Health

The mammoth task of managing menstrual waste in India

India has close to 12.3 billion disposable sanitary napkins to take care of every year, majority of which are not biodegradable/compostable

 
By Sushmita Malaviya
Last Updated: Wednesday 27 February 2019
Representative Photo: Getty Images
Representative Photo: Getty Images Representative Photo: Getty Images

Over the past few years, working with a wide range of stakeholders, the Menstrual Hygiene Alliance of India (MHAI) has approximated that there are 336 million menstruating women in India, of which 36 per cent use disposable sanitary napkins — that totals to 121 million women.

The number of sanitary napkins used per menstrual cycle — at a conservative eight — plus that for the year, implies that India has 12.3 billion disposable sanitary napkins to take care of every year, majority of which are not biodegradable/compostable. 

With only two cities in India — Bengaluru and Pune — implementing solid waste interventions to effectively segregate and identify menstrual waste during routine garbage collection, the Solid Waste Management (SWM) Rules 2016 underscores the challenge. 

Sanitary waste disposal has become an increasing problem in India as the plastic used in disposable sanitary napkins are not bio-degradable and lead to health and environmental hazards. The impact is more pronounced because of the unorganised ways of municipal solid waste management and poor community collection, disposal and transportation networks in the cities and villages.

Further, the SWM Rules raise the pertinent point about the categorisation of used sanitary products — should they be treated as biomedical or plastic waste.

According to the SWM Rules 2016, soiled napkins, diapers, condoms, tampons and blood-soaked cotton are considered household waste and are being disposed after segregation into biodegradable and non-biodegradable components.  

SWM Rules acknowledge that according to the Bio-Medical Waste Management Rules 2016, items contaminated with blood and body fluids, including cotton, dressings, soiled plaster casts, lines and bedding, are bio-medical waste and should be incinerated, autoclaved or microwaved to destroy pathogens.

Since 2000, India’s legislations on SWM have been in place and pertinent changes have been made to accommodate emerging disposal technologies, composting, strengthening capacities of urban local bodies for segregation, recycling and reuse of waste.

Today, more than ever, there is an urgent need to implement the pioneering environmental legislations. This can only be done when a cross section of Union ministries close ranks to work out seamless solutions.

Apart from that, riding on the ‘Clean India’ wave — how can segregation and safe disposal of these products become a norm rather than the exception. For an issue that continues to be brushed under the carpet, how can it be ‘normalised’ for citizens to make it easier for girls and women to use and dispose of these products efficiently?

‘Clean India’ and menstrual waste classification

Over the past five years, the commitment to ‘Clean India’ is evident in letter and spirit — with a host of campaigns and awards launched by the Government of India.

For the nation, the political will to ‘Clean India’ is driving the message home at every level, from the country’s leadership right down to resident welfare associations. 

One topic, that continues to remain under wraps due to persistent social and cultural taboos yet falls squarely in the area of waste management, is the issue of menstrual waste management.  

While the ministries of Women and Child Development and Human Resources have created an enabling environment for girls and women to access these essential healthcare products, raising awareness on menstrual hygiene management and breaking the silence and stigma around menstruation on the issue of safe disposal, other ministries need to move cohesively together – and quickly.  

Given the increasing availability, use and waste load of non-biodegradable menstrual products and lack of systems for appropriate disposal, cities and rural areas in India have a time bomb that needs immediate attention.

Ideally waste management solutions should be according to type of products being used. The challenge lies with the disposable sanitary napkins — the vast majority of which are made with non-compostable plastic liner, non-woven cover, and SAPs. The non-compostable has two varieties of sanitary napkins — with SAP and those without.

How is menstrual waste classified?

The SWM Rules consider menstrual waste as solid waste and define it as sanitary waste within the same. The Rules go on to elucidate responsibilities of the waste generator, local authorities and gram panchayats and producers of sanitary products.  

Over the past few years, the MHAI has been pulling together a wide group of people, including government/semi government authorities, implementing agencies, researchers, technocrats, journalists and sanitary napkin manufacturers to deliberate on the mounting crisis around safe disposal of menstrual waste.

From creating awareness and pushing the agenda to talk about the issue and collating material from a wide range of stakeholders, the MHAI has brought to centre-stage, an issue that has long been buried away.

A focused effort has helped generate concrete pieces of evidence that were otherwise fragmented across organisations and individuals.  

A look at menstrual waste disposal practices among adolescent girls in India gives a fair idea of current practices and their impact on the environment. 

These findings have been validated by a 2016 systematic review that pooled together evidence from research on menstrual hygiene in India and found variations in the way girls manage used menstrual hygiene products. Each has an adverse impact on the environment.

This immediately raises the issue of sustainable waste management of these products, once disposed as well as the overall sustainability of schemes that make these products easily available to rapidly increasing numbers of girls and women.

Using an interactive waste loading model developed by the global health non-profit, PATH, it is estimated that over 1 billion non-compostable sanitary pads are making their way to urban sewerage systems, landfills, rural fields and water bodies in India every month.

Not only do these products take hundreds of years to decompose, but because of the SAP present in commercial sanitary napkins, they absorb and retain 30 or more times their weight in fluid.

This often leads to clogging of toilets, sewerage systems and drains, and when burned, release toxic fumes like dioxins and furans that are harmful for users and the environment.

