Menstruation empowers women to nurture new life into the world. Why then is it shrouded in myths and misconceptions, taboos and bizarre norms? It’s a question that the society needs to contemplate often. In an exclusive interview with Health Shots, a key Unicef India expert, asserts the dire need to cut the “deep-rooted” traditional mindset and spread the “right awareness” to support women in their basic right to menstrual health and hygiene.

Health Shots spoke to Pratibha Singh, an Institutions Specialist at WASH (Water, Sanitation and Hygiene) at Unicef India, about the on-ground challenges in the road-map towards better menstrual hygiene management (MHM) in the country.

Excerpts from the interview:

Q. The theme for Menstrual Hygiene Day this year, was ‘Making Menstruation a Normal Fact of Life by 2030’. Aren’t we running too late?

The whole idea of Menstrual Hygiene Day took roots in 2014 and from there, it has gone ahead and become a kind of revolution. So many state governments in India are doing their own bit, and the national government is doing a lot. However, the themes of Menstrual Hygiene Day are still talking about #WeAreCommitted or #TimeForAction. The reason is that such a social awareness and social mindset change takes a lot of time to happen. And here, we are talking about a topic as sensitive as menstrual hygiene.

There are various factors responsible for it. Deep-rooted traditional mindset that has been there for centuries at a stretch, will not be wiped off totally due Menstrual Hygiene Day activation which started in 2014. The behavior and attitude towards menstruation will take a lot of time to change.

Still, when a menstruator, whether a female or trans-person, has a stain on their clothes because of menstruation, still they will feel embarrassed. Are the people around them willing to support them the same way as they would when a person would have a stain from a cut or bruise on some part of the body? That’s kind of perception about menstrual blood flow. Even in the most civilized and most affluent of circles, I don’t think people would be comfortable to see someone who has stained at the back of the dress near the hips. That is the reason why it’s taking so long to change the perception around menstruation and break period myths.

Q. The narrative around menstruation on social media is very different from what is happening on ground, especially in Indian hinterlands. Would you like to talk about it?

Let’s not try to see menstrual hygiene from the lens of rural-urban divide, or the attitude in hinterlands and the urban scenario. People in the lower income society have their own limitations. They cannot afford so many absorbents, pads or even clean clothes. What is being talked about on social media and what happens in reality, is totally different. That’s why menstruation needs to be spoken about more (on on-ground level). We are constantly underlining the importance of making menstruation everyone’s business and involving men into the discussion. You see, the word menstruation already includes the word men. So, somewhere, we have to sensitize them.

Also, read: Manushi Chhillar says men must be equally aware about menstruation

Q. What is the basic messaging that needs to be understood?

That just because women have periods for 5 days in a month, they are not impure, dirty or that blood is not different from any other blood. People see a person with a lot of sympathy when they bleed from an injury. But when a woman has her period, why does that attitude change? Just because the blood is coming out of another part of the body? It shouldn’t be seen as an embarrassing situation. The mindset has to change.

Q. How does lack of menstrual hygiene awareness affect a woman’s life?

It affects a woman’s life at multiple levels. A lot of school dropouts happen where girls are unable to afford proper menstrual hygiene products and develop a fear of staining. Also, using the wrong products, especially for an extended period of time, can be harmful.

* Increased susceptibility to infections

If a cloth or pad is used to soak in the blood and mucus, it is a breeding ground for infections. So, it is important to know the right way to use period products. Women must change the product frequently in order to avoid reproductive tract infections, as well as urinary tract infections. Skin rashes are also a likely side effect for wearing one product for far too long. A lot of women don’t even go to a doctor in these cases, because there is a culture of silence around menstruation problems.

* Ignorance

In urban centres, despite TV ads, girls don’t know that even if your pad is XL, XXL with wings and more to manage heavy flow, it is not to be worn for 12 hours. You have to change within a few hours.

* Use of synthetic cloth

In economically poor sections of the society, things are more complicated because they depend on cloth. These days, pure cotton is used very less as it has become very expensive. So, women are using synthetics and that increases the challenges.

Q. What are the efforts being made towards positive change in menstrual hygiene awareness?

Different state governments across India have schemes for either giving free-of-cost sanitary pads to girls or subsidized pads to working women in economically weaker sections of the society. Government of India, through its Jan Aushadhi Kendra was distributing its low-cost Suvidha sanitary pads.

Unless we break the chain of traditional taboos and norms through the right awareness, we will not be able to bring about any change per se in the whole attitude around menstruation. Also, just having sanitary pad distribution is not enough. Proper awareness has to be given to girls, and whatever touch points are available. People at the grassroots level have to be empowered with the right kind of information.

At Unicef India, we have a presence in 15 states and we work closely with various state authorities on menstrual hygiene management awareness.

Q. According to the National Family Health Survey 2019-21, the use of hygienic sanitary products has increased.

GST was removed from (sale of) sanitary pads by the Government of India in 2019. It was done after a long-pending request from various forums and parliamentarians. We must note that the representation of women in the country’s legislature and judiciary has increased over the year. They are able to voice women’s concerns.

We are aware that a few years ago, even in the nodal ministry, the policy makers used be all men and they used to design the Menstrual Hygiene Programme without listening to the voices on the ground. The whole programme shifted focus towards pad distribution, without looking at the ground reality that many women don’t even wear panties! So, why give everyone a sanitary pad, without looking at routine community practices? That sensitization has to happen.