The monthly blush by Noëlline Demeilliers

NoĂŤlline Demeilliers Transcultural Design Program in India Masterâ&#x20AC;&#x2122;s thesis 2013-2014

The monthly blush The challenges of menstruation in India

thank you To Jaicy Joseph for editing and her indispensable help all along the writing. To Aditi Gupta, the founder of Menstrupedia, for her help and support. To Arun Kumar, for stepping out of his comfort zone and being an incredible Tamil translator. To Sharon Pushpa for her sensitivity during the interviews conducted with Kannada speaking women. To Sabina von Kessel and Kshitz Anand, the teaching staff of the transcultural design program. To Richard Spitz, Mudit Gupta, Hrishikesh Neve, Dhruv Pinto, MaĂŤlle Boucaux, Maddalen Gil, Nicolas Charronneau, and my classmates for their support and friendship. To all the women who trusted me enough to confide in me.

abstract Purpose

Menstruation is a biological process that touches every woman in the world. It is the process in which a woman experiences the discharge of blood and other materials from the lining of the uterus at intervals of about one lunar month from puberty until menopause, except during pregnancy. Women represent around half of the world’s population and they all have different perceptions about menstruation. In India, there are 614.4 million women, and it is estimate that more than half of those women cannot afford sanitary pads. Nearly 25% of girls miss 3-5 days of school every month during their monthly periods. This deliberate absenteeism is mainly a result of lack of financial resources to afford the cost of conventional sanitary towels available in the market. Most of these girls as well as women are forced to use unhygienic materials to keep dry during their menses. The pain related to menstruation is a common problem. Some women take time off of work or school because feeling unwell. Dysmenorrhea is a medical condition of pain during menstruation that interferes with daily activities. Different remedies exist, but they are not well known, and dysmenorrhea is still a source of discomfort for women worldwide. In different societies, religions, and times, menstruating women were perceived in distinct ways. A lot of contrasting ideas and beliefs were created to explain women’s periods in ancient societies and cultures. Though many such ideas and beliefs have been proven wrong by science

nowadays, they are still followed in societies at present. These ideas are called menstrual myths. These myths tend to suggest that menstruation is a disease or a curse and it leads up to beliefs like: a woman’s body is polluted while she is experiencing periods. Such beliefs cause discrimination against women and, at times, can lower their self-esteem and opportunities for growth. In this thesis, I will be looking at women’s needs in India today in order to discern how design can help women overcome the challenges of menstruation.

Opportunity

How to overcome the challenges of menstruation in India?

Process

With this objective in mind, I needed to find out what menstruation is in biological and culturalsocialogical terms globally and in India. It was also essential to look at birth control, since menstruation is related to fertility and birth control allows women to choose the number of children they want and to choose when they want to menstruate or not. I considered menstruation from the point of view of a woman who do not have it any more. What is it to not menstruate again? Is it emancipation or a loss of femininity? In order to entirely understand the purpose of this thesis, I needed to find out taboos and myths engendered by the society and particularly in India. I interviewed Indian men, ana-

lysed advertisements; study different religions to understand where the wrong beliefs about menstruation come from. I had to go through menstruation from a cultural point of view. To provide a design answer to these issues, it was essential to look at the main hygiene subjects concerning women. I had to figure out the different ways in which women are managing their flow in various societies and times, and which are the benefits and the problems encounters while resorting to these solution, in order to give the right answer in my design. Finally, I met Indian women, analyzed their problem and needs according to three different socio-economical categories: low income, middle class and upper middle class women.

Table of contents Introduction Chapter 1: Menstruation

1.1 What is menstruation?

1.2 Contraception and birth control

1.3 No more menstruation

Defining menstruation in biological terms Defining menstruation in cultural terms

The birth control program Contraceptive methods

Women who chose not to menstruate again Menopause: Freedom?

Chapter 2: Menstrual taboo 2.1 The menstrual taboo

2.2 In India

2.3 Showcasing the menstrual blood

Definition History Religion

Taboos in India Menstrupedia

Study of pad advertisings Menstrala Who wants to wear this t-shirt?

Chapter 3: hygiene 3.1 Sanitary protection: material

Sanitary pads Tampons Unhealthy substances hidden inside intimate protections

Toxic shock syndrome: The tampons’ dark side What do women use in India?

3.2 Alternatives

3.3 Access to sanitation

Menstrual cup Arunachalam Muruganantham Reusable napkins

From rags to menstrual pads Access to proper toilets and disposal of menstrual items

CHapter 4: Indian women: problems and needs 4.1 Gender relation in India

Defining «gender» Status of women Financial problems

4.2 The female body

4.3 Who are Indian ladies?

Biology Menarche Lack of knowledge Menstrual pain Wild life Sanitation

conclusion References

100

bibliography

102

Introduction Menstruation has never been a taboo for me. I am French and grew up with my two elder sisters, my mother and my father, who decided take away the lock of the bathroom. It may have been because he thought that we as children might lock ourselves in the bathroom and not be able to get out. It could have also been due to the fear of not being able to access the bathroom once we grew up. He may have assumed that we would spend too much time dolling up (a little chauvinist maybe) as teenagers. But whatever the reason, I thank my father for this. Thanks to him, I knew what a woman’s body and a man’s body looked like from the time I was a child. In our household, anyone felt free to walk into the bathroom regardless of somebody else just having a shower. It was very convenient if all of us had to get dressed in a short while. And I knew what menstruation was and why women were menstruating way before I got my first period. I remember when I saw my sister coming out of the bath the towel wrapped around herself and a tiny stream of blood between her legs, I got scared! “What is happening to you?” And that is when she taught me everything there is to know for a child about the female genital system. Around four years later, I experienced my first menstruation. I was twelve, and it was my sister’s eighteenth birthday celebration at a community hall. I remember this day as my sister’s birthday and not as the day I got my first menstruation. I was surprised of course; no one is really prepared for the first menstruation. I was more concerned about dirtying my lovely

attire than being embarrassed about getting my periods. When I understood that I’d gotten my first period, I directly went to my mother for help. But, the only woman who had a spare pad was my aunt. I remember that she gave me a huuuuuuge pad, giant-sized for my twelve-yearold body, which was not really comfortable for dancing. When I got back from the washroom, every woman from my family congratulated me. They were laughing at me without making a big deal of the thing. They made me feel good about being a woman. Today, I am 22, a student pursuing my second year of Master’s Degree in Transcultural Design in India. My seniors warned me to take a stock of my favorite tampons before coming to India because of the unavailability of tampons with applicator and because it is apparently “embarrassing” to buy tampons over here. I found out that 300 million women could not afford sanitary pads and that many women did not know why they were menstruating. This lack of knowledge has led to many myths around the topic of menstruation. I personally experienced the discomfort of getting my periods while traveling in India because there is a lack of access to the usual facilities for women and I was not able to talk about it with my friends. So, I decided to dedicate my final diploma project to help women overcome all those challenges brought about by their periods (or menstruations). When I chose this topic as an end to my diploma, I did not think it would have been so difficult to conduct a research. I sometimes felt like I was a criminal when I tried to interview

people. I could then figure how much more difficult it must have been for women to answer my questions. We had to hide from men as if we were dealing drugs. I then understood that menstruation might be a barrier for many women to achieve their dreams and life’s expectations. In India, 25% of the girls drop out of school because they do not have access to adequate sanitation. All these factors play an important part in the gender relation gap. Even if in some countries the taboo is less perceptible, the discomfort still remains. In France, we can hear jokes which sound like this: “What’s the difference between a terrorist and a menstruating woman? With the terrorist you can negotiate.” To the guy who wrote this joke I would like to answer, “What do we call a man who lost his intelligence? A widower.” My main goal as a designer is not to write sexist jokes but to try to change the perceptions of women and men around the menstrual taboo and to make menstruation a strength and not a barrier.

Chapter 1 menstruation Menstruation is inseparable from several aspects like biology, environment, fertility, birth control and female sense of identity. This chapter aims at elaborating on these very features.

#1 Menstruation

1.1 What is menstruation?

Definition Menstruation

menstro͞oˈāSHən, menˈstrā-/ noun The process in a woman of discharging blood and other materials from the lining of the uterus at intervals of about one lunar month from puberty until menopause, except during pregnancy.1 Other terms for menstruation are “period” which means an “interval of time” or a “repeated cycle of events” and “catamenia” from the Greek katamenia (kata = by + menia = month). The word menstruation comes from Latin “menses”, which means month, to indicate the frequency a woman bleeds: around once a month. Generally, a normal cycle is between 21 and 35 days, and 28 days is the noticed average duration. During the first years of menstruations, the duration of the cycles can vary, be rarer and spaced out - older women have more regular cycles. Every cycle can be divided into four stages.

In biological terms Stage 1 A new cycle begins every month. In this stage, the womb is covered with a mucous membrane to get ready to receive a fertilized egg. Stage 2 During this stage called ovulation, an egg gets loose from one of the ovaries before going to one of the fallopian tubes, a ‘journey’ which can take a few days. Certain women experience a mild pain during ovulation, but most notice nothing in particular. Stage 3 If the egg meets a sperm cell while it goes to the womb, the woman can get pregnant. If not, the body will prepare to get rid of the mucous membrane and to expel the non-fertilized egg and the fluids. Stage 4 Period begins and the woman starts bleeding. This phenomenon repeats every month averaging 400 times in the life of a woman before she reaches menopause and before her periods stop definitively.

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Ovum and ovulation A girl is born with hundreds of thousands of ova. Ova are stored in two organs called ovaries. A woman usually produces a ripe ovum from one of her ovaries about once a month. When it is fully mature, the ripe ovum pops out of the ovary. This process is called the ovulation. After ovulation, the ovum enters one of the uterine tubes. The ends of the uterine tube reach out and sweep the ovum into the tube. Tiny strands of hair inside the tube wave back and forth. The waving helps move the ovum through the tube. Each month as the ovary gets ready to release a ripe ovum, the uterus prepares itself. If the ovum is fertilized, it will plant itself in the tissue lining the uterus. The fertilized ovum will need plenty of rich blood and nourishment as it develops. So, as the ovum is ripening in the ovary, the lining of the uterus grows thicker. It develops new blood vessels and spongy, blood-filled tis-

Ovary releasing an egg. Pictures from SVT, 4e, Science de la vie et de la terre, La reproduction humaine, C. Lizeaux, D. Baude, Bordas edition, 2011.

sue that will nourish the ovum if it is fertilized. If it is not, the lining is not needed. After about a week the unfertilized ovum breaks down, the uterus begins to shed the lining. Pieces of the lining slide down the uterus walls. The spongy, blood-filled tissue breaks down, becoming mostly liquid. This liquid constitutes the menstrual flow. It then slowly dribbles into the vagina and out the vaginal opening. It is said that the woman is menstruating when she experience this process. Each menstruation causes loss of around 35milliliters of blood, and a woman loses around 16 litres of blood in a life time. Menstruation lasts for around a week, for the menstrual flow to leave the body. Once the bleeding stops, the uterus starts the process again and gets ready for a new ovum. If that ovum is not fertilized, the lining breaks down again and another period begins. And so it goes month after month, around every 28 days.

Ovule leaving the ovary.

#1 Menstruation

uterine tube uterus ovaries

ovaries vagina

ova

lining

menstrual flow Pop up representation of the ovulation.

When a woman menstruates, she loses around 35 ml of blood.. 16

in a lifetime around 16 liters or 32 bottles of ketchup. 17

#1 menstruation

Henry Ford Hospital (The Flying Bed), Frida Kahlo, 1932 Painting representing Frida Kahlo miscarriage in the Henry Ford Hospital in Detroit

In cultural terms It has been less than a century since we have discovered what the menstruation blood is and how the whole female genital system works. Simone de Beauvoir, in The Second Sex, explains that science through the ages gave wrong explanations of menstruation. For example, in ancient Greece people thought that, every month, the blood that was leaking was supposed to be the childâ&#x20AC;&#x2122;s blood and flesh in case of fecundation. More information on the cultural interpretations of menstruation follow in the second chapter, The Menstrual Taboo.

