Are we bleeding red or plastic?
Alka Yadav is an ambitious young woman in her mid-twenties. She is admired by many young girls in her community who often swarm around her in the evening, seeking answers on various issues. She lives with her husband’s parents in a small town in Uttar Pradesh, while her husband serves the police in a nearby district.Mother to a young boy, she aspires to be more than a homemaker and is ambitiously pursuing her Bachelor’s in Education.
Married into a small family, Yadav, unlike her friends, is not forbidden from entering the kitchen during her menses. She also has the privilege of sleeping on a bed and taking regular baths during her periods. She knows well how to use and dispose of a sanitary napkin in a black polythene or sometimes wrapped in a newspaper. It has been not more than five years since she started using sanitary napkins. The first time she had used a sanitary napkin was when her husband got his first job.
“My husband is the only man I can talk to, about menstruation. It was always a secret affair in my father’s house,” she said. For many young girls in India, menstruation continues to be a taboo, a secret that has to be kept close to their bosom. “Nobody should know that you are menstruating, that was the aim,” said Yadav who feared having a conversation about menstruation with her mother, in her early teens.
Yadav narrates how during late evening hours, she is often approached by a group of young girls who ask her questions of all kinds. Some ask her about the significance of menstruation, while others secretly bring a pad for her to demonstrate how to use it. None of them is taught by their mother the same. If they don’t know how to use a sanitary napkin, Yadav says, how will they ever know how to dispose of it?
On a sultry day, Yadav waits outside a chemist shop for more than 15 minutes. She waits for the men, who stand just outside the shop, to disperse. Once her way is clear, she takes a piece of paper, scribbles the brand of sanitary napkin and shyly pushes it towards the chemist. The shopkeeper without making eye-contact reaches for the napkin packet placed on the side shelves and wraps it in black polythene that Yadav carries back to her house.
Harsha Kashyap, a 15-year old young girl from the same community shares how she like Yadav has nearly no conversation on menstruation with her mother. “Whatever I have learnt, it is from school,” she said. She also shares how carefully she wraps the menstrual waste with a newspaper and places it deep inside the bin.
Kashyap draws a scene from her school toilet where used sanitary napkins pile up on floors for days as the sweepers fail to clean it regularly.
As per a study ‘Menstrual Hygiene Management and Waste Disposal in Low and Middle Income Countries- A Review of the Literature’, women and girls face social constraints during menstruation that determines how and where they dispose of menstrual absorbents.
While most of the countries have developed techniques to manage fecal and urinary waste but they lag behind in management of menstrual waste that often lands up with other solid waste.
The clueless hands
Far in the south, in the small town of Kumbalgodu, located on the outskirts of Bengaluru, a small waste factory catches the eye. One can see a handful of waste pickers, segregating the mountainous heap of garbage with bare hands.
On a cloudy day, a sleek and chirpy Ruchi, a migrant worker from Bihar moves out of the factory with a burning rage. She hasn’t received her payment for the month. Her work involves segregating waste and making it ready for transportation. She earns around rupees 300 a day but the payment is often delayed, she complains. She babbles all along her way back home. “I am not going to come back tomorrow,” she exclaimed.
Ruchi is foreign to the use of sanitary napkins and uses a cloth during her menses. She is clueless about the name of the company or government authority she is working for and knows only the name of the contractor who makes the payment. Ruchi has no answer to what happens with the menstrual waste.
Menstrual waste comprises of menstrual absorbents soiled with blood and human tissues. It includes cloth, sanitary napkins and other materials used to absorb the menstrual blood. Menstrual waste has been considered as solid waste under the Solid Waste Management Rules (2016)
The worry around the disposal of menstrual waste
The improper disposal of plastic sanitary napkins is continuing to cause environmental damage. From inappropriate disposal practices at the consumer level to the lack of segregation techniques at the collection level, the waste often fails to be segregated from routine household waste.
Conventional sanitary napkins contain up to 90 per cent plastic and are non-biodegradable, thus increasing the plastic burden of the country.
The social taboo around the biological process is adding to the problem of disposal as women seek improper ways of disposal to avoid embarrassment.
According to a study conducted by Water Aid India along with Menstrual Health Alliance in 2018, there are 336 million menstruating women in India. Around 12 billion pads are used every year. As per the study, it takes 500 to 800 years to decompose.
The study further states that 28 per cent of the menstrual waste is thrown with routine waste, 28 per cent is thrown in open, 33 percent sees burial and the remaining 15 percent is subjected to open burning.
