By Dr Dani Barrington
My social media followers are accustomed to reading my seemingly endless rants about menstrual hygiene. I try to get messages across simply and boldly. Sometimes I think I miss the mark having only 140 characters to work with.
This is because menstruation, although a universal connector of women, is actually an intricate issue of physical health, cultural norms and intimate relationships, which is experienced differently across the globe.
For example, I sometimes share articles about young girls in developing countries not attending school when they have their periods. Often my followers respond to such posts with comments like “let’s give them all menstrual cups!”
Now don’t get me wrong – I LOVE my menstrual cup. But I have clean running water and access to a private and hygienic toilet, there are no cultural taboos surrounding “insertion” here, and my fiancé does not worry that my emptying the cup in our shower is going to make him infertile. Plus, when I’m not sure whether I will have access to hygienic sanitary facilities, such as when I am working away from home, I have the option of “scheduling” my cycle using the Pill. All in all, my period is about as convenient as it can be.
I know that people get really excited about sending pads, tampons and cups to women and girls in developing countries, and that in most cases this comes from a place of love. That is awesome. But I think it’s time we acknowledge a few things about menstruation so that we can get on with the job of achieving the universal human right to sanitation.
Periods are awkward. I remember being a teenage girl. First of all, there’s the chafing if you use pads. And missing of sports class because it’s swimming week. And the terror of using tampons so that you can participate next month, only to sit in the toilet for an hour reading about how you are going to die of Toxic Shock Syndrome. Let’s not force things on women and girls, wherever they are in the world, that they aren’t comfortable with.
Some girls don’t physically have a lot of options. In the instance of female genital mutilation there have been cases reported where the hole that a woman must urinate and menstruate through is so small that her period can take place for three weeks. Tampons and menstrual cups are not always a viable choice.
Insertion methods (in particular) require hygienic facilities. This one is a no-brainer. Wherever you are in the world, no health practitioner would advocate you using a tampon or cup instead of a pad if you don’t have clean water and soap available.
Belief systems don’t change overnight. Education campaigns are important, and in no way am I dissing them. But it is also important for us to recognise that cultures don’t change quickly, and it is not our job to tell people why we think their culture is “wrong”. If people believe that someone can perform black magic using menstrual blood then that is probably due to closely held cultural beliefs. Only they can come to their own decisions about how to prioritise the human right to menstrual health in line with their cultural systems. And in case you are wondering, beliefs around the magical powers of period blood are not confined to developing countries.
Used menstrual hygiene products are a health and environmental hazard. A lot of countries have no proper way of disposing of them. Often they end up being eaten by stray dogs (or pet dogs – I know my pooch has a penchant for the bathroom bin) or burned, which is generally not good for the environment or anyone nearby. Sometimes reusable options are the most suitable.
We like to contradict ourselves. For example, aid agencies have spent billions of dollars educating the public about HIV and how it is transferred through bodily fluids (particularly those emanating from reproductive areas), and then we scold men for being “afraid” of menstrual blood. Another example popular on the internet these days is concurrently campaigning for girls in developing countries to use menstrual hygiene products so that they can go to school, whilst also rallying for “menstrual leave” for Western women. I’m not saying that either of these ideas is wrong, but it does seem that we are in quite a predicament. We want girls in developing countries to have the same rights as women fought for in the 1960s in the West (i.e. “women are equal to men”), and they should thus attend school just like their male counterparts when they are menstruating. On the other hand we are advocating for working women in the developed world to have a new level of rights (i.e. “women are different, but equal to men”), where they are entitled to more, or different, sick leave to their male counterparts because of menstruation.
Some cultures celebrate periods. We have all heard the stories of women being banished from their houses, or banned from praying or cooking, when they have their period. However, in many cultures women are considered to be in a “higher state” when menstruating, and worthy of a little R&R. If you think about it, this is kind of what people are advocating for with menstrual leave. Women who are “banned” from cooking on their period do not necessarily feel subjugated – they may be grateful to their family for leaving them be with a heat pack, and having dinner prepared by a relative. What’s important is that we open a dialogue about what cultural arrangements around menstrual hygiene really mean to women, and not just assume that “the West knows best”.
I say all of these things not because I want well-meaning individuals to stop thinking about how they can do their bit to help – as a development worker myself that is about the most hypocritical thing I can imagine! I write this because I hope and believe that together we can channel all of this positive energy into achieving the human right to sanitation in ways that are reflexive and relevant to context. It is not always about the best “technical” product, or what we might consider the most “politically-correct” solution. It’s about what individuals are most comfortable with.
The only universal rule of menstrual hygiene management should be this: allow every woman and girl to menstruate with dignity.
Dr Dani Barrington uses participatory action research approaches to improve water, sanitation and hygiene in developed and developing countries. She is a board member of Share the Dignity and the Australia-Pacific Regional Coordinator for Menstrual Hygiene Day 2016. You can follow her rants on Twitter: @Dani_Barrington.
Featured image shows artwork created using menstrual blood – titled “Red Dress 1” – part of the ‘Beauty in Blood’ project. Photo credit: Beauty in Blood: Wellcome Images (Flickr).
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