Question 1

 

Why is a “ready” investigative kit so important and valuable to accident preparedness?

 

Your response must be at least 75 words in length.

 

Question 2

 

There are several interviewing tips; which, in your opinion, is the most important?

 

Your response must be at least 75 words in length.

 

Question 3

 

One step in the accident investigation process is preserving the scene of the accident. How do you preserve an accident scene?

 

Your response must be at least 75 words in length.

 

Question 4

Consider the following accident scenario:

 

Three workers were assigned to replace a water valve located in an underground concrete vault. After removing the manhole cover, worker #1 climbed down the ladder into the vault. Worker #1 collapsed and became unconscious within seconds of reaching the bottom. Worker #2 went down the ladder to rescue worker #1 but was quickly overcome by the lack of oxygen. Both workers died at the bottom of the vault. Worker #3 stayed outside the vault and called for emergency response after worker #2 collapsed.

 

Develop a list of five questions you would ask a witness to the accident. Explain why you chose each question.

 

Your response must be at least 200 words in length.

 

Question 5

 

Consider the following accident scenario:

 

Two workers were assigned to replace a water valve located in an underground concrete vault. After removing the manhole cover, worker #1 climbed down the ladder into the vault. Worker #1 collapsed and became unconscious within seconds of reaching the bottom. Worker #2 went down the ladder to rescue worker #1 but was quickly overcome by the lack of oxygen. Both workers died at the bottom of the vault. Worker #3 stayed outside the vault and called for emergency response after worker #2 collapsed.

 

Applying the “four P” evidence concept (physical, paper, people, and photographic), discuss the evidence related to the accident that you would want to collect. Explain the reasons for your choices.

 

Your response must be at least 500 words in length.

 

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MATH INVOLVED

Instructions: Municipalities make every effort to best use resources and technologies in their management of non-hazardous wastes.  It can take 5 five to 10 ten years to construct and to permit a new landfill site.  It is to everyone advantage to use the space in a manner that the right types of waste are disposed of and that compaction levels of the waste are high. This is accomplished when easily degradable wastes are composted, when particle sizes are uniform and every opportunity is made to remove recyclable content.  The technologies in this chapter are examples of the available tools that engineers use to accomplish these objectives, and this assignment will allow you to further explore this topic.

Answer the questions directly on this document. When you are finished, select “Save As,” and save the document using this format: Student ID_Unit# (ex. 1234567_UnitI). Upload this document to BlackBoard as a .doc, docx, or .rtf file. The specified word count is given for each question. At a minimum, you must use your textbook as a resource for these questions. Other sources may be used as needed. All material from outside sources (including your textbook) must be cited and referenced in APA format. Please include a reference list after each question.

1) Consider the residential waste components (1st column in Table 2-6 on page p. 53 in the textbook) and answer the following questions: (Your total response for all parts of this question should be at least 300 words.)

a. What components of mixed municipal solid waste (MSW) are rejected in storage and sent via truck to the landfill?

b. What components pass through the trommel screen? What components are screened out through the trommel screen?

c. What components that passed through the trommel screen are captured in the magnetic separator? What components are sent to the flattener?

d. What components are removed in the sorting step? See Figure 5-38 (on p.age 225) for additional details.

e. What materials pass through the sorting step and go into the Hammermill shredding operation?

f. What materials are separated in the air classifier operation?

g. How do these processes demonstrate best practices of solid waste management?

2) A local municipality has plans to annex a suburb community of 80,000 people. Neither the municipality nor the community has a curbside recyclinge program as they both put all of their refuse into the trash bin for collection. The municipality hand sorts the refuse and recognizes that they it will need to hire new employees and establish a budget to hand sort a larger amount of waste. Assume the following: (1) hand sorting is done 8 eight hours per day; 5 five days per week and (2) employees are paid $21/hr, and that includes allotted benefits. (For Parts A and B of this question, show all of your work.)

a. How many new full-time employees will need to be hired?

b. What additional budget should be planned to cover the cost of the new employees?

c. What do you think would happen if these additional employees were not hired? Describe how this would affect the municipality and why it is best to hire these additional employees. (Your response for Part C of this question should be at least 100 words).