In the year 2002, the National Green Tribunal recognized that sanitary napkins could not be placed under either plastic waste or bio-medical waste. Under the Solid Waste Management Rules (2016), sanitary waste is to be considered dry waste.
As per the rules, the dry waste collected from each household has to be segregated into biodegradable, non-biodegradable and domestic hazardous waste. Menstrual waste has to be treated as non-biodegradable waste. However, in reality, the waste collected from households is not being demarcated into wet and dry waste appropriately and is neither being further sub-categorized into biodegradable and non-biodegradable.
Anatomy of a sanitary napkin makes it hard to decay
A large part of a commercial sanitary napkin is made up of single-use plastic that poses a threat to both the environment and the consumer’s health.
As per a study, An Overview of a Sanitary Pad (2020), a sanitary napkin is made of three to four layers. Many manufacturers use wood pulp as the main absorbent material. The study states that with plastic evolution, the superabsorbent polymer (SAP) is being used widely to increase absorbency. Also, polypropylene-based perforated sheets and polyethylene are used as a barrier. These polymers increase the functionality of the pad and make it leakage proof, but they also make the napkin non-biodegradable.
Dr Veena V, Deputy Director of the Shuchi scheme, Health and Family Welfare Department, said, “The commercial sanitary napkins are certain to have some percentage of polymer-like material. They need it to make it more absorbent. There is also a high chance that sanitary napkins when burnt inappropriately may release carcinogenic dioxins.
“ A proper disposal system or switching to other eco-friendly alternatives is the only way out,” Dr Veena continued.
An exclusive study published by the Guardian shows that for the very first time, microplastic pollution has been detected in human blood.
The Rule-book for menstrual waste disposal
The National Green Tribunal in its order (2021) has made consumers, collectors and even the manufacturers responsible for the proper disposal of sanitary waste.
While the consumers have been asked to demarcate the household waste into dry, wet and rejected waste, the manufacturers, on the other hand, have been directed to provide pouches along with the product.
The Central Pollution Control Board and the State Pollution Boards can also permit the sale of small scale incinerators if common incinerators are inadequate.
The Central Pollution Control Board has prescribed the use of low-cost incinerators, high-temperature bio-medical incinerators and authorized common biomedical waste treatment and disposal facilities to treat menstrual waste. However due to the lack of segregation at the household level, such waste often ends up in landfills with routine waste
Bengaluru has two such common biomedical waste treatment facilities in the Industrial area, Dobaspet and one on Kanakpura road in Ramanagar district.
When incinerators can add to the existing problem
The centralized incinerators are often used to treat all kinds of potentially hazardous waste due to their large capacity. However, the number of such centralized incinerators is limited across the country.
Though decentralized incinerators seem like a good solution, however, there is a wide range of problems associated with them. Many decentralized incinerators have no standard emission certification, the users of the incinerators have limited or no training in properly using them and there is hardly any budgetary allocation for the same.
A small electrical incinerator can burn up to 5 or 6 napkins at a time 
The wall-mounting vending machine can hold up to 40 sanitary napkins
Using incinerators at inappropriate temperatures usually defeats the purpose and further adds to the release of harmful chemicals like dioxins.
Current disposal situation in Bengaluru
As per a report, Karnataka is one of the 19states that have institutionalized programs for the installation of incinerators. They have been placed in 32 locations in rural Karnataka.
In Bengaluru, the Bruhat Bengaluru MahanagaraPalike (BBMP) is the administrative body responsible for waste management in the city. The processes of waste collection, segregation and transportation of waste fall under the body.
Dr Sandhaya, a medical officer with the BBMP, said, “Bengaluru did start following the solid waste management rules and segregating dry waste from wet waste. There is also another category of rejected waste. However, the problem arises when people mix waste. The menstrual waste is supposed to be kept along with the dry waste and colours like yellow are prescribed for their covers. Most of the time, people fail to segregate such waste.”
Dr Sandhaya feels the lack of segregation at the household level becomes a threat to the waste collectors who have to segregate it with their hands. She believes that every household must practice composting and segregation. Lack of efficient policies in the state, she says, is the root cause of the problem. If segregation is made mandatory at the household level, she says, treatment of sanitary waste won’t be an issue.
Basavaraj Kabade, the superintending engineer with the BBMP explains the process of disposal of sanitary waste. As per the Solid Waste Management Rules and the guidelines of the Karnataka State Pollution board, sanitary waste goes to the Dry Waste Collection Centre along with the routine dry waste. In the centre, the sanitary waste is packed into yellow bags and is taken to a processing unit or centralized incinerators by an authorized agency.
