Menopause at 30 for millions in poverty

A young woman in Shikohabad in Firozabad district of Uttar Pradesh died a mysterious death 20 years ago. The reason for the death haunted her parents and relatives for days. Finally they found that it was her sanitary napkin that killed her. She had used an old blouse during her menstrual period. A rusted hook on it gave her tetanus that killed her. In the days when none dared to speak about a woman's menstrual period other than treat it as a matter of shame and embarrassment, an elder in
the family actually called women in the village to appeal to them to pay attention to the clothes they used as napkins.This incident is one of the many that have inspired a young man in Delhi to actually make sanitary napkins from waste clothes for every poor and needy woman in the country through his NGO Goonj. He and his network of 300 volunteers all over the country are preparing to send their first consignment of plastic-free napkins from waste and donated clothes to Shikohabad villages next month. At Shikohabad, another NGO would hand over the packets of folded clothes to self-help groups for further improvisation. Cords would be attached to each rectangular piece of cloth napkin by the SHGs and then distributed among women. The napkins are nothing but pieces of cloth that are actually waste material found in bags of donated clothes meant for Goonj's larger Vastradaan project. The pieces are washed four times and sun dried. They are then cut into neat rectangular shape and packaged as ten pieces per person in Gupta's office in Delhi's Sarita Vihar. The project answers the most basic need of every woman - that of a clean piece of cloth to wear during the three to four days of their monthly menstrual cycle.
The story of the tetanus death caused by the dirty rusted piece of cloth in Shikohabad is not the only inspiration for Anshu Gupta. A 35-year-old man who left his job as a management boss to start Goonj, he has many studies of women in need of a clean piece of cloth. \nIn fact when Gupta is told that the thin folds of clothes in his ten in one packet may not last for four days for any woman, he reels out another case study. A woman in Chennai told him that she used just two napkins for the entire period of four days. This was because she had no money to buy napkins, he says. \nGupta then talks of women he met in Dharavi's slums in Bombay. He found women who make do with any piece of cloth during the four days of bleeding, exposing themselves to disease and often death. It could be old clothes, wet clothes, or clothes used for cleaning the floors. \nSays Gupta, the scarcity of clean clothes comes from the scarcity of space for drying as also from shame and fear of men in the family. In Dharawi, women told Gupta that if at all they washed the clothes, there was little opportunity to dry them. Drying them in the sun was out of the question. \n"We dry them by hanging them behind the doors when the elders and men in the family are away. The clothes don't dry by the time the men are back. So we make do with the wet clothes," Gupta quotes the women as saying. \nGupta also points to the case of a woman in Chennai who died after being bitten by a centipede hiding in the old clothes she used during the cycle. This story came to him from bloggers who have responded to a news report on his clean piece of cloth initiative. \nGupta says that menstrual bleeding is considered synonymous with dirt traditionally, and the woman herself is treated as such at that time. So women consider it all right to use any cloth when they bleed. They don't relate this with their health. In fact use of unclean clothes during menstrual periods is one of the main reasons for cervix cancer says Gupta. \n",1]
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The story of the tetanus death caused by the dirty rusted piece of cloth in Shikohabad is not the only inspiration for Anshu Gupta. A 35-year-old man who left his job as a management boss to start Goonj, he has many studies of women in need of a clean piece of cloth. In fact when Gupta is told that the thin folds of clothes in his ten in one packet may not last for four days for any woman, he reels out another case study. A woman in Chennai told him that she used just two napkins for the entire period of four days. This was because she had no money to buy napkins, he says. Gupta then talks of women he met in Dharavi's slums in Bombay. He found women who make do with any piece of cloth during the four days of bleeding, exposing themselves to disease and often death. It could be old clothes, wet clothes, or clothes used for cleaning the floors. Says Gupta, the scarcity of clean clothes comes from the scarcity of space for drying as also from shame and fear of men in the family. In Dharawi, women told Gupta that if at all they washed the clothes, there was little opportunity to dry them. Drying them in the sun was out of the question. "We dry them by hanging them behind the doors when the elders and men in the family are away. The clothes don't dry by the time the men are back. So we make do with the wet clothes," Gupta quotes the women as saying. Gupta also points to the case of a woman in Chennai who died after being bitten by a centipede hiding in the old clothes she used during the cycle. This story came to him from bloggers who have responded to a news report on his clean piece of cloth initiative. Gupta says that menstrual bleeding is considered synonymous with dirt traditionally, and the woman herself is treated as such at that time. So women consider it all right to use any cloth when they bleed. They don't relate this with their health. In fact use of unclean clothes during menstrual periods is one of the main reasons for cervix cancer says Gupta.