#1 Menstruation

youhou! I’ve got my own mountain!

Numbers: A huge market, a vast problem, massive pollution Menstruation is a phenomenon touching every woman in the world. Of the world population, 49.6% is female2 . Girls hit puberty at around 12, and women stop menstruating at the average age of 51. The average duration of a cycle is 28 days, so today around 334 million women are menstruating. A woman will spend approximately 3,500 days menstruating. On an average, women in: • A modern industrialized society menstruate 450 times in their lives.

• An agrarian region menstruate about 150 times. • Prehistoric times menstruated only 50 times. Approximately 70% of women of menstruating age use pads and tampons. A woman may use nearly 11,400 tampons in her life. Every year, in Britain alone, a hole needs to be dug 300 feet wide and 300 feet deep to bury the used sanitary pads and tampons that women throw away 3.

#1 menstruation

1.2 contraception and birth control

Iâ&#x20AC;&#x2122;m the boss! iâ&#x20AC;&#x2DC;m the one deciding where, when and how! The menstrual cycle is a series of synchronized events that prepare the female body for pregnancy. All the contraceptive methods prevent pregnancy, either by influencing certain parts of the menstrual cycle, or by preventing the sperm cells to reach the ovum. Contraception as well plays a big role in the feminist movement in the west. It allows women to decide when they want to get pregnant, leading to freedom to decide personal and professional aspects. This chapter, describes how the Indian government introduced contraception in a birth control program and the different contraceptive methods.

#1 Menstruation

The birth control program In India, the growth of the population is a concern of the government. In 1951, India implemented a family planning program to help slow their population growth. As an illustration of this growth, in the year 2000, India’s 1 billionth baby was born making the country the home of one sixth of the world population. According to the UN, through contraception, family planning tries to achieve two aims: • Allow individuals and couples to anticipate and attain the desired number of children and the time between births. • Directly impact a woman’s health and well-being by influencing the number of pregnancies, the time period between pregnancies and the outcome of pregnancies. The family planning program resulted in a huge success in Kerala by reducing population growth. The fertility rate was 3 in 1979 and has currently gone down to 1.7.4 But the program kind of failed in the rest of India and particularly in the north. So where did it go wrong? For some experts, the problem comes from the program itself. A R Nanda, executive director of Population Foundation of India points out that «population growth cannot be controlled by coercive measures (but) with economic growth, education for all and empowerment of women.» So for him, the sterilization and contraception program would make no sense if the population is not educated about it. While looking at an advertising to avoid “sex selective female abortions” one would notice that the

government only explains that it is not good to practice abortion if it is a girl but do not explain why. If women are not empowered, this campaign seems useless.

«For a healthy family, wait three years before your second child. You can get these family-planning methods from government health workers, hospitals, and health centers for free.» Photo credit: Courtesy of the Medical Materials Clearinghouse at the Johns Hopkins University Bloomberg School of Public Health/ Center for Communication Programs

#1 menstruation

Contraceptive methods Even if the first concern of the Indian government, by launching the family planning program, was to slow down the growth of the population, contraceptive would also help a woman in avoiding unwanted pregnancy and protect her from sexually transmitted diseases as well as help her in planning her menstruation. “Among married young women aged 15-24 years in India, 16% used any contraceptive method in 1992-3; a little less than half were sterilized. By the year 2005-6, 27% of them had used contraceptives; nearly one third were sterilized. During this period (1992-06), use of modern spacing methods – predominantly condom use – has doubled, and there seems to be stagnation in the use of sterilization at early stage of life5”

#1 Menstruation

India: Preferred methods of

contraception The pill 9%

Female Sterilisation 19% Male Sterilisation 2%

Condom 31%

Others 2% (Rhythm, withdrawal, abstinence etc) IUD 38%

Projection based on FPAIndia (Family Planning Association of India) figures. ÂŤFPA India strengthens a voluntary commitment to advocate for SRH and Rights and, choices. It promotes access to SRH information and services related to family planning, safe abortions, HIV/AIDS and sexuality to poor, marginalised and vulnerable populations including young people.Âť www.fpaindia.org

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There are a large number of female contraceptive options available in the Indian market:

Contraceptive pill:

IUD (Intra-uterine device):

One of the most popular contraceptive options available in the market these days comprises of the oral contraceptive pill. Pills contain hormones which resemble those naturally produced by the ovaries. All the pills contain one or two hormones similar to the natural feminine hormones. These hormones not only prevent ovaries from releasing eggs, but also thicken the cervical mucus to block sperm and even alter the endometrial lining to prevent implantation. The pill makes menses regular and even reduces the risk of pelvic disease. Unfortunately it also has some negative effects, such as headache, dizziness, breast tenderness and more serious health problems like an increased risk of breast cancer. A number of studies suggest that current use of oral contraceptives (birth control pills) appears to slightly increase the risk of breast cancer, especially among younger women. However, the risk level goes back to normal 10 years or more after discontinuing oral contraceptive use according to www. cancer.gov. .

Intra-uterine device is a contraceptive device inserted into the womb. Two types of IUD are available. One is made with copper and the other one is hormonal. For the copper one, the more the copper surface is big, the more the IUD is effective, because the copper is the contraceptive element: it returns sperm cells inactive. The device which releases hormones has two effects: • It thickens the secretions of the “entry” of the womb and makes the way impassable for sperm cells. • A therapeutic effect: it decreases the duration and the volume of periods as well as the menstrual pain; some users moreover have no menstruation for 5 years. IUD can remain effective from 5 to 10 years. This contraception method is cost effective as well as reliable. However, the problem is that it might cause bleeding or pelvic infection in a female as well as increase the chance of contracting STDs.

#1 Menstruation

Condoms:

Diaphragm:

The male condom as the feminine condom prevents the passage of sperm cells in the vagina and the fertilization. Condoms are in latex or in polyurethane. It has to be placed on the penis in erection before the penetration, and it retains the sperm. Before the end of the erection, it is necessary to remove the condom by holding the condom at the base of the penis. A knot needs to be tied to seal the open end after it is removed. This can then be thrown into the trash can. The condom must be changed for every sexual intercourse.

The diaphragm looks like a disc in latex or in silicone. It is a protection which has to be placed in the vagina to prevent the passage of sperm cells from the womb. The main use of the disc is to prevent sperms from entering the uterus. It is also filled with spermicide, so that if by any chance the sperm enters the uterus, it is rendered inactive. The insertion can be a bit difficult and uncomfortable for some women.

Spermicides: Spermicides are substances which, as their name indicates, inactivate or destroy sperm cells. They are available in the form of creams, foams, gels or suppositories (that can be inserted inside the vagina). One cannot completely rely on them and they are usually used along with other contraception methods, like condoms. The formation lasts for a while, usually within an hour.

#1 menstruation

What are you talking about? Even if all those contraceptive methods are available in India, people still do not feel like using them. The main reason is the lack of information in rural areas as well as in cities. “As per the annual health survey (AHS) 2010-11, only 47.8 per cent people in Jharkhand opt for family planning out of which 44.1 per cent are from rural areas while 58.4% are from urban Jharkhand.6” The second reason is the lack of information. A lot of people are being told misconceptions from their relatives and get scared: weight gain or infertility for example. “Surveys reveal that misinformation is very prevalent among young people. Some believe pregnancy can be prevented by adopting certain positions or by washing, douching or even bathing after intercourse.7” So people prefer to use traditional methods like sterilization which is chosen in 37.5% of the cases.

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1.3 no more menstruation

ouch! Given an option, about one third of women would chose to keep their periods. In the USA, around 2 women out of 3 would chose to not have their menstruation if it still allows them to have babies. For some women, the experience of menstruation is perceived as really annoying and unnecessary. They then choose to get rid of them. For different reasons like too much of pain, they make the choice to not bleed twelve times a year. This chapter explains the relationship between menstruation, fertility and contraception.

#1 menstruation

No more periods, no more babies? Possible solutions to stop menstruating could be to take pills continuously or to get an implant one of the effects of which is the end of periods. Some women choose a definitive solution while others choose a temporary solution that lasts a few months. For instance, when there is an important event happening. In the collective representations, periods embody fertility and youth. To lose them would be dangerous if you want to get pregnant. Martin Winckler, doctor, disputes this idea on his blog: “American studies showed that of 100 women who interrupt any contraception, 95 % are pregnant in the further twelve months. Then, the contraception is not dangerous for fertility.” In the same note, he adds: “All the current knowledge show that the absence of periods on women who have an implant, or a hormonal DIU, or when a woman takes her pill continuously, does not have any incidence on health8” One of the big stakes in this debate is the subject of feminine identity. «Are women still women if they stop menstruating?» To not have menstruation anymore would psychologically be annoying. When pills were first introduced, women did not get their menstruation. So to eliminate the fear of the psychological effects, the period was restored. They are totally artificial, and there is no argument other than “it would be natural to have them”. The Brazilian gynecologist Elsimar Couthino,

the inventor of the implant, has a medical opinion on the topic. In his book “Is Menstruation Obsolete?” the doctor explains that menstruation would be useless, unhealthy (Due to outcomes like anemia, endometriosis, and PMS), unnatural and would be just culturally significant. “Menstruation is incompatible with life in nature because an animal cannot survive bleeding longer than a few minutes in the forest. The smell of blood attracts predators. The scent of blood is the scent of death9”. But why would nature make women menstruate without a good reason? And why if a woman is healthy would she take hormonal treatments and change her body?

Princess Mononoke, a hairy pelt hanging around her neck, connoting unbridled animality and, together with suggestions of menstrual blood, pointing female sexuality. Princess Mononoke, is a 1997 Japanese anime epic historical fantasy adventure film written and directed by Hayao Miyazaki, animated by Studio Ghibli and produced by Toshio Suzuki.

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When a woman is having her periods, is not her body telling her that she is able to procreate? In her documentary, The Moon Inside You, Diane Fabiánová explains that when she was on the pill she could not notice when she was ovulating but now that she has stopped, she can feel her natural instinct to be attracted by males. It is as if her body is asking her to procreate. While a woman has her menstruation, she is most of the time tired, nervous, and sensitive. In an interview which I conducted, an Indian man told me: “I know how girls are during their menstruation time! Moody!” The body would show, then, that women are not able to be fertilized and relations between men and women can be difficult during this time. Menstruation would be a break time for women, to take care of themselves and connect to her inner self. Penelope Shuttle, a poet and author, who wrote The Wise Wound: menstruation and everywoman, says “The moment of truth is the moment of menstruation. And I think it’s because, despite people having physical pain, distress, it’s just probably the most powerful moment in our lives. And it is very analogous in many ways to birth.” For her, every month, a woman is giving birth to herself and reconnects with her body. And this would be the moment of meditation which could not be experienced if the woman stops menstruating.

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menaupose: freedom?

By definition, a woman is â&#x20AC;&#x153;menopausalâ&#x20AC;? when she does not get her menstruations at least 12 months in a row, but the process that culminates in menopause can last a couple of years. Menopause can be natural or led. Natural menopause is a part of the normal process of ageing and occurs when ovaries stop secreting an ovum a month. Led menopause consists of the surgical ablation of ovaries or it occurs when ovaries stop working following lesion bound to chemotherapy or to radiotherapy. After menopause, a woman cannot get pregnant through sexual intercourse anymore. Women stop naturally menstruating around the age of 51. It is often synonymous to a mental and physical disruption in a womanâ&#x20AC;&#x2122;s life. Cycle irregularity, irritability, weight gain, hot flashes, menopause arise between 45 and 55 years. But this major life turning point for a woman does not arrive brutally. It is most often preceded by a pre-menopause period.

