MillenniumPost
Opinion

Managing menstrual waste

Better implementation of methods and cohesive management by stakeholders is necessary

Over the past few years, working with a wide range of stakeholders, the Menstrual Hygiene Alliance of India (MHAI) has approximated that there are 336 million menstruating women in India, of which 36 per cent use disposable sanitary napkins — 121 million women.

The number of sanitary napkins used per menstrual cycle — at a conservative eight — plus that for the year, implies that India has 12.3 billion disposable sanitary napkins to take care of every year, the majority of which are not biodegradable/compostable.

With only two cities in India — Bengaluru and Pune — implementing solid waste interventions to effectively segregate and identify menstrual waste during routine garbage collection, the Solid Waste Management (SWM) Rules 2016 underscores the challenge. Sanitary waste disposal has become an increasing problem in India as the plastic used in disposable sanitary napkins are not biodegradable and lead to health and environmental hazards. The impact is more pronounced because of the unorganised ways of municipal solid waste management and poor community collection, disposal and transportation networks in cities and villages.

Further, the SWM Rules raise the pertinent point about the categorisation of used sanitary products — should they be treated as biomedical or plastic waste. According to the SWM Rules 2016, soiled napkins, diapers, condoms, tampons and blood-soaked cotton are considered household waste and are disposed of after segregation into biodegradable and non-biodegradable components.

SWM Rules acknowledge that according to the Bio-Medical Waste Management Rules 2016, items contaminated with blood and body fluids, including cotton, dressings, soiled plaster casts, lines and bedding, are biomedical wastes and should be incinerated, autoclaved or microwaved to destroy pathogens.

Since 2000, pertinent changes have been made to accommodate emerging disposal technologies, composting, strengthening capacities of urban local bodies for segregation, recycling and reuse of waste. Apart from that, riding on the 'Clean India' wave — how can segregation and safe disposal of these products become a norm rather than an exception. For an issue that continues to be brushed under the carpet, how can it be 'normalised' for citizens to make it easier for girls and women to use and dispose of these products efficiently?

'Clean India' and menstrual waste classification

For the nation, the political will to 'Clean India' is driving the message home at every level, from the country's leadership right down to resident welfare associations. But it remain under wraps due to persistent social and cultural taboos that fall squarely in one area of waste management: menstrual waste management.

While the ministries of Women and Child Development and Human Resources have created an enabling environment for girls and women to access these essential healthcare products, raising awareness on menstrual hygiene management and breaking the silence and stigma around menstruation on the issue of safe disposal, other ministries need to move cohesively together – and quickly. Given the increasing availability, use and waste load of non-biodegradable menstrual products and lack of systems for appropriate disposal, cities and rural areas in India have a time bomb that needs immediate attention.

Ideally, waste management solutions should be according to the type of products being used. The challenge lies with the disposable sanitary napkins — the vast majority of which are made with non-compostable plastic liner, non-woven cover, and SAPs. The non-compostable has two varieties of sanitary napkins — with/without SAP.

How is menstrual waste classified?

The SWM Rules consider menstrual waste as solid waste, defining it as sanitary waste within the same. The Rules go on to elucidate responsibilities of the waste generator, local authorities, gram panchayats and producers of sanitary products. Over the past few years, the MHAI has been pulling together a wide group of people, including government/semi-government authorities, implementing agencies, researchers, technocrats, journalists and sanitary napkin manufacturers to deliberate on the mounting crisis around safe disposal of menstrual waste.

From creating awareness and pushing the agenda to talk about the issue and collating material from a wide range of stakeholders, the MHAI has brought an issue that has long been buried away to the centre-stage. A look at menstrual waste disposal practices among adolescent girls in India gives a fair idea of current practices and their impact on the environment. These findings have been validated by a 2016 systematic review that pooled together evidence from research on menstrual hygiene in India and found variations in the way girls manage used menstrual hygiene products. Each has an adverse impact on the environment.

