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Menstruation: Stigma, Struggle, and Sorrow in South Asia

By: Meghna Nair


I don’t remember much about the day I got my first period. I don’t remember if it was a Monday, a Thursday, or a Saturday. I don’t remember if it was in June, July, or August. I don’t even remember if I was in pain that day or if I felt nothing at all. All I can say is that I woke up one sunny summer day in 2018, a couple months before I was due to start high school, went to the bathroom, and found blood in a place it wasn’t supposed to be.


I remember I didn’t panic. I’d taken my fair share of “family life” classes in both elementary and middle school by then, so I knew what this was. I remember thinking to myself ‘Oh. Ok. So this is happening.’


As soon as I left the bathroom, I went looking for my mom. This was meant to be an important rite of passage for me (or so I’d been told), but you wouldn’t know it watching her reaction. It essentially amounted to her walking me back to the bathroom and saying ‘Look. This is a pad. This is how you open the pad. This is how you wear a pad. This is how you throw the pad away.’ The whole interaction was very clinical and matter-of-fact. It probably lasted around 10 minutes.


I didn’t mind. In fact, I’d say I rather appreciated her nonchalance. She asked me if I wanted to have a Ritushuddhi, a Hindu ceremony held when a person experiences their first period, as a way to celebrate my transition to adulthood. I declined. The ceremony can sometimes last upwards of several days, and I didn’t feel like sitting through hours of pujas and rituals for a biological process that was supposed to be a natural step in my maturation. My mom accepted my answer easily, admitting that she, too, preferred not to make a big deal out of it.


That would have been the end of our conversation, except, on a strange impulse, I decided to mention something I’d heard only in hushed whispers from the other Indian girls my age.


“Oh, by the way, does this mean I have to stay away from God now? Like…I can’t go near the puja room anymore?” I wasn’t sure why I had asked such a silly question. The answer seemed pretty obvious to me.


But my mom averted her eyes, tilting her head and twirling a strand of her hair around her finger in that tell-tale way that told me she was carefully considering her response. She was silent for long enough that I began to wonder if maybe the answer wasn’t as obvious as I’d thought.


“Is that what you want to do?”


I blinked at her. “Uh…no?”


“Okay. Then you don’t have to.”


At the age of 14, I couldn’t comprehend the weight of this brief, seemingly unremarkable conversation. I didn’t understand how significant it was that my mom gave me a choice at this crucial moment. The idea of my period placing restrictions on my mobility, determining where I was and wasn’t allowed to go, what I was and wasn’t allowed to do, was so laughable to me that I dismissed it outright and went about my life as if the conversation had never even happened.


In my naivety and obliviousness, I didn’t realize that what was a passing notion for me is the perpetual, suffocating reality for countless South Asian women and girls all over the world.


Stigma


In South Asia, the tradition of prohibiting menstruators from entering certain sacred spaces such as the puja, or prayer, room and the kitchen is rooted in the mainstream perception of menstruation. South Asian society largely views menstruation as a “dirty” and “unhygienic” process, while the menstruating body itself is interpreted as something that must be “purified” before being allowed to re-enter these communal spaces (YRIS). Consequently, women, girls, and other menstruating individuals are restricted from cooking and religious worship due to pervasive concerns of their “impure” bodies “contaminat[ing]” the food or releasing “evil spirits” into the home (National Library of Medicine).


Rural communities in Nepal, in particular, perpetuate harsh period stigmas through an extremely harmful tradition known as Chhaupadi. Rather than just limiting a menstruator’s access to the kitchen or the prayer room, the practice of Chhaupadi involves completely “banishing” the person from their house, relegating them to “mud huts or sheds” for the entirety of their menstrual cycle (ActionAid). These huts, or chau goths, are usually small, isolated, unsanitary, and cold, with no windows and no access to running water. Oftentimes, people banished to the hut need to walk for several miles to the nearest source of water in order to practice basic hygiene. When trapped in the inhuman conditions of the chau goth, a person is rendered vulnerable to a variety of dangers including “suffocation, fire, pneumonia, and animal attacks” (ActionAid). There have even been specific reports of a young girl dying from a snake bite while sleeping alone in a chau goth and yet another from smoke inhalation because she attempted to light a fire to keep warm in a poorly-ventilated hut. Considering these obvious risks, Nepal outlawed Chhaupadi 18 years ago. However, the practice continues to linger in certain communities due to deep-seated fears of “bad luck,” “ill health,” crop failure, social ostracism, and divine retribution befalling the family that breaks from tradition (ActionAid).