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Even if some women feel liberated, in the occidental world, this period marks a huge change in a woman life, it means the end of menstruation so the end of fertility. Women can feel like losing their femininity, their sex appeal. They will not be able to give birth again. “Some women report mood swings, irritability, tearfulness, anxiety, and feelings of despair in the years leading up to menopause.” Nietzsche was saying “Woman is a problem for which the solution is pregnancy10”. Even though I do not concur with Nietzsche’s opinion, it is important that I mention his remark in my thesis because exploring various perceptions associated with women and menstruation is a key requirement of my thesis. The most common menopause symptoms are: • Personality problems: nervousness, irritability, loss of self-confidence • Cognitive disorders: memory losses, difficulties to concentrate • Sexual disorders: less desire, vaginal dryness • Depressive and anxious disorders On the other hand, the psychological experience of menopause is inseparable from the sociocultural context. For example, in India, after menopause, women can participate in religious ceremonies from which they were banned before because the menstrual blood is seen as impure. A Muslim woman would gain in dignity and autonomy after menopause. “After all, it is often the most pleasant period of her life, where she is finally more independent, less subjected to whims of men and invested with more authority on other women. It is for her the entry

into an honorable position and the end of the taboos attached to the feminine function, the right to be revealed, and the access to worship, to rites and to sacred objects.11” In Japan, less than 25 % of the menopausal women have hot flashes. On the contrary, 70 to 80 % of the western women complain about annoying symptoms. One of the major components which explains this visible contradiction is the consumption of soya. Different diet around the world would then make menopause a more or less easy period to go through. Even though the physiological implications of menopause is a relatively recent discovery, the social implications of menopause have been extremely prevalent because it is connected to the notion of fertility. The end of fertility has direct consequences on families, tribes, and people. According to societies, religions, and times, menopause can be a real liberation or a revival. Contrarily, it can be a real physical or intellectual trauma.

Freedom!

Chapter 2 The menstrual taboo “Today, something new happened to me; I’ve got my periods. Mum told me that I’m a big girl now! But, I should be careful and not talk about it in front of boys. I should also sit with my legs closed and behave properly” would say a young girl in India. Here is an example of the cultural conditioning that Indian girls usually receive from their mothers when they get their first period., The flow frightens, arouses faiths and false hypotheses. The malefic power of the menstrual blood finds itself in numerous traditional societies. The food gets rotten, objects become unusable, plants stop growing and flowers fade when women touch it. Periods remain a taboo for approximately 38 % of women even in the western world.

#2 The menstrual taboo

2.1 defining the taboo

Definition Taboo

noun /təˈbuː/ (PLURAL taboos) (an action or word) avoided for religious or social reasons12 The origin of the word taboo would come from the Polynesian word tapu “sacred”, from ta “mark” + pu “especially”. This discovery comes from Captain James Cook. In a journal entry from 1777, Cook says this word «has a very comprehensive meaning; but, in general, signifies that a thing is forbidden.... When anything is forbidden to be eaten, or made use of, they say, that it is taboo.13» A theory states that the word taboo originates from the word tupua which mean “magical and sacred” and was directly related to menstruation. This suggests that menstruation might just be the first taboo.

History Different theories and views on menstruation, symbolism and taboos that have existed, but more importantly, how they originated is an instrumental aspect of my study. Historically, no one knows how the beliefs around menstrual blood originated. It has been less than a century since we found out that the cycle is related to a woman’s physical ability to bear a child and give birth – an ability that man lacks. So beliefs around menstrual blood are most probably related to blood symbolism. Death and sickness often involve blood too. That may be why women have been kept physically isolated during menstruation because of the perceived dangers of contact or contagion. Also, since women could survive this loss of blood every month, they were perceived as divine and magical. Taking a Freudian theory, this taboo could as well be related to the fear of castration that faces men, an anxiety which could be due to women’s genital bleeding. Menstrual taboos have also been seen as the dominance of men over women. Few investigators highlighted the possibility that taboos might exist because they confer an advantage to men over women.

«I bleed sometimes», Kyvan Elep, red food coloring in a glass of water, 2011.

Where comes from the problem dude? 35

#2 The menstrual taboo

If men could menstruate.. “Whatever a «superior» group has will be used to justify its superiority and whatever an «inferior» group has will be used to justify its plight. Black men were given poorly paid jobs because they were said to be «stronger» than white men while all women were relegated to poorly paid jobs because they were said to be «weaker». As the little boy said when asked if he wanted to be a lawyer like his mother, «Oh no, that’s women’s work». Logic has nothing to do with oppression. So what would happen if suddenly, magically, men could menstruate and women could not? Clearly, menstruation would become an enviable, worthy, masculine event: • Men would brag about how long and how much. • Young boys would talk about it as the envied beginning of manhood. Gifts, religious ceremonies, family dinners, and stag parties would mark the day. • To prevent monthly work loss among the powerful, Congress would fund a National Institute of Dysmenorrhea. Doctors would research little about heart attacks, from which men would be hormonally be protected, but everything about cramps. • Sanitary supplies would be federally funded and free. Of course, some men

would still pay for the prestige of such commercial brands as Paul Newman Tampons, Muhammad Ali’s Rope-a-Dope Pads, John Wayne Maxi Pads, and Joe Namath Jock Shields- «For Those Light Bachelor Days […]». In short, we would discover, as we should already, that logic is in the eye of the logician. For instance, here’s an idea for theorists and logicians: if women are supposed to be less rational and more emotional at the beginning of our menstrual cycle when the female hormone is at its lowest level, then why isn’t it logical to say that, in those few days, women behave the most like the way men behave all month long? I leave further improvisation up to you. The truth is that, if men could menstruate, the power justifications in a patriarchal society would go on and on.”

«If men could menstruate» by Gloria Steinem, Outrageous Acts and Everyday Rebellions. NY: NAL, 1986.

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Man! I lost like a liter of blood last time!

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"my girlfriend use to go for loads of pain and takes off from work. She goes sick, bed ridden everytime. so.. . no! "I don't know! How much cost the operation to change sex?" I asked a simple question to Indian men. Here are their answers.

"i think so.. but come back to being a man. i love my plumbing better!"

Would you like to be a woman and experience menstruation? "i'm happy with whatever god has offered to me. i just want to be what i am."

"No, I know how girls are during their menstruation time! moody!" "Sure! I have been waiting for this day!"

"Hahaha! I never can, i don't have a vagina and i'm fine maintaining male parts. it's much difficult for women!"

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Three girls laughing in their village in front of the «chaupadi goth,» a small hut where women sleep for four nights during their monthly period, in Siddheshwar village, Achham, Nepal on Nov. 29, 2012. Image by Allison Shelley

Professors Tomas Buckley and Alma Gottlieb critique the anthropology of menstruation, in blood magic. According to them the assumptions that taboos were served to oppress women or to protect men from the blood are too narrow. They explain that in some cultures “menstrual customs, rather than subordinating women to men fearful of them, provide women with means of ensuring their own autonomy influence, and social control”. It would provide

an access to women to a “gender-exclusive ritual power”. As an example, there is a custom of women seeking seclusion in “huts” during menstruation. This custom is common in different cultures, but the interpretation is different. Does it benefit women’s individuality or is it made to protect men from menstruating women?

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religion The principal religions of the world like Judaism, Christianity, Islam, Buddhism, Hinduism, etc. have referred to menstruating women as unclean. Sikhism is probably the only religion which condemns any form of sexism including women during their periods.

Judaism:

Christianity:

The Jewish code of law prohibits literally any physical contact between males and females during the days of menstruation and for a week thereafter. In the Torah, we can see, «anyone who touches her will be unclean until evening». After their menses, women immerse themselves for seven days in the ritual bath to become clean again.

Just like the Jews, Christian women are not allowed to have sexual intercourse during their periods. In the Eastern Orthodox Christian Church, menstruation is considered unclean and participating in the sacrament or touching holy items is disallowed. In the bible, Leviticus 15:1930 reads, “And if a woman have an issue, and her issue in her flesh be blood, she shall be put apart seven days: and whosoever toucheth her shall be unclean until the even. And everything that she lieth upon in her separation shall be unclean: everything also that she sitteth upon shall be unclean.” Among Russian Orthodox Christians, menstruating women have to live in secluded huts during this time. They do not attend church services, cannot have any contact with men, and may not touch raw or fresh food. It can affect the weather negatively as well. But, this is not true for every Christian. Western Christian rules are less extreme even if some negative attitudes still remain

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Islam:

Buddhism:

In the Quran, 2:222 reads, “They ask you about menstruation. Say, ‘It is an impurity, so keep away from women during it and do not approach them until they are cleansed; when they are cleansed you may approach them as God has ordained…”. The Quran only stipulates this law but depending on beliefs, Muslim women have to keep away from the men of their families, can’t touch the Quran and enter the mosque or offer ritual prayer. As well, if a woman is menstruating during the Ramadan, she is exempted from fasts, but she’ll have to catch up later.

From a Buddhist point of view, menstruation is, “a natural physical excretion that women have to go through on a monthly basis, nothing more or less14 ”. Also, because of the Hindu influence, some Buddhist temples do not allow women to enter. It is also believed in the Buddhist religion that ghosts eat blood. So women are considered as ghost’s prey during their menstruation and therefore a threat to themselves and others. An example cited by the Buddha Dharma Education Association says, menstruating women should not approach the place where rice is fermenting or it will get spoilt.

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Hinduism “In Hindu mythology, it is believed that women got ‘Rajaswala dosha’ (menstruation) when Lord Indra (the king of gods) severed the head of Vishwaroopacharya (the second teacher of the gods). Since Lord Indra killed a Brahmin, he got ‘Brahmahatya dosha’. He got rid of it by distributing it amongst prithvy (land), samudra (water), vriksha (tree)and stree (woman). From that day on, women started menstruating every 28-30 days and got the ability to give birth. Hence it’s believed that menstruation is a dosha.15 ” Women aren’t allowed to visit temples while menstruating. The boards outside the temples read: ‘Ladies in monthly period are not allowed’. Some women aren’t allowed to enter the kitchen and temples, sleep during the day, bathe, wear flowers, have sex, touch other males or females,

talk loudly, and touch pickle. According to mythology a pickle touched by a menstruating woman rots. In the Hindu faith, women are prohibited from participating in normal life while menstruating. She must be “purified» before she is allowed to return to her family, and can’t have contact with anyone during this period. In some parts of India, women have to leave the house and go to some hut while menstruating and if they have a young child they might take him with them.

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2.2 in india

Hindu paradoxe In general, Hindu women face restrictions and inequalities while menstruating. Paradoxically, in some parts of India, Hinduism celebrates menstruations as a big event which honors womanhood and the creation of life. The Kamakya temple, situated on Nilanchal Hill in Kamrup district of Assam, observes a festival called “Ambubachi” every year. Sati was the wife of Shiva known as the god of destruction. Legend says, even though her husband was not invited, Sati had gone to attend the universal ‘yajna’ organised by her father Daksha. Shiva was abused by Daksha. Unable to bear the insult her father was saying about Shiva during the celebration, Sati committed suicide. Hearing the news, Shiva arrived on the scene, picked up the body and cut it into 51 parts. The genital organ

The Kamakhya Temple is dedicated to the mother goddess Kamakhya, situated on the Nilachal Hill in western part of Guwahati city in Assam, India. File from the Wikimedia Commons. By Kunal Dalui, 16 May 2011.

(yoni) of Sati fell in the spot where the temple now is. That is why, every year, in the month of June, the menstruation of the goddess is celebrated. On the seventh day of Ashaad, it is said that the pool containing the uterus turns red for three days. There is no scientific backing to the event. Many believe that lots of vermillion powder is poured into the water, which then turns red. The holy water is then distributed by the priests among the pilgrims.

