Female Hygiene: A Silent Health Threat

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Women and their menstrual cycle is a hushed affair. Scurry undercover for a packet of napkins — carry back the sale swathed in black plastic wrapper or newspaper so that no prying eye can ferret out that you may be ‘down’—bundle up the used stuff and throw it surreptitiously into filth piles. In a scenario where everyone is in denial — from the vendor to the user, how can we bring out an issue that is tethered to ‘impurise’ our environs. Amongst us losers, it is the industry that laughs its way to the bank.

A whopping 1500 crore industry at present, with only a fraction (about 12-18 per cent as reported in Menstrual Hygiene: How Hygienic is the Adolescent Girl? by A Dasgupta et al., Indian Journal of Community Medicine 2008, April; and a report in The Hindu ‘An uncomfortable but scary truth’ April 12, 2013) of the population using napkins and diapers today, usage is bound to rise manifold with an all-out effort of the UN and other government and non-government bodies promoting the cause of hygiene of the individual as opposed to the hygiene of the nation. Such and such number of ‘napkins distributed among rural women’, ‘hostel women’, ‘young adolescents’, ‘sanitary napkin vending machine’, etc., scream reports and news clippings — yet none of them talk of ‘women taught to dispose napkins safely’ as there is no way that one can dispose used sanitary napkins safely. It is plastic so incineration is toxic, natural degradation an impossibility, leaving recycling the only viable option. Pause — recycling did we say, where does this feature in India’s product cycle?

How plastic is a sanitary napkin?

Plastic in napkins

Image source: thekachraproject.in

Very few people know what’s inside a sanitary napkin or a tampon, or for that matter a diaper. A potentially toxic chemical — dioxin (by product of a chlorine bleaching process), gamut of polymers and plastics, wood pulp, fragrances and deodorant are just the few things that constitute a slim and ultra-modern sanitary napkin. Although pads have less internal contact than tampons, the constant irritation of the external mucous membrane enables chemicals to reach the bloodstream.

The World Health Organization (WHO) lists dioxin as belonging to ‘a group of dangerous chemicals known as persistent organic pollutants’, which have been linked to serious medical conditions such as endometriosis, ovarian cancer, immune system damage, impaired fertility, diabetes and more. Besides the fragrances added can have an effect locally and cause allergies and skin reactions. But, the most important cause of concern is that the plastic or polymer content of an ultra-thin sanitary napkin, may range from 40 to 80 per cent depending on the manufacturer. The organic substance, wood and paper pulp is only needed to kick start the absorption, the rest of the storage being undertaken by polymer silica crystals that lock up the liquid in gel like structures. In a paper by B S Pancholi, et al., 2008 ‘Manufacturing and market potential of sanitary napkins’, The Indian Textile Journal, the author identifies the breakup of ‘the super absorbent polymer… basically acrylic based polymer which contains sodium acrylate, potassium acrylate, alkyl acrylate that form a gel after absorbing liquid. By this it can hold liquid up to 30 times its weight’. The cotton like cloth that a pad is covered with is not cotton at all but in fact a combination of waste recycled cloth, polyester and asbestos. The plastic layer is just that, a non-absorbing bottom sheet made of polyethylene. The three components are glued together and sealed with thermoplastic rubber and synthetic resin.

In the news clipping in The Hindu (ibid.), it is stated that the environmental trail of these products is alarming. It takes 236 ml of crude oil to create the plastic that goes into a single disposable diaper. Parents who put their baby in disposable diapers until two would run through 5,000 disposable diapers, for which 20 trees will be cut and 1,180 litres of crude oil used.

India and its used napkins burden

Napkins

Image source: www.wlivenews.com

The modern plastic pads clog up drainage systems; incineration leads to dangerous pollutants being released into the air; and, landfills end up adding toxins to the soil and ground water. And in a country like India where littering is a birthright, disposable pads end up along village roadsides buried amongst the household refuse and cow dung, or thrown into small dirty ponds that abound the village commons. There are about 310 million women in the reproductive age group as per the NSSO, 66th Round Schedule 10, 2009-2010 and 5.5 million children below the age of 6 (Children in India 2012: A Statistical Appraisal, Social Statistics Division, Ministry of Statistics and Programme Implementation, Government of India) who are potential users of sanitary pads and diapers.

According to an estimate published by Sakhi Sanitary Napkins in Hindustan Latex Family Planning Promotion Trust, a woman is likely to use an average of 10,000 pieces of sanitary napkins within 30-40 years in her reproductive life time. Placing these calculations against the present population records around 255 million pads would be disposed in 24 hours across the country in the years to come with the aggressive penetration of disposable napkins. As The Hindu (ibid.) mentions, “The statistics around feminine hygiene products are no less alarming. Only 12 per cent of the 355 million women of menstruating age in India can afford disposable sanitary napkins. But, conservatively, these 42.6 million women will throw 21.3 billion sanitary napkins into a landfill in their lives.” Does that ring the alarm bells?

The manufacturers

sanitary pads

Image source: www.magicworld.com

Industry records show that Proctor & Gamble (P&G) and Johnsons & Johnsons, large multinational companies, dominate the sanitary napkins sale—their product brands being ‘Whisper’ and ‘Stayfree’ respectively.

