Worldwide disposable sanitary napkins flushed down toilets cause huge problems as they clog up sewers. Most sewerage systems, being designed before the advent of disposable napkins, are meant to carry only water and excreta. Besides the huge costs in maintenance of sewerage systems worldwide, in India the problem is exacerbated by the fact that, in contravention to existing laws, conservancy workers, with no protection whatsoever, have to go down the manholes to manually clean the blockages. Ecofemme, a manufacturer of reusable sanitary pads in Auroville, recently met with conservancy workers in Chennai and learnt about the devastating social impact of disposable pads.
“When you throw something away, where is away?” asks the celebrated environmental activist, Julia Butterfly Hill.[i] Indeed, where is away? “Away” conjures that mythical place, far from one’s home, where one is absolved from dealing with the ignominious impact of one’s action.
Years ago, as a teenager, when I flushed my disposable sanitary napkin down the toilet, dutifully removing the blue plastic leak-proof shield as advised by the packaging, I was not thinking of where was away. I was celebrating my liberation as a modern, urban woman who was free from the discriminatory superstitions and taboos regarding menstruation that were inflicted on my rural cousins.[ii] The water flushed away the napkin. And “away” was none of my concern.
As the years passed, and I switched to more eco-friendly alternatives for menstrual hygiene (and I have to confess for economic reasons as much as environmental reasons), I was still not bothered by that far-away place called away, until my friends at Ecofemme invited me to a round-table discussion with conservancy workers in Chennai on various aspects of menstruation. Conservancy workers is a euphemistic term for manual scavengers and sweepers who due to society’s blind oppression continue to work for urban municipalities—cleaning toilets, removing with inadequate tools and their bare hands human excreta and discarded waste like sanitary napkins, and worst of all, going down the manholes into the muck of sewers to clear blockages. It is a term that neatly obscures the fact that in the city of Chennai, 95 % of the 10,000 odd conservancy workers hail from one particular caste, the Arunthatiyar caste, and are condemned to manually handle the 5000 tons of solid waste that is produced by the city every day. [iii]
The Arunthatiyar community
Arunthathiyars, with a population of over 700,000, are one of the most marginalized social groups in Tamil Nadu.[iv] Arunthathiyars consider themselves as Tamil, though many also speak Telugu at home. Dalits constitute about one-fifth of Tamil Nadu’s population, and of these the Arunthathiyars are one of the bigger groups constituting about one-third of the state’s Dalit population. Arunthathiyars have historically worked as grave diggers, dead animal disposers, street sweepers and manual scavengers. Because of the nature of their work, they are regarded as outcastes and untouchables. In rural areas, there are Arunthatiyars who work as agricultural bonded laborers—there are cases where parents, shackled by illiteracy and poverty, have sold their own children to their landlords.[v]
Despite over six decades of independence and despite affirmative action that allows for reservation of jobs, of seats in universities and political constituencies, many of the lower Dalit sub-castes such as the Arunthatiyars have been systematically denied the privileges enjoyed by a democratic and upwardly-mobile society. The two Dalit political parties in Tamil Nadu are constituted by the Paraiyar and the Pallar communities who regard themselves as superior to the Arunthatiyars. There are stories of how Arunthatiyar women who sought to give up their jobs as scavengers and avail educational opportunities for their children were routinely oppressed and prevented from doing so by the local populace. It is hardly a secret that India’s much-touted economic rise has been literally built on the backs of these poorest of the poor who pay for the negative externalities of globalization and consumerism.
Despite laws that ban oppression, despite decades of protest for social justice, untouchability still rules in Indian cities. Street-vendors in Tamil Nadu typically have three sets of tumblers for serving chai—one for the higher castes, one for the higher Dalits, one for the untouchable—the Arunthatiyar. Despite laws and court orders that seek to ban manual scavenging, it is the government itself, hiding behind convenient provisions and loopholes in the law, that hires Arunthatiyars for this deadly work and in many cases keeps them conveniently bonded to their work by neglecting to pay their wages in time.
