Even though menstruation is a naturally occurring physiological phenomenon, it is still considered a taboo topic in India. Unfortunately, menstrual hygiene management becomes all the more difficult for women with disabilities, especially those living in poverty. According to WHO, disability is not just a health problem, it also includes the stigmas and barriers that society puts on people with impairments by not recognizing their needs and subjecting them to discrimination [1].

Due to the stigma attached to menstruation in Indian households, it is considered as an activity that is to be ‘hidden’. Therefore, there is usually very little talk about proper Menstrual Hygiene Management, and disabled women are almost always excluded from the conversation – making them even more stigmatised.

Even though the Central and state governments have issued schemes for free distribution of sanitary napkins, often disabled women living in rural areas are unable to use them due to lack of awareness or the inaccessible design.

Sana Samad, a visually impaired disability rights advocate and member of Raindrops highlights the unavailability of disabled friendly feminine hygiene products. “The menstrual cups available in the market are not easy to use and do not have clear instructions. For example, the instructions say to fold them into a certain shape and being visually impaired, it is hard for me to ascertain what shape that is. The advertisements for such products overlook disabled women completely”, Sana replied when asked about her views.

Another problem is that public toilets built at remote locations are often wheelchair inaccessible and persons with disabilities have to crawl on the dirty floor to reach them [2].

We also cannot have the same solution for different disabilities. For instance, visually challenged women face different problems than women who use crutches or wheelchairs and face difficulty in standing when changing pads. Intellectually challenged women are unable to grasp what is happening to their bodies and others may be subjected to neglect by their caretakers who are not trained to handle their special needs. In some cases the caretakers choose to get the uterus of menstruating disabled women removed, so that they won’t have to deal with MHM each month. This may be problematic as it does not take into account the agency of the women, and simply assumes that they may never want to be mothers.

 

WHAT NEEDS TO BE DONE?

Community involvement 

The crux of the matter is that disabled people are often excluded from participating in the designing of these programmes. They should be included in the decision-making process that affects their lives and not merely considered as recipients of charity. Only by knowing what works and what doesn’t work for them can the government implement schemes which will be beneficial. The authorities should ensure the construction of proper WASH (water, sanitation and hygiene) infrastructure within the reach of women, ideally in the homes or nearby.

It is crucial to ensure that awareness information on MHM should be accessible for persons with disabilities, including circulating textual information in braille and providing sign language interpreters for awareness workshops.

The caretakers of disabled women need to be trained through local workshops, along with Asha Workers, Basic Health Workers and ANMs on how to recognize the special needs of women in their wards according to the impairment.

Awareness and Accessible Products

Also, there is a lack of menstrual hygiene products for women with such special needs and through awareness interventions, creative minds can be urged to come up with inventions.

Awareness is the key to it all. We are not mindful of the challenges people with impairments face and so very few solutions exist. Although in recent years, there have been a few interventions that were inclusive of disabled women like Vikalp Design (India), Femme International (Tanzania) and WSSCC (India) that designed tools specifically for their needs.

However, it is crucial to make the mainstream MHM products like sanitary napkins and menstrual cups disabled friendly, so that they can be picked up by women with special needs at any chemist or daily needs shop. The government should also invest in such solutions, and make them subsidised for the reach of the common person.

While these and several other organisations have taken initiatives for the welfare of disabled women, a lot needs to be done to ensure that they are treated with equity. We are talking about a group of people who have been ignored, excluded and subjected to discrimination throughout their lives. It is high time that we all do our bit by raising awareness and donating solutions that help them as much as we can.

 

References & Footnotes:

1.Go to www.menstrualhygieneday.org to know more about MHM.

2.  Go to www.lshtm.ac.uk/media/23461 to read more about the surveys conducted with disabled on MHM.

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