Menstrual hygiene needs, in times of Covid-19

Deane De Menezes

Could you please tell us little about your work background and what got you interested in menstrual hygiene, and WASH among women and girls?

I used to work as a research analyst in a big office and I got my period unannounced when I was in the office. I immediately went to get a sanitary napkin from a nearby shop. I had thought that my experiences with my periods were similar to many other girls who had their periods and that all women and girls had the luxury of privacy and access to sanitary napkins. As I got more curious, I started looking around, started doing some research and then came to know that all women do not have the luxury of a sanitary napkin. Many women still use cloth during their periods, they lack privacy, do not have a place to change and also dispose off their pads. This is how I decided to work on menstrual awareness and hygiene. To begin with, the company that I was working for gave me CSR funds to work in the community.

What is the situation related to menstrual hygiene among women and girls at present in India? Who are the most vulnerable according to you? Why?

According to Census 2011, about 336 million girls and women in India are of reproductive age and menstruate for 2-7 days, every month.  Even though menstruation is such a normal and a healthy part of our life, girls and women in India go through extreme struggles to manage their period every month. A large section of the population still looks at menstruation in a negative way and a lot of stigma is attached to menstruation. Many still believe that menstruation is a curse and that it is something impure, dirty, not to be discussed openly.

Also shocking is the extensive lack of knowledge girls still have about menstruation. For example, a 2016 study titled 'Menstrual hygiene management among adolescent girls in India' involving nearly 100,000 girls in India found that almost half i.e. 50,000 girls did not know about menstruation until the first time they got their period. As high as 23 million girls in India drop out of school annually, because of lack of menstrual hygiene management facilities like availability of clean toilets with water and lack of  availability of sanitary napkins.

Unhygienic period health and disposal practices can have major consequences on the health of women giving rise to diseases like cervical cancer, reproductive tract infections, hepatitis B infection, various types of yeast infections and urinary tract infections.

The National Family Health Survey 2015-2016 estimates that of the 336 million women are in the menstruating age group in India and about 121 million (roughly 36 percent) of them are using on an average eight sanitary napkins per menstrual cycle that are  locally or commercially produced. As high as twelve billion pads are produced and disposed of annually in India, which creates a large amount of sanitary waste raising serious concerns about how they are disposed and their impact on the environment.

What is the 'red is the new green campaign' that you started? Could you please share the details of the work that you do and the areas where you have been working among women/girls?

I started Red is the new Green (RING), a Mumbai based organisation that aims to shatter social stigma and economic inequality attached to menstruation in India. It has been focusing on menstrual hygiene management by conducting menstrual hygiene awareness sessions and also installing sanitary napkin vending machines and incinerators to create access to sanitary napkin supplies and eliminate menstrual waste at source.

We conduct menstrual hygiene awareness sessions across schools, institutions, colleges, hospitals and organisations in Mumbai. Apart from discussing myths and fears associated with menstruation and creating awareness about safe menstrual hygiene practices, we are also reaching out to underprivileged girls and women by making affordable menstrual hygiene products accessible to them by creating and broadcasting information on sustainable alternatives and solutions. We have also started installing sanitary napkin vending machines.

We soon realised that what happens to the used sanitary pads is a huge problem with many of them reaching and choking our landfills. Thus although providing sanitary napkins is a worry, the waste generated by it is a bigger problem. You should see the plight of rag pickers who are exposed to infections and other health hazards while handling these used sanitary pads. We thus also consider it important to also look at what happens to the pads after they are used and discarded and have come across the idea of installing incinerators for safe disposal and destruction of menstrual waste, an important step which is often overlooked by most organisations working in the sector. We also promote the usage of sustainable menstrual hygiene options like reusable cloth pads and menstrual  cups and guide them to places where they can learn more about the benefits of these products and the importance of making the switch towards a greener and sustainable  future.

What kind of challenges has the current Covid-19 pandemic brought up in addressing the menstrual hygiene needs of women?

The lockdown following the Covid-19 pandemic triggered a menstrual hygiene supply crisis and medical stores started experiencing an increase in sanitary napkin sales as people were anticipating a shortage in the future. When the lockdown was imposed on 25th March, sanitary napkins were not included in the essentials list until the Addendum Order issued on 29th March. As a result, the supply chains were disrupted and sanitary napkin supply became scarce across the country.

Further, due to the stigma attached to menstruation in many communities and physical restrictions due to the lockdown, women in urban slums were refraining from including sanitary napkins in the household grocery lists as only men would step out to buy supplies. This has resulted in women resorting to use cloth pads, which can increase the risk of reproductive tract infections if not washed and dried properly and can further give rise to severe consequences if not treated in time.

School girls normally get access to sanitary napkins in schools via government schemes and school donations. However, since schools were shut down, their access to sanitary napkins was also restricted. We also found that majority of the frontline women workers suffered due to the lockdown where many did not have access to toilet facilities and sanitary napkins and in order to manage their periods and long work hours, were resorting to unsafe methods to manage or delay their periods.

What is RING doing to deal with the current situation?

RING has been working on the following fronts to solve the challenge of access to sanitary napkin supplies in urban slums in Mumbai:

• Identification of NGOs who are working with communities in containment zones and determining the number of women and girls who require menstrual products. As per our interactions and keeping limited supplies in mind, we have decided to give around 15 napkins to each woman as a part of our effort to help women.
• Through donors like Pink Box India, Rotary club of Bombay, sanitary napkin manufacturing start-ups like Saral designs and individual donors, we fulfilled the NGO requirements across Mumbai by linking donors with NGOS and co-ordinating delivery and distribution efforts.

In Wadala E (F/N ward), an emerging hotspot for Covid 19, we identified 2 urbans slums to distribute napkins. We approached the local area co-ordinators who live in these localities and have distributed 230,000 sanitary pads across Mumbai, benefitting 3600 women.

I think periods are difficult to manage for a large number of women and during a pandemic, it is even more difficult due to lack of movement and also access to pads. We need more interventions to improve the current scenario to make sure that no woman or girl is left behind because of a normal body function like menstruation.

What needs to be done in the future to deal with such situations?

We recommend that there is a need for:

• Acknowledgement and clear communication from the government  that menstrual hygiene is an essential aspect of maintaining personal hygiene among women during times of crisis or natural disasters in the future.
• Priority should be given to sanitary napkin manufacturing and subsidisation of these goods.

When Maharashtra became a Covid-19 hotspot, UNICEF Mumbai swiftly brought together more than 55 organisations with diverse backgrounds to work together to respond in Mumbai and Maharashtra. Red is the New Green (RING) is a part of that collective. Read more about the collective here. The collective has rolled out several flagship programmes such as the #Jeevan Rath #Urban Slum Sanitation #Village Preparedness #School Readiness #Training of all Service Providers, Teachers and FLWs from Maharashtra and #MHM.

To support sanitation and hygiene needs if women and girls in times of Covid-19, please view the appeal below: