Breaking menstrual stigma

"Are you ashamed of being a girl because of periods?", is what the school girls were asked during the menstrual health workshops organised by Sachhi Saheli, in Delhi Schools. About 90% of girls responded in affirmative and most of them, in fact, wished they were boys. (so that they did not have to deal with menstruation).

A survey conducted by NGO Sachhi Saheli found that 68% of the girls in Delhi have no knowledge of menstruation pre-menarche. Moreover, 70% of the mothers do not talk to their daughters about menstruation before the onset of their first period.

Despite being the primary source of information and education, mothers and teachers are unable to discuss periods due to their reluctance and lack of vocabulary. Age-old myths, taboos, and misinformation are rampant and have made menstruation a crushing stigma for women and girls. It is impactful and ubiquitous and leads to discrimination, isolation from friends and local communities, and hinders daily activities.

Dr Surbhi Singh, President Sachhi Saheli, interacted with about one lakh girls, anganwadi workers, ASHAs, incarcerated women, sanitation workers, and other women over the last three years in Delhi. Most of them revealed that menstruation is an unpleasant experience and they have been cursed to bear this.

About two-thirds of girls miss school during periods due to pain, fear of staining clothes, getting teased by classmates, and also due to lack of sanitation and disposal infrastructure for sanitary pads. Many girls or women who use cloth, do not wash it properly or dry it in the sun.

The situation at homes is even worse. A deep silence, lack of scientific knowledge of menstruation, poor accessibility and affordability prevent women from using hygienic menstrual blood absorbents. Situation of women from vulnerable sections like poor households, slum dwellers, rag-pickers, homeless, incarcerated women, migrants, wage labourers is even more deplorable.

The point of concern is how unhygienic management of menstruation causes rashes and itching. It leads to reproductive tract infections and predisposition to Reproductive Tract Infections(RTIs). Use of hygienic products for a longer period or in an unhygienic manner has similar consequences.

There are thousands of questions in the mind of girls and women but they find no trouble-shooter around, causing immense psychological stress. What is normal menstruation in terms of the number of days and amount of menstrual bleeding? Is watery discharge before menstruation normal? Should they take medicine for the pain or not?

And it is the lack of information that has led to many misconceptions and taboos.

Restrictions are imposed on menstruating girls and women on entering kitchen, place of worship, and participating in socio-cultural activities. This makes menstruation a scourge, a shortcoming, and a handicap.

World Menstrual Hygiene Day, which is celebrated on May 28 every year is a time to reflect upon the prevailing situation and join hands to break taboos around periods. It is also the time to change negative social norms, build political priority and catalyze action for good Menstrual Hygiene Management (MHM). Education is a tool which can empower women and girls to embrace their bodies without being hesitant to talk about menstruation. It is a way to empower teachers, mothers, and students to start a period-centric conversation.

As Menstrual Health is a complex issue, it needs coordinated efforts of all stakeholders. The strategy should be universal and should include boys and men as allies and supporters. They can be instrumental in advocacy, providing psychological support to girls and women, and creating normalcy around periods.

An exploding training strategy involving the training of master trainers and field functionaries is vital. A volunteer workforce of teachers, ASHAs, Anganwadi workers, women police volunteers, school and college students can prove instrumental in delivering the message to every woman. Public celebration of menstruation will help dispel the myths and taboos faster. Initiatives like Pad Yatra and Pad fest should be organised regularly. It is also time for our country to declare a National Menstrual Hygiene Day. Access to affordable menstrual blood absorbents is another critical component. The current struggle of women to access menstrual health supplies must end sooner than later. Compostable and reusable pads, menstrual cups and other absorbents should be largely promoted. Myths surrounding period management products like tampons, menstrual cups also hinder women to use these alternatives.

Aside from menstrual blood absorbents, an enabling environment that promotes healthy and comfortable management of menstruation is equally important. This includes toilets with clean water and soap, safe and a private place to change. Though the situation has improved a lot in public schools, it is still abysmal in slum clusters and unauthorised colonies, public spaces, and institutions in Delhi.

It's time for action as the theme for World Menstrual Hygiene Day 2019 emphasises.