Breaking the Silence: Menstrual Challenges and MHM
The Issue
Period poverty is described as a lack of knowledge about menstruation, and the inability to access menstrual hygiene products (MHPs) or WASH facilities. It’s greatly detrimental to people who menstruate as menstrual taboos are firmly rooted within society, like the perception that menstrual blood is both polluted and polluting.
Evidence of using menstrual products is hidden in fear and shame, by drying reusable cloths in dark, damp and unhygienic places, and staying up late or waking up early to clean them. Used sanitary products that are not properly buried, can curse people with infertility. Described by Houppert (1999) as a ‘culture of concealment’, those who are menstruating are expected to maintain their menstrual practices as invisible and silent.
Because of this, one in ten students in sub-Saharan Africa repeatedly miss school during their period. The shame and fear of leaking blood whilst using alternative, and often unhygienic sanitary items, such as rags, leaves and mud, hinders school attendance. For example, a study by Boosey et al found that two-thirds of students in rural Uganda miss school at least once a month due to menstruation.
In some extreme cases, girls have to have sex in return for money to buy pads, which jeopardizes their lives, dignity, and health and risks unwanted pregnancies or contracting sexually transmitted diseases. Furthermore, because of the negative stigma attached to abortions, teenagers are more likely to carry out unsafe abortions by drinking 'concoctions.'. A natural bodily process should never stand in the way of education. Similarly, education should not be restricted to those who can afford proper sanitary products. Period poverty harms menstruators lives and their futures and is one of the key issues to solve to attain better gender equality.
I would like to point out that menstruation also encompasses transgender, genderqueer, and intersex individuals. Although I am aware that the menstrual hygiene management (MHM) movement in Africa assumes that only girls and women menstruate, I adopt a gender-inclusive paradigm via 'people who menstruate' or 'menstruators' where possible.
What can be done? The Solutions
Hardware Interventions
Improving WASH facilities and access to affordable and reusable MHPs are essential to target MHM. The term ‘menstrual equality’, coined by activist Weiss-Wolf (2017), is used to refer to "laws and policies that ensure menstrual products are safe, affordable, and available for those who need them".
The use of menstrual cups has proven to be a sustainable, affordable and cost-effective solution in the eradication of period poverty. Organicup partners with local NGOs, such as Freedom4Girls, to distribute menstrual cups across countries such as Ghana, Namibia and Kenya. Since the cup can be left in for 12 hours at a time, there is no longer the burden caused by the lack of sanitary bins or inadequate WASH facilities at school.
Similarly, ActionAid taught women in Namalusa Village, Malawi to make their own reusable sanitary pads, by providing sewing machines and training. Over 6000 sanitary pads were made and distributed to 600 people who menstruate. Women have also been able to use their skills to sell pads on the market, increasing their income, alleviating period poverty, and restoring girls’ dignity. AFRIpads has also distributed reusable pads to 800 teenage mothers in response to the alarming rise in sex for pads in Kasese District, Western Uganda.
Figure 1: Ruth in Malawi making reusable sanitary pads.
Figure 2: Distribution of AFRIpads taking place in Uganda.
Re-education
Education is key to breaking down taboos, and creating an open space where women feel comfortable enough to express their needs are essential, especially where stigma surrounds the topic. AFRIpads have incorporated MHM within school curriculums to equip girls with knowledge before menarche. Improving understanding can really boost school attendance and allow girls to effectively manage menstruation. It is vital to also include men in conversations so that they understand women’s specific needs. A study by Scott et al., (2009), found that the provision of MHPs paired with menstrual education resulted in a 50% reduction in girls' school absences in Ghana.
Evidently, community support is key throughout all of any student's education, expressly with private matters such as menstruation. Better education and understanding, especially for males in the community, is essential to erase the negative stigmas surrounding menstruation and other issues such as abortions. When young girls have access to reusable sanitary products, information about their menstrual health, and no longer feel shame whilst menstruating, they have the freedom to finally live a normal and healthy life.
Hi Greta! I really liked how you've spoken about this and how you've logically structured this post! I especially like how you've included a gender-inclusive paradigm as it is so important to consider everyone that is effected by this, to be able to make real change. While MHM programmes typically target women who menstruate, have you heard of any gender inclusive initiatives?
ReplyDeleteHi Chloe, thank you for your comment! In general, I have found it challenging to find clear-cut gender-inclusive MHM initiatives in Africa. Transgender and non-binary menstruators are recognised in conversations by AFRIpads, Water Aid..however I believe that gender-inclusive initiatives are falling behind. For example, upon further research I discovered there is a lack of gender-neutral toilets in Zimbabwe, which can pose challenges for members in the trans community, as male cubicles may lack sanitary bins. Most importantly, I found out that MHM programmes do not want to draw attention to a person's gender identity, as this can put them at greater risk of discrimination and violence. A great starting point would be to include all individuals in the classroom in MHM conversations, and normalise fluid gender identities.
DeleteI found this post very interesting! Although it is distressing to read about the plights that these people who menstruate are forced into due to what should be regarded as a normal, biological process, I'm heartened by the example of AFRIpads that goes beyond provision of pads to also tackle education, which I feel is extremely important in addressing the root of these 'cultures of shame' that surround menstruation.
ReplyDeleteThanks for your comment! It also brings me great joy to hear that organisations like AFRIpads are going beyond simply providing pads. This is exactly what is needed when addressing these 'cultures of shame', like you mentioned. I'm excited to learn about more organisations which are doing similar initiatives.
DeleteHi Greta! This was a very insightful post on MHM and MHP. I think the use of menstrual cups is incredibly progressive and a good step towards equality, sustainability and comfort for women who menstruate. However, there are often cultural taboos surrounding MHP, especially menstrual cups and tampons, as these products are associated with promiscuity. I think therefore, there definitely is a need for re-education to remove the stigma surrounding MHP and MHM.
ReplyDeleteHi Arzoo, thank you for commenting. You raise a very interesting point that products such as tampons are associated with promiscuity, and thus this is another barrier which needs to be addressed within MHM.
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