Three years ago, I found myself experiencing what it meant to be “legally homeless.” There are plenty of things that most Americans take for granted that homeless people cannot. But what I was most shocked to discover was that for many poor women, maintaining menstrual hygiene was a daily struggle. Over several months, I met women using toilet paper, stolen pillowcases, and most commonly, brown paper grocery bags to maintain their periods. Having to go to such lengths made many women feel self-conscious and even interfered with their efforts to secure transitional assistance to improve their living situations.
But this is not a problem restricted to the streets of Portland. Particularly in the developing world, where access to hygienic supplies is limited, menstrual hygiene is a serious concern for many women and can have long-term consequences for both their health and economic wellbeing. The stigma surrounding the discussion of menstruation, however, often hinders attempts to address the problem directly. If gender equality—an objective now enshrined in the U.N.’s Sustainable Development Goals—is to become a serious goal, women and girls must be able to fully address their basic biological needs.
Disease, Stigma, and Isolation
A lack of proper resources and education in low-income countries often leads to unclean methods of maintaining menstrual hygiene. Without access to feminine hygiene products, women and girls in East Africa use a variety of unsanitary materials, including leaves, newspaper, and cow-dung to maintain their periods. A study by Colin Sumpter and Belen Torondel in 2013 showed that up to 88 percent of girls in India wash cotton menstrual pads “without soap or with unclean water.”
Inadequate menstrual hygiene has no small number of health consequences. In India, 70 percent of reproductive diseases are caused by poor menstrual hygiene, and the effects can go so far as to affect maternal mortality. Additionally, reproductive tract infections, which are particularly common in poor countries, can be introduced through materials used for absorbing menstrual blood. Poor menstrual hygiene management can also cause a range of other infections, from skin irritation to fatal toxic shock syndrome.
But the effects aren’t just biological. Taboos surrounding menstruation can make those women struggling with menstrual hygiene issues feel socially isolated and negatively impact self-confidence. For many women and girls, periods are a time of the month when they are ostracized or told that they are a source of potential contamination to their surroundings. In some places, like certain pockets of Central America and Africa, women are physically displaced from their communities when they are on their periods for fear they will contaminate or curse others. Two thirds of South Indian girls describe their first periods as “shocking or fearful,” because of the two week period of social seclusion that often follows.
Taking Girls Out of School
The negative effects of poor menstrual hygiene are not only social and physical, however. More insidiously, menstruation is often a major barrier to educational attainment in the developing world. But unfortunately, due to the discomfort around discussing menstrual hygiene, it is often neglected by global development organizations.
Women’s empowerment and gender equality are major priorities for governments and NGOs worldwide, and the need to further educational equity between boys and girls in developing countries is more apparent than ever. However, poor menstrual hygiene is holding female students back from closing the education gap. Periods are the most common reason girls miss school in developing countries. In Kenya, girls miss an average of 4.9 days of school each month because of a lack of access to adequate menstrual hygiene. That’s almost a full week of class—25 percent of the school month. In rural Uganda, girls miss up to eight days of school each term. A 2013 study by Sarah Jewitt and Harriet Ryley of the University of Nottingham showed that “61 percent of girls worldwide miss school annually due to the lack of menstruation hygiene facilities” in schools. UNICEF estimates that “[one] in 10 menstruating African girls [skips] school every month or [drops] out completely.”
Increasing female access to education in the developing world, then, must entail efforts to improve menstrual health. As the link between global development and menstrual hygiene management becomes clearer, an increasing number of organization are taking action to make menstrual hygiene products more accessible and to break down the stigma surrounding periods. Femme International is a global NGO that fights for gender equality through education about menstruation and sexual health. It is one of the few non-profits that promote menstrual cups as a sustainable solution for girls. Days for Girls and Camions of Care are two organizations that work to make feminine hygiene products more accessible to women and girls in both the developing world and the United States. Companies like BeGirl and Thinx sell absorbent period underwear and advocate on behalf of menstrual hygiene worldwide. But while a handful of groups are making strides, awareness of the importance and consequences of menstrual hygiene remain low in both high- and low-income areas of the world.
If a key to global development is through women’s empowerment—through education and economic empowerment—then it is crucial that women and girls aren’t set at a disadvantage because of their natural needs. Understanding the importance of menstrual hygiene and making better menstrual health a global priority a thus a critical component to any effort toward economic development or gender equality.
Disclaimer: The author of this article is a founder and Executive Director of one of the organizations mentioned in the piece, Camions of Care.
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