I was recently asked if I could recall when I had my first period, and if it had been a celebration or a traumatic experience. The question brought back memories of my grandmother's home, where I was in the company of my male cousins but with a lot of questions and confusion in my mind. My mother had prepared me, but when it happened I remember feeling stunned and shaken. And yes, like many women of my era, my menstrual health always remained under an aura of secrecy. We were not supposed to share any information about it with anybody.
Being a part of this culture of silence, I have personally experienced the inconvenience a menstruating woman faces when she needs to communicate the discomfort with others, including men, in the family. The expectation is that you will stay silent, withdraw to yourself and somehow manage to deal with the physical and mental turmoil—alone.
The expectation is that you will stay silent, withdraw to yourself and somehow manage to deal with the physical and mental turmoil—alone.
In the work that I currently do at the Bill & Melinda Gates Foundation, I feel more connected with girls and women and I often wonder how they are managing their menstrual hygiene, and how they deal with the subject. While in rural areas women may oftentimes not be aware of how to handle and manage menstruation, the challenge is pretty stark even in urban India, where privacy is a luxury and proper public infrastructure is acutely deficient. How do they cope?
There are 336 million women of reproductive age in India. Research tells us that 45% of them think that menstruation is not normal and 52% do not know anything about menstruation. These statistics are important because menstruation is a basic biological process and to manage it with dignity is the right of every woman. These statistics throw light on the hidden problem of awareness, which is unfortunately shrouded in social taboos and myths. This leads to lack of understanding, inadequate access to the right products or infrastructure, and an overall ecosystem wherein the problem cascades from awareness to use to access and ends at disposal.
The need of the hour is to break the silence around menstruation. We need to understand the acute disadvantage that women face while menstruating and account for it across the entire sanitation value chain. The issue needs a holistic solution approach with a focus on all aspects—knowledge and information, ensuring access to products, adequate infrastructure and safe disposal. True success will be achieved when we establish menstruation as a normal process and get rid of all social taboos and myths which make it difficult for women to deal with such a basic, and significant portion of their life.
True success will be achieved when we establish menstruation as a normal process and get rid of all social taboos and myths...
Women go through physical and emotional stress during their periods. It is confusing for some, cumbersome for others, while also being painful for most of them. And women find it almost impossible to convey this aspect of their biology to the men in the family. These discomforts permeate into many aspects of their lives. Schoolgoing girls, working women in all sectors from daily labourers to the ones who work in an industrial setup face the brunt of the situation.
Managing menstruation in a hygienic way is a basic necessity and right for all women, but unfortunately, many of them do not know the kind of options they have to manage menstruation. Take for example the need for proper infrastructure with access to clean water and proper disposal. Lack of clean, hygienic facilities often implies that women are not able to change their sanitary napkins at regular frequency. This is detrimental to their health. Besides basic hygiene issues, it can lead to reproductive tract infections as well. Provision of basic access to such facilities at schools or places of work is an extremely critical enabler that can contribute to good menstrual hygiene. And this is just one element of the entire sanitation value chain. There are many aspects of this ecosystem that need to come together and work seamlessly together at different levels. The greatest leveler would be to have a policy that intervenes all links of this value chain. Better communication needs to be in place for greater knowledge and awareness. Affordable access to safe and clean menstrual health products should be enabled for all stakeholders. Infrastructure—from toilets to dustbins—needs to be in place. Most importantly, we need to position menstruation as a normal everyday subject that can be discussed without prohibition or prejudice.
How? Earlier this year, my son saw a calendar in the house themed on menstrual health and commented, "So this is now in the open!" Since I had never had an open conversation with him around menstrual hygiene I was glad to notice that he was completely at ease to discuss it. He had studied in a co-educational school and he seemed okay to talk about it just like he would about any other topic. The ability to have these conversations has a big impact on the minds of our children, and their ability to overcome artificial constraints in our approach towards life.