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Who Cares About The Menstrual Hygiene Of Sex Workers In India?

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NFI logoEditor’s Note: With #GoalPeBol, Youth Ki Awaaz has joined hands with the National Foundation for India to start a conversation around the 17 UN Sustainable Development Goals that the Indian government has undertaken to accomplish by 2030. Let’s collectively advocate for successful and timely fulfilment of the SDGs to ensure a brighter future for our nation.

From the time we’re children, we’re constantly told that health is wealth. Yet, when it comes to menstrual hygiene, the popular adage falls apart, and an uncomfortable silence takes its place.

This silence is the reason why so many young girls in India are unaware of what their bodies undergo at menarche. It’s why we can’t seem to ask for pads and tampons without whispering at the chemist’s. And it’s also why a 12-14.5% goods and services tax (GST) on sanitary napkins has gone unchallenged for so long. Yes, we have begun to break that silence, but universal access to sexual and reproductive health-care services is still scarce. Especially when it comes to marginalised groups, like sex workers.

Menstruation is still a taboo in our country,” says Dr Smarajit Jana, a founder and chief advisor of Durbar Mahila Samanwaya Committee (DMSC), a Kolkata-based sex workers’ collective. Talking about the challenges faced by sex workers in accessing products like pads and tampons, he says, “We cannot talk openly. Even shop owners cannot talk very openly; they have to go very close to the compound and whisper to them ‘What do you want to buy’, and then put it in a black bag.”

For many sex workers, however, even purchasing that pad can be a luxury. As per studies conducted by DMSC, Dr Jana says that around 40% of sex workers still use cloth, instead of sanitary napkins.

In the redlight district cloth doesn’t dry properly,” he adds. Obviously, using damp, unclean cloth comes with its own consequences. Yeast infections and vaginitis are common, but they pale in comparison to long-term problems like pelvic inflammatory disease, or sexually transmitted infections like trichomoniasis that some women suffer from.

According to the United Nations, only half of all women in developing regions like India receive the recommended amount of health care they need. In the case of sex workers, even information about health care is absent.

Pehle pehle toh hum kapda use karte the, kyunki jaankari nahi tha (Initially, we would use cloth, because we didn’t know better),” says Bharati Dey, Secretary of DMSC. “Har sal, hum har area mein meeting kartein hain, menstrual hygiene pe (Now every year, we conduct meetings on menstrual hygiene in different places).” Such programmes have really changed things for the better, but unfortunately, efforts like these are few and far between in India.

Prostitution
Girls stand outside the red-light zone, Sonagachhi.

Speaking to YKA, social worker Aysha Mahmood says: “Many projects concentrate on educating them about safe sex and their rights. But my feeling is that sanitation and hygienic living on the whole has not yet been made easy for them.

That’s not all. Things become doubly complicated for sex workers, since they are marginalised by the law as well. Mahmood worked for 4 years in women’s prisons in India as a psychiatric counsellor, and a point person for the Kerala State AIDS Control Society. In these prisons, she says, more than half the inmates were sex workers. Conditions were bad, she explains, as they were not provided sanitary napkins or underwear, that the appointed doctor was hardly ever available, and lady doctors even less. In fact, for the last few years, Mahmood and her friends have spent Women’s Day distributing sanitary pads in these prisons.

This isn’t to say that those who stay under the police’s radar have it easier. In the trade, one’s health is quite literally their wealth. If you want to continue seeing clients and earning money, you have to be in a condition to do it. Dey talks about how, previously, HIV intervention programmes were able to increase the use of condoms. “Vaise hi menstrual hygiene campaigning ke baad sanitary pads ka use badh gaya hai (Similarly, after campaigning for menstrual hygiene, the use of sanitary pads has increased).

Dr Jana adds that, “Non-specific STIs are very high among the community, even after 15 years of our HIV intervention programme. So explaining to sex workers how and why they should have hygienic practices is important.

But just how achievable is that? After all, sanitary pads are so heavily taxed. Dr Jana says that for low-income category sex workers, it’s an economic burden. And like so many people across the country, he favours a withdrawal of the tax on condoms and sanitary napkins. There is of course much more that needs to be done, and this is where the issue ties up with the country’s dismal reality of sanitation. Only 60.4% of people have access to toilets. Hand-washing facility with soap and water are also rare. And all of this combined poses massive obstacles to good menstrual health.