3) Your facility has purchased an air classification system with a fan that can generate an air flow rate in the system that goes up to 15 ft/sec. Your hammermill Hammermill shredder is able to provide a wastestream containing plastic that passes a 2 cm grate. The density of the plastic is 0.955 g/cm. The facility does not have the means to conduct a drop test, but as the site consultant, they want you to make your best estimate about whether the unit will separate out the plastic from the shredded waste. Show all work before you give your estimate. (Your total response for all parts of this question should be at least 200 words.)

4) Describe how the terms coding and switching are used in relation to MSW. Show how these terms apply to picking and hand- sorting operations, and describe best practices for each. (Your total response for all parts of this question should be at least 200 words.)

5) a. Describe how these separation technologies have evolved over the last decade. Include the factors that are driving the development and commercialization of these operations to be used in treating municipal solid waste.

b. In your opinion, which of the separation technologies in use today would qualify to be classified as best in class? State your criteria for what qualifies as best in class and state your reasons for your selection. (Your total response for all parts of this question should be at least 200 words.)

 

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#36070 Topic: SCI 207 Our Dependence upon the Environment Number of Pages: 1 (Double Spaced) Number of sources: 3 Writing Style: APA Type of document: Essay Academic Level:Undergraduate Category: Environmental Issues Language Style: English (U.S.) Order Instructions: ATTACHED Week 3 – Assignment 2 Sustainable Living Guide Contributions, Part 3 of 4: Sustaining Our Water Resources [WLO: 3] [CLOs: 2, 3, 4, 5, 6] Prior to beginning work on this assignment, please review Chapter 5: Water, in Turk and Bensel’s Contemporary Environmental Issues textbook (2014). The purpose of this assignment is twofold: first, to enable you to explore a term (concept, technique, place, etc.) related to this week’s theme of sustaining our water resources; second, to provide your third contribution to a collective project, the Class Sustainable Living Guide. Your work this week, and in the weeks that follow, will be gathered (along with that of your peers) into a master document you will receive a few days after the end of the course. The document will provide everyone with a variety of ideas for how we can all live more sustainably in our homes and communities. To complete this assignment, You will first need to select a term from the list of choices in the Week 3 – Term Selection Forum. Reply to the forum with the term that you would like to research. Do not select a term that a classmate has already chosen. No two students will be researching the same topic. Next, download the Week 3 Assignment TemplatePreview the document and replace the guiding text with your own words based upon your online research. Please do not include a cover page. All references, however, should be cited in your work and listed at the end, following APA format expectations. In the template, you will Define the term thoroughly. Clearly relate the term to the week’s theme. Explain how the term affects living things and the physical world. Relate the term to the challenge of achieving environmental sustainability. Justify if the term represents an obstacle to that goal, or perhaps a technique or technology that might promote it. Suggest two specific actions we can take to promote sustainability in relationship to this term. Provide detailed examples to support your ideas. The Week 3 assignment Must be three paragraphs in length (not including title, any quoted material, and references) and formatted according to APA style as outlined in the Ashford Writing Center’s APA Style (Links to an external site.)Links to an external site. resource. Must cite the following three sources at minimum: The class textbook, or provide a URL formatted according to APA standards to the resource in case your term was not in the text. A scholarly source. A credible source. To aid you in your research, and particularly in locating scholarly sources via the Ashford Library or using Google Scholar, please review the following Ashford videos and tutorials: Scholarly and Popular Resources (Links to an external site.)Links to an external site. How to Use FindIt@AU (Links to an external site.)Links to an external site. Database Search Tips (Links to an external site.)Links to an external site. Research, Keywords, and Databases: An Overview (Links to an external site.)Links to an external site. Accessing Full Text and Citation in Google Scholar (Links to an external site.)Links to an external site. Must utilize academic voice. See the Academic Voice (Links to an external site.)Links to an external site. resource for additional guidance. The Scholarly, Peer Reviewed, and Other Credible Sources (Links to an external site.)Links to an external site. table offers additional guidance on appropriate source types. If you have questions about whether a specific source is appropriate for this assignment, please contact your instructor. Your instructor has the final say about the appropriateness of a specific source for a particular assignment. Must document any information used from sources in APA style as outlined in the Ashford Writing Center’s Citing Within Your Paper guide (Links to an external site.)Links to an external site.. (Links to an external site.)Links to an external site.Must include a separate references list that is formatted according to APA style as outlined in the Ashford Writing Center. See the Formatting Your References List (Links to an external site.)Links to an external site. resource in the Ashford Writing Center for specifications. I choose the (PHARMACEUTICALS IN THE WATER SUPPLY) as research; In recent years there has been mounting concern about the presence of chemicals from pharmaceuticals and personal care products, such as cosmetics, in the nation’s streams and rivers. There is no question that these chemicals are present in the nation’s waterways. The USGS conducted the first major investigation in 2002 and found, on average, seven chemical compounds in the streams they surveyed. Tom Varco – Own work, CC Pharmaceuticals in our water supply. Our bodies release them when we urinate or flush old drugs down the toilet. In 2008, the Associated Press found an array of pharmaceuticals, from painkillers to antibiotics to mood stabilizers, in the drinking water of 24 major metropolitan water suppliers. Further, 34 of the 62 water suppliers contacted by the AP couldn’t provide results as they had never tested for pharmaceutical compounds. This problem won’t go away anytime soon. American drug consumption has increased rapidly in recent years, and Americans fill 3.7 billion prescriptions every year. The chemicals in