In a country that houses 1.3 billion citizens, 88 per cent women still don’t use sanitary napkins owing to lack of awareness, access and affordability.

Approximately 300 million women rely on unhygienic materials such as old rags, plastic, sand and ash to address their sanitation needs during their menstrual cycle state, reports of Aakar Innovation, which creates 100 per cent compostable sanitary napkins.

“Menstruation, the natural bio-physiological phenomenon in a woman’s life cycle, is still considered impure and stigmatised throughout the country,” Aakar Innovation founder and MD Jaydeep Mandal opined. “This is clearly reflected in the way the entire concept of menstrual hygiene gets handled.

The shame, the taboo, lack of access to clean pads or toilet facilities further adds to the challenges and serious health implications.”

READ MORE: Women’s Day: Should women get menstrual leaves?

Aakar Innovation is a pioneer in making Asia’s first natural fibre-made, biodegradable and 100 per cent compostable sanitary napkins “Anandi”.

It is high time we focus on this pertinent topic and stir conversations around menstrual hygiene and its implications.

Reusable pads

Anju Bist of Mata Amritanandamayi Math, Co-Director, Amrita SeRVe (Self Reliant Village) Programme, has introduced reusable pads called Saukhyam. This project is undertaken by the Mata Amritanandamayi Math, an NGO with consultative status to the UN.

Bist conducts awareness sessions in schools and colleges to acquaint young girls with facts about menstruation and the environmental and health impacts. She is part of the Amrita SeRVe initiative, wherein sustainable menstrual hygiene options are also being introduced to young girls in rural areas all over the country.

She described Saukhyam as reusable pads that have a base piece and an insert piece. The base has a leak-proof layer and has wings that keep the pad in place. Cotton cloth is used for both base and insert.

The insert also has banana fibre, which does the main job of absorption. “As far as we know, no one else in the world is making reusable pads using banana fibre. The pads will last 4-5 years, if properly cared for,” Bist added. “The price varies depending on whether it is a day pad or a night pad and the type of insert.

The value pack (Rs 1,600) is very popular in cities such as Chennai and Bangalore, where we have conducted workshops in schools, colleges and organisations. Starter packs are priced at Rs 600-700 and include two bases and three inserts.”

Reusable pads, informed Bist, might cost more upfront, but the costs are paid for in a few months. Currently, the pads are only available in some organic shops in Chennai and Bangalore. They are also available online.

On environmental implication, she said if 360 million women in India use disposable sanitary pads every month, assuming the average woman uses 12-15 pads per month, it adds up to 432 million soiled pads, weighing 900,000 tonnes, enough to cover a landfill of 240 hectares (320 football fields). Reusable pads are needed, even if for nothing else than to combat this huge waste management problem.

As per the National Family Health Survey 2015-16 data, only 57 per cent of girls and women in the age group 15-25 years had access to hygienic products to manage their menstruation. Rather than giving disposable pads to them, providing reusable pads would be a better solution.

Challenges in India

Like any campaign, this too faces challenges. Bist explained, “There is a strong movement in support of these pads, especially in bigger cities in India.

When we give talks in schools, colleges or organisations, about 10 per cent of the women want to make the switch immediately. We find that women are willing to experiment ~ in general, people are very ready to switching to eco-friendly options if those are easily available.”

The challenge, informed Bist, is that most people do not even know that such options exist. Reusable cloth pads are not like old pieces of cloth used in the past that were difficult to wash or hang up to dry.

The new cloth pads offer the same convenience as disposable pads. “It’s a slow, laborious process to reach out individually to schools and colleges and other organisations,” she added.

Health and environment

Menstrual issues usually depend on different age groups. Dr Kamath explains, “Young girls who have just got their first few periods come to us with irregular or heavy cycles.

Once menses is initiated, it takes about two years to set a fixed cyclical pattern for some girls. Such girls and their mothers need to be reassured.” Heavy cycles lasting for a long time happen to a small fraction of young girls, who can meet up with a health care provider and help themselves with medications.

Women in the reproductive age group tend to have heavy periods either due to hormonal fluctuations or due to fibroids. Polycystic ovarian syndrome affects about one in five women with irregular cycles, weight gain and hair growth.

As per Aakar Innovation findings, reproductive tract infections are 70 per cent more likely in women, who use unhygienic materials during their periods.

Some of the most detrimental implications are in education and livelihood. In India, adolescent girls (aged 12-19) miss five school days in a month due to menstruation.

Around 23 per cent of these girls drop out of school after they begin menstruating. This prevents a quarter of the next generation of the female population from pursuing higher education.

