Let’s Talk About Menstruation

…putting menstrual hygiene management (MHM) on the development radar.

Menstruation is something I know very little about. As such, I decided to explore this taboo subject for a term paper in my MA Poverty and Development program at the Institute of Development Studies. I was tasked with thinking about:

Why and how is gender important in development?

For many issues, development workers may have a gender-insensitive view (i.e. treating men and women as if their experiences were the same; ignoring power dynamics) and they may get some positive results, but they will usually only go so far and miss out on making real transformation.

Take the topic of water and sanitation in schools in developing countries, which was the topic of my paper. After weeks of research, I was stunned by what I discovered.

???????????????????????????????Of the Millennium Development Goals, which have acted as the development agenda for the past 15 years, the components related to water, sanitation, and hygiene (WASH) have seen the slowest improvement. Even with the combined efforts to install latrine infrastructure at schools in developing countries, plus programs for gender inclusion and education promotion, access to education (especially for girls) remains hard to come by. Things are changing, luckily.

In recent years, menstrual hygiene management (MHM) is broadening the WASH debate beyond simply building a room with a hole in the ground. Research done by Marni Sommer of Columbia University and others at the London School of Hygiene and Tropical Medicine (LSHTM) have shown the inadequacy of how latrines were designed and implemented over the past 50 years. In fact, a whole list of problems exist for girls with current WASH systems in many developing countries, including but not limited to:

  • Lack of privacy for changing materials or washing the body.
  • Inconsistent supplies of water and lack of soap.
  • Water not located in a suitable place for washing stains from clothes and reusable menstrual materials.
  • Inadequate collection and unsafe disposal options for used menstrual material.
  • Limited access to and affordability of hygienic products.
  • Locked latrines or dorms during the day.
  • No tools for cleaning in toilets.

il_fullxfull_177629346…So What?

MHM matters because boys and girls are not seeing the same results. To get a real world case for my research, I focused on the countries in East Africa, such as Tanzania and Uganda, where girls finish with one to two years less schooling than boys.

This may seem like not a huge problem, but consider that boys across these countries average only five years of education; girls average only three-and-a-half school years. We can’t ignore this clear inequality in results.

Luckily, change is coming. Since 2012, conferences on MHM are being held globally and in countries, like Uganda. Handbooks have been created for development workers. Institutions like the Water Supply & Sanitation Collaborative Council (WSSCC) and Sanitation and Hygiene Applied Research for Equity (SHARE) at the LSHTM are adding great research of MHM to the literature.

(Listen to this podcast by two SHARE researchers for more insight: Menstrual hygiene: Breaking the silence)

The market is also catching up. Products like reusable sanitary products and Moon Cups are starting to make a difference in the lives of women and girls in resource-poor environments.

Schools in developing countries are also starting to add more sexual and reproductive health lessons. Starting in Tanzania and now in Ethiopia, Ghana and Cambodia, the Grow and Know book series, originating from Sommer’s PhD work, allows girls (and boys) to receive proper information on their changing bodies, rather than relying on guesses and misinformation.

The Menstruation Taboo

Unfortunately, even will all these amazing improvements, menstruation is still a taboo around the world. Long-standing religious and cultural views on menstruation have added stigma to an entirely natural bodily process, shared by billions of people.

In many cultures, when girls are on their periods, they must resort to staying home for upwards of a week. This causes serious losses in terms of their education, resulting in girls falling behind boys in achievement. Politicians and decision makers need to open the debate to include the needs of all genders, not just the male ones.

One of the major hurdles is involving men and boys in the discussion. By having accurate, appropriate education is schools, boys can grow up to become men and fathers who can support girls during their menarche and make sure they stay in school. Men need awareness to remove the stigma of menstruation and become active in solution-building. They are the community leaders that plans projects, the masons who build latrines and the teachers who mentor children. Although it would be great to have more women in these leadership roles, the reality is that men still are over-represented and must be involved in fostering change.

And, let us not think that this is an issue for only those nations facing high rates of poverty and underdevelopment. We, in the Global North, have our own taboos and prejudices.

…What About the “Developed” World?

The recent HuffPo article ‘For Homeless Women, Getting Their Period Is One Of The Most Difficult Challenges’ clearly outlines how MHM is not being made available, even within the countries that can afford it, like the United States.

In Canada, we have our own vulnerable groups. People outside mainstream politics. We ignore the needs of the homeless. We separate and look down about Aboriginal peoples and their heritage. I am ashamed of these current realities.

In the UK, women are fighting the “vagina tax” to keep tampons and other necessary sanitary products tax-free. A few years ago, they were categorized as “non-essential”, luxury products bringing with it a 17.5% tax rate. After much protest, that rate has been lowered to 5%, but should go down to zero.

By ignoring the wellbeing of its citizens, countries are missing the opportunity to harness the true potential of every member within it. Women within vulnerable groups are unable to access equality. Girls will miss school.

This topic highlights many of the existing problems in both developing and so-called developed countries: gender equality, sexual and reproductive rights, access to education, proper sanitation, and more. Unless we go outside of our intellectual comfort zones, we will never be able to tackle the most important challenges in our society.

If I ever work in WASH, regardless of the location, I will seriously question whether planners and donors have considered the needs of all genders. Not just some.

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