these drugs end up in waterways after being excreted from the body or when unused medication is flushed down the toilet. Most municipal sewage treatment facilities do not remove the pharmaceutical compounds from your water, and major upgrades would be required to do so. The federal government hasn’t stepped in to require testing or set safety limits, leaving many questions unanswered. HOW DOES THIS IMPACT MY HEALTH? Pharmaceutical compounds are found at much lower concentrations in rivers and streams than the normally prescribed doses, but there is concern that chronic exposure to numerous compounds could cause serious health problems and that compounds can act synergistically to cause adverse health effects. Of particular concern is the presence of endocrine disruptors, which come from a variety of agricultural, industrial, and domestic sources, including pharmaceuticals. These compounds disrupt internal biological processes such as development, growth, and reproduction that are regulated by hormones. Whether these compounds are present in sufficient levels in our waterways to affect human health remains a topic of serious concern and ongoing research. SNAPSHOT: THE POTOMAC RIVER Joseph Bylund Cascade into the Potomac River The fish in the Potomac River may look normal at first glance, but many of the Potomac’s male bass are producing eggs, and similar “intersex” fish are being found in rivers across the country. While scientists have yet to pinpoint the cause of this mutation, it’s thought that a group of compounds known as endocrine disruptors are responsible. These chemicals affect key biological processes regulated by hormones, such as growth, development and reproduction, and include common medications including birth control pills. Whatever the cause, it’s unknown what effects these compounds are having on us when we drink or swim in the same waters. Like the canary in the coal mine, the story of intersex fish may be an early warning of the effects that pharmaceuticals are having on the health of our waterways and on the people and organisms that depend on them. WHAT CAN WE DO? Use the following steps to reduce the risk of long-term human health effects of pharmaceuticals in your water supply: PROPER DRUG DISPOSAL The cheapest and easiest way to limit pharmaceutical contamination is to keep drugs from entering our waterways in the first place. Drug take back programs, public education on proper disposal, and regulations to limit large-scale medicine flushing at hospitals and nursing facilities are important first steps that can greatly reduce the amount of contaminants entering our waterways. Some states and counties have begun to experiment with take-back programs. For example, Washington State collected and disposed of over 15,000 pounds of unwanted medications during a two year pilot program. RESEARCH Additional research is needed to assess potential human health effects and identify the best methods for removing pharmaceutical compounds at treatment plants. If there is a significant long-term risk to public health, more aggressive efforts to control the problem may be needed. LONG-TERM SOLUTIONS While proper disposal can limit pharmaceutical contamination, more work on source control will ultimately be needed in addition to upgrading treatment infrastructure and reassessing our approach to use and dispose of pharmaceuticals and personal care products. [clickToTweet tweet=”Pharmaceuticals in our water supply can affect our clean water supplies as well as river wildlife.” quote=”Pharmaceuticals in our water supply can affect our clean water supplies as well as river wildlife.”] First Name* Last Name* TAKE ACTION AMERICA’S MOST ENDANGERED RIVERS® OF 2018 Tell Congress: Oppose the Trump Administration’s Anti-Environment Agenda RELATED POSTS READ MORE Philip Jordan Healthy Rivers, Resilient Communities A healthy river is a community’s first line of defense, ensuring water security and… How Stormwater Affects Your Rivers How the Clean Water Act Protects Your Rivers Conserving Clean Water. Week 3 Terms *Note: The terms marked with an asterisk in the list do not appear in the course text. Use the hyperlinked url provided as a substitute for the course text. Be sure to cite the url resource rather than the text, if you choose to use one of those terms. Terms for Week 3 Assignment aquaculture aquifer depletion Aral Sea bioaccumulation *bottom trawling *bycatch Clean Water Act Colorado River *constructed wetlands (treatment wetlands) *coral bleaching droughts eutrophication / dead zones floods *graywater reuse *Great Pacific Garbage Patch groundwater pollution *microplastics in the ocean ocean acidification Ogallala Aquifer overfishing *permeable pavement *pharmaceuticals in water supply point source pollution rainwater harvesting riparian buffers Safe Drinking Water Act *septic system Three Gorges Dam *volunteer water quality monitoring wastewater treatment Week 3 Assignment Template Sustainable Living Guide Contributions, Part Three of Four: Sustaining Our Water Resources Instructions: Using the term that you have selected from the list provided in the classroom, please complete the following template. Create a minimum of 5 to 7 well-crafted sentences per paragraph. In your response, you are expected to cite and reference, in APA format, at least two outside sources in addition to the class text. The sources must be credible (from experts in the field of study); scholarly sources (published in peer-reviewed academic journals) are strongly encouraged. Delete these instructions before submitting your work to Waypoint. Your Term: Instructions: In the first paragraph; • Thoroughly define your term. • Describe how the term relates to this week’s theme. Provide specific examples. Delete these instructions before submitting your work to Waypoint. [Enter your information here] Instructions: In the second paragraph; • Discuss how the term affects living things and the physical world. • Explain how the term relates to the challenge of achieving environmental sustainability. • Justify if the term represents an obstacle to that goal, or perhaps a technique or technology that might promote it? Again, be as specific as possible and include examples to support your explanations. [Enter your information here] Instructions: In the third paragraph; • Determine at least two specific actions that we can take in order to promote environmental sustainability in relation to this term. Be creative and concrete with your suggestions. For example, you might recommend supporting a particular organization that is active in the field of your term. • Consider actions that might be taken 1) on the individual level, in our daily lives; 2) at the community level; 3) via national and global organizations working on behalf of the environmental issues associated with your term; and/or 4) at the ballot box (though voting). [Enter your information here] After proofreading your assignment carefully, please submit a copy of your work to Waypoint.

