Imagine the plight of a lady health worker, assigned at a remote rural centre, while she is menstruating. Better off than many others, she may have a sanitary napkin at hand but without a toilet, where does she change it?
Such women usually have to accommodate under a dark staircase or the like within the centre, but then where does she wash her hands afterwards? The nearest source of water is a tubewell, again, quite a distance away.
And thus, at an online Women’s Day programme, Satabdi Mitra, assistant professor of community medicine, introduced the concept of “period poverty”.
She explained the term as not just the lack of money to buy period products but also the lack of awareness, stigma and dearth of infrastructure surrounding it. “Why talk only of pads? So many women in our country don’t have access to adequate water, soap or even privacy to manage menstruation with dignity,” she noted.
The webinar “puberty, period and me” was organised by the AB Block-based Rama Ghosh and Sunil Chandra Ghosh Memorial Trust and Mitra was one of the speakers.
Poverty pangs
Mitra cited the typical case of a woman in her 20s, from a weak financial background, who gets thrown out of her marital home and is forced to live with her parents, who don’t want her back. “When every morsel of food she gets from her parents is a favour, dare she ask them for period products? It’s a luxury she can ill afford,” she said.
Another typical case is of a woman prison inmate, too embarrassed to ask a male guard for menstrual products.
Period poverty is not restricted to developing nations and Mitra cited how financially weak women in the UK have had to forgo food or sell their food coupons to buy period products. “But the UK has over the past few years introduced free menstrual products in schools, colleges, correctional homes etc. Activists like Jennifer Weis-Wolf have worked to remove ‘tampon tax’ from several states of the US too,” she said.
In Mitra’s experience, most women in Bengal know about sanitary pads and want to use them too. The problem is money. “Accredited Social Health Activists (better known as the Asha ladies in purple saris) sell pads at Re 1 to those below poverty level and at Rs 6 to others in rural areas. But supply is irregular,” said Mitra, a resident of Phoolbagan.
Adolescents lack guidance
Studies show that awareness of menstruation before its onset is very low among adolescents. “So when it does start it is a shock to girls. It is unwelcome and even affects their confidence, self-esteem and well-being,” said Mitra, citing the case of a woman from an urban slum who had tearfully recounted how her period started at the age of 13.
“The girl was scared seeing blood. She cried, kept changing her clothes and managed to hide it from everyone till it ended. But when it reappeared the next month she mustered courage to tell her mother. She felt ashamed and bad about herself,” said the doctor.
Government schools, she said, have a subject on life skills where topics like menstruation are taught but it is not taken seriously even by teachers. “They find it uncomfortable teaching such topics, especially at co-educational schools and chit-chat with students in class instead. A teacher in her 50s once told me: “Ki bhool bhaal class diyeche. Oshob abar bola jaye naki?’ Yes, the matter is written in textbooks but these are optional subjects. When students barely have time to study compulsory subjects who will read these?”
Superstitions
Worsening the taboo is superstitions. “Women are asked not to cook during their periods as they are impure, not to look at themselves in the mirror, not to worship…. The tragedy is that if someone grows up obeying these, she herself starts believing them and is unable to break out of them despite an education,” said Mitra.
The doctor cited how women are asked not to carry pads openly, not to ask shopkeepers for them out loud; even shopkeepers wrap them in black bags as if to save the woman from embarrassment and women themselves use code words when referring to it in front of others.
“Given such taboos, a film like Pad Man by a matinee idol like Akshay Kumar goes a long way. At least people talk about the subject. Otherwise even doctors would be hesitant to watch a webinar on such a topic with their adolescent daughters,” she noted.
Menstrual leave
If a working woman asks to take off early one day due to menstrual pain, colleagues would say she is making a mountain out of a molehill. “Since menstruation is a routine phenomenon they claim women should be habituated to it,” said Mitra, adding how countries like Japan, Indonesia and Italy provide menstrual leave to their employees.
This is a paid or unpaid leave available to women in case they are unable to report for work due to menstruation. But it is not without controversy.
Critics say such a leave can be misused, just like the child care leave is in India. The latter is a facility for women employees to take up to two years off till her child turns 18. “The leave is meant to look after the child in case he/she is sick or to help out with exams. But there are women who use the leave to go on vacation. Similarly, not every period is painful but some women might exploit the opportunity of four extra holidays every month!”
Critics call the menstruation leave sexist and cast aspersions on the efficacy of a woman who claims such a leave. But supporters say it would promote gender equality the way maternity leave does. “Think of a woman labourer toiling away despite crippling menstrual cramps. Wouldn’t it be humane to give her a paid leave?” wondered Mitra.
Period hygiene
Another speaker, Mumbai-based obstetrician and gynaecologist Gitanjali D. Belekar, spoke about the biological side of menstruation, asking women to stay alert in case their periods occur faster than 21 days or later than 35, if they bleed for longer than seven days or bleed between cycles.
“Every woman’s cycle does not extend over 28 days but if yours is irregular you may track it on a mobile app meant for the purpose. It will help you understand your body, your ovulation dates and indicate whether you need to consult a doctor,” she explained.
Belekar also gave tips regarding period products. “We recommend that women change sanitary pads every six to eight hours but most certainly once a day. Never wear a pad that is completely soaked,” she said. “The right way to dispose pads is to wrap them in paper and bin it, but in case there isn’t a garbage disposal system, burn or bury the pads in your backyard,” she said.
Those reusing cloth during their periods must wash the strips thoroughly, dry them in the sun and preferably iron them too. “Store the strips in a cool dry place and never share them with others. Discard after multiple use,” said Belekar, who also touched upon the availability of menstrual cups and tampons.