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The status of women in India, despite all the brave talk, remains as precarious as ever. This is, after all, a culture which not just condones, but actively encourages the termination of foetuses determined to be female. Other crimes of violence against women are routine. Can things ever change? We took a trip to the heartland to try and find some answers. Madhya Pradesh has among the country’s worst indicators as far as women are concerned. The sex ratio is skewed, the fertility rate is high, as are malnutrition and maternal deaths, and the state has one of the highest crime rates against women. In a series of six stories, Mint takes a long, hard look at some of the key issues. We examine how the state government is trying to prevent female foeticide and improve the sex ratio; a mass marriage scheme aimed at fighting poverty and dowry; how the state is trying to reduce maternal deaths, malnutrition and domestic violence. In the first of the series, Mint looks at how women cope with the deeply personal issue of menstruation, the bizarre restrictions they face and how they are forced to use home-made solutions during their periods. But some of them at least are finding some relief, with low-priced sanitary pads distributed by some self-help groups.

Dabhiya village, Madhya Pradesh: When Parvati Thakur started her periods, she felt less like a person, more like an animal.

As her menstruation cycle returned every month, the thin farm labourer with sad, vacant eyes would retreat to a dark shed next to her hut, where the family buffaloes lived. There, for the next four days, she’d eat and sleep with the animals, smeared in blood, dust and dung.

“Like a mad person, I used to just sit in a piece of cloth and bleed. I cried a lot," recalls Parvati, who grew up in the village of Rehetiya not far from here, and where the women folk, according to ancient rites, move to the stables to menstruate.

Married off before puberty, the mother of two daughters says she felt dreadfully alone each time, as she’d rummage for rags along village roads to squat on, until more experienced women taught her how to tie a cloth to protect herself.


Sitting cross-legged on the floor under the shade of a hut, woman after woman in this village, many of them daily wage workers who toil in farms and seasonally migrate for construction jobs, had similar tales to narrate—some anecdotal, others drawn from their personal experience. Like others, they spoke of using straw, wood shavings, ash, newspapers, dried leaves, hay and plastic as blotters. And they spoke of emergencies, when women would share the same strip of fabric, which would be washed and hidden inside crevices of thatched roofs and trees, away from the male gaze.

They also spoke out fears of resisting deep-seated cultural taboos associated with menstruation, viewed even today as polluting and dirty in much of India. Like millions of women, they are compelled to sleep separately for those few days every month, banned from entering the kitchen, or attending religious and social functions, bringing their daily routine to a grinding halt.

For centuries, women have been ordained to live through various forms of social ostracization, limiting their freedom and mobility in a growing country, advocacy groups say. Though cruel practices such as segregation in animal sheds are slowly fading, reports still trickle in from villages in Uttarakhand to Tamil Nadu about the practice of sending young girls and even mothers and their newborns to separate huts, if not to a pen, until they become “clean".

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Such intimate issues involving women rarely make headlines, even though poor menstrual habits cause a host of reproductive tract infections and, sometimes, infertility, doctors say. A woman died when an insect moved up the bloodstream through her vaginal tract in Tamil Nadu, while another had tetanus after using a blouse with a rusty hook in Uttar Pradesh, according to Anshu Gupta, founder of Goonj, a non-profit group that makes reusable sanitary cloth pads.

Now, several studies conducted by the World Bank, companies and non-governmental organizations (NGOs), indicate that more adolescent girls are dropping out of school due to lack of sufficient menstrual support. A 2007 study edited by Varina Tjon A. Ten, former Dutch parliamentarian for Europe External Policy Advisors, a Brussels-based centre that keeps track of European Union policies, reports that more girls are missing school during menstruation in Asia and Africa, unable to cope without proper toilet infrastructure and sanitary pads.

Also listen to Aparajita Dasgupta, professor at All India Institute of Hygiene & Public Health talk about effects of poor menstrual hygieneDownload here

Women, who make up less than half the population, have the hardest choice to make. Without education, they are likely to be married early, which could lead to immature pregnancies, low-weight babies and higher morbidity, according to Aparajita Dasgupta, professor at the Kolkata-based All India Institute of Hygiene and Public Health. “It’s a vicious cycle that is adding to the country’s economic burden," Dasgupta says.

A conspiracy of silence

A bigger problem is that the topic of menstrual hygiene is taboo even in influential circles. Policymakers skirt the issue as do industry chambers. Although a pillar of the country’s Total Sanitation Campaign since 2008, it doesn’t find mention in Planning Commission documents. Worse, sanitary napkin advertisements faced a total ban prior to the 1990s, forcing manufacturers to adopt innovative door-to-door campaigns. Retailers still like to sell them discreetly inside black plastic packets.

“There’s a total culture of silence. Nobody wants to talk about it," says R. Sujatha, programme coordinator at Shri Cheema Foundation, the corporate social responsibility wing of the Chennai-based TVS Electronics Ltd, and which is now part of a new menstrual management initiative to produce napkins with several self-help groups. Preparing a lecture on the subject for a Confederation of Indian Industry seminar, she recalls being asked to “tone down" her pitch by its officials.

