Menstruation as Taboo
The pharmacist checks that my fellow, male customer has his back turned before he slides what looks like a small, black bin-liner across the counter. Never mind the fact that I – ever eco-conscious – had told him not to worry about a bag. I’d startled him enough, I suppose, when I asked him at a normal volume for a packet of tampons.
The black bin-liner, or sometimes paper bag, is the symbol for many women in India – or at least for those privileged enough to be able to purchase sanitary products – of ‘that time of the month’. Its accusatory undertones are something I myself attempt to tackle by refusing to speak in hushed tones, and by firmly saying no thank you to a bag.
One might see the attempts of the pharmacist to cover up the purchase as a paternal act, one intended to lessen the buyer’s embarrassment – and this probably is the intention. When one delves deeper, however, one realises that ‘the bag’ is merely the tip of a colossal iceberg of shame surrounding menstruation in India; one that harms young women in all manner of ways.
For many Indians, menstruation is considered to be ‘impure’ or ‘polluting’. Some Hindu women and girls are not allowed to visit the temple, pray, or cook while on their period. They may be barred from touching others or even kept away from their family. Among Muslims, menstruating women can be prohibited from touching the Qur’an, entering the mosque, praying or fasting. Many women must, therefore, live in a society that expects them to fulfill a certain role – to be a mother, to spend their time tending to their family or in the kitchen – while simultaneously demonising an inherent part of the process of fertility and banishing them once a month from these spaces too.
In most states in India, more than half of women in the age group 15-24 do not have access to hygienic sanitary products. In some northern states, such as Bihar and Uttar Pradesh, more than 80% of women still use a cloth. Use of unhygienic methods such as these can drastically increase vulnerability to reproductive tract infections.
Has Progress Been Made?
An attempt to raise awareness of the inaccessibility of sanitary products came at the beginning of this year in Pad Man, a 2018 Hindi film, which tells the story of a social activist from Tamil Nadu who invented a machine to make low-cost sanitary pads. Arunachalam Muruganantham, initially unaware of the reality of periods, educated himself when he became concerned about his wife’s use of unhygienic rags and ended up being included in Time magazine’s list of 100 Most Influential People in the World (2014) for his work to improve access to sanitary products.
Lack of access to hygienic products may stem from a range of factors, including but not limited to poverty, local unavailability and a lack of education on proper sanitary practice. Initiatives by the government and by non-profit organisations to provide subsidised or even free products have tried and failed to make a significant dent in the issue of access.
This is perhaps because access to products is only a superficial part of the problem. Handing out pads may seem to state governments and NGOs as a straightforward and tangible solution to seize, but it is merely a temporary fix. To begin with, young women also need a place to change and dispose of sanitary products. Without proper facilities such as clean girls’ washrooms, educational and social spaces become hugely inaccessible to adolescent girls. A major part of Sanitation First’s Schools Programme is helping young women by providing them with private areas and washrooms where they are able to change their sanitary products in private. They also build incinerators in all of their schools, so that girls are able to quickly and easily dispose of sanitary towels.
It is unfortunately all too common that Indian schoolgirls miss classes or days of school due to social pressure or the embarrassment of trying to manage a period without the proper facilities. These missed days turn into weeks, and eventually, drop-out numbers increase. Today in India, 39.4 percent of girls aged 15-18 are not attending any educational institution.
Why is There No Simple Solution?
The extent of the issue begins to reveal itself. Studies have shown a direct correlation between the percentage of women in a given state aged 15-24 in with access to hygienic products and the percentage of women with 10 years of education. In Kerala, the figures are 90% and 72.2% respectively. At the other end of the scale, only 30% of women in Bihar have access to menstrual products, while a mere 22.8% have 10 years of education. This demonstrates how interwoven menstrual hygiene is with poverty, health, education, and opportunity. The solution to such a complex issue will not present itself in cheap pads.
A look at just the first six of the United Nations’ 17 Sustainable Development Goals can tell us how integral menstrual hygiene may be to global development: good health and well-being (SDG3), quality education (SDG4), gender equality (SDG5), and clean water and sanitation (SDG6). When young women are being held back from good health, from education, and from equal opportunity, we cannot move forward together. The taboo surrounding menstruation and the barriers it poses to young women in India must be addressed to allow equal and inclusive development.
This post was written for Sanitation First by Tabitha Hutchison, who has recently graduated from the University of Cambridge and is now living in Delhi, where she is working in communications in the development sector.
 National Family Health Survey (NFHS)-4 data (2015-16)
 (Report by the National Commission for the Protection of Child Rights, 2017)