 

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[Type here]

 

SC

 

Strategies to combat menstrual myths and protect women’s health in India

 

Scope of the problem

Up until adolescence, girls and boys in India attain roughly the same levels of education, health, and workforce participation outcomes. However, upon puberty, girls begin to diverge from boys and see increasing limitations in their social mobility and personal agency. Though there are over 355 million menstruating women in India, insufficient menstrual hygiene management is a significant barrier to women’s experiences. Access to clean facilities, menstrual products, and reproductive health resources categorize this as a health issue, but its implications spread to educational attainment, financial stability, social mobility, and individual autonomy.

 

Menstruation is still a taboo topic in many spheres of women’s lives in India. In some areas, 71% of Indian girls report not knowing about menstruation prior to their first cycle. Young women in Rajasthan report feeling shock, fear, anxiety, and guilt regarding their cycles, which emphasizes the heavy psychological toll a lack of education and awareness leads to. Financially, approximately 70% of women in India cannot afford sanitary products and 23% of young girls drop out of school when they reach puberty due to lack of clean, private toilets. In fact, 40% of government schools lack a functioning toilet, and another 40% lack a private women’s restroom. At home, millions of women are barred from entering the kitchen, interacting with family members, or praying during menstruation. Some essentially banish their young women to menstruation huts called gaokors[footnoteRef:1]. [1: https://www.theguardian.com/global-development/2015/dec/22/india-menstruation-periods-gaokor-women-isolated]

 

Origins of the taboo on menstruation

The taboo against discussing menstruation can be traced to cultural and religious roots wherein women are considered impure during their cycles, but women across the country are taking to the streets to break the silence and normalize menstruation. What strategies might be effective in reducing this taboo? Because these taboos affect health, educational and financial opportunities, and originate from culture, religion, lack of education and infrastructure, the solutions must be just as holistic. Some examples from the research are: cleaner toilets in schools, court cases supporting women’s rights, education for adolescent girls and their school teachers, and low-cost sanitary napkins[footnoteRef:2]. As I continue this research, I am interested in finding early legislation that either supports or denies menstruation resources to women. [2: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4408698/]

