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Menopause In Slums: How The WASH Sector Is Failing Menstruators

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“What the hell can a slumdog know?” asked the policeman in Slumdog Millionaire released in 2009.

More than 64 million people were living in India’s slums as per the 2011 census. Divided into nearly 13.8 households, they formed 17.4 percent of India’s then 1.2 billion population.

Life Clearly Isn’t A Pleasure Cruise In Slum Areas

Shanty, overcrowded, unhygienic, etc. are adjectives used for India’s infamous slums. With lack of ventilation, light, breathable air, sanitation facilities, and well, individual dignity, these slums often become the bitter truth of glorious metropolitans.

Life clearly isn’t a pleasure cruise in these areas. But is it the same for every person living there? The answer is a clear NO! But let’s narrow things down a bit and talk about a much-ignored issue in most discourses around menstruation – menopause.

Dealing with menopause mostly is not an enjoyable experience for menstruators – with irregular flows, hormonal changes, hot flashes, etc. menstruators go through an immensely uncomfortable change in their life.

Individuals while experiencing perimenopause and menopause are in a constant need to use toilets – they experience vaginal dryness, heavy flows, and irregular cycles, and are often more vulnerable to urinary tract infections.

What can help them to avoid these problems? Personal hygiene and sanitation. Consequently, what do they not get access to? You guessed it, personal hygiene and sanitation.

The 2011 census stated that one-third of the slums had no indoor toilets and 64 percent were not connected to any sewerage systems.

But clearly, various governments have been trying to solve this issue; yet, lack of menstrual hygiene during menopause is a pertinent problem for policy-makers. Despite the existence of various community toilets in nearby areas, menstruating individuals choose not to use them for various reason as listed below-

Community Toilets Are Located In Faraway Locations.

Individuals during menopause often experience irregular flows which mostly occur spontaneously, this makes their frequency of using toilets more than menstruating and non-menstruating individuals. Most community toilets are located far off from slum residences and require users to travel for 35-40 minutes (to and fro) every time they want to use them. Most menopausing individuals (who usually are in their 30s to 40s) play an integral role in managing their households and utilizing this much time for their personal hygiene, that too, multiple times a day does not resonate with them for obvious reasons.

Too Many People, Not Enough Toilets.

Another issue is the number of users per toilet, community toilets are often overcrowded and require users to wait for 10-15 minutes in a queue. A report[3] by NDTV revealed that out of the 3 community toilets in Geeta Nagar, each has 20 seats whereas the slum’s population is more than 50,000. Considering the distance issue, this increases the total time menopausing individuals have to invest.

Lack of toilets in schools and thereby inability to access hygienic menstruation practices remains the major cause of drop out of girls from school. Representational image.

Furthermore, cleaning oneself during menstruation often takes more time than per se, urination.

No Female-Friendly Toilets

Most of these toilets only have urinals and not enough space to bathe and/or clean themselves properly. Furthermore, most of these toilets have broken locks and doors posing a serious issue towards the user’s privacy. Additionally, a major motivation i.e. sanitary pad dispensers are also not available in these toilets giving most menopausing individuals no motivation to use these toilets.

No 24×7 toilets

Most of these toilets are closed at 10 pm leaving users with no other alternative to go to. Menopausing women have designated deserted areas where they go to discharge their menstrual waste and clean themselves. Usage of such locations often poses security concerns to the individual and privacy concerns to individual dignity. The anxiety caused by apprehension of being seen often acts as a catalyst and mental health issues for menopausing individuals.

Costly toilets

A study revealed that the expenditure of using community toilets is 104 times more than the expenditure of families that have their own toilets. A pertinent issue here becomes the socio-economic structures in slums.

A study revealed that 66.6% of families living in slums have a monthly income of less than Rs 10,000 which clearly suggests that individuals have to prioritize some basic needs over others. Furthermore, many families in slums are regulated under patriarchal authority – which clearly means that even if menopausing women want to choose menstrual hygiene over basic needs per se food, the men of their families won’t let them do so.

The problem worsens when authorities fail to recognize that vulnerable groups often have more vulnerable groups among them – discrimination does not stop at any socio-economic level and is often, meticulous in nature.

The sheer neglect of the existence of individuals who are going through menopause which is evident in the existing mechanisms is an absolute reflection of gender inequality – a concept that often gets ignored under the shadows of poverty.

The creation of equality involves equity of resources and India, as a country, will not achieve gender equality until it starts caring about individuals who are bleeding and the ones who won’t be bleeding in the future.

Featured image is 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, demanding that the Government of Assam install
biodegradable sanitary pad vending machines in all government schools across the state. Her petition on has already gathered support from over 90000 people and continues to grow.

Bidisha was selected in’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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