Disposable pads, disposable lives

“When you throw something away, where is away?” asks the celebrated environmental activist, Julia Butterfly Hill. 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, 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. (In India, as in most cultures worldwide, there are a 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.) 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 (I have to confess for economic reasons as much as environmental reasons), but I was still not bothered by that far-away place called “away”, until my friends at Eco Femme 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, who are condemned to manually handle the 5000 tons of solid waste that is produced by the city every day.

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. 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. In India, because labour 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 around 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 one person dies every month in Tamil Nadu, by diving down a sewer to clean blockages. This is because the anaerobic decomposition of underground sewage results in a variety of toxic gasses. Hydrogen sulfide, with its distinctive smell of rotten eggs, is the most common one. At a concentration of 100ppm, hydrogen sulfide 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 colorless and odorless 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.

Even for those who survive that inevitable descent into hell, their lives are curtailed 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. For a nation that can send satellites into space, 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 (the term “sanitary” is truly misleading for the toxic chemicals present in disposable pads can absorbed by the body through skin contact) 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. The polyacrylate layer, 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, causing conservancy workers to dive down and remove them by hand.

The people from the Arunthatiyar community that we met were 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 got 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?”

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 contain such blood-borne pathogens. 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 with 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, multinational 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 to 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 further 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. When plastic polymer products, such as disposable pads, are burned at lower temperatures, they typically release asphyxiant and irritant gasses into the atmosphere. Further, disposable pads are also known to contain furans and dioxins. Furans and dioxins 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 problems, damage the immune system, and can be transmitted by mothers directly to their unborn babies. By choosing to burn napkins rather than flushing them 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 of 432 million soiled pads every month. These pads will last over 500-800 years and occupy a landfill spread over 24 hectares. Given the increasing scarcity of land in India, “away” no longer connotes “far away” but is our own backyard.

Unfortunately, for modern Indian women, cloth pads have an association with the menstrual taboos that they once faced, 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 Eco Femme 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 Eco Femme pads, having bought them online. In concluding the round-table discussion, Kathy Walkling, founder of Eco Femme, passionately argued for giving women a choice in feminine hygiene products but also emphasized that given government negligence, society’s apathy and feudalistic attitudes, as well as corporate indifference, it was up to the individual to make informed choices and take responsibility for her action.

The 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 behaviour 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” napkins of the disposable kind.