Use of sanitary napkins is still dismal — around 20 per cent in a country where menstrual hygiene needs more believable, doable and affordable solutions
There’s no denying that the nation is waking up to the Padman challenge, what with actor Akshay Kumar turning into an onscreen social crusader and Aamir Khan challenging any man of consequence to hold up a white sanitary napkin and acknowledge the fullness of women in his life. Well-intended it certainly is and hopefully the campaign will have some positive effect but the viral effect of celebrityhood often over-simplifies the larger issue into saleable coordinates and ends up reducing a serious campaign to mere tokenism.
Most men in our country actually do not need the flash frames on social media to advertise their gender neutrality or sensitivity. If a recent survey is to be believed, then 67 per cent married men and a lesser percentage of unmarried men do buy sanitary napkins for women in their lives. And much before chivalry was documented and bandied about in numbers, householder men —fathers and brothers — have not only held the napkins in their hands but dutifully picked them up from the chemist for women they held dear. Crucially, the purported appeal of the visuals in generating awareness about sanitary and menstrual hygiene applies only in areas where the white napkin is seen and used. For, the usage of sanitary napkins is still dismal in India — around 20 per cent in a country where menstrual hygiene needs more believable, doable and affordable solutions.
Had it simply been an issue of demand and unmet supply, then product majors would have by now managed to do what Coke has done, penetrate the micro-climate of rural interiors. The larger issue of ensuring menstrual hygiene in India needs to be tackled with the three pillars of awareness, access and affordability. As Anshu Gupta of Goonj, somebody who has been working in this field since 2004 across 22 States, found out, even a rich farmer’s family couldn’t use the sanitary napkin because of lack of access while pilot schemes in the interiors failed simply because women did not know how to use it or find it convenient enough.
In some places, younger girls took to the napkin to increase their mobility to faraway schools but in the absence of toilets there to clean themselves, hurtled back to square one. In short, all current discussion of menstrual health happens in the realm of an audience that is, if not overtly familiar with, at least aware of it. But its intended beneficiaries are meant to be a large cross-section of dispossessed women who are not part of the discourse: Women in drought-hit interiors, in the poorest pockets, in resource-scarce areas, in migrant clusters, in tribal areas and so on. What about those physically challengedIJ
looking beyond the hype, India must have a well-coordinated plan and execution of what in this country is a dignity currency and a high-maintenance issue. More importantly, it has to be a graded response module, one that women can grasp and hold on to in their simultaneous battle to beat the argument of gender segregation on a biological issue that is their strength rather than weakness. Health workers on the ground have come up with shocking results: Women in remote hamlets cannot even afford a cotton cloth and make do with whatever is fibrous and absorbent locally, be it of plant origin, cow dung, newspapers and even rice husk.
In some villages, aid workers found that it was common among women to share hand-made and washable cloth pads within the family and even outside. And in the absence of enclosed spaces for cleaning and other sanitation challenges, they would revert to older practices. Still, the cloth pad kits and cups by NGOs, which distribute them in villages, have negotiated the crossover to a mobile practice. Only when this achieves acceptable levels can one talk of the next switchover to commercially produced pads. But since innovation is indigenous to our DNA, there is some momentum for low-cost and biodegradable napkins, like the one that made Arunachalam Muruganantham famous. But these, too, are not without their attendant problems. The low cost would compromise the quality of the cellulose and fibre, leading to reduced absorbency, frequent disposal and increased consumption per person. As for biodegradable variants, they are just about 80 per cent convertible. Aakar’s fully compostable Anandi pads could work in villages where getting a pit is not difficult compared to slum clusters in cities but even they need a full 180 days to break down completely. Also, there’s the question of keeping the pit a safe distance away from the water source to avoid leaching.
Even if we were able to distribute the high-quality absorbent pads with plastic shields through public and CSR efforts, their impact on the environment is another cause of concern. Gupta estimated that in a mid-sized village, with each woman conservatively using six to eight commercial sanitary pads a month (which is on the lower side given that a napkin should ideally be changed every four hours), a monthly consumption of around 5,000 to 8,000 pads would generate a non-biodegradable component of 50,000 plastic sheets. That’s a huge carbon overload on the environment and has the potential to create subsidiary havoc. So, a chain of use has to be established, from cloth to low-cost to clinically safe options, rather than going for a one-time, high-end solution.
This, of course, is just a subset of a larger ecosystem that needs to be repaired beyond just breaking down taboos. It begins with not just educating the man behind the shop counter but of imparting practical training to village women and even midwives about the necessity for menstrual hygiene in protecting them from vaginal diseases which could aggravate to cervical and uterine cancer, something which is reaching alarming proportions in our country. At primary health centres, we need to make menstrual health a definitive part of the general map of women’s health and not consign it to the category of “a natural side effect of womanhood.” School dropouts are largely being attributed to the lack of availability of disposable pads and toilet facilities but there’s hardly any talk of menorrhagia, severe cramps followed by heavy bleeding, that is plaguing most pubescent women and is often an early indicator of gynaecological health.
Sanitation should be linked to menstruation. Most of our rural women still clean themselves in the open and given the lack of enclosed, private bathing places, are prevented from either using disposables or washing and drying replicable cloth napkins. Shame and embarrassment, therefore, are not inherited or a result of the lack of awareness; they are rather imposed by the absence of facilitating infrastructure. In places where the toilet revolution is yet to pick up, even a tarpaulin enclosure for a woman’s private use is a huge relief. And once this basic dignity and respect is assured, they will have the confidence to speak about their issues and concerns and help devise more effective micro solutions.
In all the hoopla, though, nobody mentions that the standards for sanitary napkin manufacture are defined by an outdated code of the 1980s which focusses on lumpiness and comfort rather than the toxicity of chemicals used or bio-compatibility of ingredients. Social taboos and mindset change cannot be brought about via social media alone. It is in the hinterland where women’s sexual health is still a matter of hushed conversation and open dialogue seen as challenging male notions of civility and status quo where the focus must be. This government has laid emphasis on menstrual health to improve the health index but we are still behind Nepal, which has legally banned discriminatory practices around periods and Bangladesh, which has seen a 40 per cent spurt in locally developed sanitary napkins. Private efforts need to coalesce with and partner the government in this initiative which seems ungainly at the moment. It’s a tougher dare.
(The writer is Associate Editor, The Pioneer)
