Berlin. - In most regions of the world menstruation has traditionally been a taboo and negative attitudes as well as myths around this topic rather than knowledge and health concerns still dominate women´s and girl´s lives. As a rather new issue in the development sector Menstrual Hygiene Management (MHM) quickly gained attention and hundreds of organizations picked up the topic and realized various interventions. In 2014 WASH UNITED introduced the first International Menstrual Hygiene Day. Four years later Entwicklungspolitik Online spoke with Ina Jurga, International Coordinator of the Menstrual Hygiene Day at WASH UNITED in Berlin about the accomplishments and future challenges around this sensitive topic.
Entwicklungspolitik Online: What is Menstrual Hygiene and why is it important?
Ina Jurga: The term Menstrual Hygiene or Menstrual Hygiene Management (MHM) acknowledges that there are factors beyond the biological process of menstruation that are relevant in order to enable women and girls to manage their periods in a safe and dignified way. There is a need for access to toilets, clean water, soap and menstrual products. The other major component is having the knowledge about menstruation and how to handle it hygienically. MHM is also about changing laws and social norms such as negative attitudes towards periods, inclusion of health services and more research and expertise on the topic.
Epo: What is Menstrual Hygiene Day?
Jurga: It all started with a campaign WASH United conducted in India in 2012. The event, designed as a traveling carnival about access to toilets and hand-washing, also included MHM. During the journey through 6 towns, there were interventions in schools and surveys about the topic. It became apparent that the girls had neither access to toilets nor to products – most of them used old cloth – and more importantly there was a huge lack of knowledge. Many of them reported about the shock they experienced during their first period: they thought they would die. No one had told them anything. Therefore, we decided that we will have to keep working on this topic. In 2013 we had a small social media campaign and gained quite a bit of attention, that gave the spark to found the Menstrual Hygiene Day in 2014.
Epo: There are many awareness raising days for various human rights issues and diseases already, do we need a day for Menstrual Hygiene?
In our experience, we learned that a dedicated day to this topic is a great tool to get the attention and media coverage we needed and to use it for advocacy as well. It is a day to talk to the media- to politicians, to women and girls as well as men. Through this day, WASH United we have a vast network of NGOs creating events or interventions on that day, which make it quite effective. Every year since the launch more and more organizations joined the network, by now we have more than 410 members worldwide. Last year we had 200 events in 36 countries.
Epo: It is only 4 years, but can we speak of achievements or successes already?
The topic itself and the taboos about menstruation were definitely pushed forward a lot in the recent years. There is media coverage in general, books and I have a feeling it is a bit of a trend to speak about it,. Which s good.
There are art projects and more attention in general. And of course, in this globalized world, one country it inspires other quickly. When the issue of taxation of menstruation products in the US was raised, it was also addressed in the UK and India. Similarly, the awareness for the needs of homeless women or women in prisons, spread quickly. It is definitely more in the consciousness. But what is still missing is to talk about the situation in developing countries. Debating tax and toxic-free sustainable menstruation products are rather western topics. This is irrelevant and very abstract for a rural woman in India for example. The women in developing countries have the same problem as women everywhere, but on top of that they have even more challenges to deal with. For example, for many women menstruation products are neither available nor affordable. 900 million people have no access to toilets, and nowhere to change during menstruation and keep oneself clean when there is no private place. In the global north, we can find everything on the internet, in other places there is no way to find out the most basic information.
And of course, the taboo and stigma is often deeper. Not talking about periods is one thing, but devaluing one self and being stigmatized in the community and e.g. as in Nepal being banned out of the house or not being allowed to touch certain things makes change more complex and difficult to accomplish. These attitudes are deeply rooted social norms, and those need a long time to change
Epo: But is it possible to link the various concerns around menstruation and create more understanding and awareness?
We try to strike a balance between the Western period-positive or period-pride movement and to use it also to raise awareness about the situation in developing countries, where we are far away from period pride – we are working on getting menstruation accepted as normal and to enable access to toilets and products. It is not easy, because we are on very different levels. But what we have in common is that we need to talk about menstruation and menstrual hygiene.
