The Unspoken Problem

A middle-aged man from a rural town in India has recently received international attention for a new and innovative technology. Arunachalam Muruganatham’s invention creates cheap sanitary napkins for women who are unable to afford them at the regular market price. His ingenious invention has earned Arunachalam the name ‘Menstrual Man,’ and has even made him the subject of a documentary by Amit Virmani [1]. More importantly, his work has improved the health and hygiene of many women by providing them with affordable and sanitary menstrual products.

Mr. Muruganatham’s story of determination and dedication is deeply inspiring, but it also drives international attention towards the problem of menstrual hygiene, one of the most overlooked problems related to health in Southeast Asia. The social taboos and cultural practices surrounding menstruation have left many women in this region uneducated about proper menstrual health. Additionally, their socio-economic statuses have prevented them from purchasing safe sanitary napkins. A survey commissioned by the Indian government back in 2011 showed that only 12% of Indian women used sanitary pads [2]. Women in rural parts of South East Asia have resorted to using cloths that Mr. Muruganatham described as “nasty cloths” that he “would not even use” to “clean [his] scooter” [1]. The lack of proper education and access to sanitary products is not only a major health concern for many women in Southeast Asia, but it is also relevant to health and hygiene issues on the global scale.

The Unspoken problem PictureResearchers are conducting numerous studies to examine the link between women’s education and unsafe menstrual practices in order to find an effective solution to the problem. Without a doubt, this issue is deeply rooted in a lack of awareness and education, but with the advent of water, hygiene, and sanitation (WASH) groups, the deeper connection between this issue and clean water has come to international attention. In India alone, it has been reported that 28% of students do not attend school during menstruation due to a lack of proper facilities, such as single sex bathrooms and sanitary napkin disposal areas. 41% of students in Nepal said lack of privacy for cleaning and washing was the main reason for their absences from school [2]. The shortage of clean water and proper bathrooms in rural areas discourages women and girls from changing their cloths frequently forcing them to wash and dry their cloths in dark areas where bacteria is common [3]. This issue is closely linked with the absence of clean water in a way that many people may not initially realize, but it is essential to take all of these issues into account when trying to find a solution.

The issue of menstrual hygiene has been severely neglected, most likely due to the strong cultural taboos surrounding menstruation, but it is time for this unspoken problem to be discussed publicly. Many WASH groups are beginning to see that this is a three-pronged issue that includes women’s education, health, and access to clean water, all of which are already internationally recognized problems. By broadening the discussion and recognizing the interconnectedness of  all three of these topics, health professionals and WASH groups can bring greater awareness to the unspoken problem of menstrual hygiene in Southeast Asia.


  1. Venema, Vibeke. “The Indian sanitary pad revolutionary.” BBC News, March 3, 2014.
  2. WaterAid. Menstrual hygiene in South Asia. April 10, 14.
  3. Jalali, Rita. “Coping with Menstrual Hygiene in Rural India.” Presentation at American University, Washington, DC, March 19, 2014.
    Image Credit: “A hygiene promoter talks to a women’s group about menstrual hygiene in Uttar Pradesh India.” Water Hub. <

Caroline Kim is a sophomore at Georgetown University majoring in Science, Technology, and International Affairs with a concentration in Global Health.  Follow The Triple Helix Online on Twitter and join us on Facebook.