COMMENTARY (i) articulation, awareness, information Menstrual Management and and confi dence to manage with safety and dignity using safe hygienic Low-cost Sanitary Napkins materials together with (ii) adequate water and agents and spaces for wash- ing and bathing, and (iii) disposal with Nivedita Pathak, Jalandhar Pradhan privacy and dignity (Patkar 2011). It also entails methods of handling and stor- The provision of low-cost sanitary enstrual hygiene management age, not using the product for more than napkins to women in rural areas (MHM) is a subject of deep con- the acceptable duration, maintaining is not an answer to the myriad Mcern in most developing coun- personal hygiene vis-à-vis managing tries, where women, especially rural daily life activities. Thus, provision of problems they face in menstrual women, face challenges in acquiring low-cost napkins is merely a band-aid on management. Apart from the need hygienic absorbents, clean water for wash- a large wound because fi rst, the sanita- for a mechanism for ensuring the ing and a private space for changing. tion facility in villages is not women- quality of the products and Every month they are forced to opt for friendly. Census 2011 reveals that 67.3% unhygienic ways to catch the fl ow and of the rural population lacks toilets, and reducing the environmental cost of hide signs of menstruation, without caring the worst-affected states are Jharkhand non-reusable products, the need is for their own health and well-being. (91.7%), Madhya Pradesh (86.4%) and for a change in the attitude With the advent of low-cost sanitary Chhattisgarh (85.2%). Rural schools often towards menstruation. It is napkin-making technology, there is a lack functional toilets, or do not have cornucopia of governmental and non- water and provide the privacy required because this is a taboo topic ruled governmental sche m es and policies on for changing pads. As a result, open defe- by religio-cultural conventions procuring, producing and promoting the cation, bathing in dirty ponds or river that rural women face not only sale of these products. Known as the water, reusing menstrual products, wash- discomfort but also problems “menstrual man,” Arunachalam Muruga- ing menstrual rags without using soap nantham revolutionised and not drying them in sunlight has linked to reproductive health. by designing a machine to make low-cost become the norm (Das et al 2015). sanitary napkins and successfully market- A discernible escalation in the incidence ing these napkins to rural women across of infections, especially of the urinary tract the country. These pads are manufac- and reproductive tract, among women tured using wood , thermo bonded using conventional methods and those non-woven fabric, polyethylene sheet, changing outdoors has been reported in glue and release paper, and sold at an af- the literature (Das et al 2015; Sumpter fordable price (www.newinventions.in). and Torondel 2013). Studies report that A few other initiatives are the Anandi rural women store menstrual rags in Pads (Aakar Innovation), Mukti Pads damp dark corners of the house because (Society for Rural Industrialisation), of the culture of shame and embarrass- Ssodashi (corporate social responsibility ment (Garg et al 2012; Dasgupta and project by Jindal Power and Steel Plant) Sarkar 2008). As this acts as a breeding and Freedays (Government of India) that ground for pathogens, replacing rags have also catered to smaller pockets in with low-cost napkins and abandoning the country. Eco-friendly initiatives like the packets in those very corners will washable cloth pads made by the non- encourage the same vicious cycle of governmental organisation (NGO) (Goonj recurrent infections. Such unhygienic and Eco-Femme) and biodegradable pads practices are handed down from one (Azadi Pads) are also helping women generation to the other and have a manage their menstruation hygienically. certain level of acceptance and societal Though it cannot be denied that such pro- sanction. Thus, unless there is a change jects have been fairly successful in turn- in existing unhealthy and unhygienic ing the tide, there are a number of related behaviour patterns, a mere replacement Nivedita Pathak (nivedita.pathak.msw@gmail. com) is a PhD student at the National Institute issues that require immediate attention. of products will not deem suffi cient. of Technology (Rourkela), Odisha and Good menstrual hygiene does not The rural market offers a plethora of Jalandhar Pradhan ([email protected]) only refer to using factory made or locally opportunities for marketing and selling teaches at the National Institute of Technology made sanitary pads. The defi nition of low-cost menstrual products; sometimes (Rourkela), Odisha. menstrual hygiene management includes under the guise of social service.

