Modern practices of using pads, tampons, and menstrual cups for managing menstrual hygiene are familiar to most women living in big cities and people consider these products lifesaving; however, the reality is very different in the sweltering heat and the forgotten landscape of Tharparkar. Imagine being a woman, menstruating in a scorching heat of 45 degrees Celsius without electricity and water for sanitation. Also, consider the fact that most of these women keep working in the fields without any proper menstrual hygiene practice and shortage of proper nutrients. Add to that, no access to proper sanitation in most of the villages and you have a health catastrophe at your hands.
You must be thinking how these women manage their menstruation if they are deprived of even basic facilities, I was curious too and this led me to conduct a focused research project on menstrual hygiene among women in Tharparkar. My recent visit to the largest district of Sindh and adjoining cities revealed a lot of uneasy facts regarding how much this important aspect of women health is neglected there. I found out that around 80 per cent of the women in the rural part of the district free bleed i.e., do not use any hygiene products to absorb the flow of menstrual blood. About 10 per cent women use rags and the rest use handmade pads filled with sand or dried cow dung etc., to absorb menstrual blood. These figures alone would be enough to call this situation a health emergency in any developed part of the world where women health is considered a national priority.
During my conversation with local women, I found out that there are many stereotypes associated with menstruation which further increases the chances of infection, discomfort, and other adverse health outcomes among menstruating women. For example, many women thought they were not supposed to take shower during menstruation because they considered it unhealthy while others thought that they should not eat anything cold because it will cause more discomfort and increase dysmenorrhea (painful cramps in periods). Similarly, people in urban areas considered using imported menstrual hygiene products as a status symbol and repudiate all other menstrual hygiene practices, but women in Tharparkar are way too unaware of these contemporary practices of managing menstrual hygiene. When I showed them a pad and I asked, do you recognise this? The various answers I received were “is this a soap?” or “a packet of detergent?” This shows the lack of awareness and education about a natural process.
According to a survey by a local, there are 2400 villages in Tharparkar and the literacy rate is 18.63 per cent. Which justifies women being unaware of contemporary practices for menstrual hygiene management because there is lack of education. Meeting Thari women and knowing about their perspective on managing menstrual hygiene gave me a different sense of understanding that every culture is playing an important role in the society, and we need to accept that but at the same time we need to save them from this rigid and unsanitary belief system that they can free bleed and there is no harm in it. During an interview, another local woman said, “When I got my first period, I informed my mother about it and she told me that it is a normal thing and happens to everyone in the world, so I need to be relaxed with this biological process.” In rural areas of Mithi and Umerkot, which are two of the main districts in Tharparkar, women do not use any MHM product and free bleed. Above all, they are not ready to accept any new practices to manage menstrual hygiene because they are unable to afford it. Awareness regarding menstrual hygiene management can save a lot of women from being mentally tortured at the time of menarche as well as during their periods. There were also few women who said that they had their first period after they got married and until I talked to them, no one discussed about this biological process with them before. Products like pads and tampons remain beyond the reach of many due to financial constraints. Menstrual hygiene, early marriages, patriarchal society, and lack of education are the biggest indicators on which the government needs to work on. Highlighting underdeveloped areas like these to UNICEF, UN and government of Sindh can save women from different diseases they get because of not using any proper hygiene material during periods, which is an alarming situation. Government of Sindh and regulatory bodies need to intervene and take effective steps to save women from unknown diseases. Health workers need better and effective training to teach local women how to maintain their menstrual hygiene. Training Lady Health workers easy and affordable coping mechanism during menstruation can lessen the extant of diseases born out of unhygienic menstrual management practices.
*Naidah Aqeel is the author of health booklet on menarche named ‘My Body is Precious’.