Menstruation is a biological process and regular menstrual cycle signifies healthy reproductive system. Maintaining hygiene during menses is important for women’s wellbeing, mobility, and dignity. But unfortunately, all over the world, this natural biological process is treated with utmost secrecy and shrouded with taboos and notions of shame.
Even today, the topic of menstruation remains a taboo in many societies. Cultural practices, religious beliefs and social myths make it difficult for women to talk about menstruation and its related issues. And since there is complete silence, most women/girls have no idea actually what menstruation is. According to Water Supply and Sanitation Collaborative Council (WSSCC) on any given day 300 million women and girls worldwide will be menstruating. Most of these women and girls will menstruate every month for two to seven days, thus on an average for 3,000 days over their lifetime. Though a woman/girl has to deal with menstruation process for almost 30 to 35 years of lifespan, yet she has not any scope to discuss about it — what are the issues, how it is managed, how it affects her etc.
Menstruating women are seen as impure, polluting and even evil in many parts of the globe. There are myriads of myths surrounding menstruation, especially in South Asia. In most parts of India even now, menstruating girls are treated as impure and polluting, so not allowed to cook, touch anybody, especially men. With nuclear family system in urban context women are not debarred from cooking, or touching men, but irrespective of location, education and religion, women are not allowed to enter religious places. The socialisation process is so strong that even the women themselves think that during menstruation they become impure. They themselves feel dirty.
In certain communities, women are not allowed to mix with others, or touch anything. So their movement is restricted and they have to stay confined to a room. The extreme confinement sometimes leads to putting menstruating women in cowsheds/huts/sheds made outside the house. And this has detrimental effect on women/girls’ health, education, employment and on their self-confidence and dignity.
Though there are not enough study done on menstruation and girls’ education and furthermore whatever studies are done are based on small sample size, yet almost all the studies show evidence of school absenteeism among girls during menstruation. A study by AC Neilson and Plan India (source: ‘Sanitary Protection: Every Woman’s Health Right’ by AC Nielson and Plan India ) shows that girls drop out of school for approximately five days a month, or 50 days a year. Twenty-three per cent leave school altogether when they begin to menstruate. Similar findings were reported by a survey undertaken by Water Aid in India, in which 28 per cent of students reported not attending school during menstruation, due to lack of facilities (Source: Menstrual hygiene in South Asia: A neglected issue for WASH (water, sanitation and hygiene) programmes, Water Aid Report). Another Water Aid study in Nepal shows that around 53 per cent girls who participated in a survey do not come to schools during menstruation.
lack of knowledge about menstrual hygiene management and its importance also affects women/girls’ health adversely. Menstruation is considered as a strictly private affairs, thus discussion on the topic is not been encouraged. Consequently women/girls’ knowledge on is either not sufficient or inaccurate. A study conducted by AC Nielsen and Plan India reveals that about 68 per cent rural women cannot afford sanitary napkins available in the market and around 81 per cent women use unhygienic, unsterilised cloth pieces as menstrual absorbents.
Unhygienic menstrual practices is not only limited to use of unhygienic menstrual absorbents like rags, old cloths etc but also not cleaning the external genitalia frequently (because of lack of privacy and because of taboo) to storing and drying menstrual clothes in unhygienic conditions and not changing menstrual absorbent in required frequency (at least 3 to 4 times in a day).
And all these practices have impact on women’s health, especially reproductive health. Studies have found that poor MHM can lead to urinary tract infections, reproductive tract infections and vaginal itches etc. Women suffer in workplace when there is not adequate facilities and privacy for menstruating women in the workplace. A study carried out among factory workers in Bangladesh by Business for Society (BSR), found that 73 per cent of women working in these conditions were missing work for six days a month, which inevitably does significant economic harm to both the women, who are paid according to the amount they produce, and the overall productivity, and to the business (WSSCC 2013a: 2).
It is important to make girls/ women know the importance of their body and the menstruation process. So from last year globally a few organisations and networks who are working in water, sanitation and hygiene issues as well as on women’s issues came together and observed the Global Menstrual Hygiene Day on May 28 to publicly recognise the right of women to hygienically manage their menstruation wherever they are and to break the stigmas attached to menstruation with collective advocacy and education. May 28 is considered as the number 28 refers to the average days of the menstrual cycle, and 5 (May) refers to the average amount of days a woman or girl experiences menstruation in a month.
(The writer is Regional Manager, Water Aid India, Bhubaneswar)