Imagine a girl being told she cannot enter places of religious worship, cannot enter the kitchen, must be “purified,” and cannot touch boys. This situation is a universal reality many young women face across the diverse regions of India, and out of shame, many girls even stop attending school due to the stigma associated with periods. Recent social entrepreneurship — like the pad-making machine invented by Arunachalam Muruganatham that can be used by non-profits, women’s microfinancing groups, and job training organizations to produce and distribute sanitary napkins to underserved communities — merits applause. But there is still a stark divide between women who are able to afford expensive basic menstrual hygiene necessities, and poor women who forgo education and important resources whenever they menstruate.[1] To combat the issues of period poverty, these rooted stereotypes and myths that deem menstruation a necessarily bad thing must be dispelled through education efforts, and products must be made available and free for women to be able to access them rather than resorting to infectious and unsafe practices.
In South Asia, the origin of myths considering menstruation to be “dirty” and “impure” date back to the Vedic times and have been linked to the myth of Indra’s slaying of Vritras, where the guilt of this murder appears every month as women’s menstrual flow.[2] Furthermore, stereotypes arising from the Hindu faith prohibit women from participating in normal life or daily chores until they are “purified.” The major restriction among urban girls is to not enter the puja room, or the area of worship, while rural girls are unable to enter the kitchen during menstruation. Menstruating women can be considered unhygienic, so allowing them to cook food would therefore contaminate it.[3] A 2011 study found that many women reported that during menstruation, they believed their bodies emitted some sort of smell that would turn preserved foods bad and therefore were not allowed to touch foods such as pickles.[4] Dietary restrictions during the period of menstruation are often practiced in Asia and India as well, where girls avoid sour foods, and many girls believe that exercise would aggravate the menstrual blood flow. However, the opposite is true – exercise can help relieve symptoms of dysmenorrhea and relieve bloating.[5] The odor of menstrual blood especially puts girls at the risk of being stigmatized, in a society where the topic is so extremely taboo to discuss – girls’ understanding of puberty, menstruation, and reproductive health are already extremely low. In totality, none of these myths and misconceptions are backed by any scientific empirical evidence, and there is no truth to any of these cultural stigmas.
The barriers to period equity in South Asia fall along the axioms of poverty, gender, and other intersectional identifiers. Taboos and myths about menstruation permeate throughout India, leading women to believe that they are “impure” during the pinnacle of their cycle. This leads to an unhealthy cycle of menstruation taking a toll on young girls’ mental health, with no one, not even their mothers, to turn to as this cycle propagates stereotypes and a lack of sufficient knowledge. 23% of girls in India drop out of school when they begin menstruating, due to stigma and lack of access to basic hygiene products that allow them the mobility to go to school.[6] Monthly menstruation has similarly proven to be a barrier for female teachers and gender-biased school culture, infrastructure, and lack of adequate menstrual hygiene products combined with unclean private sanitation facilities undermine their rights. Over 77% of menstruating people in India use old cloths which they will reuse – an extremely unsanitary and unsafe method of hygiene. In order to accelerate absorption, 88% of Indian women will use newspapers or dried leaves in addition.[7] All of these unsafe methods provide poor protection, and compounded upon by unsanitary washing facilities, these women have increased susceptibility to infection.
In order to combat these misconceptions surrounding menstruation, it is important to raise awareness through education, since young girls’ mothers shy away from discussing these issues with them. Adult women may therefore pass on cultural taboos and bad hygienic practices. A study conducted through the socio-ecological model in Lucknow found that on the individual level, most young women lacked knowledge about menstruation.[8] At the institutional level, few resources supported menstruating young women due to dirty public toilets and broken doors – thus exacerbating women’s lack of participation in higher education because of their period. Very few participants out of 70 young girls interviewed had learned or heard about menstruation prior to menarche, or their first time menstruating.[9] Their mothers were not able to explain why menstruation occurs and the biological phenomenon behind it. Only five young women out of 70 described receiving menstruation education from their school or through NGO programs, but the few instances in which women were able to find confidants in mothers or other women to communicate about menstruation, it supported the possibility to lift the stigma surrounding periods.[10] Furthermore, school teachers and students perpetuate stigmas through miseducation and a lack of normalizing menstruation. Several young women were embarrassed or ashamed when teased by male peers about menstruating due to the shared bathrooms, and teachers had chided them from time to time about allowing male janitors to see period products.[11] Community-based health education campaigns can spread awareness among both school teachers and young girls about safe menstruation practices and remove the cultural stigma associated with it. It is imperative that nonprofit organizations and other corporate entities, perhaps in the reproductive health market, form public-private partnerships with the government to deliver both community-based and nationalized education programs about the basic biology of menstruation and hygiene.
