Feature story

Trumping a taboo

More than 200,000 women and adolescent girls from eight states power a movement that is helping shed the stigmas still attached to menstruation

There used to be a time when a perfectly natural bodily function got Vaishali Aatram in a tizzy. The cause and culprit was menstruation, that monthly caller half of all human beings have to put up with for a big part of their lives.

“I used to feel dirty and untouchable while menstruating because I considered myself impure during these phases,” says the 28-year-old from Indrathana village in Maharashtra’s Yavatmal district. That was before a programme centred on menstruation and how to manage it, came to be embedded in Ms Aatram’s community. “No living separately anymore for me and my daughter,” says Ms Aatram.

For Somi Bai, a 42-year-old from Basantgarh village in the Sirohi district of Rajasthan, learning about and understanding menstruation better, has meant a kind of normalcy. “I don’t fear its onset now,” she says. “Importantly, my relationship with my daughter is different; we talk openly about menstruation.”

That’s a crucial aspect in how the ‘menstrual hygiene management’ (MHM) programme supported by the Tata Trusts, plays out for more than 200,000 women and adolescent girls spread across 1,500 villages in eight states. And quite a few men as well.

Arun Mishra attended a counselling session organised by the MHM team for men in his village, Rampur Paida in Uttar Pradesh’s Shravasti district, and it was an eye-opener. From being unaware even of what his wife, Sangeeta, had to go through during her periods, the 29-year-old Mr Mishra has progressed to becoming a votary of hygienic menstrual practices, sharing poems and write-ups to break the silence surrounding the subject. “It’s not just the woman’s responsibility to expunge the stigma around menstruation,” he insists.

Assisting and driving the MHM cause is a 300-strong sisterhood of sakhis (or companions) who have been entrusted with the task of taking the menstruation message to village communities.

“The sakhis provide the women and adolescent girls they interact with, a safe space to share their menstrual journey stories,” says Divyang Waghela, who heads the Tata Water Mission, under which the MHM programme operates.

And a journey it certainly is, for many of those caught up in the swirl of taboos and restrictions — unspoken but clear — that come with menstruation. Understanding menstruation and how it can be managed properly — that’s the goal of the MHM effort, launched in 2016 with pilot projects in Uttarakhand and Rajasthan. The need for such an intervention stemmed from the feedback the Tata Trusts team received from women while implementing its extensive water and sanitation projects.

Usual suspects

The primary concerns were the usual: dealing with menstruation when using common toilets and living in cramped conditions, and the difficulties posed while trying to dispose of used sanitary napkins. Lesser said the better about the branding associated with menstruation, still viewed in numerous parts of India as interludes of ‘impurity’ for women and girls.

Normalising menstruation through dialogue, openness and sharing of information, not just among women and girls but also their families, was a necessary opening thrust for the initiative. This began with a behaviour-change communication campaign aimed at breaking the barriers surrounding menstruation.

The pilot project went off well enough for the MHM programme to be scaled up, in 2018, to six more states: Jharkhand, Gujarat, Assam, Karnataka, Uttar Pradesh and Maharashtra. Here the Trusts partnered their associate organisations and government bodies for implementation, with the focus remaining on women and adolescents and issues such as awareness, access, attitudes and the adoption of hygienic practices.

Creating awareness

Multiple approaches are employed to create awareness. The sakhis talk to women and adolescent girls — and men and boys too — through community interventions and outreach sessions in schools. A range of topics are covered, from reproductive systems and premenstrual syndrome to menopause and nutrition.

Sunita Devi, a sakhi from Maunda village in Uttar Pradesh's Lucknow district, discusses the benefits of cloth pads with women from her village
Sunita Devi, a sakhi from Maunda village in Uttar Pradesh's Lucknow district, discusses the benefits of cloth pads with women from her village

Companions in a common cause

Like most women around her, Sonal Kanwar found menstruation an uncomfortable topic to discuss. But that all changed in September 2018 after the 25-year-old from Lotana village in Rajasthan’s Sirohi district joined the ‘menstrual hygiene management’ (MHM) programme of the Tata Trusts.

It happened after Ms Kanwar began training to become a sakhi (or companion) in the programme. The course changed her perspective. “Not only did I realise there’s nothing wrong with talking openly about menstruation, I also learned why it’s important for women to do so,” says Ms Kanwar.

In distant Assam, fellow-sakhi Malaya Das voices a similar sentiment. “The training cleared up several misconceptions in my mind about menstruation,” says the 22-year-old from Dokoha village in Nalbari district. “And people’s attitudes have been different since I became a sakhi. I’m treated with more respect and my family feels proud of me. Women approach me frequently for advice on menstruation problems and it feels good to see them talk about this with their families.”

Ms Kanwar and Ms Das are among some 200 sakhis in the MHM initiative. The sakhis play a pivotal role in the MHM programme as frontline workers who are often the initial, even primary, source of information in these villages about menstruation.

Not everybody takes benevolently to the programme’s prodding. “Once we had a man who was enraged after we approached him and his wife for menstruation counselling,” says Ms Kanwar. “He kept shouting at his wife and threatened us with a stick.”

The awareness sessions follow a participatory, conversation-based approach. Bringing men and boys into this conversational circle is important given how influential the man of the house can be in creating a supportive environment for women and girls within families where patriarchy is as rampant as it is traditional.

Perseverance has been the key in making change possible, and in several situations it has been men who have become ardent champions of menstrual hygiene awareness. “My husband is now aware of the problems that I face and he even buys sanitary napkins for me,” says Savita Tudu, a 20-year-old from Chanaro village in Jharkhand’s Hazaribag district. “Also, knowing about ‘safe days’ helps me with family planning.”

Periods-related products and the safe disposal of sanitary waste are emphasised in the MHM initiative. The Trusts’ team ensures access to good quality and eco-friendly menstrual absorbents — sanitary pad production units have been established in Uttar Pradesh, Rajasthan and Maharashtra — and, additionally, teaches women and adolescent girls how to stitch their own cloth pads.

The safe disposal of personal hygiene products is ensured through matka (earthen pot) incinerators. These matkas, buried in specially-prepared pits in the ground, ensure that when used menstrual products are burnt in them, the resultant smoke and ash are absorbed by the soil. This unique disposal solution, which prevents used sanitary napkins from going into landfills or being burned in the open, has been one of the MHM project’s successes.

For the immediate beneficiaries, the programme has provided a platform to get talking about menstruation. “Deep-rooted myths about menstruation usually deter women and adolescent girls from questioning them,” says Mr Waghela. “The programme has made a difference, in that respect.”

The MHM team has its hands full with plans for the future. These include more awareness sessions, setting up cloth-pad production units in other states and working on new technologies to dispose of used menstrual products. Also on the anvil are a further strengthening of partnerships with government agencies and establishing an academy to train frontline workers and school authorities.

One thing’s for sure, in the present and with what lies ahead — for the women and adolescents touched by the MHM programme — there’s no going back to the red alert days of ostracism and prejudice.