Gupta has prepared graphic literature for distribution with the napkins. It is about the ability of the sun to kill germs in the clothes. If every woman heeded this, a lot of health problems can be prevented.Fifty per cent of women in villages suffer from white discharge that often is an indication of cancer. Even otherwise, this is caused by lack of hygiene, says Gupta. A clean piece of cloth is the least one can do to provide reproductive health care. After Shikohabad, the cargo of sanitary napkins proceeds to villages in 13 other states where Goonj is linked up with several NGOs, and 300 volunteers. \nThe lack of a clean piece of cloth is something that is shared in common by the poor and the women living in conflict areas. Gupta plans to take the drive to Kashmir and the North East where the agency lending a helping hand is the Army itself. \nThe Army would supply packets of clean cloth napkins to women in conflict areas, he says. And the Army jawans would also receive literature educating them on the necessity of women having access to clean cloth during the menstrual cycle. I am in the midst of preparing the literature, he reveals. \nHis inspiration for this special drive for Kashmir and the North East and maybe later for conflict areas abroad comes from the story of a Thai woman who is now in a senior position in the Ashoka Fellowship. Gupta, who is an Ashoka Fellow himself, says that the woman in her days as a guerilla had to use pieces torn from mosquito nets during menstrual bleeding. \nThe mosquito netting was hardly suitable and often caused rashes, according to the Thai woman. And the women guerillas also could not dry the scarce clothes anywhere too long. They had to run with the wet clothes for fear of being traced by the army. Gupta's only regret is that not a single funding agency in the world considers clothing, not to speak of sanitary napkins, as a cause worth funding. Gupta is today raising funds for his clothing campaign through a network of various kinds of volunteers. \n",1]
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He adds, "Our packet of clothes will help the women dry their clothes for two or three days before they wear it. Again the packet is also a message in cleanliness, besides telling the women that this is not something to be neglected. Gupta has prepared graphic literature for distribution with the napkins. It is about the ability of the sun to kill germs in the clothes. If every woman heeded this, a lot of health problems can be prevented.Fifty per cent of women in villages suffer from white discharge that often is an indication of cancer. Even otherwise, this is caused by lack of hygiene, says Gupta. A clean piece of cloth is the least one can do to provide reproductive health care. After Shikohabad, the cargo of sanitary napkins proceeds to villages in 13 other states where Goonj is linked up with several NGOs, and 300 volunteers. The lack of a clean piece of cloth is something that is shared in common by the poor and the women living in conflict areas. Gupta plans to take the drive to Kashmir and the North East where the agency lending a helping hand is the Army itself. The Army would supply packets of clean cloth napkins to women in conflict areas, he says. And the Army jawans would also receive literature educating them on the necessity of women having access to clean cloth during the menstrual cycle. I am in the midst of preparing the literature, he reveals. His inspiration for this special drive for Kashmir and the North East and maybe later for conflict areas abroad comes from the story of a Thai woman who is now in a senior position in the Ashoka Fellowship. Gupta, who is an Ashoka Fellow himself, says that the woman in her days as a guerilla had to use pieces torn from mosquito nets during menstrual bleeding. The mosquito netting was hardly suitable and often caused rashes, according to the Thai woman. And the women guerillas also could not dry the scarce clothes anywhere too long. They had to run with the wet clothes for fear of being traced by the army. Gupta's only regret is that not a single funding agency in the world considers clothing, not to speak of sanitary napkins, as a cause worth funding. Gupta is today raising funds for his clothing campaign through a network of various kinds of volunteers.
There are newspaper volunteers who donate their newspapers and magazines monthly. There are cloth volunteers who become collection centres for all old clothes in the neighbourhood. There are old used paper volunteers who provide paper on whose unused side Goonj does its writing. The money from sale of newspapers provides some income for the organization, which aspires to spread its motto of clothing for all and clean napkins for all women beyond this country. "I have a ready made network of Ashoka Fellows all over the world. I just need carriers for the idea so that more and more women benefit in areas of need," he says. \n\n\n\nOn 1/23/07, Sudhir Devadas <sudhirdin@gmail.com \n> wrote: \n\nThe Times January 23, 2007 \nMenopause at 30 for millions in poverty\nJeremy Page in Delhi\nDoctors identify malnutrition link \nProblem greater in rural areas\nMillions of women in India are going through the menopause as young as 30 because of chronic malnutrition and poverty, according to a study by a prominent Indian think-tank. The research suggests that almost one in five women in the country have gone through the \nmenopause by the age of 41. \nMalnutrition is believed to be a contributory factor, particularly in rural areas, although the study did not address the causes. Yesterday doctors called for further research into the condition. \n\nThe study, by the Institute for Social and Economic Change, based in Bangalore, found that 3.1 per cent of Indian women — about 17 million — reached ",1]
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There are newspaper volunteers who donate their newspapers and magazines monthly. There are cloth volunteers who become collection centres for all old clothes in the neighbourhood. There are old used paper volunteers who provide paper on whose unused side Goonj does its writing. The money from sale of newspapers provides some income for the organization, which aspires to spread its motto of clothing for all and clean napkins for all women beyond this country. "I have a ready made network of Ashoka Fellows all over the world. I just need carriers for the idea so that more and more women benefit in areas of need," he says.



