Break the taboo of menstruation

Lazarus Sauti

Girls in African countries miss four to five days of school each month because of their periods.

The United Nations Children’s Fund, a UN Programme that provides long-term humanitarian and developmental assistance to children and mothers in developing countries, says: “One in 10 African girls skip school during menstruation.

“Some drop out entirely because they lack access to sanitary products.

“For instance, 83 per cent of girls in Burkina Faso and 77 per cent in Niger have no place to change their sanitary menstrual materials at schools.”

Buhlebenkosi Moyo, information and communications officer for Zimbabwe Women’s Resource Centre Network, an organisation that promotes women’s rights says it is not just girls’ education that suffers during menstruation, but overall health.

“Since most girls in African countries do not have access to proper sanitary pads, they end up improvising with pages from exercise books, cow dung, newspapers, tree leaves, reusable cloth often washed without soap and rugs or feathers.

“Using these devices instead of proper hygienic pads is not only ineffective and humiliating, but causes serious health risks such as rash, infections and genital sores,” she noted.

Moyo also said that some girls end up engaging in transactional sex to raise money to buy sanitary towels, putting themselves at the risk of Human Immuno-deficiency Virus (HIV) as well as Sexually Transmitted Infections (STIs).

To make matters worse, girls in most, if not all, African nations 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, concurs: “Menstruating women and girls are wrongly considered to be ‘contaminated, dirty and impure’. Therefore, the suffer stigmatisation.

“Such stigmatisation 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.”

Ellie Mae O’Hagan, a writer on activism and feminism, added that there is evidence that in some developing countries, girls are not allowed to access water fountains because of wrongly held beliefs about menstruation.

“This means the topic of menstruation is cloaked in secrecy and negativity as it is still associated with cultural and religious taboos,” said O’Hagan.

Dr Dani Barrington, Water, Sanitation and Hygiene (WASH) specialist, therefore, said breaking down taboos so that people can discuss about menstruation is the way to go as it “has positive impacts beyond a woman’s reproductive health.”

O’Hagan explains: “Menstruation is a critical gender issue. We need to talk about periods: why is menstruation still holding girls back?”

Walker also said that “we need to raise more awareness that this is a very important issue, affecting so many girls and women in so many ways.”

To break the taboo of menstruation in Africa, asserts Moyo, female hygiene should be at the top of each government’s list of priorities.

“Improving girls’ access to proper menstruation products can lead to improved education, improved health as well as improved overall wellbeing of girls and women. Therefore, female hygiene should be at the top of each government’s list of priorities,” she said.

Moyo added that girls should be encouraged to talk and discuss this biological phenomenon in an informed and positive manner to prepare them emotionally and physically for the onset of menstruation and their monthly menstrual periods thereafter.

Education consultant, Chella Quint, believes breaking the taboo of menstruation starts with broaching the subject.

“The best place to do so is in schools, where the topic can be incorporated into hygiene and sexual education.

“This requires sound knowledge (and in some cases also the courage of teachers) on how to use sanitary items and related issues,” she said.

In most countries, sanitary products are too expensive for women and girls to buy; hence, the need for affordable sanitary products.

“Menstruation hygiene management is an urgent priority among women and girls, and essential products need to be made affordable to the poorest, most marginalised as well as most remote girls and women.

“Governments and nongovernmental organisations simply need to join hands to ensure that the appropriate services are made available, accessible over and above affordable,” explained Moyo.

Laura Wedeen, a policy adviser in the field of reproductive health, agrees: “Menstrual hygiene is a critical entry point for talking about sexual health more generally.

“Therefore, to effectively break the silence on the matter, stakeholders in health, water and sanitation sectors must engender the definition of acceptable water, sanitation and hygiene services to include menstrual hygiene management.”

Wedeen, who is also a specialist in health systems added: “To create a world in which girls and women can manage their menstruation in a hygienic way – wherever they are – in privacy, safety and with dignity, stakeholders must define menstrual hygiene management holistically as the articulation, awareness, information and confidence to manage menstruation with safety and dignity using safe hygienic materials together with, as the adequate water and agents and spaces for washing and bathing as well as the disposal with privacy and dignity.”

Public as well as private entities can also break the menstruation taboo simply by providing single-sex restrooms with water, soap and waste disposal facilities as well as having a supply of sanitary pads available to employees.

They can also support governments through establishing and implementing strategies and policies that acknowledge girls and women’s needs during menstruation.

Menstruation, without doubt, is a biological process just like defecation or urination.

Maintaining hygiene during menses is, therefore, important for girls and women’s well-being, mobility, as well as dignity.

Accordingly, African countries must bring menstrual hygiene management out of the closet – putting it on everyone’s lips – so that girls and women can enjoy their basic human rights.

However, for this to happen at scale, menstrual hygiene management as a theme must resonate across health, education, adolescent and youth development and life skills programmes and of course water, sanitation along with hygiene.

It must also be resourced and monitored across all these sectors.