When the roaches die: the dangers of diving into a manhole
When one flushes something down a toilet in Chennai, it ends up in the city’s sewer network, which spreads across 2,800 km with 80,000 manholes. [vi] And unlike manholes in developed countries, in India, there are no vents, fans, or lights to assist those who are periodically forced to go down the manhole, swim through the filth holding their breath, to try and clear the blockage. Such is the danger that lurks beneath cities that in Hong Kong, a sewer worker is permitted to enter a manhole only after rigorous training and gaining at least 15 licenses.[vii] In India, because labor is conveniently cheap and because our prevalent belief in the caste system justifies the practice, we send men down the sewers bare-bodied, with nothing more than a rope round their waists. The rope is euphemistically called a safety belt but is actually more like a death noose for it is useful in hauling up the body if the worker faints or dies from the noxious fumes.
Death by asphyxiation is a known occupational hazard for conservancy workers. Despite the 2012 law, prohibiting employment of individuals as manual scavengers, at least 1 person dies every month in Tamil Nadu, by diving down a sewer to clean blockages.[viii] The anaerobic decomposition of underground sewage results in a variety of toxic gases. Hydrogen sulphide, with its distinctive smell of rotten eggs is the most common one. At a concentration of 100ppm, hydrogen sulphide causes asphyxiation, and at lower concentrations, such as less than 10 ppm, which is routine, it results in conjunctivitis and headaches. The other big danger is methane, a highly combustible gas. Without any gas-detecting devices, the conservancy workers check for the presence of methane by throwing a lighted match in. Any build-up of methane bursts into flames and burns out, and after that, a conservancy diver still has to enter the hell-hole. Carbon monoxide and dioxide, which cause suffocation are the invisible killers as being colourless and odourless, they escape detection. One worker reported that the method for checking the toxicity of a manhole was to open the cover and check if there were dead cockroaches, for it is a well-known fact that roaches do not die easily. If there are dead roaches, the conservancy workers just allow the manhole to aerate for a while and then enter the sewer, knowingly risking death. The Hole to Hell, a 2005 study of sewer workers explains that the “presence of noxious gases can cause syncope — a sudden and transient loss of consciousness owing to brief cessation of cerebral blood flow. The brain cannot tolerate even a brief deprivation of oxygen. The long-term neurological effects of syncope can be debilitating.”[ix]
Even those who survive that inevitable descent into hell, their lives are curtailed short by inevitable bacterial and viral infections such as leptospirosis, viral hepatitis, and typhoid that they contract through their skin. Typically, Indian cities do not provide easy access to water for the conservancy workers to clean themselves after working in the sewers. They often have to walk for kilometers before they can rid themselves of the filth. In one reported case, a city municipality provided for a protective suit and an oxygen cylinder, but so clumsy and heavy was the equipment, that the conservancy workers rejected them, claiming that it was an additional millstone to ensure that they would drown. The average lifespan of a conservancy worker, assuming he does not die at work, is a mere 45 years.[x] For a nation than can send satellites into spaces, rovers to probe the moon, and test nuclear bombs, surely it is chilling indifference and not technology that prevents the government from issuing better equipment to conservancy workers.