Using an interactive waste loading model developed by the global health non-profit, PATH, it is estimated that over 1 billion non-compostable sanitary pads are making their way to urban sewerage systems, landfills, rural fields and water bodies in India every month. Not only do these products take hundreds of years to decompose, but because of the SAP present in commercial sanitary napkins, they absorb and retain 30 or more times their weight in fluid. This often leads to clogging of toilets, sewerage systems and drains; and when burned, release toxic fumes like dioxins and furans that are harmful for users and the environment.

According to the MHAI, three main concerns are central to the management of this largely non-compostable menstrual waste in India. First, the paucity of appropriate disposal and treatment options leading to unsafe management of the waste. Secondly, many girls and women lack access to those waste management options that exist due to their limited ability to negotiate for solutions because of a continued culture of silence associated with menstruation. Thirdly, lack of access to disposal options may lead girls and women using otherwise hygienic products in an unhygienic manner (e.g., use a pad for longer than it should be).

SWM Rules 2016 suggest that all menstrual waste should be sent to one of the 215 large scale common bio-medical waste incinerators that exist across the country. However, this requires organised segregation, collection and transportation of menstrual and other sanitary waste on a large scale. No viable models for this have been formulated or implemented until now. The Rules also put the responsibility of managing the waste on producers through the creation of necessary infrastructure or financial support for the same — which are not in place yet. This could take the form of large scale recycling plants of the kind that P&G and Fater operate in Netherlands and Italy. However, this is a solution that holds potential for the future but does not exist currently.

Impact on the environment

Given this, there are two decentralised methods for management of menstrual waste — small scale incineration and composting. Both can be done for disposable pads without SAP. Small scale incineration has gained popularity in the last few years and various government programmes also condone them. However, models are available in the market today that don't have appropriate emission control measures and burn waste at low temperature leading to inefficient combustion and release of carcinogenic toxic fumes. Small scale incinerators can be used as a practical solution if certain measures to ensure the safety of users and staff operating these units are ensured. The environmental risk of incineration against disposal in landfills needs to be weighed and understood better.

Composting is ideal for compostable pads. However, efforts have shown that the absorbent core of even non-compostable pads can decompose leaving behind the plastic materials. Effective composting requires community mobilisation and mechanisms for segregation and aggregation of the waste at a community or household level. While all this is easy to articulate on paper, a look at any of the garbage dumps in any major city in India makes it clear that until segregation guidelines are fully implemented menstrual waste will potentially keep polluting soil and water.

Since menstrual waste is handled and treated as solid waste, a series of steps are supposed to be followed. First, segregation and immediate disposal should be done by the user. As already established, only two cities in the country are doing so — this is simply not enough. This should be followed by collection and transportation, and secondary segregation by the waste collector and storage treatment, and finally disposal or recycling. The solid waste solution should be selected in accordance with the products disposed of. For example, commercially available sanitary napkins cannot be easily composted; however, napkins/pads made from natural materials (e.g., banana fibre, bioplastics) can be composted.

For compostable products, there should be clear labelling on product packages providing instructions on disposal. Solid waste interventions for menstrual and other sanitary waste are currently limited in India with existing solutions typically implemented in urban settings and only now beginning to show results.

As mentioned earlier, the paucity of disposal and treatment options may lead to the unsafe management of large menstrual waste. A look at the menstrual hygiene products and waste management solutions currently show that a majority of the current practices are either not recommended or are not the most suitable technology but an immediate practical solution often used in communities. Where technology is available it is both too expensive, people are not aware of it, and limited in availability.

Current disposal mechanisms

In the waste-to-energy technology incinerators, the waste generates energy/electricity. Combustion happens in highly controlled environments carefully regulating temperature and pressure, potentially controlling emissions even at low temperatures. Innovations in waste to energy incinerators for the community and institutional use are underway. These can incinerate all types of napkins. The disadvantage is that very few waste-to-energy plants exist in the country. Those that do operate at a large scale are at select locations. Expensive waste-to-energy innovations applicable to community and institutional settings are still under development and will take time to pilot before entering the market.

(The author is a communications professional. The views expressed are strictly personal)

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