Struggle


In addition to the social stigma associated with periods, hardships exist with regard to the availability of resources. In their report on menstrual hygiene in South Asia, WaterAid noted that the majority of rural populations in South Asian countries like India, Nepal, and Bangladesh have limited access to menstrual products. The organization found that while 50% of Nepali girls in urban schools reported using sanitary pads, only 19% of Nepali girls in rural schools reported the same. In West Bengal, the statistic was even lower, with only 11.25% of girls utilizing disposable sanitary pads. Rather than using pads or tampons, the popular practice in many regions of South Asia is to create makeshift menstrual products using newspapers, dried leaves, or, most commonly, “old cloths which they will reuse” (YRIS). The studies in Nepal and West Bengal identified a “lack of awareness,” and “availability and affordability” as the primary reasons for the prevalence of this practice (WaterAid).


Although these “reusable cloths” are a far more accessible option for rural South Asians, they pose significant health risks for menstruating individuals (WaterAid). If these cloths are not thoroughly cleaned after every usage, they can cause “serious and painful infections” that the majority of the people affected are not equipped to handle properly (ActionAid). However, such sanitation practices are difficult to execute because of persistent shortages of clean water to use for washing the cloths and the absence of safe spaces where people can store and change their cloths in private. Combined with the established social stigma of periods, this lack of adequate facilities forces people to seek out “secretive, dark places” to “hide” their used cloths in order to avoid the shame and embarrassment associated with menstruation (WaterAid). Storing their cloths in such places is not appropriately hygienic as the cloths must be dried in sunlight after being washed. Failure to meet this requirement further increases the probability of menstruators contracting severe health problems (Borgen).


Sorrow


When considering the pressing issue of inaccessible resources in light of established period stigmas, it becomes clear why some South Asian girls perceive menstruation as a physical manifestation of “misery” (UNICEF). Although the cultural norms and traditions that reinforce such perceptions have no factual basis, the limited menstrual education offered in South Asian countries allows for these beliefs to persist throughout the region and across generations. Knowing very little themselves, adult South Asian women tend to “shy away” from conversations regarding menstruation and “therefore pass on cultural taboos and bad hygienic practices” to their menstruating children (YRIS). As a result, around 66% of South Asian girls know next to nothing about menstruation prior to menarche (Borgen).


Ill-equipped to manage their own menstrual health and under-informed on the basic biological processes of their own bodies, menstruators in South Asia, particularly young, school-age girls, live in fear of their first periods. In focus group discussions and surveys, many of these girls expressed anxiety about period blood stains appearing on their clothes while in class, mentioning that the thought of such a possibility “caused them stress and depression” (WaterAid). To prevent such social embarrassment, many girls are frequently absent from their schools when on their periods, while others, including an estimated 23% of girls in India, drop out of school entirely, usually to prepare for marriage (National Library of Medicine). Even those who dare to attend school while menstruating do not perform as well as they typically would due to concerns of their male classmates “realiz[ing] their condition” (WaterAid). Juggling these worries along with negative social conventions and the distressing bodily changes brought about by menstruation poses “significant implications for [menstruators’] mental health” which will likely not be assuaged until appropriate solutions are implemented (National Library of Medicine).


Conclusion ~


Organizations such as WaterAid and ActionAid have already developed multi-prong approaches to uproot entrenched period stigmas, promote greater menstrual hygiene, and empower menstruators to speak out about their experiences.


In rural Nepali communities, ActionAid has worked alongside locals to form support groups, known as “reflect circles,” where menstruators can “discuss the impact of Chhaupadi on their lives” in a welcoming and empathetic environment (ActionAid). Sharing similar stories and encouraging open communication is the first step in normalizing menstruation because it allows people to feel more comfortable when engaging in period-related dialogues and motivates them to actively contribute to solution-seeking efforts. In addition to initiating meaningful conversation through support groups and surveys, WaterAid’s menstrual hygiene program in India strives to educate menstruators on the biological processes at work in their bodies and trains community members on how to produce more affordable sanitary pads (WaterAid). Education campaigns are especially effective in dispelling the irrational fears and superstitions surrounding periods while the production of sanitary pads by WaterAid-established support groups and local vendors alleviates the issue of resource scarcity. The organization has also assisted in constructing necessary infrastructure such as “lockable and gender-separated” bathrooms with “incinerator[s] or dustbin[s]” to dispose of used menstrual hygiene products in over 30 Indian schools, which addresses the concerns of adolescent girls who otherwise wouldn’t be able to manage their periods while at school (Borgen).


These kinds of initiatives have significantly positive impacts on the lives of South Asian menstruators, but there is still much more work to be done in order to permanently alter the negative sociocultural attitudes towards menstruation in South Asia. Through education and engagement, communication and collaboration, hearts and minds can change, until one day, menstruation is regarded for exactly what it is: just another part of being human.

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