstrual hygiene issue Clean and functional toiletswith water supply awareness about menstruation economical and biodegradable padsand more is needed finds Puja Awasthi

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Anupama Shukla apostgraduate in sociology adheres to the belief thatmenstruation is lsquodirtyrsquo and any breach of its mostpotent taboo ndash to avoid the Gods ndash will drawcalamities that are detailed in all religious texts In acountry of 355 million menstruating girls and women such ignorance is rampant

Yet Shuklarsquos ideas have potentially far reaching negative effects as she is the principal ofa girlsrsquo college in the district of Sant Kabir Nagar Thus when she says that college isbest avoided during lsquothosersquo days human contact be minimised and daily activitiessuspended Shukla is handing out dangerous pointers on an issue that has beenignored and wished away despite its life altering impact and huge implications for humandevelopment

A plethora of large studies lay out the numbers - 23 percent of girls drop out of schoolwhen they hit menarche 31 percent of women miss 22 days of work when theymenstruate girls miss 20 percent of school days every year while there is a 70 percentincrease in incidences of reproductive tract infections in the absence of menstrualhygiene

A smaller study which focussed on 2579 girls and women in 53 slums and 159 villagesin Madhya Pradesh Chhattisgarh and Uttar Pradesh found out that while 89 per cent ofrespondents used cloth with over half of them using the same cloth for more than oneperiod two per cent used cotton wool and the same numbers used ash to absorbmenstrual flow while only seven per cent used sanitary pads

What toilets in Uttar Pradeshs government schools look like Pic Puja Awasthi

More alarmingly of the 63 percent who had access to toilets 20 percent did not use themduring menstruation for fear of staining it and more than two out of five girls had no ideaabout menstruation when they started with their periods Of those who had some idea

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only 16 percent received any information in school

There is a potential loss of about US $100 billion in GDP to India as a result of girlsdropping out of school due to menstrual health issues and thus getting into earlymarriages and early pregnancies More girls in schools means universal primaryeducation and increased gender parity while contributing to eradication of povertyEducated mothers also contribute to improved maternal health and reduction in childmortality - all of which figure in the Millennium Development Goals

Against this backdrop the UP government has rolled out an ambitious scheme theKishori Suraksha Yojana under which one pack of 10 sanitary napkins every month shallbe handed out to all girl students in classes 6-12 in government and government aidedschools Of the many glaring gaps in that plan is its complete disregard of girls who havedropped out of school and those who attend non-aided schools like the one Shuklaheads

Neelam Singh Lucknow based gynaecologist and the founder of Vatsalya- anorganisation that has been on the forefront of the fight against female foeticide decriesthe scheme for its lack of coherence ldquoA supportive environment needs to be created forgirls to use sanitary napkins How does the giving of sanitary napkins make a differencewhen there are no functional toilets in schools or where functional toilets have no waterrdquoshe asks

Neelam is also sceptical of loading the ASHA ndash the accredited social and health activist ndashwho functions as the lynchpin of the centrersquos National Rural Health Mission with morework

Those are extremely valid considerations in a state where 647 percent of all householdsdo not have functional toilets and while official data says that only 299 percentgovernment schools and 1032 percent private schools do not have toilets the reality ofthese is dismal

A closer look at the status of hygiene and sanitation in UP schools in 2013 based oninteractions with various stakeholders and done as a follow up to the 4th South AsianConference on Sanitation in 182 schools across six districts of UP revealed that therewas an average of one toilet per 145 students whereas for girls the average was one for301

Toilets in government schools lack water supply which makes them useless Pic PujaAwasthi

Environmental costs

While merely doling out sanitary napkins without awareness and supportive infrastructureis unlikely to make any long term difference the mere idea of what currently massproduced pads will do to the environment is also worrisome

Meenakshi Gupta founder member of Goonj- an organisation that has put clothing on theagenda of development and has produced low cost sanitary pads (25 million accordingto organizational literature) says ldquoCloth is something most women are familiar with Weare just trying to get them to take up safe and hygienic practices around using cloth Rightnow the mass produced sanitary pads are not biodegradable thus these productsentering rural India would cause havoc in the environment Most cloth-based or otherbiodegradable products are either very small scale or at an experimental level still Thuswe want to make sure that women in villages have a safe familiar and a long term viable

