CHENNAI: She is like any other active teenager. The Class XI student in a private school in the city is into sports and never misses an extracurricular activity. But despite her bubbly character, K Jaya* keeps a tab on her water intake so that she does not have to use the rest room in school. Result: she was recently diagnosed with urinary tract infection (UTI).
While the absence of rest rooms in schools forces a number of girls to drop out, the schools and colleges with such facilities fail to maintain them properly. So many girls and women refrain from using them. Doctors warn that this could lead to a number of other health issues among young girls and women.
“The thought of using that rest room is enough to keep me off water for hours,” said Jaya. “I had even fainted on the playground once because I had not taken enough water. But when I visited the doctor, she told me that no matter what, I should drink enough water. So I am slowly changing my ways. But it does not change the fact that the bathroom is filthy!”
“Using bathrooms that are not clean does increase the risk of picking up the UTI,” said N Hyndavi, a gynaecologist in the city. “But even if girls do not pass urine for long, it can lead to the UTI. So I would suggest that girls pass urine rather than retain it. Menstrual hygiene is of utmost importance. Girls should change pads every three or four hours as the sanitary napkins available in the market are not of the best quality,” she said.
According to a study published in 2015 in the Annals of Medical and Health Sciences Research journal, the negative perceptions of public and staff toilets are well-spread among students. Girls are fearful of “catching germs from the toilet seat,” leading to them not using rest rooms at all.
Various other studies suggest that there is a strong association between the UTI and improper perineal washing technique, use of unsanitary pads during menstruation, malnutrition, vaginal discharge and pinworm infestation. “I cannot get myself to use the bathroom in college,” said A Rekha, *a first-year student of a women’s college in the city. “It is so dirty and smells. I sip a litre of water for the five hours that I am in college and then go home and use toilet. Since I live close by, it is convenient,” she said.
However, for those who live far away from the college, they have no option but to use the rest room. “I have to use the rest room because it takes me two hours to reach home,” said S Kumari,* a second-year student of another private college. “It is not something I look forward to because it is so poorly maintained.”
School and college officials felt that maintenance was done properly, but the students would still not use the rest rooms properly. “We have someone who cleans the bathroom every day,” said a teacher in a private school. “But it is the students who make a mess of the rest rooms. They do not flush, they do not dispose of sanitary napkins properly and make a mess.”
Menstruation may be a buzzword with the release of the movie Padman that saw several A-listers of the film fraternity posing for photographs holding sanitary napkins as a way to eliminate the stigma associated with it. While stigma is one aspect, it is essential to look into how the existing resources can be used effectively to improve menstrual hygiene and overall health and sanitation conditions of young women.
*Names changed on request
Risk factors
According to a study published in 2015 in the Annals of Medical and Health Sciences Research journal, public toilets are usually unhygienic and hence in response to the lack of hygienic toilet provision, girls are likely to ‘hold on’ resulting in urine (and pathogen) retention, leading to UTI
Waiting for a long time to urinate can cause the bladder muscle to stretch too much that not all the urine is pushed out
Most schoolgirls do not drink water adequately at school, increasing UTI risk
Women vulnerable
Urinary tract infection (UTI) is a common bacterial infection known to affect the different parts of the urinary tract and is found in both males and females. Despite the fact that both genders are susceptible to infection, women are mostly vulnerable due to their anatomy and reproductive physiology