by Jyoti Jindal and Sanskriti Dixit 24 April 2021
Introduction
Lack of awareness decked with widespread taboos has made India one of the worst countries for menstrual hygiene. The enforced etiquette of women being ‘shy and timid, especially in rural areas with low literacy levels, prevent them from raising their voice to ameliorate the situation. One of the major reasons for the missing spotlight on this issue is that while literate women are habitual to menstrual hygiene practices, doing it subconsciously, they do not realise that the underprivileged around them are unaware and need help; In contrast, for the illiterate and poor women, the cost of purchasing sanitary napkins and ignorance towards the consequences of poor menstrual hygiene outweigh their obedience towards the hygiene practices. This lack of menstrual hygiene in India, with more than half of the girls unaware about menstruation before menarche and close to 23 million girls leaving school on the onset of their puberty, owing to the unavailability of sanitary pads and toilets, opens channels for early marriage, financial dependence and forced sexual relations in proximate future. Awareness regarding menstrual hygiene, education concerning reproductive health, and availability of adequate infrastructure have not been mapped as real problems which need to be worked upon.
Pandemic distress
Adding to the menace, India had one of the strictest lockdowns scoring a perfect 100 in the stringency index for almost 2 months. In such times, schools supplying free sanitary napkins and NGOs working for the cause came to a standstill. The economic distress exacerbated the situation, and menstrual needs were thrown out of the picture completely.
Lakhs of migrant workers, including women, walked miles back to their homes. One can only imagine the plight of a woman carrying her luggage and toddlers, walking in menstrual pain without any adequate toilet facilities sanitary napkins. Once they reached their home state after this arduous journey, they were made to stay in quarantine facilities lacking adequate infrastructure or other menstrual necessities. As we witness the second wave of the pandemic in India, these needs must be prioritized regularly.
Educational loophole
Schools in India have failed to address this problem aptly, as they have focused on educating girls about menstruation but not boys. Many girls can empathise with the ‘secret meetings’ in school wherein the boys were sent to the playground while the girls stayed back in the classroom, learning about menstruation. Although it may seem like a subject concerning only women, this segregation indoctrinates the impression that menstruation is to be concealed from men, while some teachers even tell girls to refrain from discussing it with boys. This thickens the uneasiness about menstrual talks, burdening women to unreasonably hide this from half the population and diminishing boys’ understanding towards the phenomenon, often resulting in a teasing and uncomfortable environment for girls. Government can also issue guidelines or make policies to include ‘menstrual hygiene in the curriculum, to be taught regardless of.
Menstruation is passed down as a stigma from mother to daughter to granddaughter, each being a little more open about it, but the taboo is yet to be taken down completely. Women have lived in patriarchal societies for centuries, faced subjugation due to institutional biases, cultural norms, and prevailing customs, but this is one harm inflicted on women by ‘women.’ It is women who teach women not to act ‘bold’ and behave politely; it is the same women who tell them ‘menstruation’ is not to be talked about, as if it were an abhorrent disease, making roughly 10% of the Indian girls believe that it actually is.
The gravity of the situation
Over 70% of mothers consider menstruation to be dirty and shameful, possibly why 71% of girls are unaware of menstruation before menarche. An 11-year-old who starts bleeding heavily, unacquainted with the reason behind it, gets stressed, and does not know how to share it, ends up hiding her first period from everybody.
India is the 2nd most populated nation, and roughly 52% of its female population is menstruating, but only 16% use sanitary napkins. Poor menstrual hygiene results in a plethora of fungal & bacterial infections of the reproductive and the urinary tract. In fact, 70% of Reproductive Tract Infections (RTI’s) in women are caused due to poor menstrual hygiene. Not only this, 1/3rd of the global cases of cervical cancer are in India, the major cause of which is poor menstrual hygiene.
Constitution obligation
Unlike other democracies, India has only approximately 14% women representatives in the Parliament, making it less sensitive towards addressing women-specific problems like menstrual hygiene since most policies are framed by ‘middle-aged men’ who have little or no idea about the pain and inconvenience associated with menstruation.
Besides, India is a signatory to the 100 nation ‘Addis Ababa Action Agenda’(AAAA), wherein the member countries must enforce gender-specific budgeting. In 2015, India adopted the United Nations Sustainable Development Goals dedicated to achieving gender equality, good health & well- being of citizens, and quality education alongside sanitation and reduced inequalities.
A survey conducted by the government recently shows that close to 5.12 lakh adolescent girls constituting one-fourth of the numbers currently enrolled in upper primary schools of Uttar Pradesh in the age group of 11-14 years dropped out in the year 2018-19. The Right to Education Act enacted in the year 2009 enforced education as a fundamental right under Article 21(A) and laid down norms and standards concerning the removal of education-related barriers. However, this prima facie shows that ‘menstrual poverty’ is still a barrier not adequately addressed. Further, envisaged in the Constitution is the right to life with human dignity, which includes all the finer facets of leading a civilized and healthy life; menstrual hygiene is a basic need and cannot and should not be ‘let go.’
In ‘Consumer education and research centre v. UOI,’ the apex court held that the ‘Right to health and medical care is a fundamental right under article 21 of the Indian Constitution, which includes the right to livelihood, a better standard of living, hygienic conditions in the workplace and a leisurely environment. Lack of sanitation facilities and discomfort associated with ‘menstrual poverty’ undermines the working opportunities available for women, making them reluctant to opt for certain professions and forcing them to cut down on working hours, thereby violating their fundamental right to work. Therefore, ensuring menstrual hygiene is a humanitarian obligation and a constitutional duty of the government.
Government initiative
Government schemes concerning reproductive health like [A]‘Rashtriya Kishor Swasthya Karyakram’ program in 2014, dealing with spreading of awareness and providing of sanitary pads at subsidised rates through ASHA workers; [B] the 2018 initiative, making ‘Jan Aushadhi Suvidha Oxo-Biodegradable Sanitary Napkins’ available at Jan Aushadhi Centres nationwide at Rs. 4 for a pack of 4 pads are wonderful schemes that came into play. These address the major concern of low-income families regarding the overwhelming cost of sanitary napkins marketed. However, people are unaware of these subsidised pads being available, and those advertised enormously are branded, and therefore, significantly expensive. The pandemic made us all aware of the vast potential of the government when it came to spreading awareness about the virus for keeping the citizens healthy. This apparatus and the innovative steps taken in the process should not be disposed of but be utilised to generate awareness regarding other causes (including menstrual hygiene). Once people are aware of the consequences of not using sanitary products and poor menstrual hygiene, they will buy them and create demand for the products. Once this is done, the government should ensure high-quality product supply at low prices in all Jan Aushadhi Centres throughout the country. The thoughtful schemes started by the government lose their value if the citizens are unaware. The government has gone a long way to making this happen, but it will not be a win if they do not cross the finishing line.
Deploying the corona machinery
Railways, radio, television, communication lines, etc., all can serve as a medium to spread a healthy message which breaks the taboo and ameliorates lives. From disposables at railway stations to caller tunes, every nook and cranny could be used for information spread, and there is no reason why this shouldn’t be the case for managing menstrual hygiene. Moreover, the CSR arm of corporate houses should conduct menstrual awareness drives, public companies under governmental aegis should be obliged to take up measures to spread awareness, factory owners should ensure free menstrual products for their labour, and households for their housemaids.
This is our nation, and the onus for not spreading information, the mere spread of which can break taboos and help people, is on the educated class because if we don’t, who will?