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WOMENS HEALTHPro-life or pro-womenrsquos rightsWhatrsquos turning women in labour awayfrom hospitalsBarefoot auditors ensure health for tribalmothersSterilisation deaths Whatrsquos new afterallWhen kitchen smoke can kill

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Barriers to girls educationAre girl students safeSuccess in rural sanitation

product which will not strain their meagre resourcesrdquo

To put Guptarsquos worry in perspective consider that research in 2007 put the sanitary padmarket in India at US $15549 million in 2007 This was calculated at a mere 45 percentusage and worked out to 2659 million units made of non-biodegradable non-recyclableproducts the safe disposal of which does not figure in the agendas of the corporates thatare making profits of this vast and still growing market

Some answers have already been found ndash the most prominent among those byArunachalam Muruganatham the Tamil Nadu-based world-renowned pioneer of low costsanitary napkin making units who is advising the UP government in its quest for 100percent menstrual hygiene

While the governmentrsquos own target date for thatachievement is 2017 Arunachalam says ldquoThis is along term agenda Handing out free napkins can bean election gimmick at best Affordability awarenessand availability are the key issues Big corporates thatpedal sanitary napkins as comfort products used bytight jeans wearing women have no interest in reaching underserved villagesrdquo

His solution ndash a biodegradable low-cost pad that is manufactured and sold by womenwho in turn are the biggest advocates for menstrual hygiene ndash could well be a precursorto a larger change ldquoAs awareness of the harms of mass-produced napkins grows silentbrand shifts will begin to happen After farming and handloom low cost sanitary napkinswill become the third biggest livelihood optionrdquo predicts Arunachalam of a country whichhas more menstruating girls and women than any other

Tackling menstrual waste through incinerators has been on the agenda of the government since December 2013 when the Nirmal Bharat Abhiyaan guidelines weremodified to specify that ldquo(S)etting up incinerators in schools in womenrsquos communitysanitary complexes in primary health centres or in any other suitable place in village etccan be taken uprdquo

This was taken further ahead by the Swachh Bharat Swachh Vidyalaya mission whichaims for ldquoat least one incinerator in the girlrsquos toilet block and niche to keep sanitarynapkinsrdquo but despite all the rhetoric progress has been slow

In April this year for instance the UP government announced a partnership with SulabhInternational for setting up incinerators in 300 government Inter Colleges and schoolsDespite ready availability of technology as per Sulabhrsquos WASH in School programme in-charge Rupak Roy Choudhary the programme remains at the ldquodrawing board stagerdquo

Rays of hope

Yet promising stories of change are emerging from the state Anil Singh Sengar a GramPanchayat officer from Mahoba was supported by the statersquos bureaucracy and guided byArunachalam to set up a low cost sanitary napkin production unit which today produces65000 packets a month and employs 28 women - all under the umbrella of thePanchayat Udyog a decentralised enterprise model promoted as part of local selfgovernance

Subah a low cost environment friendly sanitary napkin Pic Anil Singh Sengar

The six-piece packet sold for Rs 15 under the brand name lsquoSubahrsquo (Morning) has an ISO-2014 certification and enjoys wide acceptability in all four blocks of the district Howeveras Sengar points out when the unit was set up in 2013 it was difficult to sell even 10packs ldquoIf you go to purchase vegetables you will buy only those you know or have eatenSimilarly while our pads were made available in local shops women paid no attention tothem as they had no awareness about themrdquo he explains

An intensive awareness drive spread over one and a half years and covering all 14570schools in the district has today resulted in a situation where the demand of Subah

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outstrips supply and where menfolk from villages come to collect supplies without anysense of shame

It is drives such as these which are crucial if any headway is to be made in ensuringmenstrual health in the countryrsquos most populous state Till such a time misconceptionssuch as those harboured by Shukla shall continue to flow freely

Puja Awasthi02 September 2015

Puja Awasthi is a development journalist based in Lucknow

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Comments

Vikram Pagaria Very aptly written article Emphasis should be on makingtoilets functional in all schools May the day come soon Keep up the goodwork PujaNovember 30 2015 1238 AM middot 0 middot 0

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From Aug 2013 published withsupport from Oorvani Foundation achampion of public-funded mediafor the new India

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