As a signatory to the United Nations Sustainable Development Agenda, India has a duty to ensure good health and wellbeing for all its citizens – especially sex workers and other marginalised groups. Reducing mortality and sickness caused by unsafe sanitation and lack of hygiene is a non-negotiable. We need national strategies and programmes on reproductive health care, and we need to empower people to ask for them.The government must incorporate menstruation in its efforts to achieve adequate and equitable sanitation and hygiene for all. To achieve all this by 2030, as part of our commitment to the agenda, we must work extra hard to do right by those vulnerable situations.

Featured image for representational purposes only.

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An ambassador and trained facilitator under Eco Femme (a social enterprise working towards menstrual health in south India), Sanjina is also an active member of the MHM Collective- India and Menstrual Health Alliance- India. She has conducted Menstrual Health sessions in multiple government schools adopted by Rotary District 3240 as part of their WinS project in rural Bengal. She has also delivered training of trainers on SRHR, gender, sexuality and Menstruation for Tomorrow’s Foundation, Vikramshila Education Resource Society, Nirdhan trust and Micro Finance, Tollygunj Women In Need, Paint It Red in Kolkata.

Now as an MH Fellow with YKA, she’s expanding her impressive scope of work further by launching a campaign to facilitate the process of ensuring better menstrual health and SRH services for women residing in correctional homes in West Bengal. The campaign will entail an independent study to take stalk of the present conditions of MHM in correctional homes across the state and use its findings to build public support and political will to take the necessary action.

Saurabh has been associated with YKA as a user and has consistently been writing on the issue MHM and its intersectionality with other issues in the society. Now as an MHM Fellow with YKA, he’s launched the Right to Period campaign, which aims to ensure proper execution of MHM guidelines in Delhi’s schools.

The long-term aim of the campaign is to develop an open culture where menstruation is not treated as a taboo. The campaign also seeks to hold the schools accountable for their responsibilities as an important component in the implementation of MHM policies by making adequate sanitation infrastructure and knowledge of MHM available in school premises.

Read more about his campaign.

Harshita is a psychologist and works to support people with mental health issues, particularly adolescents who are survivors of violence. Associated with the Azadi Foundation in UP, Harshita became an MHM Fellow with YKA, with the aim of promoting better menstrual health.

Her campaign #MeriMarzi aims to promote menstrual health and wellness, hygiene and facilities for female sex workers in UP. She says, “Knowledge about natural body processes is a very basic human right. And for individuals whose occupation is providing sexual services, it becomes even more important.”

Meri Marzi aims to ensure sensitised, non-discriminatory health workers for the needs of female sex workers in the Suraksha Clinics under the UPSACS (Uttar Pradesh State AIDS Control Society) program by creating more dialogues and garnering public support for the cause of sex workers’ menstrual rights. The campaign will also ensure interventions with sex workers to clear misconceptions around overall hygiene management to ensure that results flow both ways.

Read more about her campaign.

MH Fellow Sabna comes with significant experience working with a range of development issues. A co-founder of Project Sakhi Saheli, which aims to combat period poverty and break menstrual taboos, Sabna has, in the past, worked on the issue of menstruation in urban slums of Delhi with women and adolescent girls. She and her team also released MenstraBook, with menstrastories and organised Menstra Tlk in the Delhi School of Social Work to create more conversations on menstruation.

With YKA MHM Fellow Vineet, Sabna launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society. As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Read more about her campaign. 

A student from Delhi School of Social work, Vineet is a part of Project Sakhi Saheli, an initiative by the students of Delhi school of Social Work to create awareness on Menstrual Health and combat Period Poverty. Along with MHM Action Fellow Sabna, Vineet launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society.

As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Find out more about the campaign here.