According to the MHAI, three main concerns are central to management of this largely non-compostable menstrual waste in India. First, paucity of appropriate disposal and treatment options leading to unsafe management of the waste.

Secondly, many girls and women lack access to those waste management options that exist due to their limited ability to negotiate for solutions because of a continued culture of silence associated with menstruation.

Thirdly, lack of access to disposal options may lead girls and women using otherwise hygienic products in an unhygienic manner (e.g., use a pad for longer than it should be).

SWM Rules 2016 suggest that all menstrual waste should be sent to one of the 215 large scale common bio-medical waste incinerators that exist across the country.

However, this requires organised segregation, collection and transportation of menstrual and other sanitary waste on a large scale. No viable models for this have been formulated or implemented till now.

The Rules also put the responsibility of managing the waste on producers through creation of necessary infrastructure or financial support for the same — which are not in place yet.

This could take the form of large scale recycling plants of the kind that P&G and Fater operate in Netherlands and Italy. However, this is a solution that holds potential for the future but does not exist currently.

Impact on the environment

Given this, there are two decentralised methods for management of menstrual waste — small scale incineration and composting. Both can be done for disposable pads without SAP.

Small scale incineration has gained popularity in the last few years and various government programmes also condone them. However, models are available in the market today that do not have appropriate emission control measures and burn waste at low temperature leading to inefficient combustion and release of carcinogenic toxic fumes.

Issues of inappropriate placement, ventilation and operation of units have been seen to be rampant. If used, small scale incinerators can be used as a practical solution if certain measures to ensure safety of users and staff operating these units are ensured.  

The environmental risk of incineration against the environmental risk of disposal in landfills needs to be weighed and understood better.

Composting is ideal for compostable pads. However, some efforts have shown that absorbent core of even non-compostable pads can decompose leaving behind the plastic materials.

Effective composting requires community mobilisation and mechanisms for segregation and aggregation of the waste at community or household level.

While all this is easy to articulate on paper, a look at any of the garbage dumps in any major city in India makes it clear that until segregation guidelines are fully implemented menstrual waste will potentially keep polluting soil and water.       

Since menstrual waste is handled and treated as solid waste, a series of steps are supposed to be followed. First, segregation and immediate disposal should be done by the user.

As already established, only two cities in the country are doing so — this is simply not enough. This should be followed by collection and transportation, and secondary segregation by the waste collector and storage treatment, and finally disposal or recycling.

Solid waste solution should be selected in accordance with the products disposed. For example, commercially available sanitary napkins cannot be easily composted; however, napkins/pads made from natural materials (e.g., banana fibre, bioplastics) can be composted.

For compostable products there should be clear labelling on product packages providing instructions on disposal. Solid waste interventions for menstrual and other sanitary waste are currently limited in India with existing solutions typically implemented in urban settings and only now beginning to show results.

As mentioned earlier, the paucity of disposal and treatment options may lead to the unsafe management of a mounting volume of menstrual waste. A look at the menstrual hygiene products and waste management solutions currently show that a majority of the current practices are either not recommended or are not the most suitable technology but an immediate practical solution often used in communities. Where technology is available it is both too expensive, people are not aware of it, and limited in availability.  

Current disposal mechanisms

In the waste-to-energy technology incinerators the waste generates energy/electricity. Combustion happens in highly controlled environments carefully regulating temperature and pressure, potentially controlling emissions even at low temperatures. Innovations in waste to energy incinerators for community and institutional use are underway.  These can incinerate all types of napkins.

The disadvantage is that very few waste to energy plants exist in the country. Those that do operate at a large scale are at select locations.

Expensive waste to energy innovations applicable to community and institutional settings are still under development and will take time to pilot, test for efficiency and safety, and be made available in the market.

Conclusion and next steps

Menstruation is a normal bodily function that has been so effectively hidden and shame-ridden that the conversation continues to place women at the center of keeping this normal part of the waste stream hidden, primarily from men.

Despite forward looking environmental legislations, the slow progress in implementing this could potentially mean that India’s already scarce natural resources could be further polluted.

The only way to get menstrual waste disposed of safely and efficiently, requires collective attention to this massive environmental health issue.

The Ministry of Drinking Water and Sanitation along with the Ministry of Environment and Forests and Climate Change, Ministry of Housing and Urban Affairs efforts should be directed to offer safe and appropriate waste management solutions.

Cascading this down to the last mile will require the same thrust and political commitment that has been given to the ‘Clean India’ campaign – just more focused as there are cultural and gender components that need to be handled with sensitivity.  These could potentially include;

  • An inter-ministerial task force
  • Use of incinerators should be specific to the suitability for various types of products, keeping in mind the environmental impact
  • Categorisation of menstrual waste to all relevant stakeholders communicated
  • Standards for waste management specified
  • Companies make truly compostable products
  • Regulations support people to do the right thing with all their waste
  • Systems are set up to facilitate proper waste handling

(This article was first published in the State of India's Environment 2019)

Sushmita Malaviya, is a communications professional who has worked with Hindustan Times, Central Chronicle (both in Bhopal), Patriot and The Statesman (Delhi). Since 2007, she has also supported large public health programmes in India such as polio, routine immunization and family planning.  

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