Battling periods and access to menstrual hygiene in times of COVID-19

Reena (name changed) a 14-year-old girl was coming back from her tuitions when her periods started. Her evening tutorial session usually got over very late, as the didi could only come to teach them at the community centre of their slum only after she got done with the office.

When Reena reached home at around 10 pm that night, she realised that she only had about two sanitary napkins left in her store. Her dates have never followed a specific pattern, and she had no idea that she would start bleeding that very day.

She hadn’t even asked didi to replenish her share of the monthly stock. She decided she would buy some napkins the next day to last her till didi’s next visit. It was a day before the lockdown was announced, March 23, 2020.

Historically, issues that impact the lives of women and adolescent girls have usually been on the ‘forgotten’ list in times of crisis. When India entered a nationwide lockdown on March 24, 2020, to prevent the spread of COVID-19, sanitary napkins did not make it to the list of ‘essentials’ to be exempted from the restrictions.

The discussion around the access and availability of sanitary napkins has stayed as overlooked as the issue of menstrual health. By the time the product finally got included in the list of essentials on March 30, 2020, one whole week had gone by, and Reena had forgotten everything about what didi had taught her about safe periods. She was forced to use pieces of cloth available at home to manage the situation.

The latest National Family Health Survey (NFHS-4) reveals that, in India, about 58 percent of women (in the age group of 15-24 years) use a hygienic method of menstrual protection only. The same data-set also highlights that only 48 percent of rural women use a hygienic method of menstrual protection.

What these numbers do not tell us is that menstrual hygiene is not just about getting access to menstrual supplies or functional toilets.

It is as much about the knowledge of menstruation, awareness to be able to tackle the taboo, and the fact that it is deeply interlinked with the dignity and empowerment of girls and women.

About 42 percent of girls and women (in the age group of 15-24 years) were already not using hygienic methods of menstrual protection, and the number would shoot up further due to various challenges posed by the lockdown. Here are a few.

ALSO READ

Coronavirus: Access to menstrual hygiene impacted due to the lockdown, study reveals

Access to menstrual hygiene supplies

The lockdown has impacted the production and availability of sanitary napkins and other menstrual hygiene products. Not only should these products be available in larger quantities at medical and other essential stores, but also in quarantine facilities. Enough cannot be said about the requirement of napkins for health workers in the frontline, to help them continue their work without any obstructions.

Girls and women, who are from rural areas, urban slums, or are migrants returning home on foot, often rely on free or subsidised products from the government, NGOs, and CSR programmes. However, they have been left with no hygienic alternatives to take care of their menstrual health.

Affordability

Business has halted across the nation, and people working in the informal sector or as daily wage workers, have been worst hit economically. Low-income households mostly dependent on daily income and little savings, would undoubtedly prioritise food and water over anything else.

Menstrual hygiene products are not going to make it to their survival list, and neither can they be afforded, as the lack of supplies would affect the inflow of subsidised and free products as well.

Cleanliness

The one thing common between the prevention of COVID-19 and maintaining menstrual health is a focus on proper cleanliness. A proper and clean toilet, washing, and disposal infrastructures are some of the key pillars of maintaining menstrual hygiene. However, in slums, there are community toilets that lack regular cleaning due to the absence of sanitation workers, and also a safe disposal facility.

For ones living in rural areas, especially where water is scarce, even washing reusable cloth pads or cleaning themselves would get tougher as water would come at an additional cost.

Disposal of sanitary napkins and used cloth pads would be another challenge during the COVID-19 times, as poor waste management may add to contamination and spread of the disease.

ALSO READ

Meet Laad Lohar, Udaipur’s ‘Pad Woman’ who is boosting menstrual hygiene of rural women

Impact on reproductive health

The unavailability and limited supply of menstrual products are likely to create a forced need to adopt unhealthy practices like unclean cloth or old rags, which can be used over and over again. Lack of water and stigma around menstruation might hinder proper washing and drying of reusable menstrual supplies.

Along with the harmful effects of wearing menstrual products for a longer time, these factors are likely to put many at a heightened risk of getting Reproductive Tract Infections (RTIs).

Lesser means of information dissemination

For the rural population, the primary source of knowledge on maintaining menstrual health and hygiene are school teachers, Anganwadi workers, ASHA, ANMs, SHG workers, and NGOs.

However, with schools shut and restricted mobility of workers, information is unlikely to flow smoothly, and in turn, this might lead to the increased stigma around periods.

For over 40 years, Child Rights and You (CRY) has been working on children’s rights, including their right to good health. It works extensively on generating awareness around menstrual health and hygiene as an integral part of children’s health.

In a step towards reducing period stress during the nationwide lockdown, the child rights organisation partnered with Stayfree to reach and distribute menstrual hygiene supplies to over 12,000 girls and women in its intervention areas.

It is evident that over the last decade or so, the government and CSOs have taken a lead in transforming the discourse around menstrual health and hygiene. Initiatives like the Menstrual Hygiene Scheme were introduced by The Ministry of Health and Family Welfare to promote menstrual hygiene among adolescent girls in the age group of 10-19 years in rural areas.

However, in these uncertain times, even such powerful initiatives are unable to penetrate remote corners of India to create the desired impact.

It is critical to address the existing challenges affecting menstrual health, while strategising ways and means that can swiftly reach and influence masses.

Having said that, the very first and most critical step in mitigating this concern must be the non-negotiable route of increasing the supply of sanitary napkins and other menstrual supplies — be it in shops, health, or quarantine facilities, and rural or urban regions.

Second, and equally important is sharing information via various channels, audio-visuals on social media or messaging platforms, through webinars, or media channels like radio and television.

Since accessibility, period stigma, and affordability seem to become the major barriers to proper menstrual hygiene practices, information on topics like making reusable sanitary cloth pads at home, protection against infections caused by prolonged usage, or unhygienic menstrual products, and safe practices for reusing and disposing of menstrual products, can go a long way to help maintain menstrual health and hygiene.

It is also essential to ensure that there are clean and separate toilets for girls and women, along with proper disposal means available in every corner of the country, especially, in quarantine, relief and transit camps, and health facilities during COVID-19 pandemic.

All in all, besides surviving through the pandemic, Indian girls and women have to fight another battle – to ensure access to menstrual health and hygiene. Not that it’s a new battle, though, it’s an age-old struggle, which is likely to get only tougher during these uncertain times. The narrative around safe menstruation must be given due priority so that girls and women can weather the crisis with more confidence.