NAME- Mohona Chakraborty (Postgraduate student, Masters in Public Health, IIPH-Gandhinagar)
As we are well aware, public health relies significantly on addressing the social determinants of health (SDH), with menstrual hygiene and safe WASH practices being integral components of this approach. Unfortunately, I get to hear frequent reports of unsafe and unhygienic menstrual and WASH practices leading to the spread of diseases and illnesses within communities. Well, in my internship phase, I visited IIT Gandhinagar construction site where I witnessed altogether a unique scenario. The site is classified as a High-Risk Area and is predominantly inhabited by migrant populations from states such as Bihar, Chhattisgarh, West Bengal, and Rajasthan. I visited the site on 9th June Wednesday owing to Mamta Divas, a day which is dedicated totally to strengthen maternal and child health in Gujarat introduced by MOHFW and WCD department.
Accompanied by the health staff from the Primary Health Centre (PHC), I had the opportunity to visit the site mainly for immunisation services of under 5 children. During the visit, I had a detailed conversation with a woman from Chhattisgarh, who had taken on the responsibility of taking care of the children while their mothers were engaged in labour work at the construction site from 8 am to 5 pm. It was the month of June and in Gujarat, the Intensified Diarrhoea Control Fortnight (IDCF) campaign which aims for zero diarrhoeal deaths for under 5 children was supposed to begin from 12th June. As a support member for the campaign in the Child Health department, I was naturally curious to inquire about the WASH practices in the site area, given that diarrhoea is predominantly waterborne. During our conversation, the woman provided valuable insights into the healthy and hygienic practices being followed on the site, which I will now summarize for you.
Before delving into the details of menstrual and WASH practices, I would like to describe the site area. The site area comprised a single room with one common washroom. Overcrowding was highly rampant without proper ventilation. Unlike typical construction sites dominated by males, I observed a more balanced distribution, with approximately 60% male and 40% female presence. During my conversation with the woman responsible for caring for the children, I inquired about the disposal of sanitary pads, considering the challenges posed by the congested space with limited privacy for women. The woman informed me about a really unique procedure of disposal of sanitary napkins. According to her the napkins after usage were first washed with running tap water and then securely packed and disposed of in a dustbin. When I sought further explanation, she provided two compelling reasons for this practice. Firstly, in Chhattisgarh, there is a local belief that if napkins are disposed in public bins without washing off the blood, the grazing animals might consume them. According to this belief, if a female cow consumes the napkin, the impure blood could render her infertile, affecting her ability to conceive. Secondly, washing and disposing sanitary napkins prevents the spread of the bacterial decomposition which intern keeps the environment and surroundings healthy.
Additionally, the woman emphasized the need to maintain discretion in disposing of sanitary napkins, particularly to safeguard the privacy and dignity of women. Men in the site area were not to be informed or made aware of the disposal process, as per the prevailing cultural beliefs. It was considered essential to ensure that men remained unaware of any female workers going through their menstrual cycle to avoid notions of impurity associated with such natural biological processes. Furthermore, she highlighted the positive impact of regular free distribution of sanitary napkins in their colony by Government health workers. This undoubtedly played a significant role in promoting menstrual hygiene and supporting the well-being of women in the construction site area.
Regarding the hygiene and sanitation practices, despite having a single common washroom, the woman informed about the access and availability of 24* 7 running water. Additionally, the residents make use of soap for handwashing, emphasizing the importance of maintaining proper hand hygiene. Most notably, there were no instances of open defecation practices observed among any of the construction site members. To verify this, I took the initiative to speak to some women who were present there for immunisation services for their children. They confirmed that with the availability of water, soap, and a washroom, the need for open defecation is completely eliminated. One woman even shared her belief that open defecation is not only harmful for the environment but also poses risks to the health of their children. As a result, they prioritize cleanliness and sanitation in their daily routines.
Furthermore, I enquired about any cases of diarrhoea among the children in the site area to which the woman mentioned the drinking water comes directly from municipality, so no cases of diarrhoea or any stomach upset among children. Additionally, on inquiring about the knowledge of distribution and usage of ORS and Zinc tablets during monsoons, the response was positive and I learnt that the women were indeed familiar with these essential medical interventions. as they receive them from the health workers and the woman responsible for caring for the children ensured that the children received the required amounts of these life-saving supplements.
In conclusion, I would like to say as a student of public health, the experiences and observations during my field visit were profoundly intriguing. The sense of responsibility the people had towards their own health and their children’s health was really amazing. Moreover, their consideration for the environment and grazing animals left a lasting impression on me, offering valuable insights and lessons. The site area presented challenges related to congestion and limited privacy, but the community exhibited ingenuity in managing menstrual waste by following a unique disposal practice. The preservation of cultural beliefs, coupled with a concern for environmental and community health, underscored the importance of these thoughtful practices. The hygiene and sanitation practices at the construction site were also commendable, considering the limited resources available. The community’s understanding of the importance of cleanliness and the absence of open defecation practices highlighted their commitment to promoting a healthier living environment.
SOME GLIMPSES OF MY VISIT