Menopause at 30 for millions in poverty

Jeremy Page
in Delhi

Millions of women in India are going through the menopause as young as 30 because of chronic malnutrition and poverty, according to a study by a prominent Indian think-tank. The research suggests that almost one in five women in the country have gone through the menopause by the age of 41.
Malnutrition is believed to be a contributory factor, particularly in rural areas, although the study did not address the causes. Yesterday doctors called for further research into the condition.
The study, by the Institute for Social and Economic Change, based in Bangalore, found that 3.1 per cent of Indian women — about 17 million — reached
menopause between the ages of 30 and 34. Eight per cent ( 44 million) are in \nmenopause by the time they are 39, the institute's study showed, while 19 per cent have gone through "the change of life" by the age of 41. \nMedical experts say that natural menopause, when the ovaries stop producing oestrogen, occurs in women between the ages of 45 and 55, with the global mean being 51. Premature \nmenopause is defined as the cessation of menstruation before the age of 40 and affects an estimated 1 per cent of women worldwide. \n"It is very clear that a significant proportion of women in India are reaching menopause prematurely," wrote Dr T. S. Syamala and Dr M. Sivakami in the study, which has been presented to the Indian Parliament. "This is significant because most health programmes in India focus on women of reproductive age," Dr Syamala told The Times. "It is high time that we started to focus on post-menopausal women because of increasing life expectancy in India and because of the health risks associated with premature \nmenopause." \nThe study was based on a National Family Health Survey carried out in 1998 and 1999 and examined a sample of more than 90,000 married women aged between 15 and 49 across 26 Indian states. It did not examine the physiological reasons for the higher rates of premature \nmenopause in India — where the average menopausal age is 44.3 years. \nIt found that the problem was much more common in rural areas, among agricultural workers, and among women who were illiterate and had a low body mass index. "Most of these women are malnourished and that could be one of the main reasons for premature \nmenopause," said Dr Syamala.
menopause between the ages of 30 and 34. Eight per cent ( 44 million) are in menopause by the time they are 39, the institute's study showed, while 19 per cent have gone through "the change of life" by the age of 41.
Medical experts say that natural menopause, when the ovaries stop producing oestrogen, occurs in women between the ages of 45 and 55, with the global mean being 51. Premature menopause is defined as the cessation of menstruation before the age of 40 and affects an estimated 1 per cent of women worldwide.
"It is very clear that a significant proportion of women in India are reaching menopause prematurely," wrote Dr T. S. Syamala and Dr M. Sivakami in the study, which has been presented to the Indian Parliament. "This is significant because most health programmes in India focus on women of reproductive age," Dr Syamala told The Times. "It is high time that we started to focus on post-menopausal women because of increasing life expectancy in India and because of the health risks associated with premature menopause."
The study was based on a National Family Health Survey carried out in 1998 and 1999 and examined a sample of more than 90,000 married women aged between 15 and 49 across 26 Indian states. It did not examine the physiological reasons for the higher rates of premature menopause in India — where the average menopausal age is 44.3 years.
It found that the problem was much more common in rural areas, among agricultural workers, and among women who were illiterate and had a low body mass index. "Most of these women are malnourished and that could be one of the main reasons for premature menopause," said Dr Syamala.
\nSome health experts questioned the study's methods and conclusions and called for more focused research into the problem. "I'm not surprised, except that it's interesting to hear figures being specified in this way," said Urvashi Jha, founder and former president of the Indian \nMenopause Society. "I tend to be quite cynical about these sort of statistics, but we definitely need more research into this important field." \nDr Jha and Dr Syamala called on Indian health authorities to devote more resources to post-menopausal women, especially in rural areas where hormone replacement therapy is unavailable. \n"India's overburdened and underfunded public healthcare system has no special programmes for older women," the study concluded.

The study also found that the proportion of menopausal women aged between 30 and 49 was highest in the populous agricultural states of Andhra Pradesh and Bihar and lowest in Kerala, West Bengal and Rajasthan.
Some health experts questioned the study's methods and conclusions and called for more focused research into the problem. "I'm not surprised, except that it's interesting to hear figures being specified in this way," said Urvashi Jha, founder and former president of the Indian Menopause Society. "I tend to be quite cynical about these sort of statistics, but we definitely need more research into this important field."
Dr Jha and Dr Syamala called on Indian health authorities to devote more resources to post-menopausal women, especially in rural areas where hormone replacement therapy is unavailable.
"India's overburdened and underfunded public healthcare system has no special programmes for older women," the study concluded.