Twenty-Four-year-old Reshma works as a tailor in a local boutique in Bhubaneswar from 9.30 am to 7.30 pm. Once in the midst of a conversation, she suddenly excused herself handing over the measurement tape to her colleague saying she would be back in 20 minutes. Puzzled, I asked her colleague if something was wrong to which she replied, “Oh, nothing serious, she is having her periods and needs a change.” “But you do have a washroom here, right,” I retorted. She replied, “Yes but it’s out of running water most of the time and it’s quite dingy and dark, so we go to the nearest public toilet during our periods.”
This, 20-minute ‘break,’ I realised, must be happening only once a day, considering her workload. And how inconvenient and difficult and insanitary the situation must be for her. And scores of other women like her who work the whole day without access to basic sanitation, privacy and dignity at workplaces. It must be even worse for women who work in informal sectors like daily wage labourers, construction workers, and farm labourers who spend hours in the open. Not to mention the added physical and mental discomfort that accompanies menstruation every month – stomach cramps, heavy bleeding, fatigue and associated taboos, stigma and socially conditioned embarrassment and shame.
It’s not a cakewalk either when it comes to privileged and empowered women, like me, who usually have access to safe and clean toilets with running water and waste bins in our workplaces or while travelling for work. Honestly, how many times have we women gone for napkin hunting when our periods have arrived unannounced?
I am also reminded of the times when lack of such facilities in some of the offices I visit has impacted me. Once, I even had to carry the used napkins, wrapped in paper in my purse, just because there was no waste bin in the toilet. We have to be always prepared and on the lookout for safe and convenient amenities when we are having or about to have our periods. And if we don’t carry our own sanitary napkins when we suddenly start our periods, we beg and borrow, because there are no sanitary vending machines installed in most of the toilets.
Globally, on any given day, more than 300 million women worldwide menstruate. There are nearly more than 355 million menstruating women and girls in India (accounting for nearly 30% of the population) most of whom still face serious challenges in menstrual health and hygiene management. Not only due to lack of adequate awareness and access to safe products but also due to stigma and dearth of Menstrual Hygiene Management (MHM) facilities in both domestic and public spaces. This continues to be of significant concern for gender parity.
Unfortunately, menstruation, like pregnancy and childbirth, is largely considered as part and parcel of a woman’s life, a private matter not worth giving adequate thought, attention and action. Maybe to some extent as a part of reproductive health for adolescent girls and women but certainly not as major sanitation, public or workplace issue. Although monthly menstruation is a normal and healthy part of life for most women and girls, managing it safely both within and outside our homes continues to be challenging, mainly due to lack of MHM facilities, cultural taboos and discriminatory social norms.
While Menstrual Hygiene Management (MHM) has been lately gaining some attention, the programmes have been largely confined to access to sanitary products and other health aspects and not on the lack of facilities and the associated stigma and exclusion.
While women from more progressive, urban and educated families are now able to somewhat enjoy their period freedom in their homes, the same cannot be said of workplaces or public places. With increasing participation of girls and women in both public spaces and workplaces, which include institutions, offices, shops, factories, railway stations, bus stops etc., one would expect an improvement in gender-friendly amenities like clean and safe restrooms with at least the provision of running water, soap and covered waste bins. But barring airports, a few big corporate offices and progressive organisations, the situation seems to be dismal.
At the institutional level too, in schools, colleges, universities, government and non-government institutes like hospitals, courts etc. for example, there are few resources to support menstruating women. Lack of safe and separate toilets, unhygienic toilets, inadequate or lack of water supply, soap and trash bins facilities are common problems which pose major barriers for girls and women in maintaining their menstrual hygiene in a private, safe and dignified manner. Such challenges not only discourage girls from attending school, and work but also restrict them from not using the toilets for an extended period.
Poor menstrual hygiene or lack of access to hygienic toilets for long hours during menstruation increases their risk of reproductive and urinary tract infections affecting their overall sexual and reproductive health. Not having water to wash hands after changing menstrual products can also spread infections. With lack of adequate disposal facilities, women are also forced to discard used materials in water bodies, and toilets leading to other hazards.
Promoting menstrual health and hygiene in public places and workspaces is critical not just for safeguarding women’s health, dignity and privacy but also for furthering and enabling the participation of girls and women in a safe public environment, for economic and social activities. Improving MHM services and creating an enabling environment around it can help improve girls’ and women’s access to education, leading to better job opportunities and improvement in productivity and performance. In addition, the provision of MHM amenities will also help in a more healthy and open discussion on the need for MHM for girls and women, thus easing the related taboos and restrictions.
Labour laws and HR policies often do not talk about the inclusion of gender-friendly policies related to menstruation. Employers in the informal sector hardly have any legal obligation to provide women with MHM facilities in the workplace. Deepening this challenge is the lack of agency among girls and women to voice their needs and demands for the creation of such facilities. So much so that women are forced to change in open spaces under cover of darkness or in isolated spaces, increasing the risk of violence and sexual assault.
Women usually do not voice their feelings and problems due to the stigma associated with menstruation, the absence of open discussion around it and also fear of losing their jobs which has a detrimental effect on their ability to participate and contribute. Even in schools, both girls and female teachers are hesitant to mention menstruation or their MHM needs in the school environment. Several adolescent girls I have interacted with narrate how because of dirty toilets they avoid using toilets for the entire school day as much as possible.
A working woman spends most of her time at her workplace and her menstrual cycle does not, or cannot really synchronise with her work schedule, responsibilities and travel. Some women who experience painful periods remain absent from work which in most cases is not accepted well by both colleagues and supervisors. Unfortunately, period pain is often discounted as something natural and recurring and not something to be taken seriously.
In a few first steps, some states and institutions have started providing MHM facilities in both public spaces, institutions and workplaces. While Kerala has mandated sanitary napkin vending machines in all schools, the Supreme Court has installed sanitary napkin vending machines for its woman staff and lawyers. Some cities have begun to install both sanitary napkin vending machines and incinerators in public toilets and railway stations. The Vadodara police, for example, has installed sanitary napkin vending machines to dispense sanitary napkins for free in the city to ensure that sanitary napkins are available to more low-income group women. But such steps are few and far between.
Considering the multiple challenges women and adolescent girls face, it is apparent that promoting and providing MHM facilities in both domestic and public spaces is not just a sanitation matter but also a critical step for safeguarding their overall physical and mental health, dignity and privacy. More importantly, accessing such facilities positively impact their participation in social and economic activities and overall life opportunities.
Organisations need to step up and make efforts to provide their female employees with quality MHM products, safe and hygienic washrooms, covered trash bins to dispose of sanitary pads and also go a step further by providing resting places, period leaves or flexible work timings. Along with period-friendly spaces, the creation of a culture of support and understanding around periods is imperative too.
