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This article is written by Vandita Bansal, a student of Symbiosis Law School, Noida. The article discusses various menstruation-related taboos prevalent in India and period poverty faced by women.

Introduction

“I am not free while any woman is unfree, even when her shackles are very different from my own” ~Audre Lorde

Menstruation is a natural process, and basically, all women of reproductive age in the workplace go through this cycle every month. It is a natural process that begins in females between the ages of 11 and 14 years old and is one of the signs of the start of puberty among them. In fact, at any one moment, almost one-quarter of the female population would be experiencing this cycle. Menstruation has long been associated with taboos and beliefs that restrict women from many parts of social and cultural life. In India, over 365 million women and girls menstruate, with just 18% of women using menstrual hygiene products. This is due to poverty, a lack of understanding, social taboo, and a variety of other factors. It is not just an economic and social issue, but it is also a fundamental one that must be addressed. If menstruation is natural, why is it viewed as taboo? 

What is period poverty

Period poverty is a worldwide problem, with millions of women and girls suffering and even threatened because they cannot afford basic period care. Period poverty is defined as a woman’s difficulty to buy menstrual hygiene products in total. Products include more than just sanitary pads, tampons, and menstrual cups. It includes a variety of other problems like the cost of medication facilities and many more. It results in the change from sanitary to unsanitary items such as clothing, toilet paper, rags, and so on. The inadequate access to menstruation products and hygiene education has been a serious obstacle in achieving menstrual equity. Cases like shortage of sanitary napkins, washing facilities, and waste management make this a costly issue for every woman. Inadequate access to menstruation products and hygiene education has been a major impediment to achieving menstrual equity. The cases of not only a shortage of sanitary napkins but also of washing facilities and waste management make this a costly issue. The discussion on period poverty attempts to open a dialogue in order to reduce stigma and promote basic knowledge on menstruation.

It is also important to remember that ‘not all menstruators are women, and not all women menstruate’ while considering period poverty. There are women all over the world who do not have menstruation because of a variety of medical problems. It is important that we have a discussion regarding menstruation that goes beyond the gender binary. Menstruation is also strongly affected in most third-world nations as a result of malnutrition, and India is no exception.

Menstrual products and affordability

Though some people have the option to choose and buy between menstruation cups, tampons, and pads on a daily basis, there are still the majority of people in India who do not have the money or resources to do so. Pads, the most easily available sanitary item, are not economically affordable for the majority of menstruators. Also, not to forget tampons and menstruation cups, which are easily available in cities. 

Luckily, the situation is getting better. According to findings from the National Family Health Survey (NFHS-5), the majority of women who use sanitary products and follow hygiene throughout their menstrual cycle have grown across states and union territories. As of 2019-2020, Andaman and Nicobar Islands, Daman and Diu, Dadra and Nagar Haveli, Goa, and Telangana were among the states and UTs with the highest percentage of women using menstrual hygiene products. However, Bihar had the lowest proportion of women using safe menstrual items, at 58.8 %.

Root causes of period poverty

Period poverty in India has been increased by a variety of factors, including expensive sanitary product pricing, a lack of information about their use, and the normalization of silence surrounding menstruation and related cultural ignorance as a “women’s problem.” Period poverty has three aspects: a lack of knowledge, acceptability, and access. The taboos, stigmas, and misconceptions regarding menstruation are some of the primary and most major causes of period poverty. Every discussion regarding menstruation is muted, and the silence around the topic has become so common that people are embarrassed if they break it. This, in turn, worsens the already-existing problems.

Period poverty around the world

Lack of access to menstruation products has become a worldwide issue. However, in this aspect, discussions on menstruation sometimes ignore the intertwining of class, caste, and gender. The taboos and lack of information further normalize embarrassment regarding menstruation and promote stigma all over the world.

In 2020, Scotland became the first country in the world to provide its menstruators free access to sanitary products by unanimously passing the Period Products Free Provision Scotland Bill in Parliament. The Bill was introduced by Monica Lennon, a Scottish Parliamentarian. She has been fighting for the elimination of period poverty since 2016. According to the Bill, authorities were given legal responsibility to make sure that products such as tampons and sanitary pads be provided free of charge to anybody who needs them. From 2018, these items were provided in schools, but the government has now taken a step further, making tampons and pads free in all public areas. “Menstruation is normal. Free universal access to tampons, pads and reusable options should be normal too. Period dignity for all isn’t radical or extreme. It’s simply the right thing to do.“, said Monica Lennon. Since then, the example was set for the rest of the world to follow.