Disposable pads and disposable lives
Daily newspapers routinely report deaths of conservancy workers, and alternative media have sought to highlight the plight of the conservancy workers. But on talking to members of the Arunthatiyar community, what I realized with a shock was that disposable sanitary napkins can directly lead to fatality among conservancy workers. What I had not grasped until recently is that the thick Carefree cushions that I had used as a teenager had morphed into something more slick and inorganic. Disposable sanitary napkins today have a high content of LDPE plastic polymers and a layer made out of polyacrylate.[xi] The polyacrylate layer is a super-absorbent gel, which absorbs the menses to give one that feel-dry feeling, also soaks up water when it is flushed down the toilet. It continues to bloat as it makes its way through the underground rivers and clogs up the sewers leading conservancy workers to dive down and remove them by hand.[xii]
The people from Arunthatiyar community that we met were primarily incensed by the irresponsible disposal of these polymer-based sanitary napkins that were directly affecting their health and lives. So much so that Parvati, an outspoken woman-leader of the community has gotten the women to switch to washable cloth pads. “As she says: ‘we are the ones who have to clean up this waste, so why should we be producing it?’”[xiii]
The health hazards of disposable sanitary napkins are not just due to the clogging of sewers. Such is the lack of health and sanitation facilities in India that public toilets often lack a dustbin, and one often finds used and unwrapped sanitary napkins left in a corner to be manually picked up by conservancy workers. Given the fact that Hepatitis B and C are known to survive in a drop of blood or even on a dry surface for days, there is always the risk that soiled feminine care products contains such blood-borne pathogens. Other possible infectious microorganisms lurking on those used pads could E coli, Salmonella, Staphylococcus, HIV. And yet, as per common interpretations of India’s ambiguous laws on waste management, soiled napkins are considered as municipal solid waste and not bio-medical waste. An Arundhatiyar woman related a harrowing story of how she had to daily remove piles of used, unwrapped sanitary napkins with her bare hands from a women’s hostel bathroom at a medical college. The resulting infection that she got on her arms eventually forced her to stop this work. Last year, rag-pickers in Pune, were so fed up of having to deal with used sanitary pads that they sent sack-loads of it to the companies that were manufacturing them. In the past decade, multi-national corporations, having smelled the profits to be made in India by supplying women with sanitary napkins, aggressively entered the market, targeting even rural women who traditionally used cloth. In accordance with the recent Plastic Waste (Management and Handling) Rules, 2011, producers of plastic are legally accountable for organising and financing the end of life of plastic products in an environmentally and socially responsible way, but they typically fail do so and the government too does not enforce its own laws. Ironically, as did my Carefree pad years ago, most producers of sanitary pads still recommend flushing the pad down the toilet, totally oblivious of the hazards that this causes down the line.
Environmental impacts of disposable pads
In recent years, in an effort to stem the disturbing trend that cause girls to drop out of school when they are menstruating, both the central government and state government have started to distribute free disposable pads, and UNICEF has sought to provide in schools both sanitary napkin vending machines as well as incinerators to burn soiled ones. Incinerators such as NapiBurn and Reprocide are now currently cited as the scientific solution to the waste management problem of disposable pads. Yet a closer study reveals that these incinerators do not reach the necessary temperature of 800 degrees Celsius to allow for the safe incineration of napkins.[xiv] When plastic polymer products, such as disposable pads, are burned at lower temperatures they typically release asphyxiant and irritant gases into the atmosphere. Further, the biodegradable components, such as cellulose, wood-pulp, cotton in disposable pads often contain furans and dioxins. Furans are present in pesticides that are sprayed on inorganically-grown cotton. And dioxins are used to bleach cotton or the plant material so that the looks white and sanitary. Dioxins and furans are among the most deadly toxins known to science, being highly carcinogenic even in trace quantities. When pads are burnt these toxins are released into the atmosphere and can travel a long way from the point of emission. Dioxins are additionally hormone disruptors that cause reproductive and developmental problem, damage the immune system, and can be transmitted by mothers directly to their unborn babies. By choosing to burn napkins rather than flushing then down the toilet, we merely shift the problem from affecting individual lives to affecting entire populations including future generations.
Nor is collecting soiled sanitary pads separately and dumping them into the landfill a solution. A market survey estimates that only 12% of the menstruating population in India or about 36 million women use disposable sanitary pads. Assuming an average usage of 12 napkins per woman per month, India disposes 432 million soiled pads every month. These pads would last over 500-800 years and occupy a landfill spread over 24 hectares.[xv] Given the increasing scarcity of land in India, “away” no longer connotes “far away” but our own backyard.
Unfortunately, for modern Indian women, cloth pads have an association with the menstrual taboos that they once faced and, so initially at this meeting, there was a great deal of opposition to re-introducing reusable cloth pads. Most were not aware that pads like those of Ecofemme are ergonomically designed and technologically advanced with layers of absorbent flannel and a leak-preventive laminated cloth layer. The mood in the room palpably changed when a working woman suddenly proclaimed that she was perfectly satisfied with Ecofemme pads having bought them online. In concluding the round-table discussion, Kathy Walkling, founder of Ecofemme, passionately argued for giving women a choice in feminine hygiene products but also emphasized that given government negligence, society’s apathy and feudalistic attitudes, and corporate indifference, it was up to the individual to make informed choices and take responsibility for her action.