 

Current and possible interventions

As the amount and level of women in the Indian workforce grows, from 28.5% in 1994 to 43% in 2012[footnoteRef:3], women gain more financial independence and more of a political voice. Increasingly, organizations like the Bill and Melinda Gates Foundation, governments, donors, and private companies have taken in interest in these issues and four trends of interventions have arisen. They are: Education, Menstrual Hygiene Management (MHM) Products, Sanitation, and Policy. These interventions fall into the operational and political levels of political economy analysis. None of them fall into the technical bracket as widespread academia and technical know-how already exists on how to intervene effectively and relatively affordably. For example, a hollow outhouse of sorts can be built for only Rs. 5500, while a sanitary facility for an entire school can be added for roughly Rs. 50,000 (USD $715)[footnoteRef:4]. Thus, the implementation of these falls more into an operational context. The only area that may require technical innovation is the creation of hyper-low-cost sanitary products. [3: https://www.rand.org/blog/2014/08/womens-menstrual-hygiene-in-india-the-health-and-environmental.html] [4: http://www.thealternative.in/business/10-toilet-designs-for-rural-india/]

 

Both education and MHM policy require political will and influence which has yet to be triggered. In regions where a curriculum has been created, and the operational hurdles have been passed, states often lack the political will to implement teacher trainings or even allow NGOs to lead workshops. Conversely, provision of Menstrual Hygiene products and implementation of sanitation initiatives is more of an operational issue. Even though low-cost pads have been innovated, the taboo against them and the lack of selling points leaves women without access.

 

Building toilets is one intervention from the ones listed above that has actually seen bounds of improvement during the past decade majorly due to reasons other than women’s hygiene[footnoteRef:5]. The percentage of households with access to a toilet grew from under 40% in 2014 to 70% on average by 2017 due to Prime Minister Modi’s Clean India Mission which funds the construction of 111,100,000 toilets (USD$30 billion) in rural areas. To date, over 92 million toilets have been built and over 550 thousand villages have been ruled open defecation-free[footnoteRef:6]. An important point to note in these developments is that the frame has not been one of women’s access to sanitary toilets or education specifically, rather one of uplifting the entire nation to an international standard. The framing of these interventions is clearly an important one moving forward, and a strategy I will discuss in a later section. In the next stage of this project, I would be interested in mapping girls education statistics onto the new toilet statistics to see where the improvements correlate and where opportunities still exist. Another important note is the issue of monitoring and evaluation—there is yet to be independent verification of the numbers mentioned above[footnoteRef:7]. [5: https://brilliantmaps.com/indian-toilets/] [6: http://swachhbharatmission.gov.in/sbmcms/index.htm] [7: https://brilliantmaps.com/indian-toilets/]

Figure 1 Brilliantmaps.com

 

 

While toilets/sanitary interventions are framed as a general public health and wellness need and help MHM as a side-effect, the Education and Product spheres of intervention are indeed framed MHM issues and have become focuses of NGO and private interventions that I will discuss within the Kingdon and Health Pyramid frameworks.

 

Researchers understand what interventions are effective in reducing taboos and protecting women’s health, but what gets these solutions on the table? Where does the political will come from to build clean toilets in India’s poorest towns? How will the officials in a corrupt political environment with religiously-backed campaigns support MHM initiatives? What elements compelled India’s Supreme Court to rule in favor of women?

 

Generally, there does not appear to be a particular trend regarding which Indian states are more successful at policy interventions other than a case-by-case basis. However, gender parity is be an important proxy for menstrual hygiene access. McKinsey Global Institute categorized Mizoram, Kerala, Meghalaya, Goa, and Sikkam as the five most equitable regions while Uttar Pradesh, Bihar, and Rajasthan are considered the most unequal. In this memo, I will begin examining a couple of these regions based on public health frameworks.

 

Where is Menstrual Hygeine on the Agenda: Maharashtra & Kerala?

