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Empowering Adolescents With Their Rights To Sexual And Reproductive Health

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Empowering adolescent boys and girls with knowledge on menstruation can lead to significant changes

From using sanitary pads instead of hay and ash to making and supplying sanitary pads during COVID-19 to raising their voices against underage marriage. Adolescent boys and girls across Jharkhand are becoming aware of their menstrual, reproductive, and sexual rights, and the change is visible.

“Earlier, we didn’t know about sanitary pads. We used to use damp cloths or ash or hay during our periods. The damp cloths would give us rashes and infections, but we couldn’t seek help because we were ashamed; we never realised the root cause of the problem. That changed when we learned about menstrual hygiene management (MHM) through ChildFund’s Garima.

We started using pads. Now, since we are not getting sanitary supplies during the pandemic, we are stitching cloth pads using old, clean cloths,” said Meena, an 18-year-old Adivasi (indigenous) girl from a hamlet of 20 families, deep in the Saraiyahat block of Dumka district, in Jharkhand.

Jyoti, in her ChildFund-supported backyard nutrition garden
Jyoti, in her ChildFund-supported backyard nutrition garden.

Across India, periods didn’t stop for the pandemic in the past year, but access to period products did. Especially for economically-challenged families, accessible and/or affordable sanitary pads from ICDS centres and schools stopped due to their closure in many regions.

Period poverty in India is already a sad reality. According to a March 2020 report of the Ministry of Health, most menstruating females in India are primarily dependent on unsafe sanitary materials like rags, cloth, hay, sand, and ash as their only alternatives.

Such methods for a long time can lead to serious health consequences. The pandemic has only exacerbated this issue.
Meena and her friends had only recently started experiencing the freedom from menstruation-related taboos and using sanitary pads when they became part of Garima, ChildFund India’s program focusing on Adolescent Reproductive and Sexual Health (ARSH).

And they were not ready to go back to using unhygienic sanitary products. “The ICDS had stopped providing pads due to the pandemic… and a majority of us did not have enough money to buy sanitary napkins,” recalled Meena.

She and the other girls of the village discussed this issue at the Adolescent Girls’ Group meeting, a safe space formed under the Garima, for girls to share their problems, get help, and be linked to several health and counselling services.

Image of menstruation products
Period poverty in India is already a sad reality. | Image Source: Women’s Voices

That’s when it all started – they learned how to make pads via instructional videos on YouTube, collected old, discarded clothes, washed them, and got to work. “We are distributing these pads among the members of the community.

Our goal is to help girls of the community cope with the new normal pandemic situation. So, along with my friends, I am conducting regular awareness campaigns on handwashing, hygiene practices, and menstrual hygiene,” informs Meena.

But Meena and her friends weren’t always so empowered. Child marriage, anaemia, drop out of girls from schools, and avoidable reproductive tract infections (RTIs) such as Leucorrhoea were a few prevalent glaring issues in the community.

Garima ensures that adolescent boys and girls gain scientific knowledge about the changes in their bodies, hygiene practices, nutrition during adolescence, reproductive and sexual rights, and various other life skills to lead their lives with awareness. Menstrual Hygiene Management (MHM) is an integral part of this intervention.

After attending one of the MHM sessions, the girls realised that even though free sanitary pads were distributed to all girls attending government schools, their school, the Government Middle School was not under the Jharkhand government’s initiative. So they demanded that they, too, get this benefit and receive it.

The conspicuous silence around menstruation and adolescent sexual health has been a household feature of Indian families and communities forever. As a result, menstruation and menstrual practices face many social, cultural, and religious ostracisation.

In most families, menstruation is perceived as unclean or embarrassing, extending even to the mention of menstruation both in public and in private. One study found that almost 70% of surveyed mothers across India considered menstruation ‘dirty’.

 A girl stitching sanitary pads in Karhariya, Jharkhand
A girl stitching sanitary pads in Karhariya, Jharkhand

This leaves adolescents feeling confused, subnormal, diseased, traumatised, and largely uninformed. As a result, schools remain silent on the subject. A 2015 survey by the Ministry of Education found that teachers never discussed menstruation in 63% of villages and how to deal with it hygienically.

This silence and cultural and social influences create a significant hurdle in ensuring that adolescent girls are given proper knowledge of menstrual hygiene.

Jyoti, a 21-year-old woman from a village in the West-Singhbhum district, Jharkhand, suffered due to this silence.

“It affected my life in various ways… The people living in the community were not sensitive enough towards health and hygiene, which led to several problems in my life… I would often have infections due to ignorance. These confusions and issues disturbed my studies, and I couldn’t focus…I wish that no one should have such problems as I did,” she says.