Economic & Political Weekly EPW MARCH 19, 2016 vol lI no 12 27 COMMENTARY Repeated bombardment of television mechanism, fi rst, for ensuring the quality not disappear in a day, but this should and radio advertisement of factory made of the products meted out locally and not act as a deterrent. Women’s repro- sanitary products etches an idea in the second, for reducing the environmental ductive health is an important issue minds of the rural viewers that any piece cost of non-reusable products. and is the cause of increasing maternal of pleasant smelling, sparkling white mortality. Rural women are reporting absorbent, wrapped in an attractive Taboo Topic more reproductive tract infections than packaging offers instant hygiene. How- We cannot forget that in a patriarchal urban women (DLHS 3) and there is ever, this is far from reality. Most of the framework, menstruation is a taboo hardly any change in the trend in the rural sanitary napkins making units are topic kept outside the purview of polite last few years. run by self-help groups (SHGs) with a discussions, which is by far the most Low-cost sanitary napkins can be the short training and seed grant from the important reason why menstruation is revolution that every rural woman needs, government, multinationals, or NGOs. poorly managed in rural areas. This but only when the problem is looked at After the initial training and set-up, the simple biological process is controlled holistically and engagement is made grant providers withdraw and the SHG is and regulated by religio-cultural con- with other related issues like information expected to run the programme as well ventions, due to which myriad myths dissemination, access to toilet, clean as educate the buyers, and this is where and taboos restrict women’s communi- water, privacy for changing, confi dence the problem of lack of supervision arises. cation, movement, precludes expression in making health-related decisions, and Without placing the blame on these stake- of menstrual needs and suppresses all sustainable disposal of used products. holders or funders, it is important to attempts for change in favour of women. Different organisations working on understand that the housing condition Rural women mostly do not earn and do MHM should come together to learn and storage facility in most villages is far not have a say in family expenditure and from each other’s experiences, and from hygienic, and the mini-factories as a result they fail to spend on their per- share their best practices. Good men- set-up in some well-wisher’s house or sonal needs, such that, even when men- strual hygiene management is the right the village clubroom, might not be an strual products are available in the rural of every woman and nothing should ideal place to manufacture sanitary market, they lack the means and confi - stop her from reaching it. napkins. In short, the pads might appear dence necessary to make a purchase. white and clean, when in reality they Women say that the shame associated References have been through rodent infestation, with menstruation prevents them from Das, Padma, Kelly K Baker, Ambarish Dutta, Tapoja microbial attack and repeated handling buying products from male shopkeepers. Swain, Sunita Sahoo, Bhabani Sankar Das and with bare hands. Post-use disposal is As a consequence, the women SHGs Bijay Panda et al (2015): “Menstrual Hygiene Practices, WASH Access and the Risk of another priority which the producers marketing low-cost sanitary napkins Urogenital Infection in Women from Odisha, are conveniently overlooking. The trash have a better prospect as women would India,” PloS one, Vol 10, No 6. Dasgupta, Aparajita and M Sarkar (2008): “Men- produced from menstrual waste is rather buy from them. Is this not feeding strual Hygiene: How Hygienic Is the Adoles- humongous and is already presenting a into the same loop of silence and disem- cent Girl?” Indian Journal of Community Medi- cine: Offi cial Publication of Indian Association big challenge for urban solid waste powerment, which is at the very core of Preventive & Social Medicine, Vol 33, No 2, management. Though some schemes in of menstrual embarrassment? Why do pp 77–80. Tamil Nadu offered incinerators in schools women feel embarrassed or ashamed Garg, Rajesh, Shobha Goyal and Sanjeev Gupta (2012): “India Moves Towards Menstrual and villages, it is arguable whether while making a purchase from a male Hygiene: Subsidized Sanitary Napkins for incineration is the best method for shopkeeper or while drying rags in the Rural Adolescent Girls—Issues and Challenges,” Maternal and Child Health Journal, Vol 16, No 4, disposal of lined sanitary pads. view of men is a question that nobody pp 767–74. A village usually has no facility for asks. Shame is systematically ingrained IIPS (2010): District Level Household and Facility Survey (DLHS-3), 2007–08: India, Mumbai: waste disposal. into the female psyche. Can we change International Institute for Population Sciences. Thus, it is imperative to question the the mindset along with changing the Patkar, Archana (2011): “Preparatory Input on actual benefi t from the change. Are we product? MHM for End Group,” Geneva: WSSCC. Sumpter, Colin and Belen Torondel (2013): “A correctly negotiating the environmental The solution to such a multidimen- Systematic Review of the Health and Social outcomes with women’s health, or are sional problem cannot be straightforward Effects of Menstrual Hygiene Management,” PloS one, Vol 8, No 4. we blindly denying the fact that in the and easy. But it lies somewhere in near future a pile of unmanaged waste transforming the traditional mindset will mount up next to every village, just and explaining the benefi ts of good like they have in cities? Why are we not menstrual hygiene to not only women available at looking into better solutions like men- but also men. The doors of discussion strual cups? We are not undermining the must break open traditional barriers to Gyan Deep efforts made by these sanitary napkin allow change to permeate through. The Near Firayalal, H. B. Road Ranchi 834 001 manufacturers in educating women or beliefs and faiths that are deep-rooted Jharkhand the need of the consumers, but would will not change overnight and negli- Ph: 0651-2205640 like to point out that there must be a gence towards menstrual needs will

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