The Nirmal Bharat Yatra

was a sanitation & hygiene awareness & behavior change campaign conceptualized & implemented by WASH United & Quicksand. It travelled 2,000 kms across rural parts of 5 Indian states between 2nd October 2012 & 19th November 2012.

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This is the story of Neelam

Neelam is 14 years old. She has a narrow, pretty face. Her hair is long and black. Her uniform has been torn and repaired. Unusually for an Indian schoolgirl – at least the ones I have met – she has bare legs. Neelam goes to school in a place a dozen kilometres outside Gwalior, in Madhya Pradesh, India. I have met hundreds of schoolchildren over the years. I have attended dozens of sanitation-related training sessions in dozens of schools. I have heard dozens of hygiene-related songs that children have learned by heart and sing charmingly. But Neelam will stay in my mind for a long time and this is why.

I have been thinking, researching, writing and talking about sanitation since 2006. Six years of shit, toilets, sewage, faeces, excrement, poop, squits, loosies, diarrhoea. I have loved it and it is a privilege, and with 2.5 billion people still without a toilet, I will keep doing it and highlighting it for as long as I am useful. But until coming on the Great Wash Yatra, I had not thought hard about an aspect of sanitation that is even more taboo than talking shit: Periods. Blood. Chumming, as they say in urban India. Even so I am an expert in it; every woman is. Every woman whether in a developing or developed country, whether there is Always available or always no sanitary towels available, has stories about their menstruation. Mine: a girl sitting down under a tree at school when we were 13 or so, and her skirt rode up and the rest of us whispering “she’s started.” Another, earlier memory: a teacher at my boarding school when I was 9 telling us about periods but calling them “the visitors”. A friend’s 12-year-old daughter, having her second ever period, who didn’t know that she should change her sanitary pad, and who had blood-soaked socks by the end of the day. I am guessing that every woman has thought hard about wearing white trousers during their period; that every one has at least one humiliating experience of leaking through her pants, maybe onto upholstery. I have (it was in an Indian restaurant in Paris, 10 years ago, and it still profoundly embarrasses me). I have ingested probably tons of painkillers over the years; used hot-water bottles for cramps thousands of times; had to avoid high bridges during the couple of days every month when my mind turns against me, viciously, and oblivion seems a relief from the inexplicable anger, depression that is overwhelming.

But I knew what periods were. I knew what to expect.

About 60 of Neelam’s classmates first gathered in a classroom. They sat neatly on the floor, some of them on scraps of hessian bags. Unusually, they wore a mixture of uniforms. The regular school uniform was a red kurta (long tunic), white trousers, and a white dupatta (scarf). But other girls were in their own clothes, others in blue and checked outfits. They were quiet and attentive. I think they are used to outsiders coming and telling them things they are supposed to do. Wash hands. Don’t toilet outside. In this case, the visit was by the Menstrual Hygiene team attached to the Great Wash Yatra, who I am travelling with for three weeks on a 2000 km trip through rural India. They run the MHM (Menstrual Hygiene Management) lab, set up by WSSCC, where girls and women can come – no men allowed – and talk about periods, and be surveyed, and get a cloth sanitary towel kit with instructions on how to make hygienic sanitary towels from the Indian NGO Goonj. It is needed. WSSCC’s facts about menstrual hygiene in India are saddening and shocking:

  • Only 12 percent of young girls and women have access to and use sanitary napkins
  • 200 million have a poor understanding of menstrual hygiene and linked health care
  • 23% of India’s girls drop out of school after reaching puberty

 

 

So this was one of the field visits. Urmila, from the MHM team, was leading the talk. It was in Hindi and I didn’t have an interpreter, so I just noted the English words that were used in and amongst:

Gift from god
Body parts
Underkit
Operation
Bedsheet
Cotton

Urmila drew a picture on the board first. Then, as she explained afterwards, she told them that menstruation was normal. It was not dirty. It was not taboo. It was not sinful. It was a part of being a woman. She asked a skinny little girl to stand up, and showed how a woman’s body changes: the hip flaring, the breasts, the size and shape. The morphology of women. Periods are is part of life.

This may be obvious to you and me. Neelam showed me why it was not obvious to her. Afterwards, Urmila and another menstrual hygiene trainer carried out an MHM survey. They methodically went through a questionnaire in a classroom, one schoolgirl after another sitting in front answering questions like: do you drop out of school when you have your period? (Yes.) What do you use when you bleed? (old cloth, sand wrapped in cloth, old saris, dirty rags). What do you do with the cloth when you have used it? (Throw it into a field and hope no-one sees.) Are you restricted in any way? (Yes). Restricted in what way? Here is a list of things that menstruating women are not supposed to do, posted on the wall of the MHM lab, that Goonj has gathered:

The girls were shy. I don’t know if they were telling the truth, because only one admitted to not having a toilet, which seems improbable in rural Uttar Pradesh. Then Neelam came in. I was sitting next to Urmila but saying nothing. The other girls had not looked at me or acknowledged me. But as Neelam answered Urmila’s questions, she would constantly look at me, including me visually in the conversation. And she talked more. She was expansive, articulate (or so it seemed to me). She was expressive with her hands, and so graceful. Halfway through the survey, she looked at me again and said to Urmila that she wanted to know who I was, and where I came from. She was confident and charming. She was clearly poor from her patched clothing. Her story was horrific. Her story is not uncommon.

Neelam’s mother died when she was five. Her father is an agricultural labourer. He never remarried. Neelam’s elder sister tried to take over the role of the mother of the household, but it was hard, “when she was trying to cook but still crying with us.” Neelam described her mother’s cause of death as “something rotten in the breast,” so probably breast cancer. She had no close aunties or female relatives.

This August, she got stomach pains. She had eaten some street food, so thought the pains were due to that. Nothing unusual. But the pains continued in her abdomen, for hours and hours. Finally she went to the bathroom, and there she saw blood. And she was terrified. She was truly scared, because she knew what it was. It meant that she had what her mother had, and it meant that she was dying. Really. She had reached the age of 14 without knowing that one day she would bleed and it would be normal. So there she was in the bathroom, crying with fright, enough for her sister-in-law to hear. Neelam’s brother had married recently and young: his new bride was only 19, and Neelam didn’t much get on with her, because she didn’t think her brother should have married so young. There was some frostiness between them. But of all the family, it was this new sister-in-law who came to the door of the bathroom and said, what’s wrong? What is this noise? And Neelam told her she was bleeding, and that she was dying. And her sister-in-law said, no. You are normal. This is what happens to women. Don’t worry. Neelam’s hands were so expressive at this point, because she was saying this: I thought I was dying like my mother, but because of that now I realise I have a mother again.

Neelam’s experience is not special: the MHM team encounter countless girls who have no idea what is happening when they bleed, who think they are dying because their mothers had no idea, because their mothers thought they were dying too when it happened, because no-one talks about it; because this normal healthy blood is unspeakable. They have heard of women who get infections from using cloth that is not properly dried, or dirty. Some end up having their uterus removed. But having met this lively, lovely girl, I bet Neelam talks to her daughters about it, so they know what to expect, so their periods are not terror and taboo. I hope so.

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