“Aapko pata hai, mai itni besharam ban gayi hoon in dinon, maine ek male doctor se duty exchange kiya aur unko maine bol diya, ‘mera periods hai, mai nahi kar paungi, aap karlo, I will do yours. (You know, I’ve become so shameless these days, I exchanged my duty with a male doctor and told him, ‘I’m on my period, I won’t be able to do it, I’ll do your duty, you do mine)”, Dr Salma Khan, an anesthesiologist in medical Intensive Care Unit (ICU) of the Manipal Hospital in Jaipur, laughs as she narrates how she recently exchanged her duty with a male doctor on a particularly painful period day.
Dr Khan and her colleagues across India are some of the frontline workers on duty round-the-clock right now, acting as the barrier between a catastrophic infection and its community spread. On an average day, she is on her feet for 12 hours at a stretch. On the first day of her period, it means wearing a sanitary pad for that long, suffering pain, and not getting a break to change or rest. She takes it in her stride as something she’s learnt to adjust to in her demanding profession, but it’s a daunting challenge nonetheless.
“After six hours in heavy bleeding, how will you manage? In lockdown we also wear PPEs (Protective Personal Equipment) because we come in contact with patients who might be Corona positive,” she says.
“Of course I have stained my gown. There’s nothing we can do. What is the option? So I exchanged my duty with a male doctor and told him that as medicos, we should be able to talk about this freely,” she says.
The Covid-19 pandemic has called into work millions of frontline workers who are labouring round the clock to provide essential services to those in need.
Many of these workers – and there are hundreds and thousands of them right now – are also dealing with a deeply personal struggle, invisibilized by others as a non-challenge because of its routine recurrence — that of managing their menstruation.
Dr Archana B. is a pulmonologist at the Kempegowda Institute of Medical Sciences (KIMS), Bengaluru. She tests patients who come in with acute respiratory problems for Covid-19 everyday. On a regular day, she’s on her feet for six to eight hours.
The vivid picture she paints of the bodily discomfort women healthcare professionals go through during long and relentless Covid duties, is indicative of an unaddressed problem in the medical community.
“The PPEs are costly — around Rs 2000 each,” Dr Archana says over a phone call from Bengaluru. Which essentially means that the PPEs cannot be mishandled. More importantly, they cannot be taken off during the shift so as not to contract infection, which in turn means the doctors cannot use washrooms in that time. They will be sweating inside the PPEs, bleeding heavily but unable to get out of it till their shifts are over. Add to that dehydration — doctors try to train their bodies by not drinking water prior to their shift to avoid going to the bathroom.
“It’s very difficult during the periods. It’s not only the flow, there’s a lot of discomfort also. Some of the women suffer from stomach pains and back pains,” Dr Archana says. “Because you cannot use washrooms while on Covid duty wearing PPEs, you cannot change your pad.”
What’s also worrying for her is that hospital administrators who make duty rosters don’t even give women an option to choose Covid duty days. If women menstruators who suffer from acute dysmenorrhea could select the dates of their Covid duty, then they’d work in some other non-isolation wards where PPE is not a requirement on those days, which would offer them at least some relief.
Dr Archana says it’s worrying that even women in decision making positions do not consider this a problem. The nursing staff face the same problem.
The menstrual discomfiture is increased many folds by dehydration, physical isolation, mental exhaustion, being in a PPE in sweltering heat, and genital rashes she says they are likely to get from wearing the same pad for long periods of time. The complete lack of acknowledgement of this when assigning duties, especially by men in charge, speak of a condition that is affecting hundreds of thousands of menstruators, but is not being mainstreamed into conversations.
In rural Madhya Pradesh, Anganwadi workers, paid a meagre Rs 10,000 a month, are walking in the peak of the May heat going door to door to reach ration, sanitary products, and other essentials to people, and to educate them about the risks of Covid 19.
Babita Bhargava, one such Anganwadi worker in Vidisha, a city about 60 kms from the capital city of Bhopal, cannot imagine taking a day off for acute stomach cramps.
“Kya karein, duty toh karna hai na? (what to do, duty calls), Bhargava says. “We have to go into villages, it’s about six to seven hours of work, we keep spare pads in our bags. Thankfully, toilets are available at the Anganwadi centre,” she says. But some days stomach cramps, summer heat, and the work takes a toll. “I was out with a friend from Anganwadi who I could see could not even walk because of stomach cramps,” Bhargava, who surveys about 60-70 houses a day, says.
Anamika Devi Kurmi, an Anganwadi worker who has been on the job for 13 years, says supervisors will not even entertain the idea of period leave.
“Leave is only for extreme illnesses — like if you are running a high fever. Periods come every month. It will be difficult explaining a period leave to supervisors,” she says.
Things are tough for journalists too.
On the road is Neelam Pandey, a journalist with The Print, who has been travelling across Uttar Pradesh and Bihar to chronicle stories of Covid.
“When we had started off from Lucknow to Bihar, I got down. There were no washrooms available (because restaurants were also shut), so how do you go? It was quite painful for me. I had to use the toilets that were at the petrol pumps. One of them that I managed to get hold of, was quite dirty,” Pandey describes her ordeal. Not all petrol pumps opened their toilets.
“There were no dustbins to even dispose of (the pad). I was carrying tissues, I wrapped it up, put it in a polythene, and carried it with me till I could find a bin,” she says. Even at these petrol pumps, she found only a single toilet open which was for men and women both. Pandey says she worried that on top of travelling in pain, she would stain her kurta too from long pad usage due to lack of a place where she could change.
Her travel took her to villages. “You can’t just go to someone’s house and say you want to use the loo. And at one time I even had to do that. There was no option,” she says. She kept encountering open urinals that were suited for men. She speaks of women colleagues in similar situations who have had to relieve themselves in the middle of an open field because of lack of open toilets on the road during this time. Pandey raises the risk that poses to the personal safety of women.
Hindustan Times journalist Prachi Bari, based in Pune, has been going out during the lockdown to report. “I have been either going to the loo before I step out or I hold it in till I make it back home. It’s very hot right now and the more you drink water, the more you want to go to the bathroom so I try to finish a story as soon as possible,” Bari says.
“I would not think of using a toilet outside during Covid. Sometimes in an emergency, we request the Pune Union of Working Journalists office to open the ladies toilet, but there are not many on the field,” Bari says.
Manasi Saxena, a relief worker in Noida, Uttar Pradesh, has been working long hours to reach essentials to those hit by riots in North East Delhi during the NRC and CAA protests. When the lockdown was enforced, her work automatically shifted to providing relief to migrants and daily wagers. Her campaign Asha has already raised ₹10,00000.
With the general stress, she says her period stress has also gone up, a common enough problem around the world during times of disruption and trauma. Saxena, who runs an organisation called Encompassion, that works on strengthening communities through Nonviolent Communication (NVC), says her periods came earlier than they usually do, for the first time. She’s never had an issue with her cycle. “I think the stress has got to me this time.”
The lack of toilets is a glaring example of how city infrastructure doesn’t keep menstruators in mind. “If you see the images (in news), it’s mostly men who are outside. (And) it hasn’t really occurred to make facilities for women,” Pandey points out.
The lack of public facilities as menstruators step out to perform essential tasks during this lockdown, or migrant workers take the journey home on foot with girls and children in tow, and callous lack of thought that goes into assigning work for women who are afraid to ask for a period leave fearing rebuke, makes it obvious that women’s reproductive health isn’t a priority in the struggle to keep them in the workforce.
Featured image courtesy of Shambhavi Saxena.