A native of Bhagalpur district – Bihar, Shalini Jha believes in equal rights for all genders and wants to work for a gender-equal and just society. In the past she’s had a year-long association as a community leader with Haiyya: Organise for Action’s Health Over Stigma campaign. She’s pursuing a Master’s in Literature with Ambedkar University, Delhi and as an MHM Fellow with YKA, recently launched ‘Project अल्हड़ (Alharh)’.

She says, “Bihar is ranked the lowest in India’s SDG Index 2019 for India. Hygienic and comfortable menstruation is a basic human right and sustainable development cannot be ensured if menstruators are deprived of their basic rights.” Project अल्हड़ (Alharh) aims to create a robust sensitised community in Bhagalpur to collectively spread awareness, break the taboo, debunk myths and initiate fearless conversations around menstruation. The campaign aims to reach at least 6000 adolescent girls from government and private schools in Baghalpur district in 2020.

Read more about the campaign here.

A psychologist and co-founder of a mental health NGO called Customize Cognition, Ritika forayed into the space of menstrual health and hygiene, sexual and reproductive healthcare and rights and gender equality as an MHM Fellow with YKA. She says, “The experience of working on MHM/SRHR and gender equality has been an enriching and eye-opening experience. I have learned what’s beneath the surface of the issue, be it awareness, lack of resources or disregard for trans men, who also menstruate.”

The Transmen-ses campaign aims to tackle the issue of silence and disregard for trans men’s menstruation needs, by mobilising gender sensitive health professionals and gender neutral restrooms in Lucknow.

Read more about the campaign here.

A Computer Science engineer by education, Nitisha started her career in the corporate sector, before realising she wanted to work in the development and social justice space. Since then, she has worked with Teach For India and Care India and is from the founding batch of Indian School of Development Management (ISDM), a one of its kind organisation creating leaders for the development sector through its experiential learning post graduate program.

As a Youth Ki Awaaz Menstrual Health Fellow, Nitisha has started Let’s Talk Period, a campaign to mobilise young people to switch to sustainable period products. She says, “80 lakh women in Delhi use non-biodegradable sanitary products, generate 3000 tonnes of menstrual waste, that takes 500-800 years to decompose; which in turn contributes to the health issues of all menstruators, increased burden of waste management on the city and harmful living environment for all citizens.

Let’s Talk Period aims to change this by

Find out more about her campaign here.

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A former Assistant Secretary with the Ministry of Women and Child Development in West Bengal for three months, Lakshmi Bhavya has been championing the cause of menstrual hygiene in her district. By associating herself with the Lalana Campaign, a holistic menstrual hygiene awareness campaign which is conducted by the Anahat NGO, Lakshmi has been slowly breaking taboos when it comes to periods and menstrual hygiene.

A Gender Rights Activist working with the tribal and marginalized communities in india, Srilekha is a PhD scholar working on understanding body and sexuality among tribal girls, to fill the gaps in research around indigenous women and their stories. Srilekha has worked extensively at the grassroots level with community based organisations, through several advocacy initiatives around Gender, Mental Health, Menstrual Hygiene and Sexual and Reproductive Health Rights (SRHR) for the indigenous in Jharkhand, over the last 6 years.

Srilekha has also contributed to sustainable livelihood projects and legal aid programs for survivors of sex trafficking. She has been conducting research based programs on maternal health, mental health, gender based violence, sex and sexuality. Her interest lies in conducting workshops for young people on life skills, feminism, gender and sexuality, trauma, resilience and interpersonal relationships.

A Guwahati-based college student pursuing her Masters in Tata Institute of Social Sciences, Bidisha started the #BleedwithDignity campaign on the technology platform Change.org, demanding that the Government of Assam install
biodegradable sanitary pad vending machines in all government schools across the state. Her petition on Change.org has already gathered support from over 90000 people and continues to grow.

Bidisha was selected in Change.org’s flagship program ‘She Creates Change’ having run successful online advocacy
campaigns, which were widely recognised. Through the #BleedwithDignity campaign; she organised and celebrated World Menstrual Hygiene Day, 2019 in Guwahati, Assam by hosting a wall mural by collaborating with local organisations. The initiative was widely covered by national and local media, and the mural was later inaugurated by the event’s chief guest Commissioner of Guwahati Municipal Corporation (GMC) Debeswar Malakar, IAS.

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