In June 2010, the Centre approved an unprecedented scheme to promote menstrual health by distributing subsidised sanitary pads among adolescent girls. Priced at Rs.1 each, the pads were targeted at 15 million girls between the years of 10 and 19, and across 152 districts in 20 States. It also decided to supply sanitary napkins to 200 million rural women in the age group 20 to 45, providing each with an annual stock of 100 napkins.
Then, in November 2011, the Tamil Nadu government too initiated a “napkin revolution” with the free distribution of six disposable pads per month to 700,000 post-natal mothers for three months, and packs of five each month to 41 lakh adolescent girls and 700 women prisoners.
The schemes are well-intentioned: the female monthly is a taboo subject across India. Typically, the onset of menstruation is a traumatic and fearful experience for girls in India. In Tamil Nadu, it is celebrated with much fanfare, inviting friends and relatives to a grand feast and a ritualistic ceremony of purification of the girl. Yet the girls themselves are unprepared, with little knowledge about the cycle and how to deal with it.
Though in any family senior female members are supposed to be the traditional sources of information, most are absolutely ignorant about the need for hygiene associated with the menstrual cycle. In fact, menstrual hygiene is a much ignored aspect of public health, especially women’s health.
Hygienic insufficiencies are considered to be one of the reasons for maternal morbidity which is still high at between 250 and 450 per 100,000 live births, according to a 2010 Unicef report. Other Reproductive Tract Infections primarily related to a lack of hygiene are also widespread in the country. Multiple studies have revealed that unhygienic conditions during periods are one of the major causes of cervical cancer among rural women. An improvement in overall sanitation can help reduce the number of victims. The focus indirectly put on menstrual health management (MHM) by the Millennium Development Goal 5 dealing with maternal health and universal access to reproductive health aims at a three-quarter reduction in maternal morbidity by 2015.
Getting women to use disposable sanitary napkins is viewed as one of the essentials of MHM.
But there is another dimension to napkins that rarely comes up in a debate — that is the environmental havoc that sanitary products cause. The distribution of millions of disposable pads can only add to the burden of India’s badly managed waste disposal system. Modern pads are not biodegradable. In urban areas, disposing them down flush toilets can end up causing large-scale clogging of the drainage system. Also, improper incineration leads to air pollution.
“Even if the used pads end up in land refills, they never break down or reintegrate into the environment. In India, most disposable pads end up littering village roadsides or getting burned in huge trash heaps, releasing toxins from the plastics,” said Kathy Walking, of the Pondicherry-based Auroville Village Action Group (AVAG).
Many self-help groups are now helping women to cope with the cultural taboos around menstruation in ways that can also be eco-friendly.
“Women should become aware of their biological process and manage it in a safe way,” said Anshu Gupta, founder of Delhi-based Goonj, which pioneered the initiative “Not Just A Piece of Cloth” nearly a decade ago.
“In 2004, we started providing affordable (Rs.5 for a pack of five sanitary napkins) easy-to-use clean cloth napkin made out of waste cloth for women in villages and slums. We found clothing gave these women, who neglect or are ignorant of this critical health issue, a sense of dignity and self-respect.”
Today, Goonj pads — 100 per cent biodegradable, and can be either reused or disposed of — have takers in 21 States. Other non-governmental organisations (NGO) like “Vikalp,” and AVAG are also working on eco-friendly MHM products.
In Tamil Nadu
Earlier this year, Eco Femme, AVAG’s outreach to rural women in Tamil Nadu, began a pilot project to distribute reusable sanitary pads designed by it among 1,200 women across the State
AVAG is working with seven NGOs in the State to distribute the product and collect feedback by the end of the year. If the responses are positive, the findings will be submitted to the government in the hope of collaborating on a social enterprise.
Each woman is provided a set of three washable cloth pad prototypes expected to last three to seven years and produced by the rural self-help women. They are invited to a seminar for a general introduction to menstrual health management issues and exposure to different products.
For southern Tamil Nadu, the Palmyrah Workers’ Development Society, Madurai, is the key agency collaborating with its local partners in Thoothookudi, Tirunelveli, Kanyakumari and Ramnad.
Aside from reaching out to women, the workshops have the incidental benefit: of raising awareness about and the importance of MHM among men.
As MHM becomes a more “talkable” issue, the aim is to provide women the best solution — one that protects their dignity and is least harmful to the environment.