Empowering India’s women

India is a country that lives in several centuries simultaneously and her people at any given time and place encapsulate all the contradictions that come from being a multi-cultural, multi-religious and multi-lingual society. And so it is the case with women. On the one hand, we have had a woman prime minister, a woman president, several women in strong leadership roles and on the other side, access to basic human rights is denied to a huge majority of them.

It is accepted the world over that women are an essential part of what makes a society successful, and only through supporting and empowering women can a country truly be strong. Sadly, this is a point that is too often forgotten by the world, and particularly by India. According to the 2011 census, women account for 49 per cent of India’s population. Despite this, women continue to lag behind men, with a gender pay gap that sees women earn up to 20 per cent less, and a school dropout rate that increases with age, with 32 per cent of girls not enrolled in education by age 18. It is in the sector of health, however, where this inequality has become most pronounced. In 2017, a World Economic Forum report on the Global Gender Gap across 144 countries ranked India as the fourth lowest in health and survival, highlighting a distinct lack of progress for women’s health in the country. India’s women are being left behind — and perhaps most worryingly, it is because of widespread and outdated taboos and beliefs about female biological processes like menstruation.

Menstrual hygiene awareness remains a critical issue, with 71 per cent of girls in India having no knowledge of menstruation before their first period. Part of this lack of awareness is down to the intense taboo that surrounds the topic, with menstrual blood considered impure, and women who are on their period sleeping away from the rest of the family and even discouraged from worshipping in temples.

Because of the stigma that is attached to this perfectly natural biological process, there is also a distinct absence of education about menstruation, and how to manage it in an appropriate way. Unsanitary and dangerously unsafe methods of management have gained traction across various communities — from rags to old cloths and even hay, the lack of conversation and acknowledgement of periods have led to dangerous habits being passed down from generation to generation as the cycle of shame and silence continues. A woman in Mijwan, a tiny village in Azamgarh where I work tells me, “I wash the cloth I use during my period and reuse it, but I do not dry it in the sunlight because it is recognisable. So it is common practice amongst us to dry it under the mattress or on our cots.” Little wonder that 70 per cent of  women suffer from reproductive tract infections. What a crying shame that in 21st century India, a large number of women do not have a patch of sunlight to call their own!

The health impact of unsanitary menstrual hygiene management can be immense, leading to reproductive tract infections, and even infertility. Whilst this problem is more commonplace in rural areas, it is by no means exclusive. There are 355 million menstruating women in the country, and 82 per cent of them are using unhygienic methods of managing periods, with only 18 per cent of women using sanitary pads. And even for the 18 per cent women that use sanitary pads, there is no guarantee that they have been educated on the correct usage of a pad.

Furthermore, this only takes into account able-bodied women. There exist a large number of disabled women in India, who are suffering because of the taboo and lack of education around menstruation, but due to other stigmas around disability, goes undiscussed. The taboo that surrounds this topic has ensured that it has become an invisible issue. 

Part of the attitudes that need to change are those of men who do not understand menstruation or believe periods to be “none of their business”. 

Only through discussion, education for both girls and boys on periods can begin, ensuring that women are able to better manage menstruation. This will almost certainly see a decrease in the instances of reproductive tract diseases. Furthermore, it will enable women and girls to understand their own health better, giving them a better quality of life and helping to empower them. There is a wider public health cost too that goes undiscussed. Contrary to popular belief, menstrual hygiene has reverberated on the overall health of the country, as unsafe practices can lead to severe complications, including reproductive failures. For a country such as India, whose public healthcare system is already severely strained, the lack of awareness and adaptation of safe practices by menstruating women is known to add another dimension to the overall problem. With the government’s recently announced plan to introduce free healthcare for poor and vulnerable families across India, better menstrual hygiene, if implemented, will stop women from being at risk of easily preventable diseases and reduce any potential strain on the healthcare system. By helping to improve women’s access to menstrual care, the standard of everyone’s healthcare is bound to improve.

Women’s health is not a niche issue — it impacts everyone in some way. That is why a collective effort to improve awareness and understanding of menstrual hygiene is key to closing the gender health gap. As one of the world’s most prominent emerging economies, it is essential that India improves its position, and develops into a world leader in equality. The only way to do this is to afford women’s health the same amount of focus that we afford men’s — and the best way to do that is through breaking down the taboos around women’s biology and tackling the stigma around menstruation head on. 

The Niine Movement, an ambitious five-year plan, aimed at raising awareness on the importance of menstrual hygiene and tackling the taboos associated with menstruation, which proclaims “Swachh Bharat ki Shuruwat Humse [girls and women], Hum Swachh Toh Bharat Swachh” is an effort that needs all our support.

The writer is an acclaimed author and activist. She is also a champion of the Niine Movement, a movement that breaks taboos around menstrual hygiene. Views are personal.