Climate action must incorporate women’s Sexual Reproductive Health (SRH) needs, Health News, ET HealthWorld
In 2019, a district of Maharashtra gained infamy for all the wrong reasons. Reports about ‘Womb bless’ cane cutters of the beed district in Marathwada caught global attention. A committee setup by the state government at the time found over 45% of the 82,309 women to have undergone a hysterectomy in the past decade. Women surveyed were between 35-40 years of age with some under 25 years.
Hysterectomy is the irreversible surgical removal of a part or all of the uterus. It is advised in extreme cases of cancer, endometriosis, uterine fibroids and pelvic inflammatory disease. Often the last recourse for treatment, it is not recommended for women under 35 years of age due to the potential adverse effects on both physical and emotional wellbeing.
Whether coerced or voluntarily, what was causing so many women to get hysterectomies? The answer is both simple and complicated. High illiteracy, child marriages leading to early childbearing implied poor status of women. Primary an agrarian community, Beed is also one of the worst affected in Marathwada by drought and witnesses high farmer suicides. Worsening dry conditions due to climate change over recent years has coincided with higher emigration.
Beed families migrate to parts of western Maharashtra as daily wage laborers during sugarcane cutting season. Intensive labor in fields for over 12 hours every day meant a woman’s choice was to either resort to old rags for pads causing serious infections or take breaks from work and lose earnings. Since contractors employed couples as a unit, women in reproductive age came to be seen as a liability. This perception overtime further pushed women into getting hysterectomies who are now left to deal with long term physical and emotional health side effects.
The social, economic, political and cultural inequalities faced by women are well understood. Land ownership, pay gap, access to education, gender-based violence, forced marriage, absenteeism from school are some ways this discrimination manifests. Climate Change exacerbates existing gender-based inequities which is especially visible in women’s sexual and reproductive health (SRH). The following highlights key ways this interlinkage manifests in the case of menstruation:
- Menstrual taboo: Many cultures celebrate menses as a sign of fertility in females, giving women a place of reverence. This is seen in the form of festivals, female goddesses and many religious symbols. Ironically menstruation is seen as a period of purification and multiple restrictions are put on the menstruator like touching pickles, visiting temples, going in the kitchen, eating certain dishes and many more. There is a dualism at play here which is symbolic of women’s position in society. On the one side society is focused on valuing women for their ability to birth and simultaneously tabooing menstruator as impure and limiting their movement.
- Limited awareness of Sexual and reproduce health: Menstrual taboos limit awareness and conversations. Consider for instance, 71% of girls in India are unaware of menstruation prior to their first period. Even today, sexual education is not a mainstay during schooling years or in university studies. This silence helps perpetuate menstrual stigma and incidences of sexually transmitted infections (STIs), unplanned pregnancies and unsafe abortions. Further, it discourages menstruators from accessing essential healthcare services and life-saving information.
- Affordability of menstrual products: A 2014 report found that 88% females in India use unsafe menstrual alternatives like old cloth, rags, hay, sand, wood shavings, dried leaves and ash. Of the 12% females who use commercial products, rural areas accounted for only about 32% of total. A lack of access to menstrual hygiene products, menstrual education and sanitation facilities has come to be known as period poverty.
Personal preference, familiarity and lack of education about menstrual hygiene (MH) are key factors for such choices. For low-income women, affordability and availability of marketed MH products such as pads, tampons and menstrual cups is a big constraint for use. There are also gendered disparities in availability to sanitation facilities.
- Access to sanitation and waste disposal facilities: Gendered disparities such as lack of toilets, availability of clean water and disposal facilities determine choice of MH product. A cloth pad or menstrual cup requires more water than a menstrual pad.
- Community attitudes: Women’s immediate community attitudes around menstruation directly influences their toilet usage, choice of menstrual products and disposal. Faced with a high level of period shame, women are more likely to discard used pads by burying in an open pit.
- Environmental impact of menstrual hygiene products: As per The Menstrual Hygiene Alliance of India, 121 million females use disposable sanitary napkins each month creating over a billion used pads monthly and generate 113,000 tons of waste annually. India’s Solid Waste Management Rules, 2016 puts onus on manufacturers to provide pouches to users for safe disposal, and financial support to local administration for creating safe waste management systems. In reality, MH waste ends up buried underground, rot in the open on streets, rooftops, window panes, are burned, or find their way to water bodies where they swell up and clog drains.
Disposable sanitary pads are composed of different kinds of plastic sandwiched on top of each other with cellulose superabsorbent polyacrylate polymer foam in the middle. Left untreated, a pad can take over 700 years to decompose. Whatever breakdown of the menstrual pad occurs naturally ends up as micro plastics in water systems and entering our bodies. Incineration is increasingly being promoted as an eco-friendly method to dispose of menstrual waste by many including the government. However, most incinerators have been found to not meet CPCB standards, and do not prevent the release of carcinogenic dioxins and furans from burning menstrual pads.
Menstrual cups, cloth pads and compostable pads are the best available options with respect to their environmental impact. However, many women face a host of social, cultural and economic marginalization to make an informed choice. It is critical, therefore, to view the impact of climate change on women from a reproductive justice framework. This is an evolution from reproductive rights lens to include the practical ability of women from different class, caste and economic backgrounds to afford to make informed decisions about their sexual and reproductive health.
- SRH is missing from climate action: There is growing evidence of the indirect benefits to women’s SRH from climate change adaptation efforts that improve health systems, women’s education and economic status. This interlinkage is increasingly being recognized but is yet to be translated into decision making. National and state policies on climate mitigation and adaptation need to incorporate SRH considerations.
Arpita Bhagat is a development sector professional working in the climate and gender movements both locally and globally. She is currently supporting Baatein Unlocked, a movement for youth across Madhya Pradesh, Odisha, and Jharkhand.
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