That Crime of the Month

Ladies: in your lifetimes, you will spend an average of 1400 days on your period; and get through an average of 125-150kgs of sanitary towels or tampons.

Yikes!

Periods. Yay.

Enfin, when I say ‘you’, that’s making three enormous presumptions:

1) That you have money to pay for sanitary towels/tampons;

2) That there are some available to buy;

3) That you have somewhere to dispose of them afterwards.

How many of us have ever had to think about any of those questions?

Menstruation, I think we all agree, is not fun.  You’re a girl, you hit puberty, you start bleeding every month.  Urgh.  It’s messy, it’s painful, it takes you a few years to get the hang of it, we probably all have that awful never-publicly-admitted story of the time the period came on early (and you were wearing white) or late (and you were scared you were pregnant).

But we manage. By way of contraception that diminishes or eliminates periods entirely; or by way of that aisle in the supermarket only ever visited by women, filled with masses of white fluffy pads and (now usually brightly coloured – eh?) tampons of all shapes and sizes.

Imagine that all taken away.  What would you do? How would you go about your daily life? Work? Study? Travel? Sleep at night?

That is the hush-hush situation of millions of women worldwide in poorer countries, who face their monthly period not with exasperation and a bit of PMT, but fearfully: without any reliable way of absorbing the flow (disposable pads often too expensive or inexistent), or keeping themselves clean during their menses.

For girls still at school, this means skipping classes; not only for fear of leakage/stains, but also given a lack of sanitary facilities.  For example, one study showed that 66% of schools in India did not have a functioning toilet.  And even if toilets are available, studies show they are too few (1 toilet per 600 students in Nigeria); lacking doors, running water or soap (essential for flushing away blood, cleaning hands, or washing reusable pads).

Poor sanitary facilities, of course, is a bane for all students (not just girls or female teachers) but imagine not having access to a toilet during your period.  You can hardly go behind a bush; where do you put your soiled sanitary towel or tampon? And if you have an accident, how do you wash out the stain, before you are teased (best case scenario) or ostracized (commonly reported) by male classmates or even teachers?

Because periods are not just a practical nightmare in developing countries.  Research shows that menstruating girls and women are seen as “dirty”, “shameful” or “polluting”; many are forcibly excluded from everyday activities such as prayer, preparing food, socialising, sleeping in their own beds.

With that in mind, it’s understandable that a young woman will prefer to stay away from school altogether during her period.

The problem is, she won’t just be missing school on one occasion.  Our periods, as we blissfully know, come once a month.  Every month.  Twelve times a year, every year, beginning on average at the age of 13 (“menarche”). That is potentially a lot of missed schooling.

Even though there is a real lack of reliable quantitative evidence on how menstrual hygiene management (MHM) impacts girls’ attendance at school, qualitative studies clearly indicate the link between having knowledge (“software”) or supplies (“hardware”) and the likelihood of making the commute to and from a long day at school.

This is why UNESCO estimates that one in ten girls in Africa will eventually drop out of school as a result of their periods.

One in ten. 10% of the next generation of women, slipping out of schooling because of their period.  This with the knowledge that two-thirds of all illiterate adults today are still women; and knowing also that gender parity for school enrollment remains a utopic vision (despite progress made via the Millennium Development Goals), given continued social norms around girls’ role as carers in the home, or the economic value of investing in girls’ education with limited household budgets.

Without schooling: fewer qualifications, fewer job opportunities, higher likelihood of early or forced marriage, knock-on effects in terms of income, health, children’s health, wider economy… et j’en passe.

So what is being done about it?

Hmm.  Not much, actually.  (surprised?)

At least, not on the scale necessary.  There are some dedicated movements, such as the charity 50 Cents.Period; and other NGOs have sought to incorporate/advocate principles on MHM into their broader work, especially on water and sanitation.  Other research institutions such as J-PAL are investigating which “hardware” solutions could help, including the menstrual cup or reusable pads.

Afripad. Photo credits: ImpactAlpha.com

So there is some mainstreaming.  And growing recognition of the issue, and of the need for more and better research.

Oh, and a new international day for menstrual hygiene, in case you missed it – 28 May.  Have a look at the interesting Facebook page that’s promoting it (and put it in your diary for next year).

But that’s about it.  Why so little interest?

Well, first up, periods make people uncomfortable.  Admit it – you’ve not been enjoying this post very much, have you? (if you’ve got this far, keep going.  You’re almost there.)  There are thousands of years of social myth, religious connotation, mystery associated to a woman’s monthly cycle.  Even without these, we all are squeamish about blood, and especially menstrual blood – like, beurk.

But those attitudes are not only old-fashioned, they are damaging.  Young girls discover periods without understanding what they are or having any way of managing them, because talking about them is taboo.  Even my own mother, in nice middle-class developed-country England, did not give me any heads-up; I can tell you, it wasn’t a nice surprise.

Managing menstruation is also taboo (and expensive).  Given the lack of materials, women resort to whatever they can find to prevent or mitigate the flow: leaves, mud, tree bark.  Which of course is inefficient, not to mention uncomfortable and ultimately risks bacterial infection.

Second up, periods are a women’s issue.  Now, (I know! no generalisations! I promised!) by and large, that means that in structures where power, budgets and decision-making are managed by men and not women, the issue will be given less or no consideration because it simply isn’t something that men have to contend with (a bit like whoever designed the metro cheerfully forgetting disabled users or parents hefting prams).

For some donors, and some developing country governments, forgetting about periods is an oversight they’re willing to correct. For others, menstruation is surrounded by so much cultural and social stigma, that it will never be a priority (amongst all the other pressing priorities).

For example, the new global development framework, the Sustainable Development Goals (to be agreed in September 2015) doesn’t address menstruation – or at least not specifically.  The only relevant target in the current draft is:

6.2  By 2030, achieve access to adequate and equitable sanitation and hygiene for all and end open defecation, paying special attention to the needs of women and girls and those in vulnerable situations

Not overly prescriptive, you will agree.

Which is a shame.

No, wait, it’s much, much more than just a shame.  As Ashlee Betteridge sums up neatly:

“…just because women and girls cope doesn’t mean that menstrual hygiene management (MHM) is an issue that can be overlooked by those working in development. It’s important to recognise that this affects women and girls’ health, dignity and confidence, as well as their participation in education, the community and the economy.”

A-men(struation) to that.