The odd group of students, human right lawyers, doctors, activists, public health workers and representatives of the Arundhatiyar community who had gathered for this discussion are likely to meet again to come up with strategies and policies to manage the problem. As an immediate strategy, Kathy said, “Spread the word—don’t flush soiled napkins away.” But in the long run, I believe a massive “behavior change strategy” needs to be engineered to shift Indian women away from disposable pads to reusable pads and menstrual cups. Even a simplified social and environmental life-cycle analysis shows that a reusable cloth pad is vastly superior to the disposable polymer-based pad. And with proper care, a reusable cloth pad is actually more hygienic than the so-called “sanitary”[xvi] napkins of the disposable kind.
Bindu Mohanty
[i] Quote taken from a video clip that is part of “Awakening the Dreamer, Changing the Dream” symposium, which is an educational program offered by awakenthedreamer.com
[ii] In India, as in most cultures worldwide, there are number of prevalent beliefs and taboos about menstruation that seek to limit a woman’s activities. Some of the more common ones in India are refraining from religious rituals, not cooking, and staying secluded from male company during menstruation. Social activists oppose such practices as gender discrimination, especially as one’s monthly period interrupts a girl’s education.
[iii] The percentage of Arunthatiyars working as conservancy workers is extrapolated from the fact that 95% of conservancy workers in Tamil Nadu are from this caste. Source: https://firstwitness.wordpress.com/2011/06/03/arunthathiyar .
The actual number of conservancy workers in Chennai is reported in Roopa S, Padmavathi R, Akolkar A et al. (2013) Abstract. Respiratory functions of conservancy workers working in solid waste management sector of Chennai, India. https://doi.org/10.12688/f1000research.1-67.v2
[iv] The data is from the 2001 census and not 2011. Source: https://censusindia.gov.in/Tables_Published/SCST/dh_sc_tamilnadu.pdf
[v] Source: https://firstwitness.wordpress.com/2011/06/03/arunthathiyar
[vi] Source: http://archive.tehelka.com/story_main36.asp?filename=Ne081207LIFE_INSIDE.asp
[vii] Source: http://www.infochangeindia.org/livelihoods/sidelines/dying-for-a-living.html
[viii] Source: https://www.thehindu.com/news/national/tamil-nadu/New-law-no-relief-to-manual-scavengers/article11864581.ece ; Also, while this article focuses mostly on the plight of conservancy workers in Chennai, this practice of sending scavengers down manholes with no protection occurs nationwide, and some estimate that nationwide 2-3 people die in manholes.
[ix] Source: http://archive.tehelka.com/story_main36.asp?filename=Ne081207LIFE_INSIDE.asp
[x] Ibid.
[xi] Source: Zohuriaan-Mehr, M. and Kabiri, K. (2008) Superabsorbent Polymer Materials: A Review. Iranian Polymer Journal, vol. 17 (6), pp. 451-477.
[xii] The Stockholm Environment Institute (SEI), an independent research institute that formulates policies on environment and development issues at a global scale, noting that the blockage of sewers due to flushing of disposable pads is a worldwide problem, recommends a “re-introduction of reusable menstrual products” (p. 18). See http://www.susana.org/_resources/documents/default/2-1556-sei-projectreport-kjellen-globalreviewofsanitationsystemtrendsandinteractionswithmenstrualmanagementpractices.pdf
[xiii] Cited in The Social Impact of DSN: Stories from the Arundathiyar community. Source: https://www.facebook.com/media/set/?set=a.684843494871613.1073741838.177908912231743&type=1
[xiv] Source: http://www.who.int/mediacentre/factsheets/fs281/en/
[xv] Source: https://www.downtoearth.org.in/coverage/kicking-up-a-stink-41036
[xvi] The term “sanitary” is truly misleading for the toxic chemicals present in disposable pads can absorbed by the body through skin contact. Rashes and excessive bleeding have also been reported by women who use disposable pads.
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