On February 18, 2021, to eliminate period poverty, the Prime Minister of New Zealand Jacinda Ardern declared that all schools will have free access to sanitary items starting from June 2021. According to research, one in every twelve teenage girls misses school because of this issue, and Ardern’s government wants to eliminate period poverty in the country with this campaign. In a declaration, she stated, “We want to see improved engagement, learning and behavior, fewer young people missing school because of their period, and reduced financial hardship amongst families of participating students. Providing free period products at school is one way the government can directly address poverty, help increase school attendance, and make a positive impact on children’s well-being,”.

Several other nations are also trying to eliminate period inequity in their own ways. In an effort to eliminate period poverty, Britain announced in January that it will repeal the 5% VAT on female sanitary items. As per the BBC, the European Union (EU) is in the process of abolishing the period product tax. In the Republic of Ireland, however, such items are exempted from VAT.

Periods are not a luxury, therefore items should not be charged at a higher rate. Even Germany reduced the tax on tampons and sanitary pads from 19% to 7% starting in 2020. France, Spain, Poland, and Austria have also reduced sales taxes on sanitary products. Kenya, a lower-middle-income African country with 36.1 percent of its population living below the poverty line (2015/2016), reduced the VAT on sanitary pads and tampons in 2004 to make them more affordable. Also, the Kenyan government has planned for a program to provide free sanitary pads at schools in low-income communities. 

Poor menstrual hygiene is not limited to developing nations, even people living in developed countries cannot afford sanitary items and end up using rags, newspapers and toilet rolls, etc.

Right to bleed with dignity

In the United States, a new way of campaigning known as the menstruation movement or period movement has grown since the 1970s. The movement began in the 1970s in response to toxic shock syndrome, a rare and deadly illness caused by bacteria growing in tampons used to collect menstrual blood. The movement is focused on a woman’s personal comfort.

The effort has also brought in free hygiene products in school washrooms. As part of “menstrual equality,” efforts have now been made to expand this campaign to trans men who also menstruate. In the United States, several colleges are providing free menstrual products in men’s washrooms, claiming unheard menstrual rights.

Menstrual Hygiene Management

Empowering women and girls to handle their periods with dignity is not a problem that should be given to women and girls to solve on their own. Instead, all societies, governments, and non-governmental organizations (NGOs) should work together to find multiple solutions to existing challenges. MHM (Menstrual Hygiene Management) involves three main steps:

  • Menstruation education and awareness, as well as ways of dealing with it in a dignified manner.
  • Adequate water and safe places for women and girls to keep clean during their menstrual cycles.
  • The facility of providing safe and easy disposal of sanitary items.

MHM is important because the difficulties these women and girls suffer during menstruation restrict them from exercising their human rights, changing a natural fact that nearly all women suffer a barrier to gender equality. Menstrual hygiene rights are human rights, as the concept of human rights says in the Preamble of the Universal Declaration of Human Rights that all human beings should be identified for their basic dignity. This is challenging for women to do without proper menstrual hygiene management practices. Menstrual hygiene rights are also related to the rights to non-discrimination, to health and a healthy environment, to education, and to work. 

Effective menstrual hygiene management is also required to fulfill a number of the Sustainable Development Goals, such as ensuring healthy lifestyles, equal and fair education, gender equality, clean water and sanitation, and economic growth. Menstrual Hygiene Management also helps to keep the environment clean by reducing waste and conserving water.

Menstrual Hygiene Day

Menstrual Hygiene Day was formed in 2014 by the German-based NGO WASH United to publicly honor women’s right to manage their menstruation in a clean environment wherever they are. Menstrual Hygiene Day (28 May) addresses the stigmas associated with menstruation via social awareness, education, and action by recognizing that menstruation is a natural human activity and a sign of good health. The taboo related to discussing menstruation must be eliminated. The campaign for respect for menstruating women goes beyond their right to visit places of worship. It involves giving them suitable sanitary napkins as well as a healthy diet.

Menstruation and human rights

Human rights are those rights that almost every individual enjoys as a result of his or her human dignity. We can say menstruation is inextricably linked to human dignity. If women do not have efficient bathing facilities and effective and safe ways of managing their menstrual hygiene, then it is difficult for them to manage their menstruation with dignity. Taunting, isolation, and humiliation due to menstruation also violate the concept of human dignity. Dignity and health fall within the ambit of life and liberty under Article 21 of the Indian Constitution. Since the Right to Health is a part of the fundamental right to life, it is a basic right guaranteed to every Indian citizen under Article 21.