The goddess Kamakhya or sati, also called the menstruating goddess during her menstruating time. Ramendra Singh Bhadauria ©

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I'm sitting here for 9 days but after i will have my puberty ceremony!

sadangu

traditions

In Tamil Nadu, a state in Southern India, when a girl hits puberty and gets her first menstruation, a ceremony is held in her honor. After interviewing a 40 year old Tamilian woman, Anita, I got an overall idea of how this ceremony takes place. Exactly how the ceremony is performed might vary between families or cities though. When Anita got her first period her parents made her sit in the corner of the main room of their house for nine days. At the end of the nine days comes a ceremony. In traditional communities most people contribute generously, bringing rice, vegetables, fruit and cash. The girls

wear new clothes, are given a ceremonial bath with turmeric after being oiled with sesame or coconut oil from head to toe. Itâ&#x20AC;&#x2122;s a way of announcing that the nubile young things are available for marriage, and families with sons can come in search of brides. People give the girls money and presents. And everyone treats it as a joyous occasion, one worthy of celebration. There are several reasons of having this ceremony like welcoming a girl to adulthood, purifying her soul and spirit, cleansing her, beautifying her body and many more.

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Hindu temple in India displays its prohibition against menstruating women. «Outside Dilwara temples», Mt. Abu, 2007, shunya.net

a famous indian case study In 2006, an actress, Jayamala, was investigated by the Crimes Branch of the police, by order of the Kerala state government in India and then officially charged with violating an Indian law. Her crime was committed in 1987. She was charged for “deliberate and malicious acts intended to outrage religious feeling of any class by insulting its religion or religious beliefs”. She revealed that she had touched the idol of Lord Ayyappa at the Sabarimala temple. But like many temples in India, no woman between the age of ten and fifty can enter them.

precinct, the only way to keep it ‘clean’ is to keep the pollutants out. To ensure that no pollutants enter the temple, the temple made a law that no female between the age of 10 years and 50 years (the menstruating years) can worship at the shrine. WHat?? I can't enter the temple? roaaar!

Why? Menstruating girls and women in most sections of Indian society are viewed as “unclean” and “polluting,” like a garbage heap or noxious traffic fumes would be. Females who are menstruating are believed to “pollute” the environment. And, since the temple is a sacred

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Illustration of an article from the blog Menstrupedia. «How Difficult Is It To Discuss Periods With Siblings?», Aditi Gupta, Dec. 2013, http://menstrupedia.com/blog

mENSTRUPEDIA Very little in India is being done to help Indian women overcome the challenges of menstruation and particularly to fight menstrual taboos. Menstrupedia aims to spread awareness around the menstrual topic. NID graduate Aditi Gupta is the cofounder of this organization. Menstrupedia is a website presenting menstrual taboos, menstrual hygiene management and a forum where girls can freely ask questions that are addressed by a gynecologist. It is a blog with articles around the topic in which women talk about their experience of menstruation. But the main idea of Menstrupedia is to launch a comic book with the intention to educate girls

and boys about menstruation. Aditi Gupta explained to me in an interview that she chose this medium because it gets past the feeling of shame. The comic book will be distributed by schools, book stores, online stores, Menstrupedia website and NGOs. It will be available in Hindi and English but the organization has the ambition to translate it also in several South Indian languages and to create an audio version for illiterate girls.Aditi’s Gupta, ambition comes from her own experience; she had to deal with problems related to menstruation all her life. She explained that even her husband did not know much about menstruation because he had two brothers; he is now working with her on the

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Samples of the menstrupedia comic book. «Menstrupedia comic – an essential guide about menstruation for young girls» Aditi Gupta, Tuhin Paul, 2014, www.menstrupedia.com

Menstrupedia project. She always felt that there was a need to bring awareness around the topic of menstruation. She then started her research in collaboration with the Ford Foundation at NID. For their research, Aditi and the cofounder of Menstrupedia, Tuhin Paul, visited schools in Gujarat and interacted with many girls to understand their state of mind and their knowledge about the topic of menstruation. She asked girls to write about menstruation, and what they aspire to become. At the end of the research, they created a Hindi prototype of the comic. The returns have been really positive: “Not only did the young girls who we gave samples of the comic enjoy it, educators and parents found it

very helpful too. Parents felt that using comics to educate youth about menstruation is very effective in eliminating the feeling of shame associated with this topic and creating a favorable environment for them to discuss this topic with their daughters.” But the fact that parents always want to first go over at the contents of the comic before allowing their daughter to read it is a noticeable point that Aditi has noted.

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2.3 Showcasing the menstrual blood

Study of pad advertisings: Use of blue color instead of red to represent the menstrual flow

While looking at the advertisement of sanitary napkins, one notices that there is always this

idea of discretion; menstruation is something you have to hide. In a Stayfree ad, a girl is really excited because she had applied to an army school, like the men in her family. Her father gets the letter of admission for the girl, but for him, this is nonsense. The girl finally ends up joining the army, and while she is packing, her mother asks her in another room, far from any other ears, “Hey! But what will you do during your periods?” The girl then shows the Stayfree packet in the suitcase discreetly. Even the names of some brands suggest this idea of discretion. For instance, Whisper suggests that it’s related to something which should not be said aloud or related to something which is spoken in private.

Screenshot of a kotex advertisement on youtube.com

The first advertising to show blood to sell a sanitary pad has been made by Leo Burnett Chicago Agency in 2010 for the brand Always. Several media wrote that the ad had broken “a long standing taboo16 ” and others went so far as to call it a “historic moment17 ”. In this ad, we can see a drop of blood, which looks like a small red circle, imprisoned in a labyrinth to represent the efficiency of the pad. Willy Chyr, the designer explained, “There was going to be no white spandex and no blue liquid. Just a simple,

The fluid used to depict the flow is blue. Red fluid is never used. It is possible that people do not want to make it obvious and in turn embarrassing for the viewers. The brands probably do not want to turn the advertisement into a horror movie. On the contrary, in ads for band aid, the blood is shown. So there is actually a problem with menstrual blood. But, by doing this, the fact remains hidden. In many cases, out of curiosity, little children use napkins to blot ink like they see sanitary napkins soak blue fluid spilled on them in the ads.

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The first pad or tampon advertising to show blood. Always advertising, Leo Burnett, Chicago Agency, 2010.

clear message: The product works – nothing more, nothing less.”While analysing Indian sanitary pads advertising, I have noticed that the brands are selling their product as if they were items that provide freedom and confidence. With a napkin or a tampon, everything becomes possible. In a Whisper commercial, a girl whose father is putting pressure on her to win a dance competition when she has her period will wear a napkin and feel more comfortable. There is nothing which can stop her from succeeding. Due to the flexibility of the material used in the pad, she can move around with ease and the pad will not slip.

the napkin is your best friend. While some women are acting, a background voice declares, “When there was nobody, you helped me. Whenever there was a difficult time, you gave me a helping hand. When I had troubles in my heart, you gave me reinsurance. Only a woman understands another woman. But, if a woman doesn’t understand another woman, you have Stayfree Secure. It is a relationship of trust, the bestselling sanitary napkins in India. Stayfree Secure is a priceless relationship”.

In another ad for Stayfree, it is clearly said that

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From left to right: «Galaxy Crossing», «Before My Door», «Seeing Through Other Eyes», Vanessa Tiegs, Blood on paper, 2003. http:// www.vanessatiegs.com/creations/menstrala/

Menstrala Menstrala is the term to define menstrual art. The word menstrala was coined and created by the artist Vanessa Tiegs “to represent her collection of 88 paintings affirming the hidden forbidden bright red cycle of renewal.18 ” While the art world is probably not surprised by the concept or the execution, the mainstream world still reacts with shock at the thought that anyone would consider menstrual blood or a woman’s menstrual cycle the subject or material for art. But, this type of art does not lack meaning and represents a feminist movement against the menstrual taboo. For example, Zanele Muholi Triesto denounces with her art the practice of the “corrective rape” in Africa. This practice intended to straighten homosexual women. There is as well Ingrid

Berthon-Moine who makes women pose with some menstrual blood on the lips or May Ling Su who spent two years documenting her menstrual moments in photos and videos. On her website, we can find a video in which she is spreading blood all over her body. Sometimes the message is not clear, but the idea is to shock, create a reaction with the objective to stop hiding menstrual blood and be shameful of it. As artist Vanessa Teigs explained in an interview, “Menstrala simply reminds us that menstrual blood is not invisible, not to women. Menstrual blood is the only blood that is nonviolent.”

Menstrual Blood Lipstick. Red is the colour, 2009 by Ingrid BERTHON-MOINE, The art of being a woman. Menstrual Blood Lipstick.

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Who wants to wear this t-shirt? The T-shirt bears a name, «Period Power», which reminds us of other fights: Black Power, the Gay Power, etc. We see fingers, pubis, hair and the red of menstrual blood. It is collaboration between the brand, American Apparel, and a young 20-yearold, feminist artist, a Canadian, Petra Collins. She works on the feminine sexuality and the adolescent culture. Daily Mail wondered if the brand had gone a little too far. Usually renowned for reporting trash, the British daily paper chose to blur the T-shirt and reported that buyers were outraged and disgusted. In an interview with OysterMag, the artist explained that the purpose of its work was to confront people with the facts that they prefer

to ignore. She confronts three taboos: • Feminine masturbation (Yes, she explains that the fingers at the top of the pubis are not there accidentally.) • Pubic hair • Periods

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T-shirt ÂŤperiod powerÂť, Petra Collins,American apparel, 2013

Chapter 3 hygiene Menstruation is a natural process, but it can be the source of numerous health problems if good measures are not taken. According to reports, there is a link between bad hygiene during menstruation and urinary infections, problems with respect to reproduction and some other diseases. Hygiene is important during menstruation; that is why it is essential for women and girls to have access to appropriate water and systems of purification. At the same time, it is important that men and women know about menstrual hygiene. At present, cultural practices and taboos about menstruation have a negative impact on the life of women and girls, and it strengthens the gender disparities and exclusion.

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3.1 Sanitary protection materials and disposal

Sanitary pads or napkins A sanitary pad or napkin (sanitary napkin is the word used in India) is an absorbing device worn by women: • During their menstruation • After a surgical operation of the vagina or the neck of the womb • After a childbirth.

The pad that used today was invented by French nurses during the war to stop excessive bleeding mostly on battlefield. They used wood pulp which was very absorbent, cheap enough to throw away after one use and easy to produce. Manufacturers borrowed this Idea to produce menstrual napkins. The first ones were available in 1888 and called the southball pad. Johnson Unlike a tampon, it is an external protection, and Johnson started producing their own, calwhich is attached inside underwear. led Lister’s Towel: Sanitary Towel’s for Ladies, in 1896. The sanitary pad is probably the most used way of managing menstruation. It is easy to use and Even after sanitary pads were available, they easy to get. It can be reusable or disposable. It were not successful because women were ashacan be made of cotton fabric, wooden pulp, med to ask for the product in the shop and they papyrus, and can be produced by multinational were too expensive. It took several years for saindustries or by local companies. Today, there nitary pads to become commonly used. Those are different varieties of disposable sanitary pads were not adhesive like the ones available pads available in the market, ranging from ul- today but had to worn with belt or suspenders trathin panty liners to oversized maternity pads. or were sanitary panties. The earliest disposable From reusable ‘rags’ to disposable ‘napkins’, pads were generally in the form of a cotton womenstrual pads have indeed come a long way. ol or similar fibrous rectangle covered with an absorbent liner. A sanitary pad was used for the first time during the tenth century in ancient Greece. It is said Self-adhesive pads became available in the early that a woman threw her used rag to one admirer 1970’s. Over the last 40 years, the sanitary pad into get rid of him19. dustry has advanced. Gone are the days of belts. With the invention of more absorbent materials Before the pad was invented, women were using and better designs, pads are more comfortable surprising elements such as rags, old cloth, cot- and practical than ever. The invention of ‘wings’ ton, sheep’s wool, rabbit fur or even grass.20 keeps pads in place in the underwear, and the invention of ‘scented pads’ reduces odor.