Especially during the pandemic, stringent stay-at-home orders exacerbated period poverty, leading key period packaging distribution centers and nonprofit organizations to ramp up their operations. Compounded with job loss, some women had to resort to using cloths rather than pads to absorb menstrual flow after losing their jobs. In March 2020, when Prime Minister Narendra Modi issued “a total ban of coming out of your homes,” he inherently banned the production of menstrual products, since period-related products were not on India’s list of “essential goods” that were exempt from shutdown orders.[12] Later, menstrual products were added to this list, but there were examples of some young women who came together to create their own pads, inspired by previous community-based menstrual education programs sponsored by the non-profit SAHAYOG.[13] Furthermore, without access to public toilets, many women living in homes without toilets now faced the added dimension of lack of proper sanitation and hygiene, something that is required during menstruation. In Jaipur, only 51.27% of households had access to toilets within their own homes.[14]
Sustainability is also a concern with regards to sanitary waste disposal, especially in a country such as India where the urban waste management infrastructure is a mosaic of inefficient systems of collection, recycling, and transport that often result in hazardous toxic waste dumps. There have been numerous documented events of these trash piles falling into rivers, even bodies of water deemed holy, and polluting them. The plastics used in disposable sanitary napkins are not biodegradable and contribute to environmental hazards, which are only exacerbated by the unorganized methods of urban solid waste management. According to the 2016 Solid Waste Management Rules, only two cities in India – Bengaluru and Pune – introduced solid waste management measures to segregate and classify menstrual waste during garbage collection.[15] Since studies indicate that it can take up to 800 years for a sanitary napkin to decompose, it is of utmost importance that future social entrepreneurs continue to look toward biodegradable and affordable menstrual hygiene solutions.[16]
Increasing women’s access to the political sphere and ability to use their voice in policy decisions will allow women to advocate for sanitary napkins and adequate public toilets – for example, in Delhi, women can access only 8% of the total number of public toilets for men.[17] Finally, low-cost pads can be locally produced and distributed within rural areas and slum neighborhoods. Recently, the government of India approved a scheme to improve menstrual hygiene for 15 million adolescents by distributing low cost pads to rural areas under the National Rural Health Mission since 2010.[18] In 2018, India scrapped a 12% tax on sanitary products, another step toward making these expensive products accessible to India’s most socioeconomically marginalized. This was only possible after vast campaigning efforts that argued that menstrual hygiene products were not a luxury, and that periods were never a choice for women.[19]Furthermore, men are complicit in their roles of ignorance of the Indian period poverty epidemic. The roles of male partners and belief systems are pertinent in these deep-rooted societal stigmas and systems of power which require Indian women to take care of their menstruation alone without the educational or hygienic tools to manage a normal yet painful bodily function. Men must gain knowledge of menstruation to support their menstruating family members.
The Supreme Court of India held Article 17 as an anti-exclusion principle in the context of menstruation as well, where the apex court held that notions of “purity and pollution” that stigmatize individuals.[20] Socially excluding women due to their menstrual status is therefore unconstitutional and strongly condemned. India has also put menstrual equity and health as a cornerstone of its healthcare policies with the adopting of Sustainable Development Goals 4 and 6, in which the state pays special attention to women and the issues of women’s liberation.[21] The menstrual hygiene management framework formulated as the MHM guidelines in 2015 obligates states to create the necessary and accepting atmosphere for menstruators.[22] The government is tasked with facilitating regular education on safe menstrual absorbents, water, sanitation, and hygiene infrastructure, access to safe disposal of used menstrual products especially in schools, and a pollution-free means to dispose of menstrual waste.[23]These regulations ensure a dignified menstrual experience for adolescents and aim to increase awareness at all levels of the community. However, with these various schemes being implemented nationally and at the state level, it is still important that India approaches these laws and policies through a human rights framework, ensuring that every woman and every menstruator has the right to basic hygiene and menstrual health care.
