Washing Away Poverty

Tackling Menstrual Hygiene Among Adolescents in India

Educating India’s girls about menstruation and ending the existing culture of shame requires a multifaceted approach: The Indian government’s flagship toilet-building initiative is one step; another is getting people talking and tackling period-based taboos.

Written by Bhavya Dore Published on Read time Approx. 4 minutes
Girls in school in Chennai, India. Photograph: Pippa Ranger/Department for International Development

MUMBAI, India – If you wash your hair during your period, water can enter your brain, so it’s best to avoid doing so on those days of the month. This is just one of the bizarre beliefs that Bhavana Ganu has encountered while working to educate girls on menstrual hygiene. In the schools where her initiative, Bindii: the Red Dot Revolution, conducts awareness programs and helps install sanitary napkin towels, questions and doubts about puberty come thick and fast. “As much as mothers nowadays are more friends to their daughters, there is still a gap and people are still shy to talk about these things,” she said.

Ganu’s organization, Chariton Enterprises, began working in schools two years ago in Maharashtra, Karnataka and Goa, seeking to address the dual issues of poor sanitary facilities in schools and inadequate menstrual hygiene awareness.

In India, with a population of 120 million adolescent girls, these remain very real issues. Antiquated menstrual taboos and superstitions persist, ranging from not being allowed into places of worship on those days of the month, to being sequestered in rural areas in separate huts outside the house or being forbidden to touch household objects. A report by the Dasra Foundation published in 2014 found that 71 percent of girls were unaware of menstruation until its first occurrence and that 70 percent of mothers surveyed considered menstruation “dirty,” enabling a culture of shame. “I was raised in a hush-hush environment on this topic,” said Ganu. “Things like people saying don’t visit a temple when you are menstruating. Now I go, but it took me a while. It didn’t come naturally.”

Aside from the social constraints, such beliefs also have very real consequences – both for the education of girls, who are often absent from school during their periods, and also for their health, since they aren’t always sure how to protect or handle themselves.

The same Dasra report indicated that 23 percent of girls drop out of school when they hit puberty, and that girls are typically absent for 20 percent of the school year because of their periods. Studies from Delhi and Maharashtra have thrown up even higher absentee percentages – from 40 percent to 60 percent. “School absenteeism was significantly associated with the type of absorbent [protection] used, lack of privacy at school, restrictions imposed on girls during menstruation, the mother’s education, and source of information on menstruation,” said a study by Hamdard Institute of Medical Sciences and Research in Delhi. “Nearly 65 percent reported that it affected their daily activities at school and that they had to miss their class tests and classes as a result of pain, anxiety, shame, anxiety about leakage and staining of their uniform.”

Experts say school toilet facilities – often lacking entirely in rural schools or missing a regular water supply – are practical hindrances to menstrual care, in addition to being general disincentives for girls’ attendance.

However, a lot of that is now changing. Under the central government’s flagship scheme, multiple toilet-building initiatives are underway. State governments have also been trying to address these issues. Last year, Maharashtra made menstrual hygiene education mandatory in schools, and Kerala announced it would provide free sanitary towels in government schools. Orissa and Bihar announced similar initiatives this year.

Providing decent sanitation facilities is one step. But rewiring society and dispelling age-old notions is another task altogether. And a raft of nonprofits have been working on changing the conversation around menstruation. The online resource Menstrupedia, which publishes a comic book on menstruation in 15 languages, began as a crowd-sourced blog five years ago when these things were still not spoken of much.

Aditi Gupta, who started Menstrupedia, did so after experiencing her own series of taboos growing up. Now they work with five state governments to provide reading material for young girls and have reached more than 5,000 schools. “One thing is certain, there was nothing much before and people weren’t talking about it,” said Gupta. “But now the conversation has changed, there is more progress. At least a conversation is happening.”

Even smaller outfits have looked to tackle menstrual issues at a local level. Spandan, a student club at the Symbiosis Institute of Operations Management, began addressing these issues two years ago and helps provide sanitary towels to several schools run by the voluntary organization Dang Seva Mandal in the rural and tribal areas of Maharashtra. They have reached about 8,000 girls so far. “Menstruation did seem to impact school attendance and their education,” said Ratna Paluri, the faculty member in charge at Spandan. “But we have seen the awareness levels on the issue increase since we started working on this.”

In some cases, students have taken matters into their own hands. In one school in rural Rajasthan, as part of a design competition, the students were asked what immediate problem they wanted to solve. They had an easy answer: Why did they feel so ashamed during menstruation? The girls, accustomed to reusing a single piece of cloth, said they felt terrible about themselves. “Why do we have to go through this? Why do we have to sleep outside? We are treated as outcasts, they told us,” said Sumedha Sharma, the head of training and curriculum at Design for Change India, which organized the competition. After winning that competition, the girls are not only creating sanitary towels for the community at large, they have also been running door-to-door campaigns.

Gupta said the entire ecosystem needs to evolve – from parents and local authorities to sanitary towel providers and media portrayals of menstruation. “The scope of our work is a lot and the real impact can be created if we all work together,” said Gupta. “If I can raise my daughter free of taboo, this is how change will happen.”

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