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Belts to hold menstrual pads from the brand modess. Women wore commercial belts at least from the latter part of the nineteenth century. Because self-adhesive pads became available only in the early 1970s, if women used pads, they had to wear belts, suspenders, «sanitary panties,» (underpants with hooks or tabs or something else to hold the pad in place) - or invent some way of getting the pad to stay in place. «Modess, Empress belt», 1973, USA, Museum of Menstruation and Women Health, www.mum.org/belts

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Tampons A tampon is a usually disposable absorbent, mostly made in viscose sometimes surrounded by a cotton net, inserted into the vagina as a hygienic protection to absorb the blood during the menstruation. The tampon has been recognized in 1986 by the publishers of the magazine, The Consumer Report, as one of the 50 best inventions launched during the first half of the 20th century. They studied more than 100,000 products and services and choose the ones who had the biggest influence on daily life. Among other familiar products such as air conditioning devices and the running shoes, the magazine chose the tampon as one of “The 50 little marvels and big business which revolutionised consumers’ life”. The origin of this small marvel, the tampon, goes back to history. In ancient Egypt, people designed disposable tampons made of soft papyrus. The Greek doctor Hippocrates, in the fifth century before JC, already described another type of tampon made from wood pulp wrapped in fibers. In other countries, women improvised with materials they had at hand: • • • •

In Rome, some wool; In Japan, some paper; In Indonesia, vegetable fibre; In Equatorial Africa, lawn rolls.

While other manufacturers marketed menstrual pads during the 1920s, the idea of a tampon persisted in other domains. For more than a century, doctors used improvised corks made of cotton to absorb secretions caused by surgery and to apply antiseptic products in the vagina in order to stop the bleeding. It is the doctor Earl Cleveland who thought of leading the tampon beyond the stage of improvisation. From 1929, he tried to invent a product which can be expressly made and launched in the market to absorb the menstrual flow. The first tampon with applicator was launched.

An alternative to tampons are natural sea sponges. They are not containing any Dioxin or synthetic fibers. They are sustainably harvested and reusable for three to six months.

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Unhealthy substances hidden inside intimate protections21 Tampons and menstrual pads were invented at the beginning of the 20th century to help women manage their menstrual flow. From then, the market continued to grow: self-adhesive pads, advertising, perfumes, etc. The race for the most absorbent material obliged manufacturers to develop more sophisticated products. But what is inside those items? In tampons and sanitary napkins, residues of numerous toxic products are found. These toxic products are in very close contact with a woman’s body, but brands never warned women about harmful substances. Nowadays, the toxic ingredients contained in tampons and disposable napkins include aluminum, alcohol, perfumes (that can cause irritation), hydrocarbons and pesticides. The vaginal wall is very absorbent. Therefore, the chemical substances contained in these disposable products can easily penetrate into the body. The problem arises when the body does not know how to get rid of them which leads to higher levels of accumulation of these chemicals posinghealth threats. Pads contain gels called «super-absorbents».

Come on guys! Let’s destroy their vagina! They are actually crystals of sodium polyacrylate, the same ingredient that is present in nappies or baby wipes, an absorbent polymer which turns into gel when it gets wet and absorbs until eight hundred times its weight in water. This ingredient is also seen in small white bags, which absorb humidity. The process of bleaching tampons leaves residues of dioxin. The chlorine used to clear pads and tampons, to give an image of purity, reacts with viscose and leads to the creation of a very toxic substance called dioxin. According to Greenpeace, «dioxin is one of the most toxic synthetic substances ever studied” and it affects women’s health, since it might lead to sickness such as endometriosis, as well as to ovarian dysfunctions, diminished fertility, premature delivery, miscarriage and hormonal changes. It is impossible to find the exact composition of these products on the packaging. Kotex, Whisper, Carefree and Co. do not mention these constituents on their products keeping their consumers in the dark.

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Toxic shock syndrome: The tamponsâ&#x20AC;&#x2122; dark side* Women began becoming aware of problems bound to tampons at the beginning of the 80s. If they are not changed frequently enough or if they are too absorbent, the use of tampons can cause the toxic shock syndrome (TSS)*. Cases of TSS appeared when artificial hyper-absorbent fibers such as viscose were introduced into the tamponsâ&#x20AC;&#x2122; composition. Nevertheless, this type of fiber is nowadays always used, mixed with cotton. The problem arises when tampons not only absorb the menstrual blood, but also the vaginal secretions (lubricant and protective film on the vaginal wall) and the vaginal flora. Deprived by its natural protection, the body then becomes vulnerable to the TSS and various infections such as thrush. The symptoms of TSS include fever, vomiting, diarrhea, a skin rash that looks like sunburn, peeling patches of skin on the feet and hands, muscular aches, headaches, a sore throat, red eyes, confusion, a drop in blood pressure, joint pains, sensitivity to light, kidney failure and collapse. The artificial fibers used in tampons and pads are abrasive as well. When a tampon absorbs the blood and stretches out, it puts pressure on the uterine zone, causing small cuts. We found tamponsâ&#x20AC;&#x2122; filaments in the vaginal mucous mem-

branes and in the fallopian tubes (which lead to the ovum). Some cases of infertility can be attributed to the presence of these filaments in the fallopian tubes that prevent sperm cells from reaching the ovum.

Mouhahah hahahah hahahah hahahah hahahah haha!

*The toxic shock syndrome (TSS) is a rare and potentially life threatening illness that is thought to be caused by infection with certain types of bacteria, including Staphylococcus aureus and Streptococcus pyogenes. Most cases occur in women who are menstruating, so it is thought to be associated with tampon use.22

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What do women use in India? In India, only 12% of menstruating women use sanitary napkins23. The lack of money is the biggest reason. Around 70% of women in India say their family cannot afford to buy napkins. To manage their menstruation they then use solutions such as sand or ash wrapped in newspaper or old rags. They undergo regular discomfort and repetitive infections. Incidents of Reproductive Tract Infection (RTI) are 70% more common among these women. The numbers come from a survey by AC Nielsen «Sanitary Protection: Every Woman’s Health Right» and show a real problem of women’s hygiene care in India. In comparison, 100% women in Singapore and Japan, 88% in Indonesia and 64% in China use Sanitary Napkins. the arrival of synthetic saris that were used as a measure to manage menstrual flow led to a worst situation. The same survey shows that 74% of rural Indian women still use “unsanitised cloth” i.e. household cloth from old saris and the like for menstruation. This could be explained as well by the fact that people do not like paying for an expensive item they will use only one time. Women who can afford menstrual protection tend to prefer pads in India. The use of tampons is limited because of beliefs. According to a belief, a girl would lose her virginity if she uses a tampon. Another reason is the difficulty to find

them in stores. In cities, they are widely available but in rural India it is a challenge. An example was given by one of my friends while she was traveling in Kerala. She got her period when she was not anticipating it. She was in a village and went to the nearby chemist with a tampon as a sample. The guy took the tampon and wondered what it was. If you go to a shop in India, pads are available, though they are often big, bulky and designed for overnight wear. If looking for a thin pad, not much of a choice is available; brand names include Whisper Ultra Thin or Stayfree Dry Max. Otherwise, OB tampons without applicators can be found, but not everywhere. Another similar experience happened to me. I was going to NH7, a music festival which was happening in Pune. At the entrance of the festival, there was a security guard frisking people and checking the contents of bags. I had my periods and was carrying a packet of tampons in my bag. The lady took the tampons one by one, smelling at them, unravelling them to check if they were drugs in it and at the end asked to her boss, “Madam? What is it?” This experience opened my eyes on how unaware women were about menstrual management in India even in a big city such as Pune.

ash or sand

More than 300 million women canâ&#x20AC;&#x2122;t afford sanitary pads in India.

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3.2 Alternatives

Menstrual cup A menstrual cup is a small cup in the shape of bell with round edges which most of the time end with a small stalk which allows removing it with ease. Generally in medical silicone, but sometimes in latex according to the brands, it is usually very flexible or sometimes a little stiffer according to the models. The woman introduces the cup manually into the vagina to collect the menstrual flow. Unlike a tampon or a sanitary towel, the cup does not absorb the blood. During the menstruation, it must be emptied and rinsed with clear water two-three times a day. It replaces 1300 tampons and pads but costs only 30 euros. It is practical, eco-friendly, and exists in six colors. The menstrual cup indeed presents a couple of benefits: • Financial: By cycle, a box of tampons cost Rs.175 x 13 cycles = INR 2275 a year, that is INR 11,375 in five years, while a «cup» costs around INR 2500 • Health: No Toxic Shock Syndrome and secretions circulate normally. • Practical: It stays in its position, and a fresh stock of tampons is not needed. • Ecological: Imagine what is thrown every month, three-six times a day during a week. Tampons, applicators (cardboard or plastic), pads, and the packaging. According to Wikipedia, in France, 4.8 billion tampons and pads are thrown each year.

Cups have been launched a couple of years ago by MoonCup, a British company. Since then, several brands have come up with the same product. But while I was in France, I was looking to buy one. I first went to a supermarket to see if it was available. On finding out that it was not, I went to a pharmacy and the chemist didn’t even know what I was talking about. I even asked my doctor and he thanked me for revealing a new product to him. So the question is why is the menstrual cup so difficult to find out? I got mine when I was back in India. I ordered it from the website www.mooncup.co.uk. The industry of pads and tampons obviously have a lot at stake if the Mooncup gets popular. They thus flood us with advertising of their products to persuade us that the only solution for a period is to spend INR 2275 a year. Thus, MoonCup is perceived as a product that is accessible only to the rich few.

A menstrual cup mooncup, www.mooncup.co.uk

VS. Tampons:

Menstrual cup: Credit: Love your vagina production, mooncup.co.uk

Unhealthy Polluting Expensive Can be wear up to 6 hours risk of toxic shock syndrom

doesn't content chemicals reusable 10 years economical Can be wear up to 12 hours doesn't leak

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Reusable napkins Another alternative to disposable items are washable pads. Usually made in cotton, several brands propose them in the market. Those pads have to be first washed by hand with cold water and then can go in the washing machine with the remaining clothes. Since the use of these pads is the same as every other pad, I will talk about an organization called Eco Femme. “Eco Femme is a social enterprise with a global mission and reach, working in the area of menstrual hygiene management. It began in 2010 under the umbrella of Auroville Village Action Group (AVAG), an NGO working for grassroots community development in rural Tamil Nadu, South India.25” They produce pads made of cotton and layers flannel to absorb the flow. To produce them they employed underprivileged women. Their project as well supports education for girls and livelihood for women to provide them materials and knowledge to manage their menstruation in a healthier way. Several organisations like this had been launched in India. Women are trained and educated to stitch pads with an export quality. It is according to me a good way of creating employment and to empowering women, but my opinion on the product is negative. First, the product isn’t really practical; when you have to change, you have to keep the spoiled pad with you and carry it until you go back home and wash it. Second, you might need a dozen of them to manage one

cycle and wash them all. No one wants to wash blood spoiled cloths. In a nutshell, it reminds me of how my grandmother used to overcome menstruation and is for me is an obsolete solution.

Now you have to wash! Mouhahahahah hahahah hahah hahahah haha hahah haha!