The Superintending Engineer further explained the need for incinerating sanitary waste as it has a bio-medical element to it and may contain polymers that must be treated.
As per the new government policy, small scale incinerators have to be implanted all across the schools and colleges of India. However, Kabade says that the policy is still under process in Karnataka.
If the segregation of waste into dry, wet and rejected waste fails at the consumer level, the probability of such waste being segregated at the collector level seems rather dim.
In defenceof the BBMPs effort, an environmental officer (unnamed) from the Karnataka Pollution Control Board said that the segregation of menstrual waste from every household is a tedious task unless some cooperation comes from the manufacturing units.
“Manufacturers must work with local bodies, provide them with funds. The product is theirs and the disposal of it is also their responsibility,” said the officer.
The manufacturers on their defence
As per the National Green Tribunal Order 2020, the manufacturers and brand owners of sanitary napkins were required to provide a pouch or wrapper for the disposal of each napkin. This further increased the plastic burden as the covers provided were also rich in plastic.
Prabhu, the managing director of Nature Care Solutions, a vending machine manufacturing unit in Bengaluru contradicts the claim that sanitary napkins have any plastic content. “Using these incinerators at 700-800 degrees temperature for destroying sanitary waste is just a waste of energy,” he said. In terms of waste incineration, he says, Karnataka lags behind states like Tamil Nadu where the installation of incinerators is going at a fairly high state.
In the year 2018, over 4000 incinerators were installed across educational institutes of Tamil Nadu.
The unwelcoming exposure
Since most plastic pads are burnt at lower temperatures, the biodegradable components such as cellulose or wood-pulp in absorbent often contain furans and dioxins which are deadly toxins and carcinogenic even in trace quantities. Sanitary napkins are also a major cause of sewage blockage. Improper disposal of menstrual waste leads to unhealthy exposure of waste-pickers to bodily fluids which may or may not be infected.
Beena Devi who works as a sweeper in a missionary school draws a picture of the school’s washroom where one common bin stands for all separate toilet units. While some girls throw the pads in the bin, others do not bring them out of the unit and rather throw them in the backside of the pot or flush them off. Many times, these sweepers have to take out the pads from the pot pit, wearing plastic gloves.
The independent fight
Shantha P is an activist working with Stonessoup, a non-governmental organization working towards effective waste management techniques. She shared how many small scale organizations are coming up with the idea of composting. Many such organizations led by activists hunt for apartments where they exercise segregation of waste and make compost without the involvement of BBMP. The menstrual waste collected from the households is segregated and sent for incineration.
Rupal Mehta from the same organization talks about the initiatives taken by her organization in making reusable menstrual cups. Unlike the complicated conventional cups, she says, their cups don’t have stems and cause little discomfort when inserted. While many women and girls are unaware of their genital anatomy, she explains, that her organization walks the customer through all the processes involving the use of menstrual cups.
Eco-femme, an organization that rose from the township of Auroville is selling organic washable cloth pads in a range of sizes. All the four layers of the cloth pad are made of cotton.
Another organization, Bliss Pads is making use of kenaf, a plant fibre similar to jute as an absorbent for organic pads.
Government brings biodegradable sanitary napkins to the table
In the year 2018, the central government introduced the Jan Aushadhi Suvidha Oxo-Biodegradable pads at Rs 2.50 per piece. These sanitary napkins were proposed to be made of a special additive, which makes them biodegradable when they are brought in contact with oxygen.
These pads are being distributed at the same price at all the Jan Aushadhi Kendra all across the city. The prizes of these pads have been reduced to Rs. 1 per pad.
A salesman from a Jan Aushadhi Kendra in Indiranagar informed that the shop was selling on an average 50 such pads each day.
Attitude towards new alternatives
Organic alternatives are still struggling to get the attention of women across the country.
Heena Nazkani, a consumer of sanitary napkins in Bengaluru shared her hesitancy in trying other alternatives like tampons and menstrual cups. She feels that these products are out of her comfort zone.
Urmila Rao, a home-maker in Bangalore feels happy about her choice of switching to menstrual cups. “Initially I was a bit skeptical but once I started using it, I got used to it. I can use it for more than a year. However, there are days when you need to fall back on sanitary napkins when the bleeding is heavy,” she said.
Many young women are sceptical of wearing these insertable options as they involve a certain risk of hymen breakage which is still a testimony of virginity.
Shubha Rao, a middle-aged woman from Mysuru, who is nearing her menopause, wishes to continue with sanitary napkins. “I have worn this all my menstrual phase, I don’t wish to switch at this stage.”