According to the Country Report prepared by Euromonitor International, a strategy research outfit for consumer markets in September 2012, P&G’s brand led value sales in 2011 with a share of 55 per cent, followed by Johnson & Johnson’s brand with 31 per cent (with higher usage in rural areas). The Report also claims that sanitary protection in India is likely to grow at a strong rate with a constant value compound annual growth rate (CAGR) of 7 per cent over the following years. The growth can be largely attributed to the development of the mid-price and economy segments. Moreover, the popularity of ultra-thin towels will also support further growth adds the Report. In terms of money this translates to sales of around 600 to 700 crores annually for P&G (we conjecture from newspaper reports as no financial records are online in its official website) with sale proceeds mapping a healthy jump of about 40 per cent in first quarter of 2012 (Live Mint, May 9 2012) — rising to 416.63 crore for the third quarter against about 326 crore for the same period the previous year (Business Standard, June 14, 2013).

India is indeed likely to see an exponential growth in this sector with greater accessibility and ease of use of these products in semi-urban and rural areas — apart from the increasing affordability of Indian consumers. The radical change in lifestyles and consumption habits of modern Indian consumers, coupled with the influence of western culture in urban areas, are also supporting growth. So it is a win-win situation for all except the environment of course, which in any case is a non-issue as far as the authorities are concerned.

The urgent Do’s

sanitation

Image source: www.sampurnearth.com

Well, we can scream ourselves hoarse, yet never be heard. But try we shall, to bring to the notice of the authorities and policy makers that we are just too many, too unorganised and too corrupt to take the bulls by the horn. There is a polluters pay policy in place, yet the companies are never ever hauled up for not being responsible for the environmental damage that their products may be causing.

In India around 255 million pads would be disposed in 24 hours in the years to come with the aggressive penetration of ultra-modern plastic sanitary napkins. The politicians and conniving bureaucrats are loophole seekers that let companies go scot free even in cases of incriminating evidence, let alone in an indirect scenario such as this. It is the job of the municipality to clean up, multinationals say — and perhaps rightly so, except Indians never segregate or recycle — that is the job of the expendables, the sub-humans, and the rag pickers. So we invest human wealth, to physically pick up every piece of sanitary pad that we the ‘elite’ have soiled, so that we may continue to do the same in sheer disregard for our fellow species. Lately waste pickers in Maharashtra agitated, protesting against the unhygienic methods of disposal of sanitary pads/diapers and according to a report in the Times of India (March 9 2013) sent boxes of used sanitary pads to the corporate offices of manufacturing companies as a mark of protest. “We will continue this form of protest if the companies ignore our demands. Our health and hygiene should be a priority too for these companies,” said a member of Solid Waste Collection and Handling (SWaCH). Do developed nations of the world have rag pickers? Do they have a population size anywhere close to ours? Do they have malnourished poor living on incomes below Rs 28.69 (Planning Commission 2012)? And are the products priced the same in India and abroad? Well no, it is cheaper in India—the consideration being larger sales and more profits. In the same breath why then do we not have a separate ‘poor-countryclean-up’ diktat from the policy makers that approve the multinational entry. The guidelines should clearly state advisories such as:

■ Plastic/polymer percentage declared on individual packs ■ Environmental and toxicity risk for water and soil printed on the pack ■ Chemicals used and possible medical reactions clearly stated on napkin packs ■ Recycling norms with do’s and dont’s in the Indian perspective ■ And all of it in easy to understand illustrations —not in fine print.

If the tobacco industry could take it in their stride and print health risks prominently, why can’t women sanitary products have it too? As of now the situation is dismal to say the least as even computation of sanitary pad waste in the solid waste stream has not begun let alone retraction. In a telephonic interview, B Madhusudhana Reddy, Sr Environment Engineer, Delhi Pollution Control Committee stated that in Delhi (and elsewhere), “… the said form of waste is directly going to the sanitary landfill, which is not a good practice [they know —hallelujah]. They should be incinerated in an incinerator [now that is a revelation]”. And when asked if the authority has any computation/ record of the waste generated monthly or yearly— Reddy drew a blank, adding that no authentic data is available about the ‘said stream of waste’.

As for J S Kamyotra, Member Secretary, Central Pollution Control Board (CPCB), he refused to comment even after repeated attempts by us to elucidate a response, such is the apathy of the keepers of India’s health.

End note

sulabh napkins

Image source: indiatogether.org

There are options afloat. Sulabh International Social Service Organisation, has taken up the heroic task of providing near organic sanitary pads, which can be incinerated within homes in keeping with the covertness of the operation. Although outfitted at a small scale now, products such as these need the fillip with massive over the counter availability so that India can at least have a healthy option. Then, we have hemp and flannel reusable cloth pads, chemical and perfume free; we have the ‘She Cup’, a terribly named silicone insertable cup that collects bodily fluids and can be used for 8 to 10 years; and we have our own homemade messy cloth nappy solutions. But, in the present scenario, in the absence of the former three options being readily available, the last one is all we can offer, which is not really a solution at all—being the most unhygienic. So P&G and J&J zindabad, till the time we are buried in our own filth.

Co-authored by Sulagna Chattopadhyay

Cover image source: foodmatters.tv

Note: The article first appeared on Geography and You magazine.

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