Even gender inequality, extreme poverty, humanitarian crises, and bad practices transform menstruation into a period of deprivation and humiliation, affecting women’s enjoyment of basic human rights. This is also applicable for women and girls, as well as transgender males and nonbinary people who menstruate. Every person at some point in their life faces menstruation-related exclusion, neglection or discrimination.

Some of the rights which get affected by how women and girls are treated during menstruation:

  • The right to health – Whenever women and girls lack the resources and facilities required to maintain their menstrual health, they also suffer health problems. Menstruation taboo can also discourage women and girls from seeking medical help for menstruation-related illnesses or pain, restricting their right to enjoy the best of health and well-being. The global community has decided to address this and provide safe Water, Sanitation, and Good Hygiene (WASH) for all people by 2030 under the Sustainable Development Goals (SDGs), adopted in September 2015.
  • The right to non-discrimination and gender equality – Taboos and beliefs regarding menstruation often promote unfair practices. Menstruation-related restrictions to school, job, health care, and public activities further promote gender disparities.
  • The right to water and sanitation – Water and sanitation facilities, like bathing facilities, which are personal, healthy, and culturally acceptable, as well as an adequate, safe, and cheap water supply, are essential requirements for maintaining menstrual health management.
  • The right to education – A lack of a safe place or the skill to manage menstrual hygiene, as well as a lack of treatment to reduce menstruation-related pain, can all lead to increased rates of school absence and poor educational results. Some studies have found that when girls are unable to manage menstruation well at school, their attendance and performance drop. This creates a great impact on their dignity and well-being, as well as their right to an education and to work.
  • The right to work – Poor access to adequate ways of managing menstrual hygiene, as well as a lack of medication to treat menstruation-related problems or discomfort, limit women’s and girls’ employment opportunities. They may refuse to take certain professions, or they may be forced to reduce working hours and salaries.

What is being done

Regardless of the challenges raised, it is important to recognize that much is being done across the world to eliminate period poverty. UNFPA (United Nations Population Fund), for example, offers a number of strategies to promote and enhance menstruation health across the world. Among these are:

  • Menstrual supplies and clean sanitation facilities are provided directly to women and girls by UNFPA. In times of humanitarian crisis, UNFPA provides dignity kits, which include disposable and reusable menstruation pads, underwear, soap, and other essentials (In 2017, 484,000 dignity kits were provided in 18 countries).
  • Menstrual health education and skill development are also promoted by the UN organization. Some UNFPA initiatives educate girls on how to make their own reusable sanitary napkins. Others provide information on menstruation cups.
  • Furthermore, as a human rights problem, the organization seeks to promote menstruation education and awareness. This is provided through youth programs and comprehensive sexuality education initiatives such as the Y-Peer program
  • Similarly, UNFPA is contributing to the collection of data and evidence related to menstruation health and its relation to global development. Surveys funded by UNFPA, for example, give important information into girls’ and women’s understanding of their menstrual cycles, health, and access to sanitary products and facilities. 

The Sanitation and Hygiene Fund

The Water Supply and Sanitation Collaborative Council has been replaced by the Sanitation and Hygiene Fund (SHF). A new global financial institution that functions continuously to ensure that no one is left behind. The SHF, in collaboration with donors and other partners, seeks to fill a gap in the worldwide response to the sanitation, hygiene, and menstrual health crises by providing nations with the resources they need to achieve sanitation and hygiene for everyone.

Despite the efforts of appropriate authorities within the United Nations human rights system, especially the treaty-monitoring bodies and the Human Rights Council’s specific guidelines, neither of the core international human rights treaties deal freely and directly with the problem of menstrual hygiene. Hence, the issue continues to receive less attention in the area of policy, research, and resource allocation.

It is the responsibility of the State to ensure fulfillment of all human rights, including those relating to menstrual hygiene, and also take steps, both nationally and through international help and cooperation, especially economic and technical guidance, to respond fully to menstrual hygiene needs through all means available, such as the adoption of applicable legal frameworks.

