How COVID-19 impacted menstrual hygiene in India's rural and semi-urban regions
The response to Covid-19 pandemic has not really been gender-neutral. Across India, in the past one year, periods did not stop for the pandemic but access to period products and menstrual hygiene did, especially for socioeconomically challenged families.
Lack of gender-sensitive response in the lockdown, and issues of accessibility, affordability and awareness have further magnified it, Pratibha Pandey, Senior Health Specialist, ChildFund India tells IANSlife.
Access scarcity
Access to safe menstrual products and sanitation were overlooked during the lockdown, as girls and women from the rural areas who relied on free or subsidized products from government centers or NGOs, had little or no access to the same.
"Many of migrant workers, who walked several miles from the cities where they worked, to their native villages were women. Some of these women had to go days on the national highways, menstruating with only a light cloth to manage the same. They had no access to hygiene products or washrooms and their plight was truly horrifying. Medical shops in densely populated urban areas with low-income families reported absence of affordable sanitary products," she says.
"Period poverty is a very real concept in India. According to a March 2020 report of the Ministry of Health, majority of menstruating females in India are largely dependent on unsafe sanitary materials like rags, cloth, hay, sand, and ash as their only alternatives," Pandey says.
The lockdown forced many girls and women to resort to the age-old unhygienic practice of using a cloth during menses. "A shocking 84 per cent of women had restricted or no access to sanitary napkins. Only after intervention from several groups championing the cause of women, Ajay Bhalla, the Home Secretary to India instructed the states to add sanitary napkins to the list of essential items on the March 29, 2020 (six days into the first lockdown)," she points out.
Periods, a luxury
As the country continued to remain behind closed doors for the next two months, access to sanitary napkins continued to be a challenge, especially due to the socio-economic disparity. The low-income population was the hardest hit by job losses across India. Families were left to defend themselves from their savings and through charity. In such times, sanitary pads became to be considered a luxury that many females had to go without.
Already, in rural India, according to the National Family Health Survey 5, less than half of the women used sanitary napkins. This worrisome trend shall continue as families continue to struggle to regain economic stability, says the expert.
"The use of such methods for a long time can lead to serious health consequences, leading to challenges in attaining equality in education of the girl child and added burden on the health system of India, such as increased rates of anaemia in women and children which leads to maternal and infant mortality rates, to name a few," she says.
Patriarchy and Periods
The conspicuous silence around menstruation has been a household feature of Indian families and communities; it is tabooed, embarrassing and unclean, extending even to the mention of menstruation both in public and in private. In fact, one study found that almost 70 per cent of surveyed mothers across India, considered menstruation 'dirty'.
"While the lockdown has been lifted, many men continue to stay at home due to loss of livelihoods and reverse migration. Out of deference and shame, women with husbands, brother and elders living at home, try to hide or not buy sanitary napkins. The females do not perform thorough ablution and dry their menstruation cloth in dark corners, due to lack of privacy, which creates a breeding ground for infections; lack of access to menstruation management and understanding of reproductive health further aggravating these issues," states Pandey.
This is the story of majority of many girls in marginalized, rural India. They remain ignorant of the significance of their menstrual cycle for many years, engage in unhygienic and harmful cleaning practices and pass the same knowledge to the next generation.
The Road to Equality and Freedom
The difficulties that girls and women faced during this period have exposed the need for a change in the narrative around menstrual hygiene for girls at personal, familial, communal, and state level. A life of dignity and freedom cannot be lived if women and girls are told that period, an intrinsic, biological process, is dirty or tabooed.
"More than 40 per cent of students in India resort to missing school while menstruating because of social stigma, isolation, embarrassment and inaccessibility of products and sanitation facilities. It has been estimated that 1 out of 5 girls drop out of the school after they start experiencing menstrual cycle," she says.
"Dropping out of school means increased chances of child marriage, early pregnancy, anaemia, increased gender disparity, and the list goes on. What happens when girls, mothers, fathers, brothers, teachers, and communities stop being shy of discussing menstruation and health and sexual reproduction rights? They dismantle shackles holding their females back."
Pandey says they have found encouraging changes across 15 states when they impart scientific knowledge, to dismantle taboos and misconceptions around Menstrual Hygiene Management (MHM) and Adolescent Reproductive and Sexual Health (ARSH).
"Girls demand sanitation products and facilities as their right, child marriages reduce and girls are motivated to complete education to become empowered women, families look beyond patriarchal hegemony and communities give space for women and girls beyond their gender -- as leaders, participants and as equals," she concludes.