Presentation from Break the Silence! We Talk About Menstrual Health breakout from 2022 Rotary International Convention

2. R A G M H H

3. A PAGE FOR BIG BOLDBULLET ITEMS

4. Presenter
Chair
Sharmila Nagarajan

5. “Break
The
Silence”

6. Major objectives of
RAGMHH
R A G M H H

7. R A G M H H
We covers all
The 7 Areas
of Focus

8. R A G M H H

9. R A G M H H
• Most menstrual pads are made from 90%
plastic
• Plastic products can take up to a thousand
years to decompose in landfills or in the
ocean

10. R A G M H H
Plastic waste kills up to 1 million seabirds,
100,000seamammals, marine turtles and
countless fish each year. Plastic remains in our
ecosystem foryears, harming thousands of sea
creatures every day

11. R A G M H H
40% girls remained absent from school during
their menstruation.
School absenteeism was significantly associated
with the type of absorbent used, lack of privacy at
school, restrictions imposed on girls during
menstruation, mother's education, and source of
information on menstruation.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6130156/

12. R A G M H H
Ideas:
❖ Encourage your circle of friends to use Menstrual Cups
❖ Give them as part of their birthday gift
❖ Speak to your colleaguesat work
❖ Write about it on social media
❖ Talk about it
Lastly - Spread the word!!!
Break The Silence!!!

13. Presenter
Medical Director
Dr Meenakshi Bharat

14. R A G M H H
Improving women’s
wellbeing during periods
by using reusable
sustainable products

15. R AG M H H
➢Single use disposable sanitary products: effect on our health &
environment.
➢21st century solutions:
1. Newly designed cloth pads
2. menstrual cups
“no rash, no cash, no trash”
➢How we as Rotarians can transform women’s life.
Overview

16. R A G M H H
1.9 billion menstruating women in the world
Worldwide there is “PERIOD POVERTY”
- Women do not have enough money to buy
hygienic period care products.
Only 50% of women use single use disposable sanitary products but
amounts to billions of disposable menstrual products used annually
producing enormous menstrual waste.
www.thelancet.com/public-health Published online July 16 2019 http://dx.doi.org/10.1016/S2468
-2667(19)30111-2

17. R A G M H H
Evolution of Pads

18. R A G M H H
What’s hiding in a disposable pad??

19. R A G M H H
Story of Plastics!!!!!
‘The most common menstrual products are a veritable cornucopia of plastic.
Tampons come wrapped in plastic, encased in plastic applicators, with plastic
strings dangling from one end, and many even include a thin layer of plastic in
the absorbent part. Pads generally incorporate even more plastic, from the
leak-proof base to the synthetics that soak up fluid to the packaging.’
- National Geographic Magazine “How tampons and pads became so
unsustainable”, 6th Sept 2019

20. R A G M H H
Effects of using disposable pads and tampons
Pads
• Chaffing of the thighs and the genitals
• Cystitis – E-coli carried from the anal
area to the urethra.
• Imbalance of bacterial flora (Bacterial
Vaginosis)
• Contact dermatitis
• The mal odor associated with periods.
• Bulge of the pad which is visible under
the clothes that we wear
Tampons
• Leaks
• Dryness of the vaginal mucosa
• Interferencewith vaginal microbiome
• Infections like Moniliasis, Bacterial
Vaginosis & Trichomoniasis
• Risk of Toxic Shock Syndrome &
DEATH!

21. R A G M H H
Toxic Shock Syndrome
• Associated with
Tampons, Left in the
vagina for > 24 hours
(6-12 per 100,000
users)
• Medical grade silicone
products have a lower
incidence (2.25 per
100,000 users)

22. R A G M H H
Waste disposal issues of single use sanitary products

23. R A G M H H
Health impact on waste workers and sanitation systems
• Waste workers handle contaminated sanitary waste
manually, therefore are at a huge risk respiratory and
skin infection.
• Super absorbent gel makes the disposable pads /
tampons bloat and clog the sewage system which is
then needs manual clearing.
• Plastic tampon inserters add to the garbage created by
disposable menstrual products

24. R A G M H H

25. R A G M H H
Menarche 18 yrs/ age at Marriage Menopause
Cloth Pads Menstrual Cup
It is recommended to use cloth pads from the start of periods till the girl reaches
the age of 18 years or gets married / becomes sexually active. After that using
a menstrual cup till menopause is ideal.