Period poverty in India

Due to the lack of resources available, India’s policy of exempting sanitary napkins from service tax didn’t create enough impact on both people and the economy. As per, the study of the Indian Ministry of Health, only 12% of menstruating women in India have access to hygienic sanitary products. The remaining 88%, on the other hand, are dependent on unhygienic products like rags, cloth, sand, leaves, etc as their only options. This puts them at risk of infectious urogenital diseases like Urinary tract infection (UTI), vaginal itching, bacterial discharge, etc.

As a result of this social shame, isolation, humiliation, and lack of access to products, more than 40% of students in India miss their school when they are menstruating. Avoidance of education because of menstruation shows the country’s lack of adequate sanitary facilities. It is believed that one out of every five girl children drops out of school soon after they begin menstruating. As a result of such inefficient and unhealthy measures, young girls are exposed to various physical health problems at a very young age. It also impacts their sexual, reproductive, and mental health. The increasing privatization of India’s health system has eventually ignored the demands of a large section of the country, especially the menstruating women.

Though the sex education curriculum addresses the difficulties of menstruation, it always reaches the people after they start experiencing the menstrual cycle. As a result of the lack of information on this, around 71% of India is clueless about ‘what a period is’ before they go through it. Even the exclusion of boys from menstrual education creates a sense of confusion among them, which leads to incidents of discrimination based on ‘period shame.’

Another issue for girls is that 40% of government schools in India do not have well-functioning common toilets and others don’t have separate toilets for girls and female teachers. Among the incidents of poor sanitation, access to sufficient sanitary products remains to be a question. The main issue is the lack of menstrual-friendly culture in schools. First of all, the non-availability of female teachers throughout the country, especially in rural areas seems to be unaddressed, and second is the cultural taboo attached to menstruation restricts the involvement of male teachers in such conversation. In India, menstrual products are not considered as necessary as other products. Thus, it doesn’t come in essentials because of people’s conservative thinking and beliefs.

Interventions and period poverty

After a voice raised by many people and activists on social platforms, various non-profit organizations are working in developing menstrual equality policies throughout the country to solve the challenges faced by women due to the unavailability of sanitary products. Even the government is trying to create an impact for the same among people. In 2014, the “Swachh Bharat: Swachh Vidyalaya” initiative was launched with the motive of providing functioning and well-maintained ‘WASH’ facilities in schools throughout the country. The facilities provided under ‘WASH’ are soap, a private area for changing pads, enough water for washing, and a place to dispose of old and used sanitary napkins.

Also, Menstrual Hygiene Management (MHM) suggests that both teachers and school administrations should participate in spreading awareness about menstrual health and its consequences.

Time by time, efforts have been made by the government to uplift the menstruation taboo like the introduction of napkin vending machines and eco-friendly disposal techniques. On Women’s Day in 2018, the government introduced 100% oxy biodegradable sanitary napkins, named ‘Suvidha’ in packs of four for the price of ten rupees. Though the government tried to incorporate the use of sanitary napkins through this campaign, it failed to create a nationwide awareness.

Organizations tackling period poverty in India

Here are some of the organizations which try to tackle period poverty in the best way they can.

Project Stree

The founder of this organization, Juhi Patel while growing up in India, witnessed menstrual health stigmas and period poverty from the very core. In an interview with The Borgen Project, she said, “I simply felt so incomplete not having done anything about it”.

She co-founded Project Stree a non-profit organization in 2019 with Ria Soni. The project aims to eliminate period stigma and address period poverty in India. The organization organizes various seminars in communities to raise menstrual education and awareness along with distributing eco-friendly pads. Fighting period poverty in India, according to Patel, is about more than merely giving free sanitary products. “It is also for those women who don’t have a voice and don’t feel secure in their body to be able to stand out for themselves,” she explained.

The limited access to sanitary facilities can also be linked to taboo. Many Indian women are embarrassed to buy sanitary pads even when they can afford them. In rural areas, when menstruating women and girls are not permitted in religious institutions, they are then forced to spend nights in menstrual huts to avoid contact with any person as the impure blood makes them untouchable. To address this concern, Project Stree began physically delivering pads to communities and homes. Since its start in 2019, Project Stree has helped over 2020 people and provided 6,965 pads, assisting in the reduction of period poverty in India.

Sanitation First

Breaking the taboo of menstruation is simply one part of addressing period poverty in India. Many girls living in poverty do not have access to safe and cheap sanitary products. Because of poverty, their families are forced to choose between food and these items. The COVID-19 pandemic has worsened the situation for them when even food items are not available to them. Thirukurungudi Santhanam Padmapriya, the chief executive of Sanitation Primary, told The Borgen Project that for many Indian households, “the first concern is to secure food with whatever money is available for the family.” Then, and only then, we can consider buying sanitary products.”