Using Kingdon’s stream framework, we can examine where in the agenda-setting process menstrual hygiene falls[footnoteRef:8]. Applying Kingdon’s framework precisely becomes difficult when the particular topic of menstrual hygiene has not reached the national agenda and there is significant variation from state to state and even within a single state. It becomes important then to choose a specific local case and hash it out step by step to glean insight for the national level. [8: Howlett et al Ch 4]

 

For now, I will discuss the examples of Maharashtra, considered one of the worse-off regions with over 223 menstrual huts. The ethnic groups where this is most prominent are the Gond and Madiya[footnoteRef:9]. Here, most of the women do not enjoy the practice of staying in the huts but feel they must maintain their traditions and customs. Most of these huts do not contain kitchens, clean toilets, or beds, so some actors have recognized the practice as a problem, placing menstrual hygiene in the “problem stream.” Another important part of placing menstrual hygiene in the problem stream is the presence of social media. The #periodforchange and #happytobleed campaigns grew out of public and celebrity reactions to the stigma around menstruation[footnoteRef:10]. [9: https://www.theguardian.com/global-development/2015/dec/22/india-menstruation-periods-gaokor-women-isolated] [10: https://www.bbc.com/news/world-asia-india-34900825]

 

Within the policy stream, NGOs, researchers, private actors are actively researching solutions and beginning to implement them autonomously where they can. In one village, Sitatola, the village’s Panchayat, a local self-governing body, decided to bring the gaokars closer to the village and put beds in them. A Maharashtrian organization, Lok Biradari Prakalp, has created a school to teach 350 girls about menstruation. A local NGO, Sparsh, actively evaluates and monitors the gaokors and has run 12 workshops in remote villages. One representative tellingly says, “Because it’s a sensitive topic, we try to educate them about health and hygiene without mentioning gaokor.” This comment speaks to the issue of changing the context while maintaining cultural sensitivity, which I will discuss in the next section.

 

Regarding the political stream, governments are experiencing slight pressure from organizations like the National Human Rights Commission, which instructed the Maharashtran government to end the use of gaokors. Yet, the state government as a whole has not taken any action on the matter. In fact, one of the only regions where the state has taken a stance on menstruation is Kerala. In September 2018, the Supreme Court lifted a ban that prevented women ages 10 to 50 from entering a Hindu temple in Kerala. In January 2019, when two women actually entered the temple, it triggered protests and riots throughout the region. This court case could be labeled the focusing event within the four-month “routinized political window” created when the Supreme Court is in session every year.

 

One issue with the Kingdon framework is that it is primary helpful to label events and “streams” retroactively and does not appear to yield much predictive power. For example, it will be interesting to examine whether the protests sparked because of the Supreme Court decision will becoming the focusing events or “random problem windows” through which activists will move forward on the issues of menstrual awareness. But it will be difficult to call it a trigger or focusing event until some action actually does take place. That being said, a recent documentary, Period. End of Story was published to bring light to the issue following the January protests[footnoteRef:11]. Media attention further categorizes this as a focusing event. Regarding the building of toilets as discussed earlier, the public health framing of the need for toilets may also have created a spillover problem window which brought attention to MHM issues. But again, it is hardly possible to preemptively label events as problem windows. Political windows, on the other hand, are much more useful as they are more predictable and provide avenues for policy entrepreneurs. [11: https://www.economist.com/prospero/2019/01/22/a-new-documentary-addresses-the-stigma-of-menstruation-in-india]

 

Framing is another essential component in understanding why India’s highest court decided to rule against the centuries-old custom in a country where many women are still banished to menstruation huts. The courts cited their decision as necessary to uphold the rights to equality of worship[footnoteRef:12]. In the judgement, Justice Dipak Misra said, “Patriarchy in religion cannot be permitted to trump over element of pure devotion borne out of faith and the freedom to practice and profess one’s religion.” This frame and the argument surrounding this case focused on religious freedoms rather than menstrual rights and women’s rights in general. [12: https://www.reuters.com/article/us-india-court-temple-idUSKCN1M80MK]

 

The issue of framing, for toilets, court cases, and even education in villages with menstruation huts is important in changing the context surrounding MHM in India.

 

Friedan’s Health Pyramid: changing the context for menstrual health

 

Frieden’s health impact pyramid is a useful lens through which to examine menstrual health issues in India. I’ll briefly examine interventions that fall into each level of the pyramid. At the bottom socioeconomic factors level, WASH initiatives (“sanitary interventions”) are the most effective and far-reaching. Access to clean water and sanitary facilities to maintain a hygienic environment will go a long way to providing women access to education, public areas, employment etc. that would have otherwise been inaccessible.