A multidisciplinary approach across diverse sectors and fields are needed to combat the various facets of period poverty, which has only become exacerbated by the COVID-19 pandemic. Sanitation and water infrastructure projects must be improved and implemented to increase womens’ access to proper hygiene when menstruating, in order to combat the risk of infection. Linking these physical infrastructure schemes to reproductive health education and programs would address the issue, while increasing community partnerships to help women dispel their menstruation myths and learn about it as a normal biological process.
References
[1] Bridget J. Crawford and Emily Gold Waldman, “Period Poverty in a Pandemic: Harnessing Law to Achieve Menstrual Equity,” Washington University Law Review 98, no. 5 (2021): 1572.
[2] Suneela Garg and Tanu Anand, “Menstruation Related Myths in India: Strategies for Combating It,” Journal of Family Medicine and Primary Care 4, no. 2 (2015): 184–86, https://doi.org/10.4103/2249-4863.154627.
[3] Ibid.
[4] Ibid.
[5] Ibid.
[6] Ibid.
[7] Ibid.
[8] McCammon, Ellen, Suchi Bansal, Luciana E Hebert, Shirley Yan, Alicia Menendez, and Melissa Gilliam. “Exploring Young Women’s Menstruation-Related Challenges in Uttar Pradesh, India, Using the Socio-Ecological Framework.” Sexual and Reproductive Health Matters 28, no. 1 (December 2020): 1749342–1749342. https://doi.org/10.1080/26410397.2020.1749342.
[9] Ibid.
[10] Ibid.
[11] Ibid.
[12] Crawford and Waldman, “Period Poverty in a Pandemic,” 1578.
[13] Ibid.
[14] Ibid.
[15] Sonali P. Banerjee and Rahul Gupta, “Shhh!! It’s a Taboo Don’t Touch!! Pickles Go Sour! Sweets Become Inedible! Meals Become Impure! Plants Die!,” in Socially Responsible Consumption and Marketing in Practice: Collection of Case Studies, ed. Jishnu Bhattacharyya et al. (Singapore: Springer Singapore, 2022), 105–12, https://doi.org/10.1007/978-981-16-6433-5_8.
[16] Ibid.
[17] Garg and Anand, “Menstruation Myths.”
[18] Ibid.
[19] “Why India must battle the shame of period stain.” BBC News online, May 28, 2020. https://www.bbc.com/news/world-asia-india-52830427
[20] Divya Salim and Kavya Salim, “Ensuring Right to Menstrual Hygiene and Health in India: A Microcosm of Right to Life,” in Expanding Horizons of Article 21 of Indian Constitution: A Critique, (The Delhi Law House, 2021): 142-146, https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3962311.
[21] Ibid.
[22] Ibid.
[23] Ibid.
Works Cited
Bridget J. Crawford; Emily Gold Waldman, “Period Poverty in a Pandemic: Harnessing Law to Achieve Menstrual Equity,” Washington University Law Review 98, no. 5 (2021): 1569-1606
Garg, Suneela, and Tanu Anand. “Menstruation Related Myths in India: Strategies for Combating It.” Journal of Family Medicine and Primary Care 4, no. 2 (2015): 184–86. https://doi.org/10.4103/2249-4863.154627.
McCammon, Ellen, Suchi Bansal, Luciana E Hebert, Shirley Yan, Alicia Menendez, and Melissa Gilliam. “Exploring Young Women’s Menstruation-Related Challenges in Uttar Pradesh, India, Using the Socio-Ecological Framework.” Sexual and Reproductive Health Matters 28, no. 1 (December 2020): 1749342–1749342. https://doi.org/10.1080/26410397.2020.1749342.
Salim, Divya, and Kavya Salim. “Ensuring Right to Menstrual Hygiene and Health in India: A Microcosm of Right to Life,” in Expanding Horizons of Article 21 of Indian Constitution: A Critique, (The Delhi Law House, 2021): 142-146, https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3962311.
Sonali P. Banerjee and Rahul Gupta, “Shhh!! It’s a Taboo Don’t Touch!! Pickles Go Sour! Sweets Become Inedible! Meals Become Impure! Plants Die!,” in Socially Responsible Consumption and Marketing in Practice: Collection of Case Studies, ed. Jishnu Bhattacharyya et al. (Singapore: Springer Singapore, 2022), 105–12, https://doi.org/10.1007/978-981-16-6433-5_8.
“Why India must battle the shame of period stain.” BBC News online, May 28, 2020. https://www.bbc.com/news/world-asia-india-52830427