Menstruating in Silence
52% of the female population is of reproductive age, and most of them are menstruating every month. However, this topic consists mainly of whispers. In India, among many other societies, menstruation is not only discussed in a limited manner, but there are many taboos associated with this time of the month. While menstruating, social obligations and cultural and religious taboos — such as being forbidden to enter temples and sacred spaces, or not being able eat certain foods — restrict women physically and socially. In a recent menstrual educational awareness session with girls from an urban private school in Bangalore, girls (ages 11–14), were asked what activities they heard they should not engage in while on their period (See their answers below).
This list is clearly limited to the perceptions of 50 teenagers, however is telling of the limited education girls receive concerning their menstrual and sexual health. While social and cultural taboos surrounding menstruation is obviously highly contextual, both in developing and developed nations alike, they have caused women to remain silent in the face of their reproductive duties.
Silence around this issue has adversely impacted women. According to Sukhibhava, only 12% of India’s reproductive female population has adopted absorptive sanitation methods. Due to both a lack of awareness, and economic factors, a large sum of the 500 million reproductive women in India use alternatives such as sand, ash, plastic, newspapers, and rags during their menstruation.
Besides the obvious health implications these type of sanitation measures cause, women’s access to education and employment is also being hindered. According to Sukhibhava, an estimated 1/5 of girls drop out of school once they hit puberty. There are varying studies that find different correlations between providing proper sanitation and improving attendance in schools. Nonetheless, even the United Nations Educational, Scientific and Cultural Organization reports many girls stay home from school due to menstrual cramping, insufficient menstrual hygiene materials, inadequate water and sanitation facilities in schools, unsupportive environments, and fear of a menstrual accident. As it is, girls and women face a litany of obstacles accessing education. Unfortunately, lack of proper menstruation education and sanitary products continues to be part of the complexity of problems infringing on achieving education for girls.
Upon the first day of arriving to Bangalore this summer, I met Janice, currently a Clinton Fellow, who is working to create a picture book to easily explain menstruation to girls in India. With a bright smile, a notebook always at her side, and a never ending list of questions, she is easily one of the most intelligent and curious women I’ve ever met. When I asked Janice how she became involved in this field, she said when she hit puberty, she was forced to miss school because of her period. Because she was using makeshift cloth pads, her skirts would always become stained red while on her period, causing her to leave school frequently. One those days, her mother would have had to pick me up from school in an auto, an unfavorable and costly option. So, on heavy flow days, she stayed home. But education was extremely important to Janice and her mother, so by cutting out expenditures in other areas of their lives, they eventually were able to afford quality sanitary pads.
In this instance, a mother and daughter’s commitment to education overcame the obstacles presented by one’s period. Many girls, however, are not given this opportunity. I can’t help but think how many women like Janice the world is missing out on because their periods held them back.
And this brings up another point — for women lacking proper restroom facilities, menstruation can also cause a type of “forced” mobility. While some women may be restricted in physical mobility (constrained mobility) because of economical or social reasons, many are forced to travel outside of their home for resources and facilities, such as toilettes, water supply, and dustbins. This is often a problem in rural villages and slum settlements, where homes lack water, sewer, or electrical connections. While not having these resources nearby is a difficult and time consuming for both men and women, these tasks become even more taunting for women at night.
According to the World Bank, across India, more than 600 million people do not have access to private toillettes. In the search for restrooms, women tend to fare the worse, as many urinate or defecate late at night or at dawn to avoid being embarrassed by going in broad daylight, leading to safety issues. For example, after teen cousins were thought to be brutally gang raped and hanged while relieving themselves in a field in Uttar Pradesh in 2014, Sulabh — an NGO who has provided toilets to 1.2 million homes and has installed 8,000 such public latrines since 1970 — founder Bindeshwar Pathak told the Hindu went as far to say, “Absence of toilets in houses, particularly in rural areas, is behind such incidents of rapes and sexual assaults in villages.” There are clearly multiple issues at play beyond lacking infrastructure: the fact that women feel ashamed to the point where they need to take care of these activities during the nighttime, and of course, the fact that these types of violent and heinous crimes occur when women travel in public space.
Women seem to cope differently to the lack of proper restroom facilities — some women who are menstruating may wait all day to change their pads, some may strategically plan out when to use restrooms (most public restrooms are not free), and some may stop going to school or their job if the challenges becomes too daunting. We can assume for women who are using inferior sanitary products (plastic, newspapers, and rags), which are prone to leak more, the impacts of not having proper restroom facilities becomes even greater.
Taboos and social norms across the world cause women to hid the fact that they are menstruating, from the notorious “slipping” your tampon in your shirt, or referring in front of others to your condition as “aunt flow.” I try to wrap my head around managing my period by having to strategically plan every trip to any available restroom. I try to comprehend lacking the basic education to understand why periods happen. I try to comprehend having to resort to sand, ash or leaves as a sanitary option. I try to comprehend, but I can’t.
Organizations such as Sukhibhava are working to create solutions to this problem. They identify poor urban women in Bangalore’s slums to act as micro entrepreneurs. These women are responsible for educating their clients about menstruation, as well as selling sanitary products. Their organization has also enabled people to “adopt” a girl. For 999Rs/year — less than 20 USD — girls receive two packets of sanitary napkins per month for an entire year, three informative sessions on Menstrual Health Management, and health checkups.
When asked if there is a greater need for these types of businesses in rural settings, co-founder of Sukhibhava, Dilip Kumar replied,
Many assume that rural women are lacking the most resources. This of course is true. However, just because there are alleys of stalls and goods in close proximity to urban women, does not necessarily mean they have access to them. Improved menstrual health requires education and economical resources, which the urban poor often lack.
Sukhibhava, among other organizations in Bangalore recently held an awareness event in honor of Menstrual Health Awareness month. Onlookers were asked to sign the “Wall of Pads” and pledge to break the silence surrounding menstrual health.
At the beginning of the educational session (discussed at the start of this blog) when students were asked what periods were, one student raised her hand and stated, “It’s when impure blood leaves our body every month.” It seems ironic for society, which often places great responsibility on women to bear families, to label periods as being “impure.” Without needing to being stated, periods are the foundation of human life.
Achieving greater awareness of menstrual health requires, most importantly, improving education about puberty and reproductive health, for both boys and girls, the young and old. Moreover, providing greater access to restroom facilities and affordable sanitary options is also needed. While there is certain social and religious stigma against certain sanitary options, it seems reusable menstrual cups, and washable cloth pads (such as Diva Cups and EcoFemme) are not only the most ecofriendly options, but also the most financially sustainable. These improvements would not only allow for women to safely manage their periods every month, but also provide them more opportunities to achieve greater livelihoods.
