When I started the Menstrual Hygiene Awareness initiative three years ago, in government schools, I assumed the answer to menstrual hygiene was distributing sanitary napkins.

So we got donors and napkins and gave them for free in rural government schools. And then, we ran out of donors. And then, a small voice in my head asked me why I never bothered to ask the girls if they did need sanitary napkins and what they would do if I (or others like me) stopped supplying these. And about the same time, a not-so-small voice asked me what about the environmental damage that sanitary napkins cause by improper disposal methods.

Due to the nature of such thoughts which usually trouble me until I act on them, I was forced to find out what women and girls do when there are no sanitary napkins, and also what do they do with sanitary napkins.

Most women and girls I interacted with (around 5000 in the last three years) across rural Karnataka, use cloth (cotton) to absorb menstrual flow. Unlike my own earlier assumption, the reason wasn’t always that cloth is cheaper, but rather, that cloth is familiar. In that part of our country, where tradition and ancient methods exist, cloth is a familiar, comfortable option. And why not? It absorbs blood quite well, can be procured easily without the embarrassment of asking a shop-keeper, can be washed and re-used and thereby eliminating the problem of disposal and environmental damage.

So why do so many NGOs, the government and women themselves say that cloth is bad and we need to promote the use of sanitary napkins to solve the problems faced by women during menstruation?

I found that it was not the usage of cloth, per se, that caused health and hygiene issues, but rather “how” the cloth was used. In many places, women told me the cloth is dried inside the house in some dark corner so that no man sees it, stored in the roof or some hole in the ground so that men and children don’t access it, and many women in one household share the same cloth.

These practices  without doubt, are likely to create health issues when the cloth is not fully dry, exposed to sunlight to kill germs and unhygienically stored and shared.

The solution is not in blindly telling girls to not use cloth, but instead telling them how to use it right. I have witnessed how such information has been far more empowering to women who realised that their health and hygiene was in their hands, rather than being dependent on something they were unfamiliar with.

Lastly, it is wrong to assume that introducing sanitary napkins in itself solves these issues. I have come across cases where just because they use sanitary napkins, girls think that it has some super absorbing capacity and do not change it as frequently as they should, or would if it were the good ol’ cloth. Thereby, the harm caused by sanitary napkins not being used properly is not greatly different from that of improper usage of cloth.

The point here is that we should be careful not to mislead young girls and women by promoting that hygiene is all about switching to sanitary napkins, simply because we (read the urban women) do not know any better. Instead, we need to tell them how to maintain hygiene, regardless of what they use. Why not leave it to them to decide what to use, and respect that decision?