Pressure from grass-roots organizations is, however, forcing the government to take action. Last year, the Union government announced plans to make sanitary pads, once viewed as a luxury item, available to impoverished girls across 150 districts at subsidized rates. Last week, a government release said it will make pads available at 1 a piece to “promote safe and hygienic practices" among adolescent girls; production tasks will be shared between self-help groups and public sector undertaking HLL Lifecare Ltd (formerly Hindustan Latex Ltd), according to an official who declined to be named. In this year’s budget, finance minister Pranab Mukherjee announced tax breaks to widen its reach, prompting companies to lower prices.

Procter and Gamble Hygiene and Health Care Ltd, the leader in the domestic sanitary napkin market valued at 1,351 crore in 2010-2011, and maker of the popular Whisper brand, has already slashed prices in its low-priced categories. “We believe that a reduction in prices of Whisper (will) significantly aid cloth conversion," the company said in an email.

New research, however, cautions about putting emphasis on sanitary pads to promote girl schooling. Economist Emily Oster, associate professor at University of Chicago and co-author of a report on menstrual hygiene in Nepal last year, says though the World Bank has put the loss of school attendance by menstruating girls at “10-20%", the impact may be less. For their research, they provided new sanitary products, but found that school attendance remained unchanged. “Although there might be reasons for the government to subsidize better sanitary products, it would be a mistake to do so on the assumption that it would improve schooling," Oster said in an email response to Mint.

Only 12% of 355 million menstruating women use sanitary napkins in India, according to market research group AC Nielsen, which is much lower than China (64%) and Indonesia (85%). The India survey, which was carried out among 1,000 rural women in October, also stated that more girls dropped out from school after menstruation in north India.

Innovative responses

To meet the dire shortage of affordable sanitary pads, a quiet revolution is brewing across the rural heartland. Self-help groups are beginning to set up rural production units, establishing local labels with names such as “Easy Feel", “Free Style" and “Be Free", sold for as little as 15 a packet. Schools in Nagaland and in small towns such as Panipat in Haryana, too, are setting up vending machines for pads made of materials such as wood pulp and non-woven fabric. States such as Haryana are promoting NGOs to produce them. Not just girls, but boys, too, are being taught lessons on menstruation with dolls as props around villages in Udaipur.

A. Muruganandam, a Tirupur-based entrepreneur, even clinched a National Innovation Foundation award for his cost-effective mini pad-making machine. “I call it the bottom-of-the-pyramid product. It doesn’t have aesthetic appeal, but serves the purpose," says Muruganandam, who’s doing well by selling machines to state governments, NGOs and self-help groups. He claims his equipment costs 65,000 and takes four unskilled persons to produce 1,000 pads in an 8-hour shift. A packet of eight could cost as low as 20.

Foundations launched by TVS Electronics, Hyundai Motor India Ltd and Saint Gobain Glass India Ltd have come together to put up seed money to buy sanitary pads and have plans to offer pad disposal incinerators in village schools in Tamil Nadu.

In many ways, social marketing, as it has come to be known for increasing income-generating opportunity among rural women, got a fillip when states such as Tamil Nadu saw the relevance of converging government projects such as building school toilets and sanitation awareness with poverty alleviation. The efforts received a further impetus in 2004 when the tsunami left hundreds of women victims with trauma-induced menstrual bleeding. A quick, practical solution was needed, and some activists responded by turning surplus clothing arriving from charities into cloth pads.

“It’s not just about shortage, but there was this huge cultural barrier staring at our face. But the topic had to be out in the open," says Shantha Sheela Nair, a senior retired bureaucrat who goes by the popular sobriquet of “Lady who broke the silence" for aggressively promoting self-help groups to produce sanitary pads.

These barriers also run very deep in places such as this village in Madhya Pradesh, where women have recently experienced the comfort of using reusable cloth pads that have begun arriving in small batches from Delhi-based Goonj. “Many women fear that they have been made with dead people’s clothes, so don’t use them," says Girija, a farmer.

In a village behind a warren of apartment complexes in south Delhi, women are hard at work making a product essentially for women. Inside the workshop run by Goonj, they take apart old saris and suits, trousers and skirts. The pieces of cloth then go into washing machines and are pressed by hand before being folded and packed. A land rights group bringing a large contingent of villagers placed a large order a few years ago, when many of the supporters marching in the shadow of New Delhi’s landmark Jantar Mantar observatory turned out to be women.

With the invasion of polyester saris in villages, women are now left with less cotton resources to make home-made cloth pads, says Goonj founder Gupta, even though they are 100% biodegradable and pose less environmental hazard than the plastic-lined modern pads.

The candid women of Goonj, likewise, swear by their cotton pads, acting as its unofficial ambassadors. When Sheela Mishra went back to her ancestral village in Uttar Pradesh to attend a marriage last year, she took a bunch of them to gift to her nieces and sisters-in-law. “Use them, I tell them, because they are clean," she says. “I scold them if they use rags."

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