 

The next level of intervention, Changing the Context is more MHM-specific and requires targeted efforts. For the issue of menstrual health, changing the context means normalizing the issue of menstruation for the Indian populace and creating an environment where women have the ability to stand up for their rights and discuss their bodies. This is a tall order, but it can be broken down into practical interventions. A broad example is building private girls’ toilets in schools—an intervention that would make young girls’ default decision, going to school, both feasible and healthy during menstruation. While building toilets somewhat also falls into the socioeconomic factors level, it also applies to changing the context, specifically in schools.

 

Another effective way to change the context, which NGOs and private corporate donors are working on is building access to affordable MHM products. Currently, over 70% of Indian women cannot afford access to products like sanitary napkins. Therefore, their default decisions are to use rags to absorb blood and reuse them, often without sufficient cleaning, which is a health hazard to the women and those around them. If they were accessible, cheap and clean pads whether reusable cloth or disposable or menstrual cups where culturally acceptable, would become women’s default choices. Producing such pads cheaply and selling them in local markets in unassuming packaging even in rural areas would be a good first step.

 

Access to menstrual education and awareness for both girls in and out of school is also an important part of changing context—if girls knew at an early age how their bodies were going to change and how to practically deal with changes, the trauma and social stigmas would, by exposure within a few generations, cease. Unfortunately, government has volleyed this intervention to NGO initiatives due to a lack of political will and teacher willingness.

 

Changing the context in the most rural areas of India, where indigenous populations like the Gond and Madiya live will probably be the most challenging. Already, these groups are marginalized and lack resources, which adds another barrier. Firstly, there is little trust between these tribes and a national government they believe is trying to steal their land[footnoteRef:13]. In their situation, it will be particularly important for NGOs to work with local Panchayat and tribal leaders to come up with innovative solutions perhaps beginning with teaching women how to practically manage their periods and slowly moving toward further MHM interventions. [13: https://www.downtoearth.org.in/news/community-forest-rights/gond-tribals-madhya-pradesh-government-fight-for-4000-hectares-of-land-58397]

 

The next level, long-lasting protective interventions in for menstrual health come in the form of policy decisions like the Supreme Court case in Kerala. This is essentially a long-lasting protection of menstruating women’s rights if not their health directly. Another example would be regular access to a women’s health nurse or doctor, something rural India struggles with—only 3% of India’s doctors live and work in rural areas[footnoteRef:14]. One solution that has been proposed is a menstrual leave policy where women can leave work due to their periods. Western feminists have criticized this intervention as a way to separate women from the workforce and allow discrimination. Others say it allows women to take a break during a time that is strenuous on their bodies, similarly to how a pregnancy might be treated. Nonetheless, it provides a possible solution, which locals ought to weigh in on to make a decision. [14: https://www.bmj.com/content/351/bmj.h5195/rapid-responses]

 

Finally, in the clinical interventions and counseling and education route, all roads point to the wealthy. India certainly has the facilities to deal with clinical interventions in urban areas, but for rural Indian women, access to an OB GYN is significantly out of reach. Over time, these interventions should also become a priority.

 

Research Design

Moving forward, I would like to continue to build an overview of India’s 29 states levels of access to menstrual rights in each. A region/town with plenty of clean toilets, access to cheap sanitary napkins, open temples etc will be ranked high, while a region/town with a dearth of these elements will be ranked low.

 

I will focus on the regions with the highest reported gender parity, Mizoram, Kerala, Meghalaya, Goa, and Sikkam, to begin looking at successful interventions in those areas and see how they originated and developed. My hunch is that framing has been an essential part of creating broad interventions to support women. From all the articles I read, specifically those about the broadest interventions, menstruation was rarely if ever mentioned while general public health, international standards, or educational attainment frames were much more common.

 

I would like to reach out to some of the NGOs involved in creating interventions, like Sparsh and WASH India to access some of their reports and stories of creating a political shift. Hopefully then I’ll be able to understand what the political factors were that helped get some of these interventions on the table. Was there some sort of trigger such as a protest or death? Was it a question of funding? Did the religious community have a change of heart? One question I have not discussed in depth yet is the role of the religious communities, and how Christian, Muslim, and Hindu religious communities interact with menstrual health interventions.

 

Ultimately, I would like to examine the political process used to establish some of the effective interventions across India and figure out how they could be replicated in other regions of the country, especially when the government takes responsibility rather than passing it to NGOs. The broad question I would like to answer is “In what situations do Indian government entities (local, regional, or national) effectively intervene for women’s menstrual health and how can such interventions be replicated across the country?”

 

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