26. R A G M H H
Solution 1
Reusable CLOTH PADS

27. R A G M H H
• Very different from the traditional cloth pads
used down the ages
• Has a leak proof layer that keeps the
underwear dry-prevents staining of clothes.
• A set of 5 pads lasts over 2-3 yrs .
• Produces very little trash as compared to
single use disposable pads
• Savings –15 single use pads/month x 30
months=450
• Creates local employment –Self Help Groups
can stitch and earn money
Cloth pads =
healthy, cost
effective and
creates
minimal
garbage

28. R A G M H H
Maintaining hygiene of a used cloth pad
is easy with these steps!!

29. R A G M H H
Solution 2
Reusable MENSTRUAL CUPS

30. R A G M H H

31. R A G M H H
Learning curve!
• Insertion & removal can be learnt in 2-3 cycles.
• Once comfortable; life long habit.
If you’ve learnt to use
then why not this???
Tampon users can cupvert easily

32. R A G M H H
Insertion
•Don’t worry! If the woman is comfortable
with intercourse, inserting the cup should
not be problem.
•The menstrual cup is much smaller than
the size of a baby’s head at childbirth.

33. R A G M H H
Cleaning
•Just 1 cup of normal water is enough to clean. Wash, dry and keep it in a cloth pouch
between periods.
•No need to sterilize it as the vagina is not a sterile organ.
•NEVER forget to remove the cup at the end of the period.
•Where will you store it between periods?

34. R A G M H H
Can one use the menstrual cup with CuT?
Yes!

35. R A G M H H
Can the blood in the menstrual cup reverse into the uterus?
The cervix is a one way road-from
inside the uterus to outside.
No back flow is possible as the
cervix contracts if any liquid is
introduced.
Van Eijk, A.M. et al, 2019. Menstrual cup use, leakage, acceptability, safety, and availability: a
systematic review and meta-analysis. The Lancet Public Health, 4(8), pp.e376-e393.

36. R A G M H H
1- Easy to use and clean: very little water needed.
2- Increased feeling of cleanliness , no feeling of wetness.
3- Vaginal white discharge is reduced, less chances of bacterial vaginosis, less rash in the
groin.
4- One time purchase –Rs 900 to Rs1000 –lasts 10 years
5- No trash created, no need to hunt for dustbins
6- Not necessary to wear underwear.
7- Reduction in abdominal cramps-dysmenorrhea
Oster, E. and Thornton, R., 2012. Determinants of technology
adoption: Peer ef f ects in menstrual cup take-up. Journal of the
European Economic Association, 10(6), pp.1263-1293.
Phillips-Howard, P.A. et al., 2016. Menstrual cups and sanitary
pads to reduce school attrition, and sexually transmitted and
reproductiv e tract inf ections: a cluster randomised controlled
f easibility study in rural western Keny a. BMJ open, 6(11).
Advantages of menstrual cup

37. R A G M H H
8-No need to remove the cup while passing urine or stools unlike with pads.
9-Requires less frequentremovals –increased capacity as compared to pads
used. Can be used over night
10-Not affected by rain.
11-Doesn’tfeellike you’re wearing anything.
12-Can travel light
13- Can participate in any kind of activity –
swimming, hiking, heavy work, field work
Juma, J., et al. 2017. Examining the safety of menstrual cups among rural primary school girls in western Kenya: observational studies nested in a randomised controlled feasibility study. BMJ open, 7(4), p.e015429.

38. R A G M H H
Does the cup produce endometriosis? No
Does the usage of cup lead to urinary infection ? No, just wash your hand
before inserting the cup
Does the cup in any way affect fibroid uterus and PCOD? No effect on them
Does the wearing of the cup expand the vagina? No
Myths!

39. R A G M H H
Comparative Health Analysis

40. R A G M H H
Disposal
analysis

41. R A G M H H
In 10 years a single woman would use
Which would you choose?
v
s
20
cloth
pads
v
s
1
cup

42. R A G M H H
Four way test of Rotary
• Is it the truth? Yes it is.
• Is it fair to all concerned? Yes it benefits the women of the world, it is hugely economical and most importantly it saves the
environment from further degradation.
• Will it build goodwill and better friendship? Yes the women who will receive these products will be forever grateful to the
donor for this wonderful gift.
• Will it be beneficial to all concerned? Of course it is beneficial to all concerned; with 50% of the world population being
women- 1.9 billion menstruating women will forever be thankful for making their lives so much more comfortable during the
stressful time of menstruation. This leads to a huge saving of money and more than anything else, for not creating any more
trash that has so many harmful ramifications for the whole world. Also if women are happier during their periods then the world
will be a more peaceful place.