#3 hygiene

Arunachalam Muruganantham: How a man made an access to proper menstrual hygiene possible for millions of women India witnessed a hygienic revolution, thanks to the invention of a low-cost sanitary napkin for millions of women. Before starting his project, Arunachalam Muruganantham used to hear his wife say that if she bought sanitary napkins she would not have enough money to buy milk. It was the reason why he saw her hiding old rags she was using to manage her menstrual flow. Seeing these shocking hygienic manners, he got the idea to invent a low-cost pad, which millions of women in India could afford. From Tamil Nadu, a southern state in India, this 49-year-old man managed to make his idea come true after 14 years of research and development. The pads are produced in a very simple way by women in rural zones through all India. I went to visit one of these factories an hour away from Erode and run by a woman called Sumathi. She started her project after seeing Arunachalam’s project in a magazine and decided to go for a training program, since she thought it was a great idea: «Pads are always necessary for women, and this project creates employment for women as well. I thought about a lot of diffe-

Interview with Sumathi

rent businesses but this one is evergreen since women will always get their periods.» She set up her business two years ago, and has now employed seven women. The process is simple and uses only three different materials, glue and four easy-to-use machines. Here is the process by which napkins are manufactured at the factories: • Women tear up cotton fabrics in small pieces and grind those pieces. • They create 0.007 grams heap of this ground cotton and put them in rectangular molds to compress them. • They stick the compressed rectangles of cotton on to a rectangle piece of “butter paper”. • They wrap the assembly in a piece of synthetic cloth and seal the edges. • They stick the cotton wrapping on top of another piece of “butter paper” to create a self-adhesive pad. • The pads are sterilized under a UV lamp for one minute and packed ten by ten. Each packet containing ten pieces is sold for INR 28. In a telephonic call, Muruganantham

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napkins

told me that the price of his napkins is really low: “Already, we can make napkins for INR 1.50.” In comparison a packet of ten Whisper pads is sold for INR 70 so one pad cost around INR 7. Arunachalam’s enterprise is spreading, and he is in negotiations with a lot of countries to broadcast his product: Nepal, Pakistan, Bangladesh and also Rwanda, Nigeria and South Africa showed interest. But the project of Arunachalam is not the only solution to the millions of women who cannot afford sanitary pads. Jaydeep Mandal and Sombodhi Ghosh of Aakar Innovations, created a Delhi-based start-up. They have developed a machine that produces low-cost sanitary napkins using as raw agricultural waste such as banana fibre, bamboo and water-hyacinth pulp. Each machine can churn out 1,600-2,000 pads a day and is sold for 40% less than the branded mass-market products.24

25% of women living in cities and the proportion is lower in the rural market. “By bypassing middlemen and using existing rural retail networks, the founders believe they can win 6 million customers and provide direct employment to 11,000 women in the next five years.”

A lady working in Sumathi workshop and her daughter.

The market of pads for those small startups is a big opportunity. Big industries such as Procter & Gamble are selling their products to only

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3.3 Access to sanitation

From rags to menstrual pads: The government helps providing sanitary napkins to women through small organisations. In June 2010, the Ministry of Health of the Indian Union launched a 1.5 billion rupee program to promote the menstrual health among teenagers in rural areas.26 The non-availability and the high cost of sanitary towels are obstacles to women’s menstrual hygiene in rural India. The project aims to offer a six sanitary napkin pack for INR 1 to girls living below the poverty line. For others, the package will cost INR 5. The first phase of the project covered 15 million girls between the ages of 10-19 coming from 150 different districts. The government suggested to get the sanitary pads from the self-help groups which make lowcost pads, in particular in the South of India.27 The Self Help Groups met a big success in the South of India. Tamil Nadu alone has approximately 100 pad production units. Every unit makes 30 thousand to 50 thousand napkins a month and sells them to the women for INR 1 - 2 for a napkin. A group, created 10 years ago by Kannaghi Chandrashekhar from the village of Puddukottai, helped 150,000 women in and around the village to move up from rags to pads. His group called WOMAN (Welfare Organi-

An employee of WOMAN uses pine wood pulp to make napkins.

Photos: Vibha Varshney, «Rags to pads», www.downtoearth.org.in

sation for multi - purpose Mass Awareness Network) produces 600,000 month on month and sells them for INR 2. The pads are made from pine wood pulp, cotton and fabric. Each pad costs INR 1.20 to produce. The production unit sells pads to the retailers for INR 1.50 and the profit keeps the units functional. Those pads can be burnt without polluting since they are made of natural materials. Units gain in popularity among different states of India including Karnataka. And today, with the government project, those groups hope they can expand their project to reach more and more women.

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Water aid work: Access to proper toilets and disposal of menstrual items. In general, poor Indian women do not wipe at all when they pee unless they are menstruating. Then, they wear underwear or pin cloth around themselves and put a folded up reusable towel or rag to manage their menstrual flow. Women are starting to purchase disposable sanitary pads, but as these are expensive it is still more common for them to use towels and rags. They clean the towels and rags themselves and hang them to dry. There are all sorts of taboos associated with menstruating women; some are not allowed to cook, visit temples, touch their husbands, etc. But the most difficult part is urinating or defecating. There are not enough public toilets in India, and it is much more difficult to discreetly urinate when one must first lift the sari up high and remove panties and menstruation rags. Because periods are messy, women then have the need to wipe with water each time they urinate, and this is also difficult to do in public. For this reason, womenâ&#x20AC;&#x2122;s activities are limited when they are on their periods. The toilet facilities in most schools are not adequate to give girls the space to clean themselves while they are on their periods, and the taboos associated with menstruation can cause a young girl a lot of embarrassment. It is strictly a taboo to leave any evidence of menstruation such as soiled sanitary pads or bits of blood in the toilet, yet the public facilities usually do not have running water or trash bins.

For middle class women, things are a lot easier. They have a larger range of clothing to choose from and they use disposable sanitary pads. Moreover, they can easily clean themselves with water when they are on their periods. They can also wash their hands with soap afterwards. Another problem is the disposal of menstrual items after use. How do women manage with their soiled pads and being mostly in public areas? One of the main issues in India is the lack of bins in public areas. I remember that during my internship there was no bin in the toilet of the studio. I asked a couple of friends how do they handle this situation and most of them take their purse with them in the toilet and put the used pad in a plastic bag, in their purse. If they did not have a plastic bag, some of them admitted that they were leaving used pads on the floor of the washroom. But I might point the fact that it is more and more common to see trash bins in public restrooms in India.

Chapter 4 indian women problems and needs In most parts of the world, fewer females are born than males, but they have a longer life and outnumber the males at any point of time. On an average, female life expectancy is five years more than male life expectancy. Women live longer; thanks to genetic difference, a different lifestyle (no smoking, drinking etc.), a better immune system or the ability to bear and breastfeed a child. In India, women live longer as well, but unlike most parts of the world, they never outnumber men. Except in 2001 and 2011, every year, the number of female per 1000 has been decreasing. The census lists “sex selective female abortions” and “female neglect” as the key reasons to explain this phenomenon. The roots can be seen in the patriarchal system which sees women as inferior, as objects to be exploited and used for domestic, sexual and financial gain of men.

#4 Indian women: problems and needs

4.1 Gender relation in India

Definition Gender

noun / • [mass noun] the state of being male or female (typically used with reference to social and cultural differences rather than biological ones):traditional concepts of gender • [count noun] the members of one or other sex: Before mentioning the notion of gender, it is important to understand what gender means? Let’s first look at the difference between sex and gender. the “sex” of a person means that a person is born female or male. So, the sex is a part of biology. But, when he or she grows up in the society to become a man or a woman, then it is gender. Therefore, one must understand the difference between the sex of one’s physical body and the addition and transformation that make up a person’s gender. For example, the special biological feature of the female is that she can conceive and give birth to children. But the rearing of a child is a social process, and the idea that women are best suited for this one is a “gender construct”. Gender is then a social term, influenced by the images of women and men transmitted in society. When we understand something to be natural

or biological, it becomes inescapable. But, if we understand that gender is constructed by society, we can struggle to change it. A woman may not be oppressed by bearing a child or by having menstrual periods, but we know the women are oppressed by the way the society understands and treats childbearing and menstruation. After analyzing how women are perceived in society, I understand why menstruation is viewed in a negative light though it is a very important biological process. It is also because of the fact that the society is patriarchal; women too look at themselves in a way as if menstruation is an impure thing. This might lead to a low self-esteem among women.

#4 Indian women: problems and needs

Status of women Description of the status of women in the Indian subcontinent necessitates generalization because it is characterized by extreme cultural diversity and strong disparities at the same time. The notion of a feminine condition depends on several factors like: • Region • Language • Religion • Traditional hierarchies (connected to the caste) • Contemporary hierarchies (connected to the social dynamics and the economic growth over the last few decades). The relationship between genders might have originated amidst this big diversity.

Nehru’s daughter Indira Gandhi served as prime minister for three consecutive terms (1966–77) and a fourth term (1980–84). This photograph is a work for hire created between 1952 and 1986 by one of the staff photographers at U.S. News & World Report. It is part of a collection donated to the Library of Congress.

To illustrate the status of women in India, I will then evoke two strong images which have been often represented in the media and which correspond to two extreme positions of women in the Indian society. On the one hand, we have thousands of wives murdered by their in-laws because of insufficient dowry, and on the other hand, Indira Gandhi was a powerful Prime Minister of India for sixteen years and a leader of the non-aligned movement.29 The «dowry deaths»30 symbolize the victimization of women: the official figures tend to put in perspective the scale of the phenomenon (there were 8,391 reported cases of dowry deaths in 201131 alone). The slow progress offeminist organizations in their fight against the practice of

#4 Indian women: problems and needs

dowry (illegal since 1961, but practiced by more and more communities) show that this threat concerns women in a large number. Contrarily, the extraordinary political career of Indira Gandhi proves that there is no glass ceiling that forbids women from accessing the highest position in leadership. The range of possibilities for Indian girls ranges between these two realities - the worst violence against women and the exceptional openness of the Indian political system to women.Table with numbers of gender inequality by the global gender gap report is coming here.These national averages are of course influenced by several factors. At first, we see big regional contrasts between the North and the East of India, globally less developed, than the South and the West of the country. In Uttar Pradesh, a state in the extreme North of India, 25% of the women are literate versus the 56% of the men. They have an average of five children, and their life expectancy is 55 years. On the contrary, in Kerala, a small coastal state on the southwest of the peninsula, indicators of the condition of women are close to that of a developed country. Their literacy rate is 88%; the fertility rate is about two children per woman, and the life expectancy is 74 years.

cording to the socioeconomic categories: so the Muslim women and those belonging to the “scheduled castes” (ex-untouchable) accumulate the discriminations and are in the lowest rang of the scale.32

Indian matrimonial site Shaadi.com has launched a Facebook game called “AngryBrides”, where a woman throws things at her future husband seeking exagerated dowry.

Another factor to be taken into account is the contrast between cities and the countryside. Finally, the status of women varies widely ac-

#4 Indian women: problems and needs

Sharmila Tagore and Deepa Malik in the movie «An Evening in Paris.»

«An evening in paris», 1967, Shakti Samanta and Sachin Bhowmick.

Financial problems: “Women earn, men decide how to spend”33 A survey has shown that in the eight biggest cities in India, a majority of women do not decide how money is spent in their household. The survey revealed than only 46% of the 1000 women interviewed chose how their money will be invested. The panel of women contained working women, house wives, married and single ladies. So, who decides for the 64% remaining? The parents mainly do for single working women; husbands mainly do for married women in general and housewives in particular. In India, the percentage of women who have an account in a formal ﬁnancial institution is 26% while 44% of men own one.34 Ironically, women work longer hours than men, and carry the major share of household

and community work that is unpaid and invisible. According to the pilot Time Use Survey conducted in 18,620 households, women spend about 2.1 hours per day on cooking food and about 1.1 hours on cleaning the households and utensils. There are far more unemployed women than there are unemployed men in India. It is important for my project to get to know how much and what for a woman spend her money on. If men decide how to invest the money of their wife and daughters then my target should as well include men in the process and convince them than my product is necessary to buy.

#4 Indian women: problems and needs

4.2 The female body

Paris 1971, Simone de Beauvoir participating in the demonstration in Demonstrators hold placards as they take part in a protest rally in favour of contraception and of abortion solidarity with a rape victim from New Delhi in Mumbai December 27, 2012. Coll. Sylvie Le Bon de Beauvoir/Diff. Gallimard «India tries to move beyond its rape culture» REUTERS/Vivek Prakash, december 27, 2012, http://blogs.reuters.com/

Biology «The woman? It is very simple, say the amateurs of simple formulae: it is a matrix, an ovary; she is a female: this word is enough to define her. In the mouth of the man, the attribute «female» sounds like an insult; nevertheless he is not ashamed of his bestiality, on the contrary, he is proud if we say of him «it is a male!»35 The term «female» is pejorative not because it roots the woman in the nature, but because it confines her in her sex;» Feminists tried to prove the distinction between sex and gender in the society; the anatomy is a synonym of destiny. The sex is supposed to be invariant. This chapter is going to show the inconvenience of the anatomically different aspects of the feminine body.

