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Prioritising Safe Sanitation Can Make A Post-Pandemic World Bearable For Menstruators

This post is a part of Periodपाठ, a campaign by Youth Ki Awaaz in collaboration with WSSCC to highlight the need for better menstrual hygiene management in India. Click here to find out more.

By Khushi Desai, Analyst, Urban Sanitation, Dasra

On 1st February 2021, the Union Budget of India announced with great fanfare the increased allocations for Swachh Bharat Mission 2.0 (SBM 2.0) – an extension of the government’s flagship Swachh Bharat Mission 1.0 from 2014. This time around, the focus is on thinking and building ‘beyond the toilet’ towards safe and sustainable sanitation. This includes faecal sludge management and wastewater treatment, bio-remediation of legacy dump sites and source segregation of waste among other key planks.

With this multi-pronged strategy, SBM 2.0 can be a game-changer for our communities, which can become healthier and responsive to the needs of vulnerable women, children and segments of society and provide for a more dignified life. But are you wondering what safe sanitation really means and why it’s relevant to both periods (women, transpersons) and pandemics (public health)?

Safe sanitation refers to sanitation that encompasses the full cycle of waste management, from containment, emptying and transport to treatment and safe disposal in the natural environment or reuse. Sustainable and inclusive sanitation systems (cognizant of the needs of menstrual health and the differently-abled etc.) ensure that all segments of society, including the most vulnerable and underserved, have access to safe sanitation. Unfortunately, women and transpersons are often the first victims of unsafe and inadequate sanitation systems – especially in the context of menstrual hygiene management (MHM), which is deeply interlinked with sanitation, water and hygiene.

Essentials to Collaboratively #PrioritiseCleanPeriod

Periods Don’t Stop For Pandemics

Menstrual Hygiene Management (MHM) has consistently been a critically neglected but unavoidable part of our society, cast under age-old taboos and stigmas. Although 355 million women in India menstruate every month for the majority of their lives, very few have access to menstrual products, Water, Sanitation & Hygiene (WSH) infrastructure and appropriate disposal facilities for used products – and this is further exacerbated in rural areas.

In India, a report by Dasra, ‘Spot On’, finds that nearly 23 million girls drop out of school at the age of menstruation for the lack of safe toilet and water infrastructure. Even more disturbing is the fact that a large proportion of girls are forced to fulfil their sanitation needs in the open once the sun sets – making them more vulnerable to physical abuse and harassment.

While the National Family Health Survey – 5 provides encouragement with an increasing number of women across India adopting safe sanitary products (instead of unhygienic rags, ash, mud etc. from the recent past), access still remains inequitable, especially for women from underprivileged backgrounds and transgender women. Even beyond access to sanitary products, important issues of lack of safe and personal hygiene infrastructure remain – that of poorly maintained or non-existent separate toilets for women and transpersons, lack of clean water and menstrual waste dustbins.

In fact, a case in point is the plight of communities like that of women and transgender sanitation workers, who have dealt with a great many challenges during the Covid-19 pandemic. While they have contributed to the fight against Covid-19 on a war footing, their safety needs have rarely been provided for – not the least of which includes menstrual hygiene management facilities. They have worked in unhygienic surroundings – with the threat of infection from being outdoors as well as in contact with Covid-related waste –  without toilets and sometimes, with immense difficulty in procuring sanitary products due to lockdowns and closed shops leading to shortages.

Over the last 18 months, millions of menstruating frontline workers and patients at COVID-19 facilities have suffered, along with the larger women and transgender community due to the lack of MHM infrastructure and systems. If there’s anything the pandemic should teach us with regards to MHM, it is that periods can’t stop even for pandemics. This means coherent MHM policies, implementation and markets are indispensable to support the menstruation needs of over 350 million menstruating women, girls and transpersons in India.

Representational image.

Menstruation Matters

This begs the question of how MHM can be made holistic and available to those with the least access?

The primary step is recognizing that menstrual hygiene management moves beyond logistics: it, in concept as well as effect, must be treated as a full cycle, from making sanitary products available and affordable to providing necessary hygiene and toilet infrastructure with clean water and finally, safely disposing of menstrual waste.

Evidently, there is a profound interlinkage between WSH and MHM, and both these value chains need to function in conjunction for sustainable results.

Significant efforts have been placed towards the first part of the MHM value chain, which is in procuring and equitably distributing sanitary products- which further challenges need to be addressed rapidly with a WSH outlook?

  1. Infrastructure: It is now crucial to focus on building and maintaining WSH infrastructure (with a push for Individual Household Toilets or IHHTs) that can provide safe spaces for menstruating women and transpersons while providing a healthier and more hygienic menstrual experience.
  2. Disposal: There is also a massive need for ensuring that used menstrual products (1 billion used pads per month!) find their way to incinerators and other disposal facilities, rather than clogging sewer systems or ending up in landfills, where some of their components cannot decompose naturally for almost 500-800 years (Menstrual Waste Disposal In India, NFSSM Alliance, TQH Consulting).

Here is where the implications of SBM 2.0 become clear – FSM, bio-remediation of legacy waste and source segregation are all steps that would ensure a well-greased cycle of MHM, integrated with the necessary WSH tools. Existing isolated policies like the Menstrual Hygiene Scheme and the Solid Waste Management Rules, 2016 (mandating source segregation) are not just parochial, but also inefficiently implemented on the ground. Even though several states like Bihar, Maharashtra and Jharkhand have well-defined MHM policies, their execution (and quite often, in concept too) is largely limited to the provision of sanitary products and behaviour change communication, which, while important, is not the end of the journey – as we have established so far.

SBM 2.0 can take leaps ahead from these restraints, integrate smaller policy modules to tackle different parts of the MHM value chain with the support of WSH and also trickle down to state-level policies, towards safer, more sustainable and inclusive menstrual hygiene management for all women and transpersons. And inevitably, the COVID-19 pandemic and its aftermath (and all future crises) will perhaps be a notch-less terrible for menstruating communities across India.

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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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