In the United States, for the most part, menstruation can be an inconvenience, but it is not life-altering. However, in rural villages and impoverished urban areas in India and much of the Global South, the situation is vastly different, and the strong stigmas around menstruation can lead to negative consequences including: dropping out of school early, limited access to job opportunities, and the most severe of which are infections and illnesses such as cervical cancer. These consequences contribute to “gender inequality and economic disparity.”
In order to solve these problems, the focus must be on increasing access to accurate information about menstruation for girls and women, as well as for the population as a whole, and on ensuring that all girls and women have access to the adequate products and sanitation facilities for menstrual hygiene management, so they can manage their periods effectively and not be held back in life.
One of the greatest barriers for many of the 355 million Indian women who menstruate is lack of accurate information, which is impeded by the fact that talking about menstruation is considered taboo. A group of experts from the UN stated, “persistent harmful socio-cultural norms, stigma, misconceptions and taboos around menstruation, continue to lead to exclusion and discrimination of women and girls.” In India, nearly half of girls are unaware of menstruation until their first period and the lack of information is even greater in particular regions. For instance, in Tamil Nadu it is an astonishing 79 percent. In addition, just over one-third of menstruating girls spoke to their mothers about their periods, and in more than two-thirds of schools in villages, menstruation and menstrual hygiene management were not discussed at all.
Furthermore, only slightly over half of respondents in a recent study viewed menstruation as “normal,” and over three-quarters faced restrictions in their daily lives, such as on visiting places of worship and praying. Additionally, many girls and women face other restrictions on cooking and engaging in community activities during their periods. The lack of information and understanding about menstruation is impacting girls’ and women’s lives profoundly and must be addressed.
A startling 23 million girls in India drop out of school every year when they start menstruating due to lack of access to bathrooms, sanitary pads, and information about menstruation. This can lead to girls being married off early, becoming pregnant, and thus having limited job opportunities, which continues the cycle of poverty for that girl. In addition, it negatively impacts the economy and the ability to achieve equality for girls and women. Regions with the greatest need for education about menstruation, such as Tamil Nadu, should be prioritized by NGO and government programs.
Solving this crisis of access to accurate information about menstruation is not just the right thing to do, it has serious implications for the health of Indian women and girls and can even be deadly. The issue of awareness, made worse by lack of access to sanitary hygiene products such as pads, leads girls and women to use unhygienic options to manage their periods such as old rags. According to one report, 90 percent of those living in rural areas use makeshift pads out of unhygienic materials out of necessity in large part because they are unable to afford commercial pads. Poor menstrual hygiene, combined with lack of access to bathrooms and proper sanitation, can cause various infections which when left untreated can be contributing factors that can lead to cervical cancer and other reproductive diseases, as well as untimely death.
In fact, poor menstrual hygiene causes about 70 percent of all reproductive diseases in India. In addition, a 2003 study supports the link between poor menstrual hygiene and cervical cancer. It found that reusing old cloths “was associated with a 2.5 times greater risk of serious cervical problems compared to clean cloths or menstrual pads.” The Global South has the highest rates of cervical cancer and India has one-third of the world’s cases, with two women dying every 15 minutes. Moreover, a majority of the population lives in rural areas, which is where cervical cancer risks are heightened and access to doctors and preventative care is very limited. The fact that so many women are becoming ill and dying of preventable causes should raise alarms and be a call to action.
Many individuals and organizations in India and the United States are currently working on solving this problem, however more research and awareness of the negative health consequences of poor menstrual hygiene management must be priorities. In addition, the focus must be on providing sustainable, sanitary methods such as reusable cloth pads and menstrual cups, which cut down on waste, eliminating disposal issues and environmental effects. These methods also save a great deal of money over time and solve the issue of regularly needing to obtain new pads, which can be particularly challenging in rural villages.
Organizations employing women to make and sell reusable, sustainable, and affordable pads, such as Jatan Sansthan and the Myna Mahila Foundation, which was recently featured in the Global Citizen Prize television special on NBC, have a central role to play in tackling these issues, not just the large organizations, including the Gates Foundation and the UN, which are working in this space. Additionally, government initiatives providing free and low-cost pads to those who need them should be expanded as well as educating about menstrual hygiene in schools. All of these efforts are key to a multi-faceted solution.
Films including Period. End of Sentence. which won an Oscar in 2019 and Pad Man, as well as awareness campaigns, such as Menstrual Hygiene Day, and ones using photography are essential in overcoming the stigma around menstruation and educating the public on this issue. More academic programs should educate their students on these issues and how to be part of the solution, such as the GATE program at Columbia University. A broad coalition made up of NGOs, the government, and the private sector will need to work together to tackle the formidable challenge of menstrual hygiene management and stigma in India.
Addressing the menstrual hygiene needs of women and girls in India and throughout the Global South must be a top priority and is key to increasing the equality and economic standing of women and girls around the world. A robust approach that involves both the private and public sectors is essential to ensuring that the menstrual hygiene needs of women and girls are met, while also addressing concerns around the cost of menstrual hygiene products, environmental effects, and logistical issues, such as access to proper sanitation. Finally, the health of women and girls and the high cervical cancer rates must be recognized on a wider scale, and a collaborative and innovative approach must be taken, so that women and girls do not continue to suffer preventable illness and death, and are instead able to thrive and live lives of their choosing.
