By Khushi Desai, Analyst, Urban Sanitation, Dasra
On 1st February 2021, the Union Budget of India announced with great fanfare the increased allocations for Swachh Bharat Mission 2.0 (SBM 2.0) – an extension of the government’s flagship Swachh Bharat Mission 1.0 from 2014. This time around, the focus is on thinking and building ‘beyond the toilet’ towards safe and sustainable sanitation. This includes faecal sludge management and wastewater treatment, bio-remediation of legacy dump sites and source segregation of waste among other key planks.
With this multi-pronged strategy, SBM 2.0 can be a game-changer for our communities, which can become healthier and responsive to the needs of vulnerable women, children and segments of society and provide for a more dignified life. But are you wondering what safe sanitation really means and why it’s relevant to both periods (women, transpersons) and pandemics (public health)?
Safe sanitation refers to sanitation that encompasses the full cycle of waste management, from containment, emptying and transport to treatment and safe disposal in the natural environment or reuse. Sustainable and inclusive sanitation systems (cognizant of the needs of menstrual health and the differently-abled etc.) ensure that all segments of society, including the most vulnerable and underserved, have access to safe sanitation. Unfortunately, women and transpersons are often the first victims of unsafe and inadequate sanitation systems – especially in the context of menstrual hygiene management (MHM), which is deeply interlinked with sanitation, water and hygiene.
Periods Don’t Stop For Pandemics
Menstrual Hygiene Management (MHM) has consistently been a critically neglected but unavoidable part of our society, cast under age-old taboos and stigmas. Although 355 million women in India menstruate every month for the majority of their lives, very few have access to menstrual products, Water, Sanitation & Hygiene (WSH) infrastructure and appropriate disposal facilities for used products – and this is further exacerbated in rural areas.
In India, a report by Dasra, ‘Spot On’, finds that nearly 23 million girls drop out of school at the age of menstruation for the lack of safe toilet and water infrastructure. Even more disturbing is the fact that a large proportion of girls are forced to fulfil their sanitation needs in the open once the sun sets – making them more vulnerable to physical abuse and harassment.
While the National Family Health Survey – 5 provides encouragement with an increasing number of women across India adopting safe sanitary products (instead of unhygienic rags, ash, mud etc. from the recent past), access still remains inequitable, especially for women from underprivileged backgrounds and transgender women. Even beyond access to sanitary products, important issues of lack of safe and personal hygiene infrastructure remain – that of poorly maintained or non-existent separate toilets for women and transpersons, lack of clean water and menstrual waste dustbins.
In fact, a case in point is the plight of communities like that of women and transgender sanitation workers, who have dealt with a great many challenges during the Covid-19 pandemic. While they have contributed to the fight against Covid-19 on a war footing, their safety needs have rarely been provided for – not the least of which includes menstrual hygiene management facilities. They have worked in unhygienic surroundings – with the threat of infection from being outdoors as well as in contact with Covid-related waste – without toilets and sometimes, with immense difficulty in procuring sanitary products due to lockdowns and closed shops leading to shortages.
Over the last 18 months, millions of menstruating frontline workers and patients at COVID-19 facilities have suffered, along with the larger women and transgender community due to the lack of MHM infrastructure and systems. If there’s anything the pandemic should teach us with regards to MHM, it is that periods can’t stop even for pandemics. This means coherent MHM policies, implementation and markets are indispensable to support the menstruation needs of over 350 million menstruating women, girls and transpersons in India.
Menstruation Matters
This begs the question of how MHM can be made holistic and available to those with the least access?
The primary step is recognizing that menstrual hygiene management moves beyond logistics: it, in concept as well as effect, must be treated as a full cycle, from making sanitary products available and affordable to providing necessary hygiene and toilet infrastructure with clean water and finally, safely disposing of menstrual waste.
Evidently, there is a profound interlinkage between WSH and MHM, and both these value chains need to function in conjunction for sustainable results.
Significant efforts have been placed towards the first part of the MHM value chain, which is in procuring and equitably distributing sanitary products- which further challenges need to be addressed rapidly with a WSH outlook?
- Infrastructure: It is now crucial to focus on building and maintaining WSH infrastructure (with a push for Individual Household Toilets or IHHTs) that can provide safe spaces for menstruating women and transpersons while providing a healthier and more hygienic menstrual experience.
- Disposal: There is also a massive need for ensuring that used menstrual products (1 billion used pads per month!) find their way to incinerators and other disposal facilities, rather than clogging sewer systems or ending up in landfills, where some of their components cannot decompose naturally for almost 500-800 years (Menstrual Waste Disposal In India, NFSSM Alliance, TQH Consulting).
Here is where the implications of SBM 2.0 become clear – FSM, bio-remediation of legacy waste and source segregation are all steps that would ensure a well-greased cycle of MHM, integrated with the necessary WSH tools. Existing isolated policies like the Menstrual Hygiene Scheme and the Solid Waste Management Rules, 2016 (mandating source segregation) are not just parochial, but also inefficiently implemented on the ground. Even though several states like Bihar, Maharashtra and Jharkhand have well-defined MHM policies, their execution (and quite often, in concept too) is largely limited to the provision of sanitary products and behaviour change communication, which, while important, is not the end of the journey – as we have established so far.
SBM 2.0 can take leaps ahead from these restraints, integrate smaller policy modules to tackle different parts of the MHM value chain with the support of WSH and also trickle down to state-level policies, towards safer, more sustainable and inclusive menstrual hygiene management for all women and transpersons. And inevitably, the COVID-19 pandemic and its aftermath (and all future crises) will perhaps be a notch-less terrible for menstruating communities across India.