We need to talk about periods: why is menstruation still holding girls back?
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Version 0 of 1. Girls in Kenya miss an average of 4.9 days of school each month because of their periods. In fact, the United Nations Children’s Fund says one in 10 African girls skip school during menstruation. Some drop out entirely because they lack access to sanitary products. 83% of girls in Burkina Faso and 77% in Niger have no place to change their sanitary menstrual materials at school. Similar issues affect girls in India, Cambodia and Iran. In WaterAid’s report on menstruation, Menstrual Hygiene Matters, a woman from Tanzania about her first period. She remembered, “I didn’t know what was happening or what to do to manage menstruation. I used cotton wool, pages from an exercise book, leaves from trees. I suffered much embarrassment at school because I leaked and stained my uniform.” It’s not just girls’ education that suffers during menstruation, but overall health. For instance, 70% of all reproductive diseases in India are caused by poor menstrual hygiene – it can also affect maternal mortality. In urban India, 43%-88% of girls use reusable cloth during menstruation, yet they are often washed without soap or clean water. Moreover, girls also suffer from social exclusion due to inaccurately held social beliefs about menstruation. Helen Walker of Afripads, a social business in Uganda that manufactures and sells cost-effective reusable sanitary pads, says, “menstruating women and girls are wrongly considered to be ‘contaminated, dirty and impure’. Girls suffer stigma.” Such stigma can be found in dozens of cultures across the globe and in different eras (the Roman author Pliny thought menstruating women had the power to turn wine sour), and they limit access to hygiene, community and family time. There is evidence that in some developing countries, girls are not allowed to access water fountains because of wrongly held beliefs about menstruation. Until 2003, Nepali communities forced menstruating women and girls to engage in chhaupadi a practice that forces women and girls to sleep in separate huts or sheds (and subjects them to other harsh restrictions). The practice is now illegal but it is still observed in many rural areas. Today is the second Menstrual Hygiene Day, founded to “create a world in which every woman and girl can manage her menstruation in a hygienic way – wherever she is – in privacy, safety and with dignity”. The day aims both to end the silence around menstruation and highlight positive solutions for managing periods. So what are NGOs doing to address this global challenge? Nancy Muller, senior programme officer at international health NGO Path, who works on designing solutions to good menstrual hygiene, gives one example of a recent initiative. “We were trying to determine whether we could turn agricultural waste – bananas, rice and so on – into an absorbent pulp, which women and girls could then use to make their own pads. But we’ve moved away from that now: girls go to school for long days, so the pads need to be adaptable to different absorbent materials.” For another initiative, Path gave women and girls disposable cameras to take pictures of their sanitation systems. “We wanted them to record their relationships with menstrual hygiene,” says Muller. Afripads provides girls in Uganda with washable sanitary pads. Helen Walker says these are preferable to disposable pads, because they “come close to what girls and women in Uganda are already used to”. Reusable pads are also more suitable for women and girls in refugee camps: “Since our pads last for at least 12 months, [aid workers] don’t need to distribute them as regularly as they would need to do with disposable pads. Plus you don’t have the issue of disposal. Now you have latrines at refugee camps filling up rapidly because girls and women throw their pads in the latrines.” People prefer not to think about it or talk about it ... it’s a challenge to secure funding One problem facing NGOs in this sector is cost. Many sanitary products are simply too expensive for women and girls to buy, so they must rely on aid. But solutions to this problem are being developed. Arunachalam Muruganantham discovered his wife could not afford to maintain good menstrual hygiene and set about designing a machine to help women manufacture their own low-cost sanitary products. Since then, he has supplied machines to 1,300 villages in 23 Indian states. He told the BBC that his sanitary pads are “by the women, for the women, and to the women”. But most NGOs agree the main obstacle to securing good menstrual hygiene for girls is a culture of silence around periods. Nancy Muller says, “people prefer not to think about it or talk about it. It’s a challenge to secure funding because menstruation is not seen as a critical or life-threatening issue.” Helen Walker agrees, “we need to raise more awareness that this is a very important issue, affecting so many girls and women in so many ways.” There is still squeamishness around menstruation that affects most women across the world. This creates a twofold challenge for organisations wishing to improve menstrual hygiene: on one hand, it is hard to convince partners in developed countries to talk about supporting menstrual hygiene initiatives. On the other, it is difficult to convince women and girls in developing countries to take up support because of the stigma of coming forward. Nevertheless, those working in the sector remain sanguine. “It’s an amazing opportunity to reach girls at a really formative time in their lives,” says Muller. “Menstruation is a critical gender issue. We’d love to have conversations with boys about girls, puberty and gender too.” Her colleague Laura Wedeen, a senior policy adviser in the reproductive health division, agrees: “Menstrual hygiene is a critical entry point for talking about sexual health more generally.” And though Wedeen concedes menstrual hygiene is not a well-developed element of sex education globally, she says: “I am very optimistic that we will get there. We just have to have these conversations.” Join our community of development professionals and humanitarians. Follow @GuardianGDP on Twitter. |