Epo: It can be difficult to understand how women and girls are stigmatized because of their period. Can you give a few examples?
Jurga: In several communities one is not allowed to use the same cutlery or sleep in the same room as the family, during the period. Some women are asked to sleep on the floor or in the case of Nepal to stay in a hut. I personally am most fascinated by those myth, which could be tested and proven wrong easily – if you touch certain food it goes bad for example, but these myths still stick in the society.
Epo: It demonstrates how deeply women and girls have internalized this negative image of women. The women themselves feel unclean and bad.
Jurga: Yes, and it shows how complex and difficult it can be to address this and change attitudes. It can become a conflict specially with claims about menstruation, which are based on religion. But luckily women do change and demand change for themselves. It is rather the men, in largely patriarchal societies, who are the problem e.g. in the debate about access to temples in India.
Epo: Through the WASH UNITED network you know about many projects. Which is the most innovative or inspiring organization or initiative dealing with MHM?
Jurga: There are actually many amazing projects. There is one group, which uses the fabric of old umbrellas to make sanitary pads. This is a great idea, it shows one does not need fancy industrial products, but one can find a solution with local resources. Another really great initiative was a peer-to-peer program in South Africa. Girls from the city were teamed up with rural girls and they talked about menstruation. Very impressive are also a few men -lead initiatives. This year there is a bike rally in India with men and women, who want to question gender stereotypes and end the stigma of menstruation.
Epo: In which countries do you see the most promising efforts?
There are a few countries, which were very open to deal with MHM and introduced new programs and projects readily. In India, Kenya, Ghana and Sambia there are interested politicians and policy making is happening. There are many projects and NGOs as well as state-run projects to address MHM. In India has issued a dedicated MHM policy under the Clean India – Campaign. In Pakistan, there is huge MHM Coalition which brings stakeholders together, that is already a good sign.
Epo: What are the biggest challenges?
In the countries that started policies and programs, I just mentioned the biggest challenge is to go beyond having something on paper. It needs financial back up and will power and of course someone needs to follow up on the ground. The ideas developed in the capital need to make it to the rural areas. That takes time. It also depends ultimately on the community and people´s commitment and awareness. A policy on paper is useless if people do not know about it or do not want to use it because menstruation is still such a taboo. And the district and community officials do not want to work on the topic and teachers do not want to teach about it. In general, there is still a lack of research and expertise in this field. We need this, because, politicians are often convinced with hard facts and numbers rather than anecdotes about the hardship periods can mean to girls.
There is a lot more to do, e.g. women in prison or in refugee settlements in developing countries and developed countries also face lots of challenges in terms of menstrual hygiene.
Epo: Does it make sense that MHM is under WASH, or should it be under Health or Education?
Jurga: In order to make sure that our work is sustainable and goes beyond the MH Day we actually just launched together with Simavi and supported by Global Citizen, the Menstrual Hygiene Alliance, which aims to increase the prioritization of Menstrual Hygiene and ensure collaborative advocacy efforts. An important aim is to shift MHM away from WASH and integrate it also into the field of sexual and reproductive health and embed education about MHM into awareness raising about puberty for example. In many places, where talking about sexuality is a taboo as well, such as India, MHM can be used as an entry point. How do you talk about contraception if you do not know anything about the menstrual cycle and menstruation? Therefore, it makes sense to give a higher priority to MHM within health and within the education sector as well.
Epo: What is the aim of the MH Alliance?
Jurga: By 2030, the MH Alliance wants menstruation to be a normal part of life that does not hold women and girls back in any way. The launch of the MH Alliance is the start of a multi-year partnership for advocacy throughout the year. The MH Alliance calls upon the different development sectors (health, WASH, education, gender), governments at national and international level, donors, organizations, researchers, and the general public to join us in meeting our ambition by 2030
Epo: Thank you for the interview.
Foto: © MHM Education Session in Rajasthan, India by Monalisa Padhee