 

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An average of more than 40% of students in India resorts to missing school while menstruating due to social stigma, isolation, embarrassment, and inaccessibility of products. The instances of avoiding school are also ramifications for the lack of proper sanitation facilities.

It has been estimated that 1 out of 5 girls drop out of school after experiencing the menstrual cycle. Dropping out of school means increased chances of child marriage, early pregnancy, anaemia, increased gender disparity, and the list goes on.

But can only providing access to sanitary pads increase girls’ chances of a brighter future? Several studies across the globe think not. A famous proverb goes, “Give a man a fish, and you feed him for a day. Teach a man to fish, and you feed him for a lifetime.”

Similarly, a mere replacement of products will not suffice to ensure dignified menstruation and reproductive health. There is a need for knowledge building to ensure that girls and larger communities are free of archaic and unhygienic behaviour patterns.

Abhay, a peer educator from Garhwa, Jharkhand
Abhay, a peer educator from Garhwa, Jharkhand.

When they learned about MHM, the girls in Meena’s village were encouraged to follow their dreams and study. They demanded (and received) that their schools have functional toilets that they can use, encouraged each other for regular check-ups, started having conversations around menstruation with everyone in their community, promoted intake of nutritious food and iron-folic tablets when necessary, and started going to school more regularly.

“The program also trained us on decision-making and leadership skills, which have helped us unite as an (adolescent) club and take decisions for our wellbeing and rights. We have even stopped many early marriages,” informs a resolute and hopeful Meena! In Jantalbeda, Jyoti too started speaking about MHM and ARSH. She convinced more than 20 girls in her village to start using sanitary pads instead of cloths and other materials.

Garima also acknowledges that targeting adolescent girls isn’t enough to ensure a long-term behaviour change around MHM and ARSH. Mothers, boys, men, and the community at significant need to be included.

Sanjay Ghanju, a government teacher at Government Middle School, Shemarsoth, a village in the Latehar district of Jharkhand, loses many of his female students to child marriages who become adolescent mothers. Still, he has seen a shift in behaviour ever since he started conducting discussions around sexual and reproductive health, menstruation and hygiene under Garima.

Sanjay Ganjhu, Govt Middle School teacher in Latehar, Jharkhand
Sanjay Ganjhu, Govt Middle School teacher in Latehar, Jharkhand.

“As a teacher, I want that all children should get equal education, irrespective of Gender. Since I have started holding monthly discussion clubs on ARSH and MHM at my school, I have seen girls become more confident and increase female attendance. The instances of child marriages have also reduced in our village.”

Abhay is an 18-year-old boy from Garhwa District in Jharkhand. Like many others, he was unaware of the changes in boys and girls during puberty. However, he saw that his cousin suffered RTI without help due to the taboos attached to menstruation. “The infection went worse over time before we got her help.”

He decided this needed to change, and he became part of Garima, “I don’t want other girls in the community to suffer from hygiene issues,” states Abhay. So when he developed a scientific understanding of adolescence, he first spoke to his cousin and convinced her to shift to sanitary pads. Next, he talked to his mother and said he wanted to talk to more people in the community and school about it.

Under Garima, Abhay is a peer educator who informs his peers, links them to necessary resources, and promotes a healthy and hygienic lifestyle. He is a trusted friend who helps curious, confused, and uninformed peers in his community gain knowledge and counselling.

He says, “Boys ask me about changes such as voice change, hair growth on the face and private parts, attraction, night-falls, etc. I listen to their problems and explain to them that these changes happen because of secrecy of hormones and that they are normal changes which help us grow towards adulthood.”

Upendra with his mother
Upendra with his mother.

He advises boys and girls to follow nutritious diets. In addition, he promotes MHM, iron-folic tablets, and sanitary pads to girls while encouraging them to talk about menstruation to their families and friends. “I want that my community’s future generations are free of blind, unscientific practices so that they can keep them safe from infection caused due to unhygienic practices.”

Upendra, a 19-year-old peer educator from Latehar district in Jharkhand, dreams of a day that all the girls and boys in his community are equals and children and adolescents aren’t victims of archaic knowledge and misconceptions.

He says, “For equality, we need to intervene on all fronts. More and more boys, girls, and community members need to share information about ARSH and menstruation among the community. We are the real change agent to fight this issue.”

Just like the Meenas, Jyotis, Sanjays, Abhays, and Upendras of Jharkhand, Garima aims to create an army of change-makers works across districts in 15 states of India so that adolescents can lead a dignified and healthy life where they can make informed decisions.

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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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