Sanitation First is a non-profit organization committed to reducing period poverty in India via the distribution of sanitary napkins, teacher training, and student education. Sanitation First offers anti-microbial napkins known as Safepads, which prevent infectious microorganisms. Additionally, the organization created areas and facilities throughout schools for the proper disposal of sanitary napkins. Padmapriya, also, stated that this was not the “end-all solution.” “We need to start focusing on hygiene education.” The hygiene education is not limited to girls as “we thought that girls are only a small portion of the population, so we target everyone,” she explained. Education campaigns have been started by them to remove the stigma regarding menstruation. Due to the implementation of the teaching programs in their schools, about 92 percent of boys and 91 percent of girls thought that periods should not be kept hidden.

The Humanify Foundation

Humanify Foundation founder Niraj Gera also organizes seminars and workshops where he interacts with both boys and girls. The Humanify Foundation is a non-profit organization started in India. In 2019, it started a major campaign in rural India to educate and raise awareness about menstruation. The organization holds seminars in communities and schools and distributes sanitary napkins to low-income women. Gera is a motivational speaker who promotes a variety of causes. As a man, discussing these problems motivated young girls to feel secure and to discuss their periods with their families more freely. The Humanify Foundation also issued a photography series portraying menstruation taboos and difficulties that women experience.

What can the government do

If we want to change the way menstruation is seen today, the education, health, and municipal sectors should collaborate on this initiative. Here are some pointers which can be used to address the issue and ensure growth in terms of menstrual hygiene management (MHM).

Providing sanitary goods for free/reduced rates

Making sanitary products more available to women is one of the most important ways to prevent period poverty. Moreover, the figures show the lack of access to sanitary items is severely disappointing in rural parts of the country, even metropolitan cities are the same in this situation. Moreover, while the figures that show the lack of access to sanitary goods are severely disappointing in rural parts of the country, metropolitan cities are not performing much better in these areas. As a result, rather than just reducing taxes, governments should ensure that high-quality sanitary items are given free of charge, mainly people belonging to the lower strata of society.

Bettering other facilities

Whenever the government plans to construct more toilets, they should consider that public toilets are places where gender issues arise. They must prioritize menstrual health management in their development plans, which usually focus on infrastructure growth (in quantity) above improving the already awful public toilets.

As already said, the areas of health, education, and infrastructure must work together to create a more gender-equitable society. Therefore, various amenities such as water supply, waste management systems, public safety, well-maintained public toilets, and gender-sensitive infrastructures should be put in place in order to establish a functioning and successful MHM system.

Conclusion

Menstrual health is still considered taboo in many countries. The shame of menstruation and menstrual sanitation is a clear violation of various human rights, especially the right to human dignity. Therefore, resolving these challenges requires a thoughtful approach. One solution can be to start a movement that does not exclude any vulnerable menstruators (girls with physical and mental disorders, trans-men, teenage girls living on the streets, child workers, and persons in imprisoned juvenile centers). It is high time that period poverty should be identified as a part of the country’s public health crisis.  

Government can reduce stigma by enlightening themselves, normalizing conversations about periods, imposing gender-sensitive policies (mandatory menstrual hygiene sensitization programs, menstrual leaves), providing sanitary items and services in schools and workplaces, prioritizing menstrual health and well-being as much as food, water, or medicines, and revising health curriculum in schools and universities.

Menstruation is a natural biological process, and young girls and women should realize that they can reproduce only because of this virtue. ‘Menstrual Hygiene,’ as one of the most basic fundamental human rights, needs immediate attention and action across the country, and this cannot wait.

References 

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4408698/
  2. https://feminisminindia.com/2020/05/21/missing-out-addressing-period-poverty/
  3. https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(18)30143-3/fulltext
  4. https://feminisminindia.com/2021/07/28/what-is-period-poverty/
  5. https://feminisminindia.com/2021/02/26/period-poverty-endangers-womens-right-to-dignity/
  6. https://www.unfpa.org/menstruationfaq
  7. https://www.wvi.org/blogpost/menstrual-hygiene-rights-are-human-rights-period#:~:text=Menstrual%20hygiene%20rights%20are%20connected,greater%20risk%20of%20developing%20infections.
  8. https://ideas4development.org/en/menstrual-hygiene-fight-human-rights-dignity/

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