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mons

The vulva In earlier generations, even Western women never talked about their sex organs. They would call them “private parts” or “down there”. But the real name for the external female sex organ is “vulva”. The vulva (see figure 1) has several parts. At the top is a pad of fatty tissue called the mons. Next, we move toward the bottom of the mons. There it divides into two folds of skin called the outer lips. Between them lie the two inner lips.

clitoris outer lips

(labia majora)

vagina

urethra inner lips

(labia minora)

anus

Figure 1.

#4 Indian women: problems and needs

Comparative male and female urination postures.

«The Bathroom», Alexander Kira, Viking press,1976

The inner lips join at the top. The folds of skin where the lips join form a sort of hood. You can see the tip of the clitoris peeking out from under his hood. The rest of the clitoris lies under the skin. Straight down from the clitoris is the urinary opening where urine leaves a woman’s body. Below this is the vaginal opening. The vagina connects the outside of the body to the sex organs inside woman’s body. Having a vulva can represents some practical inconvenience if we compare it to a penis. Unlike men, women do not have a sex which allows them to control where their urine will land, which makes urinating much more difficult. In “The Bathroom”, Alexander Kira compares male and female urination posture. We can then notice than men can pee standing up when a woman has to pee in a sitting position or by

leaning. Men do not need a place to hide when they have to urinate unlike women who have to find privacy. In India, 626 million people do not have access to a closed toilet; 40% of the schools lack a functional common toilet and another 40% lack separate toilet facilities for girls. So Indian women, because of their genital organs have to go outside to defecate; they have to find a place to get privacy. They then have to wait for the night to come before being able to answer the basic need of urinating, defecating or changing their pads. Venturing out at night and looking for privacy often jeopardizes their safety. In Bihar, 872 cases of rape were reported between November 2012 and June 2013. About 40% to 45% of those rapes took place when the women were going out to defecate in the open.

#4 Indian women: problems and needs

Menarche: what it means Menstruation appears during the puberty, between 11 and 13 years old, but it varies from a girl to another (between 10 to 18 years old). Periods arise generally at the end of the juvenile period, two years after the breasts and the pilosity start developing. In most cultures, the first period symbolises the beginning of womanhood. Historically, menarche marked the age at which a slave could be sold off as a woman in Virginia.36 In Tamil Nadu, the ceremony of Sadangu is celebrated in the girl’s honour when she gets her first period. But menstruation is as well a moment of big loneliness for certain girls. Here is a testimony I got from a 30 year old Indian woman who experienced her first menstruation at the age of twelve: “I was scared initially and embarrassed when my uniform was stained once. When I learnt more, I got surprised and was proud that I was probably the first in my class to get it. My mother was away, and I was living in her ancestral home. When I told my aunts what I was experiencing, they smiled and explained that it was natural” In this report, we can see that she did not know about menstruation before getting it. In that case, we can understand that the experience might be traumatic, scary and awkward. In My Little Red Book, a book collecting testimonies of women’s first menstruation by Rachel Kauder Nalebuff, Suzan Shutan explains that she did not know about menstruation and thought

she was dying: “I was okay about dying, but thought my parents and my friends might be upset, so I kept my dying a secret. I told no one. Every day for eleven days, close to sunset, I took off the blood-drenched underwear and shorts or pants through which the blood had seeped, went outside to our trash cans hidden behind a fence bordering some woods, and set fire to the bloody objects, watching them burn until they turned to ash.” According to Aditi Gupta, the founder of Menstrupedia, most Indian girls study the subject on their own and only after they get their first menstruation. It is surprising that in spite of the elaborate way in which menarche is celebrated in the culture (Sadangu in the south of India), it is surprising that young girls are not prepared for it with information about the biological process, health and hygiene issues, social meanings (including social readiness for marriage) and implications for conception. According to the Report done by Auroville village action group on Rural Menstrual Hygiene Management in Villipuram District in Tamil Nadu, only 21% of the respondent women felt wellinformed about menstruation.

#4 Indian women: problems and needs

lack of knowledge: Periods are connected to sex, and maternity and are perceived by certain parents of girls as taboo. Aditi Gupta explained to me that the parents of girls she met, about testing her work, verified what she was going to speak about and show to their children. This, she said, was out of fear that they will learn more about sexuality. In their mindset, the more girls knew about sexuality, the more they will want to experiment. In their mindset, the more girls learn about biological processes, the bigger would be the risk for them to run wild and to get pregnant. After a conversation with a friend, I found out that in Indian schools the topic of sexual reproduction is taught around the age of fourteen or sometimes even later,whereas the average age of first menstruation is twelve. In most of the interviews I have conducted, girls explained that they did not know about menstruation before having their first period and that they learned about it by talking with a relative but not much at school. A study on knowledge and practices regarding menstrual hygiene among rural and urban adolescent girls in Udupi Taluk, Manipal, shows that only around 34% participants were aware about menstruation prior to menarche, and mothers were the main source of information among both groups. The study is epidemiologic and was undertaken using cross-sectional study method among 550 school-going adolescent girls aged 13-16 years. A total of 270 were from urban and 280 from the rural area.37

??????

It is estimated that only 34% of the adolescent girl in Udupi Taluk, Manipal are aware about menstruation prior to menarche.

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90 80 70 60 50

urban

rural

total

20 10 0 Menstruation is a Menstruation Normal duration Duration of occurs because of menstrual menstrual cycle physiological process of hormones cycle is 3-7 days (25-32 days)

Source of menstrual bleeding

Knowledge regarding menstruation Projection based on GLOBAL JOURNAL OF MEDICINE AND PUBLIC HEALTH figures: «A study on knowledge and practices regarding menstrual hygiene among rural and urban adolescent girls in Udupi Taluk, Manipal, India.» http://www.gjmedph.org/

#4 Indian women: problems and needs

60 50 40 urban

rural 20

total

Fear

No reaction

Embarassed

Anxious

Guilty/ Bad

Reaction to first menstruation

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Menstrual pain: Out of the 15 women I have interviewed during my research, only one did not get any pain during her period. About 50% to 80% of women suffer from dysmenorrhea.38 I asked those women to help me understand their pain. Some only feel a little discomfort as you would see in these verbatims: “little bit tired” or “I feel something is happening in my abdomen”, while some others describe the pain as a war in their body as you see in these verbatims: “feels like the hip girdle is being sucked in” or “it feels like someone is twisting and pulling off my ovaries”. Most of the pain comes from the abdomen but a lot of women also mentioned backache and pain in the right leg. Usually, this pain is only mild to moderate but it can appear to be really uncomfortable as is evident in this woman’s words, “If first day’s pain is bad, I have to return home from work”. About one in ten women has severe cramps.39 These cramps usually start with the menstrual flow but might arrive one or two days before menstruation. The pains felt in the lower abdomen or the back are triggered by womb’s contractions. In the absence of pregnancy, the ovum has not been fertilized, and the ovaries suddenly stop producing oestrogens and progesterone. This process activates the uterine contractions. Due to these contractions, the endometrium (mucous cover of the womb) and the blood are expelled. For some women, the womb contracts more intensely. This is the main cause of menstrual

pain. The excessive pain can be attributed to overproduction of prostaglandins, substances secreted by the endometrium and which starts the contractions. Prostaglandins acts on other muscles as well which explains the other symptoms that accompany the dysmenorrhea like nausea, vomiting, headaches, and diarrhoea. Sometimes, simple measures, home remedies or just a rest is enough to remedy cramps. If not, there are a couple of medicines available without prescriptions like Ibuprofen or Aspirin. Some women practice simple exercises like breathing exercises to ease their pain.

Yoga, a hot water bottle or infusions are good and simple remedies against menstrual cramps.

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"only when i got my first menstruations, it was awful, never felt that bad. But since then, nothing at all!"

"there is pain.. leg pain, weakness.. depends."

Any pain? "Leg pain and sometimes stomach pain"

From a questionnaire conducted on 15 women.

"yes. sometimes my right leg hurts and backache"

"i experience mood swings that are at times disruptive!" "the first couple of days are painful"

"sometimes, mostly winter. feels like the hip girdle is being sucked in. if first day's pain is bad i have to return home from work" 87

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wild life: A human characteristic or just like in other species While understanding that men and women can be considered equal, why is it that the female body is most often seen as an object and the menstrual process as a problem and an embarrassment? This could be explained by looking closer at the male and female behavior in animal species and in Anthropology on how human society has developed. In most mammalian species, during mating, females exhibit and titivate their bodies to attract males. The female attracts as many males as possible in order to have a wider range of selection. Despite the attention of many males, at a time she mates with only one of them, the strongest and the fittest of all. The males are as well programmed to be attracted by females and fight to win the right to mate with the female. The mechanism of nature ensures that only the best genes from one species remain in the gene pool. The same mechanism is observed in human society. In most cultures, women try to create a desirable image in the eyes of the opposite sex exposing themselves as objects of desire. They show their curvy body exposed parts of the body like their cleavage, wear tight clothes, makeup, perfume or jewelry. Males, therefore, see the females as an object of desire, a trophy. In some cultures, women are more hidden and exhibit much less to avoid the male gaze. This effort, in many cultures, is so extreme that women must

endure pain, stress and trauma to conceal their bodies and their sexuality. The society attempts to control female sexuality by social and moral constraints. In the bargain, natural bodily processes such as menstruation are also hidden. For the other mammalian species, the cycle happens only during one season and that menstruation is specific to human, some primate species, elephants and bats. Moreover, mammalians do not experience flow of blood. Some scientific hypotheses explain that Homo sapiens did not get as many periods as women nowadays get and that our species evolved. There are several explanations in circulation. It could be a way to eliminate the harmful pathogenic agents injected into the reproductive organ by the ejaculation of males. But this last phenomenon is omnipresent. Another explanation is that it is more effective to get rid of the endometrium when it does not serve infinitely; but it is a false distinction because other mammals do not keep the endometrium; they produce it when they need it i.e. during the fecundation process. And finally, another reason is that the human beings have rather aggressive embryos which become established profoundly in tissues of their mother and that menstruation ÂŤprepacksÂť the mucous membrane to overcome the stress. There are a couple of other hypotheses but none of them are foolproof.

#4 Indian women: problems and needs

Elephants are one of the only other mammalian species menstruating, as well as bats and primate species.

ÂŤFlareÂť, Junko Mizuno, Treville Editions, 2009

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sanitation: what women need As seen in the chapter 3-Hygiene, part 3-access to sanitations, women have needs and requirements in their washroom because of their biology, status and role in the society. The following are female sanitation priorities â&#x20AC;&#x201C; mostly connected to dignity and convenience rather than health: - Privacy: so that no one witnesses a woman going to the toilet or bathing. - Security: separate Male and Female facilities, in public and school toilets. - Soap and water: to wash hands, bodies, clothes, utensils, nappies/diapers and pads. - Disposal facilities: for sanitary cloths, waste-water and garbage. - Potties: to help deal with infantsâ&#x20AC;&#x2122; excreta. - Proximity to home: so that visiting the toilet does not mean leaving children unaccompanied and there is easier access for the sick, elderly and disabled (all cared for by women). - Easily cleanable designs: women are invariably responsible for toilet maintenance.

#4 Indian women: problems and needs

A toilet installation in London streets. The toilet brings about what could only be described as a true feeling of discomfort. «Don’t miss a sec’», Monica Bonvicini (2003/2004) Two-way mirror structure, stainless-steel, toilet unit, concrete floor, aluminum, fluorescent lights.