Niharika Sharma, a young working woman in Delhi feels that her transition from napkins to tampons had been smooth. “Now I don’t fear change. I am planning to consider menstrual cups that are more eco-friendly,” she said.
Yogita Dhanwani, a teacher in Agra brought a menstrual cup on her friends’s advice. On her first trial, she was disappointed as the cup couldn’t hold the heavy flow of the blood. Dhanwani, who had no idea about the correct size of the cup, was discouraged and decided to fall back on sanitary napkins for a little longer.
The experts have a say
Dr Chennuru Nishitha, a working gynaecologist in Telangana says that the usage of menstrual products over a certain period can result in infections and sometimes may lead to a dangerous situations like the Toxic Shock Syndrome where the body develops systematic sepsis. Women however, she says, wear these products for more than the prescribed time as the country lacks a good disposal system.
Paati P, a gender consultant says that from house construction planning to city planning, all the public spaces are gendered. The places, she says, are not inclusive of the biological process and lack basic amenities like clean water, soap, menstrual waste collectors and incinerators.
Sandeep Aniruddhan, an environment activist says that there is always an alternative choice but the industry ethics are often compromised. Selling the product, he says, is the only aim. “The consumer’s mind runs on ethics of convenience. We believe in use and throw and not exploring new possibilities,” he added.
Aniruddhan says that one’s waste must be one’s problem and not merely a centralized problem.
The way forward
Menstruation continues to be a taboo subject across various parts of the country. When the society fails to be inclusive of the biological process, its management and disposal are bound to be affected adversely.
The first step in managing menstrual waste is the identification and segregation of menstrual waste. The long standing taboo around the process results in women shying away in segregating their menstrual waste from routine waste. Hence, for a change to occur, there is a need for segregation at the source and waste collection points.
As per a study ‘Menstrual Hygiene, Management and Waste Disposal : Practices and Challenges Faced by Girls/ Women of Developing Countries’, menstrual hygiene practices are directly affected by cultural norms and socioeconomic conditions. In some parts of the country menstrual waste is seen as dirty, polluting and must be disposed of secretly. In similar findings, it is believed that menstrual waste can be used for witchcraft and must be buried secretly. The taboo around the biological process continues to hinder the disposal process. In 2017, many news outlets reported the suicide of a 12 -year old girl in Tamil Nadu who had killed herself after a teacher had allegedly humiliated her over a blood stain from menstruation.
Another social blockage in management of the waste as per the study is the gendered infrastructure of houses and public places. Decisions related to construction of toilets in houses are often taken by male members of the family. Many women and girls who have toilets at home feel shy and embarrassed as the drain that leads out the period blood is not covered.
With rising popularity of social media influencers, many small non-governmental organizations are using the platform to change the narrative around menstruation. From fighting taboos around the biological process to promoting more eco-friendly menstrual products like cloth sanitary napkins and menstrual cups, social media has become a good force in bringing about a change.
However, the country lacks in a strong policy-framework around the management of sanitary waste.While the Solid Waste Management identify sanitary waste as a third category waste, no such demarcations can be seen under the government program ‘Swachh Bharat Mission’. There is a missing collaboration between the waste management bodies and the running government programmes. Instead of a single source of funding, the money allocated for the management of the waste, including that for the establishment of incinerators is largely divided under various schemes and government bodies. This somehow dilutes the effort and creates confusion while tackling the waste.
The government must also issue guidelines for the procurement and installation of incinerators across the state, which is the only suitable way of treating plastic-rich sanitary waste. Also, there is a need for the incinerators to be provided with a standard certification. The consumers must also be trained in operating the incinerators that require a certain expertise and maintenance when in use.
As per the waste management guidelines, the sanitary napkins can be demarcated into compostable and non compostable type. The napkins having SAP must be incinerated while those without it could be subjected to composting at home.
Many studies show that the fundamental problem in management of menstrual waste is the lack of consensus over how menstrual waste must be classified. The country lacks in a strong and uniform policy framework when it comes to the disposal of such waste.
At last, there is also a need for more community involvement in the disposal of sanitary waste. In 2018, a Pune based non-governmental organization ‘SwaCH’ had initiated the ‘Red Dot Campaign’ where they encouraged women to wrap the menstrual waste in paper bags with a big red dot to make them discreet, leading to easy recognition and segregation.
The only way forward to deal with menstrual waste is the joint cooperation of government, consumers, collectors and manufacturers at all levels. Also there is a burning need to adapt to the new alternatives and say no to plastic pads.
At the end, we must understand that menstrual waste is not a one man’s burden.
