Reflecting on menstrual hygiene: Committing to action #WeAreCommitted

Every day, more than 300 million women and girls menstruate and on average, women cumulatively menstruate for about 7 years of their lives. A statistic that although repeated, often does not seem to have the needed impact. It means that every day 300 million women and girls are not only struggling to access affordable and safe menstrual products but also the sanitation facilities that ensure they undergo their period in hygienic environments.

Numerous studies have shown that inadequate WASH (water, sanitation, and hygiene) facilities, particularly in public places, such as schools, workplaces, or health centres, can pose a major obstacle to women and girls. It contributes to school absenteeism and the general inability to properly engage in educational, professional, social, and economic opportunities.

To clearly understand how these challenges compound, let’s look at a few things you may not know about menstruation:

A lack of early education for all genders causes social stigma. From the onset, a lack of clear pre-menstruation education, for all genders, contributes to social exclusion and unhealthy menstrual habits. Early, complete, and accurate education on menstruation as a normal biological process should be provided at home and at school to dispel myths, empower girls, and foster solidarity. Girls that understand the basic facts linked to the menstrual cycle can manage it with dignity and without discomfort or fear.

A lack of clear pre-menstruation education, for all genders, contributes to social exclusion and unhealthy menstrual habits

Some of the damaging myths that exist because of ignorance include; “women can somehow control their period blood,” “period blood can attract wild animals,” “PMS-Ing & periods happen at the same time,” “menstrual cycles are tied to the moon, or all come at the end of the month like a salary,” “everyone gets a period in exactly the same way” and so on.

Poor menstrual hygiene can pose physical health risks. The sometimes dismissive attitudes that exist toward menstruation are because many people do not understand the gravity of lacking access to menstrual health and hygiene (MHH). The use of clean and safe menstrual materials that can be changed regularly for the entire duration, and access to safe and convenient sanitation facilities for regular body washing, product disposal and overall management play a vital role in reproductive health.

Poor MHH is linked to urogenital diseases or problems that affect the urinary and genital tracts. Some examples include Yeast infections and Hepatitis B (from not hand-washing when changing menstrual materials), Fungal infections (from using unclean sanitary napkins), urinary tract infections (due to unhygienic menstrual practices), and toxic shock syndrome (when tampons are left in for too long). Some research has also linked unhealthy menstrual practices to Cervical cancer and infertility.

Unsafe sanitary products are in distribution. While providing access to private facilities with water could reduce urogenital diseases, companies that produce sanitary products must also prioritise safer low-cost menstrual materials. In recent years African women discovered that popular brands were using damaging materials in the products earmarked for developing countries.

When the Women’s Voices for the Earth commissioned testing of four types of Always menstrual pads, manufactured by Procter & Gamble, their testing indicated that both scented and unscented Always pads emit toxic chemicals. Always menstrual pads were found to contain several chemicals of concern, including Styrene (carcinogen), Chloromethane (reproductive toxicant), Chloroethane (carcinogen), Chloroform (carcinogen, reproductive toxicant, neurotoxin), and Acetone (irritant).

The effects of these toxic chemicals were widely discussed in 2020 using the hashtag #myalwaysexperience. Women talked about the huge and painful rashes, itching, severe burning sensation, and unpleasant odour that typified their experience using Always pads.

Always pads cause excessive sweating, pads aren't breathable, develop rashes painful & huge, the skin in contact with the pad itches profusely, severe burning sensation when walking and the gel substance produces an unpleasant odour. #MyAlwaysExperience

— Scheaffer Okore (@scheafferoo) February 15, 2019

Why does it matter when there are other brands in the market? Because in Kenya for example, “Always, was one of the first mass-market pads and the only one easily available countrywide dating back to 1992 when it launched and developed an unparalleled market dominance. As such, even when individual women experienced issues, for a long time, they didn’t have anything else with which to compare their bad experiences given Always’ dominance,” according to Quartz. This is not isolated to the country as was discovered when the online continental discourse began.

Low-cost sanitary products are a human right. Pink tax (gender-based pricing) is arguably one of the worst capitalist practices that currently exist. Charging women, a premium for gendered items is one thing but when this premium extends outside ‘luxury’ items it becomes inhumane. Feminine hygiene items should not have the value-added tax applied to them.

Because women and girls are the only people using menstrual products, these taxes do not only disproportionately affect us, but also make menstruating unaffordable for the vast majority. The “economics of menstruation,” is involuntary and exploitative. When the cost of sanitary products is equivalent to the daily cost of living, then once a month, a substantial portion of the 4 billion women around the world has to choose between sustenance and dignity.

Menstrual cups are environmentally friendly and less expensive (over the long run) than disposable products. Photo credit: Source/Flickr: https://commons.wikimedia.org/wiki/File:Diva_Cup_and_the_Keeper.jpg

Zero-rating these products might be a good first step but for meaningful change, they should be free. If not for the benefit of half the population, countries should remember that menstruation connects to several critical Sustainable Development Goals (SDGs): SDG 3: good health and well-being, SDG 4: Quality education, SDG 5: Gender equality, SDG 6: clean water and sanitation, SDG 8: decent work and economic growth and SDG 12: responsible consumption and production.

Menstruation challenges are worse for vulnerable women and girls. It should be pretty straightforward that the above challenges are compounded for vulnerable women and girls. Girls and women with disabilities, those facing temporary displacement or homelessness, and those living in poverty have even less access to all the things needed to manage menstruation.

It should become a requirement for all demographics of women and girls to be considered and consulted in the design, implementation, monitoring, and evaluation of reproductive interventions. Relevant information must also be provided in effective ways i.e., depending on the disability, language barrier, or technological barriers this could be in form of public announcements, town-halls, tactical tools, or more audio-visual materials with sign language, or shorter demonstrative sessions.

Menstruation isn’t part of emergency or disaster protocols. In 2020 the World Bank released an article aptly titled, “Periods Don’t Stop for Pandemics.” In it they urge for MHH needs to be included in COVID-19 emergency response interventions and policies across sectors, including health, education, WASH, and gender. At the time, in a bid to stop the death of millions and find a vaccine for COVID-19, menstruation challenges brought on by the pandemic were under-discussed.

Afripads Facebook Cover Photo

Some of these challenges were affecting the workforce that was on the frontlines. For example, poor WASH infrastructure in health care facilities affected both patients, and the female health workers, who make up a sizeable portion of this workforce globally. Disrupted access to products and financial stress from the pandemic’s economic impact caused families to prioritise other basic needs. Disruptions caused by broken supply chains meant that more than hindered access, the increase in the cost of sanitary products made them even more unaffordable.

Dignity kits containing sanitary products and other items needed for menstruation management should have been a mass distribution priority item. Instead, women were struggling to meet this basic need on their own, in majorly compromised conditions.

To continue in the fight to end period poverty, this year’s Menstrual Hygiene Day shifted from calling for action to leading by example and committing to action, under the theme, #WeAreCommitted. The aim is for organisations around the world to commit and contribute to creating a world “where no one is held back because they menstruate,” detailed the website dedicated to the day.

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