Personal hygiene. Health risks. Choking rivers. The connecting factor — menstruation — is a social concern, says the writer Usha Rai

A small group of NGOs working on health issues and calling themselves Bejhijhak (which means ‘without hesitation’ or inhibitions) got together in the Capital recently for starting a dialogue on menstruation, breaking the various myths and taboos around the issue and improving menstrual education, management and hygiene. School children set the mood for the discussions by performing street plays on those unspeakable five days.

Menstrual Hygiene Day seeks to break the culture of silence and ignorance that plagues 335 million menstruating women and girls in India — 113 million of them adolescents. Seventy per cent of mothers consider menses dirty and polluting and pass on their biases to their children. Menstruating women and girls are still not allowed into kitchens, puja rooms and temples, nor are they allowed to touch utensils.

Despite the large-scale advertisements about the various brands of sanitary napkins and how they empower women to work like a man during those difficult days, a study shows that 71 per cent of the girls are unprepared for their first period and 83 per cent of school-going children reported they faced restrictions during menstruation, leading to poor hygiene and increased risk of infections and diseases.

Most women in rural India and urban slums use cloth pads. Though sanitary napkins are the only other viable hygienic option, 88 per cent of menstruating women can either not access or afford them. A large number of women still use sand and ash to cloak their menses.

What is equally worrying is the serious threat to environment from the non-degradable sanitary napkins. In rural India, in particular, they choke water channels and drainage systems. The wood pulp absorbent core of the sanitary napkin is bio-degradable, but it is sealed between a layer of plastic polymer at the bottom and a non-woven fabric at the top, both non-biodegradables. The super absorbent polymer (SAP) gel is also sealed within the absorbent core and its basic purpose is to super absorb, but that is also non-biodegradable. So though the absorbent core is biodegradable, all other parts make it otherwise. There is also no mechanism to separate the biodegradable and non-biodegradable parts.

Dhirendra Pratap Singh from Azadi, with a mission to make menstruation a non-issue in India, points out that most pads are made from low-density polyethylene plastic polymers, bleached wood pulp and super-absorbent polymer gel. Dioxins and furans, some of the most deadly compounds known, are by-products of the bleaching process that makes organic materials white, using pesticide sprays on the organic materials and incinerating chlorine-containing products.

According to WASH United, a Bejhijhak partner, working to end global sanitation crisis by providing toilets, 432 million non-biodegradable sanitary napkins are used each month across India and the widespread advertising and media campaigns will increase this number in the coming years.

Data collected by WASH and other agencies shows that 30 million school children in India have no access to toilets, 40 per cent of schools do not have a separate toilet for girls and 66 per cent of girls’ schools do not have functioning toilets. So, in these cases, disposal is often done outside a toilet — by carrying the menstrual waste home and either burning it or washing and disposing it in a community water source.

Research conducted by PATH, an international non-profit that works on global health issues and partner of Bejhijhak, confirms that in Tamil Nadu too sanitary napkins are collected and then discarded through a water source, causing pollution and blockages.

Waste can also be disposed through incineration, but it is not popular and has side-effects. Most informal waste incinerators burn at low temperatures and produce toxic ash and emissions. If plastic polymers are not burned above 800 degrees Celsius they release asphyxiates and irritant gases into the air. Long-term exposure to these emissions or resulting ash may adversely impact the immune, nervous, endocrine and reproductive systems.

Many NGOs are therefore experimenting with re-usable cotton cloth pads and promoting hygienic use and maintenance as an alternative to the commercial sanitary napkins. So, there are Uger pads by Jatan, eco-femme cloth pads and Goonj cloth pads. PATH is also experimenting with a hybrid pad concept where the reusable/washable sleeve has a layer of poly-urethane laminate (PUL) fabric which is non-biodegradable but it minimises wastage as this layer is reusable. The user can add a biodegradable, easily disposable locally available material as the absorbent layer in the sleeve. As one works towards environment-friendly, safe sanitary napkins and their disposal, it is important to remember that reproductive tract infections are 70 per cent more common among women who use unhygienic materials during menstruation. India accounts for 27 per cent of the world’s cervical cancer for which poor menstrual hygiene is partly to blame.