Want to have an uninhibited talk about menstruation? Try the “Hello Saathi” helpline, a game-changing scheme from the menstrual health group Uninhibited helping 150,000 people in less than two years, as two of its practitioners report.
Surekha Hamre walks five to eight kilometres a day to reach the most distant Adivasi settlements, often crossing streams and hills on foot.
She is on a mission.
She wants to talk to girls and women about menstruation – their curiosities and challenges – without them feeling ashamed or judged.
“If I talk to women with love and care, women open up about issues they can’t even share with their families. Some women cry while sharing stories of recurring problems around white discharge, infections, pregnancy and period pain that they’ve been dealing with for years,” said Hamre.
Hamre is one of the many community champions delivering last-mile help and care for our menstrual health organisation, Uninhibited, as part of the “Hello Saathi” helpline service.
Hello Saathi provides information and medical guidance to girls and women about all aspects of menstrual health and sexual reproduction. It is primarily a telemedicine helpline providing necessary information and medical guidance.
There are 355 million menstruating women and girls in India – but most still struggle to live with dignity because of the belief that menstrual blood is “impure and dirty.”
This menstrual stigma prevents women and girls from accessing information, healthcare and sanitary products. Never mind it means many live with shame and suppression that only widens health and gender inequity gaps.
These problems only intensified during the lockdown.
A whopping 93% of India’s 243 million adolescent girls miss school each month during their cycle because they find it difficult to manage their periods at school, according to a 2019 study from the Journal of Global Health.
How much school do they miss?
Six days a month on average, according to Spot On!, a study conducted by the Dasra that supports non-profit organisations.
What’s worse is that this leads to almost 23% of girls dropping out of school when they reach puberty. This in turn undermines their potential as individuals and future workers. 200 million women and girls are unaware of safe menstrual practices, increasing the risk of preventable infections.
Girls often turn to their mothers for information and support, but 70% of mothers consider menstruation “dirty,” further perpetuating taboos. Menstrual stigma has serious consequences on women’s education, workforce participation and right to dignity.
34-year-old Sakshi, from Maharashtra’s predominantly Adivasi district of Palghar, ignored crippling period pain for several years as the only doctor in the closest primary health centre was a man.
Sakshi’s story is not unique. This stigma means millions of girls and women de-prioritise their own menstrual, sexual and reproductive health, escalating the risk of related health challenges.
COVID-19 and the lockdown intensified this public health challenge.
“The pandemic curtailed menstruators’ mobility even further. In our research, we found that women from marginalised communities postponed accessing healthcare. This increased their risk of associated health disorders and medical expenses,” said Dilip Pattubala, founder of Uninhibited.
Based on their grassroots work, Uninhibited developed Hello Saathi – India’s only free telemedicine support for menstrual, sexual and reproductive health.
“We launched Hello Saathi helpline to bring quality health care for menstruators at zero cost. All you need is one rupee balance in your phone to call 8047104234 and the desire to take care of yourself.”
A user can call Hello Saathi without depending on a male family member. The menstruator does not have to go to the hospital or miss out on work and wages, nor be highly educated to understand the information.
The helpline offers 12/7 remote access to menstrual health information, counsel for self-care and low-cost remedies through trained agents, tele-medicine consultations by accredited gynaecologists, general physicians, sexologists and counsellors, and updates schemes around menstrual, sexual and reproductive health in their respective states.
The helpline’s team is from marginalised communities to bridge the gap in languages and help understand hyper-local contexts. The information is available in Hindi, Marathi, Tamil and Kannada.
Hello Saathi’s remotely accessible telemedicine model has overcome steep challenges to reach the most marginalised. With limited access to phones and healthcare, Hello Saathi’s team of on-ground workers, fondly referred to as ‘community champions’ reach out to rural women.
Every day, a community champion goes door to door in some of India’s most underdeveloped villages in Madhya Pradesh, Maharashtra, Karnataka and Bihar to connect users by offering their phones and translating messages to local dialects.
Once a user calls the helpline they’re connected to the agents of Hello Saathi helpline, known as swasthya saathis. They’re trained to be non-judgemental, maintain confidentiality and to use minimum medical jargon.
Users who require medical attention are connected to doctors, who in turn, provide telemedicine consultations, e-prescriptions and follow-ups.
If an issue requires further diagnosis, the helpline also recommends the nearest primary or smaller health centres, ensuring that the user continues to prioritise his or her own self-care at zero or low cost.
Since its launch in July 2020, the Hello Saathi helpline has helped over 150,000 vulnerable women, men and adolescents.
It has helped users learn about natural bodily processes, hygiene and common infections, among other topics.
The most prevalent concerns of marginalised women – regardless of what region they come from – are premenstrual syndrome, painful periods, white discharge and irregular periods.
In 2021 Uninhibited also launched Hello Saathi in Hindi for non-menstruators. Silence and isolation around men’s sexual and reproductive health stems from an intense cultural pressure of performative masculinity and deep shame around not being a ‘complete man’.
Male community champions go door to door, encouraging men to open up around their sexual health queries or concerns. The helpline has received almost 3,000 calls from rural Indian men, commonly battling with erectile dysfunction, premature ejaculation, insecurity about penis sizes and sexually transmitted infections.
Apart from their own sexual health, men also call the helpline to be informed about menstruation. Take for example, Piyush, a father from rural Bihar, who called the helpline to support his 17-year-old daughter who was struggling with irregular periods. Piyush was happy that his daughter could call a reliable system at no cost.
The Hello Saathi team, along with technology partner Strauss Healthcare, is working on taking the helpline to other marginalised communities who face severe stigma.
In collaboration with community-based organisations, like Saheli Sangh and Swathi Mahila Sangh, Hello Saathi is now accessed by sex workers too. In the coming months, it will expand to service trans and queer persons.
While Hello Saathi was launched in response to the pandemic, we have validated its immense potential to provide quality menstrual, sexual and reproductive healthcare and education to marginalised communities. What this means for adolescent girls going to school, and their access to equal opportunities later in life – the scale of impact is unimaginable.
Ultimately, Hello Saathi envisions a world where menstruators take control of their own health. It is one small, but sincere step to remove gatekeeping of geographical and socio-cultural discriminatory barriers for equitable access to quality universal health care, especially for the most marginalised.
The lead image at the top of this page shows a woman checking the Hello Saathi helpline (Photo courtesy Uninhibited)
Rucha Satoor is the Campaigns Manager, and Meenal Khare is the Chief Operating Officer, at Uninhibited, a Banglore-based organisation working on making menstruation a non-issue across India.