43. R A G M H H
What can we as Rotarians do?
➢Start using these sustainable products first.
➢Convert those around us
➢Think of projects through the sustainable menstruation lens.
➢Not install incinerators or distribute disposable sanitary pads as part of projects.
➢Identify communities where SHGs to make the cloth pads are developed.
➢Join hands with clubs across the world to make these projects happen

44. R A G M H H
The shift to sustainable menstruation starts with us, and will have huge
impact on women’s health, economy and environment.
Join us in making it happen.
• Total independence from period problems.
• Reducing 90% of expenditure on menstrual care products
• Avoiding 95% of sanitary waste
No Rash, No Cash, No Trash!!

45. A PAGE FOR BIG BOLDBULLET ITEMS
MENSTRUAL HEALTH
& HYGIENE
Projects
All Over The
World
Inés García Murúa
Argentina

46. A PAGE FOR BIG BOLDBULLET ITEMS
WHERE WE GO?
Ambassadorsand Projects
Buenos Aires - ARGENTINA

47. A PAGE FOR BIG BOLDBULLET ITEMS
PILOT TEST SMALL COMMUNITY
Buenos Aires - ARGENTINA
In ROJAS CITY,
ROTARY CLUB OF ROJAS with
8 trained sanitary agents and
supported by the City Major
are detecting women beneficiaries
- WOMEN IN POOR NEIGHBOURHOODS
- SANITARY STAFF
- GIRLS IN POOR SCHOOLS

48. A PAGE FOR BIG BOLDBULLET ITEMS
IMPACT OF THE PROJECT
MEASURE IN 6 STEPS
ROTARIANS AND
SANITARY AGENTS
FOLLOWED THE RESULTS
OF A SURVEY CONSENTED
BY BENEFICIARIES

49. A PAGE FOR BIG BOLDBULLET ITEMS
PILOT TEST IN JAILS
Buenos Aires - ARGENTINA
RC SAN TELMO CONSTITUCION
AND RC OF ROJAS GIVING
EDUCATION CUPS AND
REUSABLE PADS
TO WOMEN IN JAIL
- WOMEN IN JAIL

50. A PAGE FOR BIG BOLDBULLET ITEMS
Ambassadors and Projects
Sogamoso
COLOMBIA

51. A PAGE FOR BIG BOLDBULLET ITEMS
Ambassadors and Projects
COLOMBIA
District 4281
GIRLS IN SCHOOL

52. A PAGE FOR BIG BOLDBULLET ITEMS
Ambassadors and Projects
Ibiza
ESPAÑA
MENSTRUAL CUPS ACCESS

53. A PAGE FOR BIG BOLDBULLET ITEMS
Ambassadors and Projects
RC of Rosaville, MN.
USA

54. A PAGE FOR BIG BOLDBULLET ITEMS
Ambassadors and Projects
RC of Hyderabad
Telengana
INDIA

55. A PAGE FOR BIG BOLDBULLET ITEMS
Ambassadors and Projects
RC of Bangalore
Karnataka
INDIA

56. A PAGE FOR BIG BOLDBULLET ITEMS
Ambassadors and Projects
RC of Bharuch
Gujarat
INDIA

57. A PAGE FOR BIG BOLDBULLET ITEMS
Ambassadors and Projects
RC of Bhiwadi
INDIA

58. A PAGE FOR BIG BOLDBULLET ITEMS
The RAGMHH initiative
• Awareness,counselingand education of girls and boys to ensure a proper understanding
of the phenomenonof menstruation for better acceptance and adaptation.
• Selective distribution of reusableproducts in communitiesthat include schools and
marginalizedgirls and women.
• Reduce pollution of the environment (soil and water) due to the elimination of menstrual
waste.
• I use the cost-benefit analysis of using disposable versusreusable pads, as shown in the
table below, to demonstratethe value of reusable products.

59. A PAGE FOR BIG BOLDBULLET ITEMS
Let s put menstrual poverty in the past!
We want you to join us:
Rotary Action Group for
Menstrual Health & Hygiene
www.RAGMHH.org

60. Questions?
Email:
RAGMHH@GMAIL.COM

61. Rate this session in the Rotary Events app,
available in your Apple or Android app store.

62. THANK YOU!
Sharmila Nagarajan,
Dr Meenakshi
Bharat
& Inés García Murúa
Email US @
RAGMHH@GMAIL.COM