“At the age of 18, Jeeshabai got married with the expectation of having a happy family life with her husband. Owing to the malpractices and shyness of menstruation, her story didn’t turn out as she had expected it to be. As a practice from days behold, while menstruating, she’d been using an old discarded/waste cloth, ever since she started the cycles of blood. Unaware and ignorant of the noxious effects of these practices, she continued using cloth from her old blouse, which, somewhere hidden in the hemming creases, had a ‘hook’ that unhooked her. Close contact of the hook with her vulva caused serious bacterial infections inside her vagina. Oblivious to the growing infection, she kept the matter hush-hush and ignored the symptoms until the pain and irritation became unbearable. A few days later, when it became unbearable, she had to visit a doctor and she got to know that the hook had caused severe infection inside her vaginal tract and uterus. She had to undergo surgery to stop the infection from causing tetanus and becoming a life threat.
But her suffering did not end with two months of physical pain. It brought along mental pain when her husband announced the end of their relationship because the infection had impacted her reproductive system in a way that she would no longer be able to give birth to a child to continue his lineage. All her dreams and aspirations from life got shattered at the young age of 20.”
The above story is not one of its kind. Just like Jeesha, there are lakhs of women in India and all around the world who either do not know the consequences of poor menstrual hygiene or, if aware, are helpless to take essential measures due to unaffordability and stigma. According to the National Family Health Survey IV (2015-16), only 48% of women in rural India use sanitary napkins. Some sources also cite that a significant number of Indian women often use discarded and soiled cloth pieces, cow dung, and sometimes mud for managing their periods.
Sometimes, the clothes are reused without even proper washing or drying in sunlight. Such poor menstrual health management practices increase the risk of serious reproductive tract infections, sometimes as severe as Jeesha’s. According to BBC Magazine, around 70% of the reproductive infections in Indian women are caused by poor menstrual hygiene.
The reason for poor menstrual health management at a large scale is manifold. The affordability crisis is an issue of significant concern and leads one to think that free and easy access to menstrual hygiene products should be a basic right of each menstruator. Here, it should also be noted that taboos and stigma around the subject worsen the situation.
In many rural areas, it is still believed that talking about menstruation with the husband or any male member of the family will bring bad health to them and may cause difficulty in getting their wives pregnant. During periods, women are restricted to enter temples, kitchens and sometimes, in the same room as males. Such practices and myths have resulted in silence on the subject of menstruation, which further leads to ignorance of menstrual health and hygiene by women.
There is no evidence to support the inability of Jeeshabai to buy sanitary napkins, but mostly due to stigmas, mal-practices and myths surrounding menstruation, she was pushed into the situation. We are all aware how a few decades ago, only datun was used to clean teeth, and sand to clean hands, but awareness and open-mindedness encouraged people into using toothbrush, toothpaste and soaps even in rural areas. Then what purports that these people, when sensitised about the benefits of using a hygienic means for menstruation, won’t be willing to prioritise spending on sanitary hygiene?
Also, as emphasised above, only having access to sanitary products cannot ensure good menstrual health practices by itself. Access to such products should also be backed with education and correct information on its use. This need is also reflected in the fact that many women who use sanitary napkins, tampons or other products also complain of serious vaginal infections. There are many facts that a menstruator must have the knowledge of the product they’re using to avoid health issues.
For example, sanitary napkins or tampons should not be used for more than 8-10 hours at a time, as it can increase the risk for infections and sometimes toxic Shock Syndrome (TSS); wet and clean panties should be used to avoid fungal and urinary tract infections; and panties should be dried in sunlight to stop harmful bacterial growth.
To prevent cases like Jeeshabai’s from happening and have sustainable solutions for poor menstrual hygiene, it is required that all the above aspects of menstrual hygiene are considered. Providing awareness and education on the subject to each menstruator at the right age will be a milestone towards fighting the stigma around menstruation and only then menstruators and their family members will be able to realise the need and importance of having access to menstrual hygiene products.
With such realisation, the demand for better access to information and safer products will be raised by menstruators themselves. Such demand will then directly build pressure on governments, NGOs and other stakeholders to come up with better policies and ensure education and accessibility of good menstrual health.