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Friday, January 24, 2014

The Rotarian Magazine an Excellent Article about Women's Health - Menstruation

A Rotarian friend brought this excllent article about women and the cultural stigma of menstruation, by Rose George, to my attention, published in the January Rotarian Magazine

This monthly magazine is circulated throughout the world to every person who is a member of a Rotary Club, which includes many who live in India. In summary, the article raises awareness about how the archaic attitudes about menstruation are negatively impacting the educational goals of women in many third world nations and thereby holding back their ability to become independently successful. Unbelievable but sadly true.

Much of this information is especially concerning, considering how much attention world health organizations are giving to improving the health of women and children around the world.

Given these myths and superstitions about menstruation are pervasive, women everywhere must be diligent about protecting our right to healthcare. We must especially protect young women from developing negative self esteem related to their feminine physiology.

Health: Menstruation:  There, we said it. Now let’s talk about it, because girls are suffering, by Rose George

There are many candidates for the title of “last taboo,” but the strongest contender is menstruation. Even within the field of sanitation, which I have been writing about for seven years, menstruation is hardly mentioned.

This is absurd, and dangerous. Menstruation is inevitable and natural. Yet throughout the developing world, women are ostracized, shamed, and damaged by this pointless taboo. In 2012, I traveled through India with the Great Wash Yatra, a sanitation carnival organized by WASH United, a nongovernmental organization. In 51 days, it covered more than 1,200 miles and went through five Indian states. It attracted 150,000 visitors to play educational games about sanitation and hygiene, such as Poo Minefield, in which a blindfolded contestant had to avoid potentially dangerous excreta while picking up lifesaving soap bars. There was WASH Idol, whose winner sang the best sanitation-themed song, and there were dance contests.

But I was drawn to a corner of the carnival, to a yellow and red tent that bore a sign saying “Women and girls only.” This was the Menstrual Hygiene Management (MHM) Lab, where women and girls could tell researchers about their experiences, get free sanitary cloths, and make themselves a bracelet using red and green beads to symbolize the days of the menstrual cycle. (Mine was made by a male volunteer who must think my period lasts 21 days.) Twelve thousand women and girls passed through the MHM Lab. Even on holy days, when researchers expected nobody to turn up, there was a queue several hundred meters long outside the entrance.

What did the women want? The free sanitary cloths were useful, of course. The advice about how to keep them sanitary was good too. (Iron them or dry them in the sun.) But what they wanted most was information. They wanted to talk. They wanted to know things they had never been told because of the breadth and depth of the taboo. More than 70 percent of them told the MHM workers that they had known nothing about menstruation when they started bleeding. Their mothers had not talked to them about it, because their own mothers in turn had not talked to them. When they had begun bleeding, many thought they were ill. Some thought they were dying. I met a young woman in a schoolyard whose mother had died of cancer, so when she started bleeding one day, she was convinced that she had cancer too. What else was she supposed to think?

Many of those 12,000 women said their menstrual blood was dirty blood, and so they were dirty too.

In another schoolyard in another state, I met three delightful young girls who told me more. They were 10 or 12 years old but spoke with charming confidence, even about their periods (once the male cameraman had moved away). They told me what periods meant to them: restriction, taboos, and not being able to eat pickles. Pardon? Yes, madam, they said. Pickles. Other common restrictions compiled by the Indian NGO Goonj included seeing birds, going near a newborn baby, going out at noon, having sex with your husband, talking to boys, serving food, keeping flowers. One of the young women in that schoolyard told me with perfect seriousness that she couldn’t paint her nails when she was menstruating, because obviously menstruation makes nail polish go rotten. Elsewhere, women are not allowed to bathe during their period. In extreme circumstances, such as in the western Himalayas in Nepal, they are confined for the duration of their menstruation to the family cattle shed, known as a chaupadi – even in the depths of the Himalayan winter.

Why do those things matter? Because when something languishes in silence and shame, it can do harm. When women and girls must keep their sanitary cloths out of sight, many dry them in damp spaces under their beds, risking urinary tract infections and worse. An outreach worker told me of a case in which a young woman had to have her ovaries removed because of such an infection. Afterward, her fellow villagers crossed the road when they saw her, because a barren woman is a curse.

That’s the health toll. Then there is the damage to women’s futures. Research carried out in India found that 23 percent of girls drop out of school permanently when they begin to menstruate. Another study in Uganda put the figure at 30 percent. Why? The schools have poor or nonexistent sanitary facilities, and no clean, private washing areas. Schoolmates mock the girls when they have accidents in lessons, although they must sit for hours without toilet breaks. A young woman in Liberia, who attended a brand-new school that had been built without a toilet block, told me she wears two pairs of underpants, two pairs of trousers, and two skirts when 
she has her period. It is not surprising 
that many girls prefer to stay home, and 
eventually – especially when they reach the age at which they are considered fertile and suitable for marriage – don’t come back 
to school.

An educated girl is more likely to live longer, be healthier, have a smaller family, and experience greater prosperity than a girl who doesn’t receive an education. The loss of a quarter of girls from the education system is huge and disgraceful. And it’s avoidable, as are the diarrhea death tolls resulting from poor sanitation. The solution is the same in both instances: clean, safe toilets for everyone. Yet in India, 628 million people still have no toilet whatsoever. And only 12 percent of the country’s women and girls use sanitary napkins.

There’s reason for cautious hope: The government of India has launched a nationwide plan to provide girls with subsidized sanitary pads (though it has yet to reveal how a country that struggles with disposing of waste, both human and other, will deal with millions of sanitary pads in its systems). I attended an extraordinary high-level meeting at the United Nations this past March that brought together NGOs, businesspeople, and education experts, all talking periods, all working out how to break the taboo, with ideas such as sending out menstrual hygiene information with the HPV vaccine, due to be delivered to 30 million girls over the next decade. Perhaps menstruation is coming out of the linen closet, slowly.

In one of the schoolyards, I watched as a laborer hefted bricks out of one of the latrines. He was rebuilding the latrine as a sanitary pad incinerator. One of the male schoolteachers had been to an MHM workshop and told me that his female students needed a private space in which they could get rid of their sanitary cloths. It had cost him 200 rupees – only US$4, but no small sum to him. But it would be worth it if his pupils stayed in school, were educated, and grew up into young women who knew how to talk to their daughters about this natural human function without shame and fear. –Rose George



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