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4.3 who are Indian ladies? The lower most segment women*:

«What is this blood?» «Is it normal?» «Bloody hell!» -Wrong informations -Myths -You are «unpure»

hear

see

Feel

say

-Shameful -Sick -Uncomfortable -Dirty -Happy for her first periods (meaning that she will get married)

*Based on the SEC Classification40

-Blood coming out of her own body -Rags/ old cloths

think

Nothing

do -Do not go to the temple/ mosque/ church... -Do not sit where other people sit -Rituals -Do not cook or participate to the house life - Use rags/ Ash/ Sand/ News paper

#4 Indian women: problems and needs

Interview with women living in a slum in Yelahanka, near Bangalore. Picture by ClĂŠmence Palvadeau, November 2013.

#4 Indian women: problems and needs

The middle segment women*:

«What is this blood?» «Is it normal?» «Bloody hell!» -Her friends/ mum/ sister - Myths -Advertisement

-Blood -Advertisement TV/ magazines -Western model -Pads and tampons from the shop -Health and glow ( India’s first health & beauty chain)

think hear

see

Feel

say

-Shameful -Sick - Tired -Uncomfortable -Not well informed

Nothing

do -Do not go to the temple/ mosque/ church... -Do not cook or participate to the house life - Stay home

*Based on the SEC Classification40

#4 Indian women: problems and needs

Interview with the cleaning ladies of Srishti school in Yelahanka, near Bangalore. Picture by ClĂŠmence Palvadeau, November 2013.

#4 Indian women: problems and needs

The upper and upper middle segment women*:

«It happened» «shit!» «How do I manage this item?» -Her friends/ mum/ sister -Advertising on TV -Doctor/ gynecologist

-Blood -Advertisement TV/ magazines -Western model -Pads and tampons from the shop -Health and glow ( India’s first health & beauty chain)

think

hear

see

Feel

say

-sick -tired -uncomfortable

Don’t talk in public about menstruation

do -Keep a plastic bag with her to cover hes used pad -Throw her soiled pads anywhere if there is no bin

*Based on the SEC Classification40

#4 Indian women: problems and needs

Interview with Jaicy Joseph, living in a upmarket township of Bangalore. Picture by Richard Spitz, October 2013.

Conclusion This thesis was instrumental in providing the required insights in order to answer the following question:

be of importance in their future lives as women and mothers, especially with the extended use of contraceptives in rural areas.

How to overcome the challenges of menstruation in India?

They would as well be more careful about their hygiene. The use, for some women, of crummy habits to manage their menstrual flow is unhygienic and can lead to infertility. One of the first priorities should be to provide an access to safe menstrual practices. The decision from the Tamil government to subsidise free pads to young girls and Arunachalam Muruganantham’s initiative are two big steps forward.

Through this dissertation, I have been able to identify the different challenges women are facing in India. The conclusions of this thesis show that menstruation is a complex part of an Indian girls’ life; Aspects of menstruation include rituals, taboos, restrictions, hygiene matters, pain, discomfort and worries about the changing body with very little information. Menstruation is a topic which is not discussed enough and brings a lot of misconceptions in the core of the society. People are unaccustomed to talk about menstruation and therefore do not discuss about it. Families and schools do not recognize the need, or the benefits, for girls to know more about menstruation and puberty. Learning about the restrictions and rituals take all focus and people do not see the purpose of learning about physiology. Not even all of the girls themselves seemed to be urging for more information. This lack of awareness can bring women to resort to unhygienic and dangerous practices. They are not conscious about what is happening to their bodies. The girls know little about their body’s reproductive functions and it would

India represents the second biggest population of the world. Until now, menstrual pads were not affordable for the majority of Indian women. Some industrial pads can contain the equivalent of four plastic bags in their composition and women would need around twenty pads each month. With inventions, like Arunachalam Muruganantham’s machine, which produces low cost sanitary napkins, and initiatives launched by the government to provide free pads, environmental issues should become a priority in the future designs. The reusable cloth pads are a good alternative, especially when produced in women self-help groups. Unfortunately, they present some unpractical aspects and for some women mean a back to the past. The last aspect which should be taken into consideration is the pain and discomfort menstruation is leading to. Some women chose to

not menstruate again because of the cramps, thanks to contraceptive methods. More than the pain, the lack of facilities in schools or public toilets confines some women at home and forced them to drop out. Menstruation represents a physical and mental discomfort. Many girls report that they feel disgraceful when they are menstruating. Those very facets of the challenges menstruation represents are problems which can be answered by design solutions. In order to create an effective product I have identify several requirements: • The product should be comfortable, enjoyable and useful. • The product should be handy and should be produced at a low budget so that it could be distributed and could be produced for a large group of users. • The product should give factual information. It should tell the girls about the biological process. • The process of menstruation, its cause and effect is known to girls in form of myths. Myths are a major aspect to be dealt with. The product should play the role of a myth buster. • The information given by the product should also seem reliable to the girls, because it is seen that the girls believe on any and every source of information if it deals with menstruation. • It should take into consideration envi-

ronmental issues and not create a new problem • Taking into consideration the lack of public dustbins in India, the disposal should be healthy and not be a complication for women. • It should break the taboo and help bring the topic of menstruation in conversation • It should not only touch women but men as well • Menstruation is always seen in a negative light, the product should try to have an attitudinal change among society • The product should be healthy, and not include any chemicals • The product should be clean but also look clean. Women are attentive in what they use in term of hygiene. • The form of the content of the product should be such that it appears appealing for the girls to use the product. Based on most or all of those requirements, I will develop a product. I will research in the field of biodegradable materials available in India, impactful communication tools to spread a contemporary appearance to menstruation and advanced system to dispose of soiled sanitary pads without impacting on the environment.

References Chapter 1 1. Definition from the oxforddictionaries.com 2. www.worldometers.info/world-population/ 3. 68 random facts about menstruation, facts.randomhistory.com 4. Times of India, How India’s family planners lost the plot, Shobhan Saxena, Jul 19, 2009 5. Contraceptive Use among Young Married Women in India, Usha Ram, Ph.D. 6. The Times of India, Modern birth control methods still taboo, Kelly Kislaya, Mar 5, 2013 7. Common myths about contraception in India, Lakshmi Ananth, Apr 13, 2013, www.womensweb.in 8. Absence of periods, Martin Winckler, martinwinckler.com 9. Elsimar Coutinho in an interview in the mood inside you, Diane Fabiánová, Ubak Producciones, 2009 10. http://womenshealth.gov, Menopause and mental health 11.The psychosocial consequences of menopausal: realities, symbols and myths, Tunisian Society of internal medicine, DOUKI S, NACEF F, BOUZID R , CHOUBANI Z.

Chapter 2 12. Definition of taboo noun from the Cambridge Advanced Learner’s Dictionary & Thesaurus 13. The American Heritage® Dictionary of the English Language, Fourth Edition copyright ©2000 by Houghton Mifflin Company. 14. http://www.buddhanet.net/ “It is commonly believed that women are unclean. How true is this belief ? » 15. “menstruation, religion and society” by Aru Bhartiya 16. Daily Mail reporter, “Red dot ends taboo: Feminine hygiene advert dares to show blood rather than blue fluid”. 17. “In Historic Moment, Feminine Hygiene Ad Shows Blood” www.jezebel.com 18. from the Menstrala official website www.menstrala.blogspot.in

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19. The history of the sanitary pad, Sabrina Rubli, June 24 2013, www.femmeinternationale.org 20. The museum of menstruation www.mum.org

21. Women Beware: Most Feminine Hygiene Products Contain Toxic Ingredients, Dr. Mercola, May 22, 2013, http://articles.mercola.com 22. Toxic Shock Syndrome, http://www.betterhealth.vic.gov.au 23. «70% can’t afford sanitary napkins», Reveals Study, Kounteya Sinha, Jan 23, 2011, http:// articles.timesofindia.indiatimes.com 24. The economist, «Cut from a different cloth», Sep 14th 2013 25. Ecofemme.org, 26. Press information bureau, government of India, Government Approves Scheme for Menstrual Hygiene, 1.5 Crore Girls to Get Low-Cost Sanitary Napkin,16 June 2010, http://pib.nic.in 27. The Hindu, «Scheme for low-cost sanitary napkins to rural girls approved», 16 June 2010

Chapter 4 28. Gender composition,Censusindia.gov.in 29. The non-aligned movement is a grouping of chiefly developing countries pursuing a policy of neutrality towards the superpowers (i.e. the US and formerly the USSR) in world politics. 30. Died for insufficiency of dowry 31. National Crime Record Bureau (NCRB) data 32. Stéphanie Tawa Lama-Rewal Les femmes en Inde (women in India), 2008, a CNRS (center of national scientific research) report 33. Times of India, Women earn, men decide how to spend march 8th 2009 34. The Global Gender Gap Report 2013 35. «The second sex», 1949, Simone de Beauvoir, chapter 1 36. Zannette Lewis in «my little red book» by Rachel Kauder Nalebuff 37. Global Journal Of Medicine and Public Health, GJMEDPH 2013, vol. 2, issue 4 38. Passeportsante.net « les règles douloureuses (painful periods) » 39. The “What’s Happening To My Body?” book for girls, Lynda Madaras and Area Madaras, 2012 40. The SEC Classification is the classification of Indian consumers on the basis of parameters. The two parameters used to categorize consumers are: education of chief earnerand number of “consumer durables” ( from a predefined list)- owned by the family. The list has 11 items, ranging from ‘electricity connection’ and ‘agricultural land’- to cars and air conditioners

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Bibliography Books Rachel Kauder Nalebuff, My little red book, 2009, Twelve books Simone de Beauvoir, Le deuxième sexe (the second sex), 1949, Folio essais Malcolm Gladwell, What the dog saw, 2009, Penguin books Ltd Thomas Buckley & Alma Gottlieb, Blood Magic: The Anthropology of Menstruation, 1988, University of California Press Janice Delaney, Mary Jane Lupton, Emily Toth, The Curse: A Cutural History of Menstruation, 1976, 1988, First University of Illinois Press Edition Nel Yomtov, The Grimy, Gross, Unusual History of the Toilet, 2012, Capstone Press Harvey Molotch & Laura Norén, Public Restrooms and the Politics of Sharing Toilet, 2010, New York University Press Elissa Stein & Susan Kim, FLOW: The Cultural Story of Menstruation, 2009, St. Martin’s Press Modern Girl Blitz, fanzine: STIGMA #3-Menstruation, 2013, personal printing

documentary «The Moon Inside You, A secret kept too well» by Diana Fabianova, Andana films, Ubak Producciones, 2009, www.4science.cz/en/stream/movie/11

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Websites Menstrupedia: www.menstrupedia.com The period blog: http://myperiodblog.wordpress.com Water supply and sanitation collaborative council/ Menstrual hygiene management: www. wsscc.org Water Aid/ Menstrual hygiene matters: www.wateraid.org Ecofemme/ Washable cloth pads: www.ecofemme.org Times of India/ Menstruation still makes them ‘dirty’, Banjot Kaur Bhatia, 2013: http://articles. timesofindia.indiatimes.com 50 million missing, Is it a crime to menstruate?, 2010: http://genderbytes.wordpress.com The period store: www.theperiodstore.com Joseph Mercola, Women Beware: Most Feminine Hygiene Products Contain Toxic Ingredients, 2013: http://articles.mercola.com Julie Mollins, Menstruation taboo puts 300 million women in India at risk, 2013: http://www.trust. org 68 Random Facts About Menstruation, 2010: http://facts.randomhistory.com Sabarimala case: HC lets off actor Jaimala, Kochi, July 13, 2012: www.hindustantimes.com Natural Remedies for Painful Menstruation: http://natural-fertility-info.com The history of Tampax: www.tampax.tm.fr Whisper sanitary pads:www.pg.com/en_IN The museum of menstruation and women’s health: www.mum.org Willy Chyr, How I Made The First Feminine Hygiene Ad To Ever Feature Blood, 2011: willychyr.com Global gender gap: www.weforum.org/issues/global-gender-gap Jayaashree industries: newinventions.in The history of sanitary pads: http://www.femmeinternational.org/

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