Monday, August 05, 2019
India’s menstrual health: End the crisis of shame
There are five areas that need attention to take up ‘safe-periods’ as a public health issue. We must look into them
Madhu (13) lives in a remote village in Northern India, and belongs to a low-income household with no toilet, and limited access to water. When she got her first period, Madhu’s mother gave her a piece of rag to manage her menses. She told Madhu, in whispers, that she was unclean, and what norms she should follow to avoid polluting the kitchen and puja (prayer) space. Following her mother’s well-meant advice, Manju began the process of endangering her health for five days, every month. She started accepting a natural body cycle as a matter of shame.
There are millions of girls like Madhu, especially across rural India. According to the National Family Health Survey 4 (NFHS-4), sanitary napkin usage in rural India is only 48.2%. In the absence of sanitary methods, women take recourse to dirty rags, ash, newspapers, and hay when they menstruate.
The health and social implications of poor menstrual hygiene are not widely appreciated. Reproductive tract infections are 70% more common among women who use unhygienic materials to manage their menses. These infections can also be passed on from pregnant woman to unborn child. Cervical cancer incidence in India is almost twice the global average and is associated with inadequate menstrual hygiene. The drop-out rate of girls in school is 23% when they start menstruating, and absenteeism is over 20% of the school year. (all data, ‘Spot On!’ report --Dasra, et al).
There are five areas that need attention to take up ‘safe-periods’ as a public health issue.
The first is to create awareness. Women’s self-help groups are widespread in many states, and often focus on savings. Health, including menstrual hygiene, needs to be part of their agenda. Menstrual health is supposed to be part of the rural school education programme — but it has to be taught to girls, and also to boys. Mothers-in-law must be counselled by the three government health workers who operate in every village.
Second, stigma must be tackled relentlessly. The cultural norm that menstruating women are in some way “unclean” and cannot enter places of worship, or kitchens must end. Until 1990, sanitary napkin advertisements were not allowed on TV — today’s media has a big role to play in fighting menstrual taboos. The movie Padman demonstrated the power of film to destigmatise the issue. TV shows like Veera incorporated the issue into their content.So far, no woman Bollywood star has championed the issue.
Third, there must be easy access to sanitary methods, and this is best done by involving the community. Locally produced napkins through women’s’ self-help groups was pioneered in Tamil Nadu. At Barefoot College, an NGO in Rajasthan, four women make enough high-quality sanitary napkins, to serve the entire village, at a cost of only Rs 11 per piece. Quality alternatives to the sanitary napkin are also needed – UNICEF has promoted the use of local, sanitised cloth.
Fourth, availability of water, sanitation and hygiene and disposal facilities are essential. Making sanitary napkins available is not adequate. Toilets are needed at home. The government’s Swachh Bharat scheme is a big step in this context. Tamil Nadu, in 2004, was the first state to address menstrual health management as part of its sanitation policies and programmes.
Fifth, school infrastructure must be made more comfortable for menstruating girls. Tamil Nadu provides separate toilets, incinerators and sanitary napkin vending machines for girls in school. Menstrual hygiene clubs increase awareness among students and teachers in government schools.
Sixth, governments must regard menstrual hygiene as much more than just a health issue. Himachal Pradesh has demonstrated how relevant and effective interdepartmental coordination can be in this context. Three government departments — health, education and rural development — have collaborated for the state-wide implementation of a menstrual hygiene programme.
The problems of menstrual health range from ignorance to infrastructure, sanitation to stigma — and more. Today, there is a much-needed national mission in nutrition. Swachh Bharat plays a pioneering mission role in sanitation. Surely, the time has come for India to also launch a national menstrual health management mission.
India’s women are enduring a crisis of menstrual health. Let’s put an end to this crisis of shame.
Ashok Alexander is founder-director of the Antara Foundation
Source: Hindustan Times, 4/08/2019
Homeless in Assam
The battle over NRC data pits government against Supreme Court, could open new faultlines
The National Register for Citizens (NRC) process in Assam seems to be spinning out of control with the state government refusing to toe the line set by the Supreme Court. On Thursday, a senior BJP minister in the Assam government, Chandra Mohan Patowary, revealed the district-wise break-up of the NRC inclusion and exclusion data (from the draft report published in July last year). The Court had instructed the NRC coordinator, Prateek Hajela, to submit this sensitive data in a sealed cover. The minister’s act is in defiance of the spirit of the Court order, therefore, and it may trigger new divides in the state. The move comes in the backdrop of the Court refusing to entertain the government’s plea for a 20 per cent re-verification of the data in districts bordering Bangladesh. The Court also noted that Hajela had submitted that NRC officials re-verified 27 per cent of the data when it adjudicated on the citizenship claims.
The intent behind the state government’s move to reveal the NRC data at this juncture is, clearly, political. The BJP government in Assam considers the NRC an instrument to isolate those who it sees as people who came from Bangladesh after March, 1971. It has been argued that districts bordering Bangladesh are prone to high levels of illegal immigration. However, the NRC has altered the picture and threatens to subvert the narrative on illegal migration. According to the figures revealed by Patowary in the state assembly, maximum exclusion from the NRC has been reported from districts not on the border but in Hojai and Darrang in central Assam. And, ironically, a large percentage of the people who have failed to prove their citizenship claims are members of indigenous tribes and Bengali-speaking Hindus. The anachronism is hardly surprising since the sort of documentation demanded of people by the NRC is not readily available or easy to produce, especially in non-urban and tribal areas with low penetration of the government. The government is apprehensive that the exclusions may trigger a backlash. It should have anticipated this situation since these concerns were flagged by civil society groups at the very outset.
Both the Supreme Court and the government need to be sensitive to the enormous impact the NRC will have on the people. An estimated four million persons may lose citizenship rights and would be forced to relocate to camps as non-citizens or doubtful voters. The enormity of the crisis on hand seems to have escaped the authorities — the SC frames the NRC as a legalistic exercise while the government views it through an ideological lens. Neither approach is helpful to resolving the human tragedy unfolding in Assam.
Source: Indian Express, 3/08/2019
Suicide is Not an Option
Hermann Hesse was a famous German poet and novelist (1877-1962). In his early age, Hesse experienced personal turmoil and conflict with his parents. This situation led to extreme frustration such that at the age of 15 in 1892, he attempted suicide. But he was saved. According to a study, it has been established that those who attempt suicide but do not die, develop in them great incentive to live and later emerge as heroes. The same happened with Hermann Hesse. He completed his education and subsequently took to writing as a career. After a long struggle, he became a great writer and in 1946 was awarded the Nobel Prize in Literature. Man is not born in this world by way of accident, but in accordance with a divine plan. The Creator has endowed us with great qualities. It is required of every human being to unfold these qualities, unlock one’s potential and play the role that is destined for him by providence. According to this creation plan of the Creator, every person must live in hope. There is no reason or excuse for becoming pessimistic. The world is full of opportunities. If someone fails in doing something, he should take it as a temporary setback or an inordinate delay, and not as a final failure. In such a situation, committing suicide is not an option for any individual. One has to adopt the formula of wait and see, rather than killing oneself, for, by ending one’s life, one leaves no other option open.
Source: Economic Times, 5/08/2019
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