Similarly, women are forced to miss roughly four working days a month, resulting in 48 days of lost income in a single year. The ramifications of this loss manifest themselves in everything, from food availability to health and the larger space of women empowerment.

As for the environmental impact, it is estimated that 9,000 tonnes of sanitary waste (432 million pads) is being generated annually in India. Furthermore, more than 80 per cent of this waste is either flushed down the toilet or end up dumped in a landfill.

Experts’ take

Menstruation is a physiological cyclical event in a woman during her reproductive years. Experts opine that menstruation should not be stigmatised in any way as it will make young girls feel deprived or underprivileged when compared to the opposite gender.

“In the present day, it is important for healthcare providers to stress the need for girls and women to go ahead with routine activities during periods,” said Dr Gayathri Kamath, Senior Consultant Obstetrics and Gynaecologist, Fortis Hospital, Bannerghatta Road, Bangalore.

“Lack of awareness is quite rampant in the rural areas. Poverty, overwork, lack of education and basic needs are the probable reasons for a higher incidence in the rural areas. Women in urban areas seem to be more aware, thanks to the networking of women and media as well.”

On menstrual hygiene, Dr Kamath added, “It is essential that girls at a young age are taught how to contain menstrual blood and how to dispose them as well. This education can be imparted through schools or by media. Lack of awareness and ignorance can cause infection in the private parts.”

Also, renowned fashion designer Pallavi Mohan, who is associated with sanitary pad campaign “donthideitperiod”, believes that even fashion can play a critical role in spreading awareness.

“Fashion industry has always been very supportive in raising awareness on various issues that need public and governments attention,” Pallavi Mohan said. “Fashion is a platform that transcends across the globe while ensuring the message is delivered.

I think it is time that the society breaks out of the taboo that is associated with women and their mensuration cycle. This is just a step closer to what we envision towards a world where both women and men are aware and consider it a very important conversation that they need to have.”

The donthideitperiod campaign was launched in January this year. Their pads are packaged in a canvas bag featuring bright red and orange polka dots that contains 1O regular sanitary pads. Each pad carries a tagline that is aimed to spark conversations around the subject and dismiss the taboos that are still very prevalent.

Mohan explained, “These pads are being retailed at Rs 285 from Nykaa.com. The entire (100 per cent) proceeds of the sales go towards The Better India and Aakar Innovations, and for setting up a factory in Ajmer to manufacture and distribute bio-degradable pads.

There is a website dedicated to the campaign, Donthideitperiod.com, which also invites users to join the conversation by writing their own messages on the virtual pad and share to create wider awareness on social media.”

Stigmas and taboos

According to Women Economic Forum report, only 12 per cent of India’s girls/women use sanitary pads, 23 per cent girls leave school with the onset of puberty, 200 million women out of 355 million live in the dark about menstruation and good health-hygiene practices; most believe menstruation is a burden, going by all the restrictions imposed on their activities during periods. In some parts of India and Nepal, women and girls are forced to sleep outside their homes when they have their period.

They are not allowed to enter temples. Menstruation is a natural, monthly reality. However, as the subject continues to be taboo in societies around the world, access to basic menstrual hygiene management materials remain inadequate.

Many myths and taboos still persist around menstruation and lead to negative attitudes toward this biological phenomenon not only in India but across the globe. In the US 42 per cent women have experienced period shaming; about 48 per cent girls are embarrassed by their period in the UK.

UNICEF estimates that one in 10 school-age African girls “do not attend school during menstruation”. World Bank statistics highlight absence of approximately four days every four weeks.

Partly due to the difficulties in measuring absenteeism and its causes, especially when linked to menstruation, there are differing opinions on the impact of inadequacy of basic menstrual hygiene materials.

In this context, Mandal said, “Aakar not only works on creating compostable sanitary napkins through a community-based model of production, but also works in communities across India to address the gap in menstrual hygiene management (MHM) awareness and encourage behavioural change.

We implement menstrual hygiene management awareness programmes throughout village and slum communities.

Through composting, our project looks at the environment and the waste aspect of disposing of sanitary napkins ~ a critical area to be looked at in the menstrual hygiene space in India.”

What next?

As of now 12 per cent GST (Goods and Service Tax) is levied on sanitary napkins, which has spurred lot of debates and discussions around it in the country.

The Supreme Court has, however, stayed the proceedings on matters relating to imposition of GST on sanitary napkins.

The apex court has said it would examine the case and see if all the matters pertaining to it should be heard by the apex court itself.

Also, the SC expressed displeasure over the fact that the GST Council did not have even one single female member.