Period pains: Menstrual Hygiene Day to raise global awareness on how traditions impact education and employment

Period pains: Menstrual Hygiene Day to raise global awareness on how traditions impact education and employment

In Nepal, communities that still practise the ancient, albeit illegal, Hindu custom of chaupadi (menstrual exclusion) ensure that women and girls are banished from their family homes while they are on their periods. For teenagers like Radha Bishwa Karma (pictured left), this also means being served food (boiled rice only) behind a toilet.


When 15-year-old Roshani Tiruwa lay down to sleep close to an open fire in a small mud hut last December, she was unaware that the smoke from the fire would suffocate her. Why was such a young girl sleeping alone just metres from her family home? Because Roshani was on her period.

Her death on 16 December was the second within a month in Nepal’s western Achram district caused by women being banished from their family homes because of cultural beliefs surrounding menstruation. Dambara Upadhyay, 21, was found dead in a hut on 19 November under similar circumstances, according to various news reports.

The ancient Hindu practice of chaupadi considers menstruating women to be impure. Those who uphold the practice forbid women and girls from touching men or even entering their own homes, and prohibit them from eating certain foods. Disastrous consequences are believed to follow transgression, such as crop failure.

Confinement in a basic chaupadi hut can last between four and seven days every month. Each time, women are vulnerable to dangers such as attacks from wild animals, extreme temperatures and gender-based violence, including rape.

Although the Nepalese government outlawed chaupadi practices in 2005, change has been slow. And the situation in Nepal is not unique. Around the world, attitudes to menstruation are inhibiting women’s freedoms and endangering their health.

Every month, millions of girls are prevented from attending school, which damages their education, while millions more women are unable to work, which impacts their livelihoods. The negative effects of these attitudes are highlighted annually on 28 May, Menstrual Hygiene Day, which aims to break taboos and raise awareness of good menstrual hygiene management (MHM).

One global development organisation tackling the issue is the UK-based charity WaterAid. It has delivered MHM training to girls, boys, families, teachers and communities in Nepal, Madagascar and India, providing accurate information about menstruation and seeking to challenge fears and stigmas.

Thérèse Mahon, regional programme manager in South Asia, says many girls are frightened when they begin menstruating because no one has explained what will happen.

“They think they’re suffering from a major illness, or they’ve done something wrong and they’re too scared to tell their parents,” she says. Often mothers themselves are ill-informed as they were brought up under similar restrictive practices. Teachers frequently lack the training to teach young people about reproductive health.

WASH in schools and workplaces

Female absence from education and employment during their periods is not just the result of deep-rooted cultural beliefs. Poor local water, sanitation and hygiene facilities (WASH) also contribute greatly to the problem.

A 2012 UNICEF report on WASH in schools suggests that 21 per cent of schoolgirls in Sierra Leone stay at home during their periods. In Nepal 30 per cent of menstruating girls avoided classes, while female students in Somalia said they missed up to five days of school a month.

Little research exists on the situation in workplaces, but with menstrual-aged girls and women representing about 40 per cent of the global labour market, it is easy to imagine the economic impact of female workers experiencing monthly work absences.

While Brazil and Italy could soon join east Asian countries such as Japan, Taiwan and South Korea in giving female workers menstrual leave, for most women workers across the world – particularly the vast majority of women working in the informal economy – provisions are severely lacking, be it sufficient toilet breaks or access to hygienic disposal systems.

For example, a World Bank study from 2008 across Cambodia, Indonesia, the Philippines and Vietnam found that 25 per cent of all workplaces in Cambodia did not have toilets, while 14 per cent in the Philippines had inadequate toilets.

In Vietnam, 74 per cent of market places – where women often work – had no toilets. Assuming women employees were absent for one day a month due to a lack of WASH facilities during their periods, the study estimated 13.8 million workday absences in the Philippines and 1.5 million in Vietnam, resulting in an economic loss of US$13 million and US$1.28 million a year respectively.

Mahon says broaching the subject of menstruation through WASH is an uncontroversial way to instigate change. “You can build up trust and relationships from which to start talking about some of the more taboo areas, and provide practical solutions,” she says.

These have included working with schools to build latrines and rooms where girls can change period materials “with dignity”. Mahon says setting up systems to keep facilities clean is also important, or women do not use them.

Trade unions have also argued employers have a duty to provide WASH facilities suitable for menstruating women. The global public sector workers’ union PSI is planning to launch research into the impact of menstruation on working life in the public and private sectors, and in formal and informal economies, after it formerly adopts a resolution to achieve “equality for menstruating human beings” at its world congress in October.

Gender equality officer Verónica Montúfar says this will result in a campaign to raise awareness of how menstruation affects all women, in particular those living in poverty. She adds: “Our major challenge is to deconstruct the patriarchal approach to women´s bodies.”

The move is backed by Swedish municipal workers union Kommunal. The head of its international unit, Anders Jonsson, says employers need to create workplaces where women can “work and train in the same way as men”. He added that unions should take the lead by ensuring their own meetings and training courses provide good sanitation facilities for women.

Sanitary materials

Enabling women and girls access to safe and affordable period materials is another important issue. A WaterAid study in Bangladesh found 60 per cent of textile factory workers used rags from the floor as menstrual cloths.

That has resulted in infections which caused 73 per cent of female workers to miss about six days of work a month. In Nepal, girls told the charity they are ashamed to let their period cloths dry in the sun, so they reuse them damp, risking infections.

According to Celeste Mergens, founder of the US charity Days for Girls International, in Uganda and Kenya women absorb period blood using leaves, mattress stuffing or feathers.

“It is very difficult to concentrate in class, let alone sit down, and once you do leak through, you are likely teased and shamed,” Mergens says. “The same is true for women trying to go to work.”

Her organisation is addressing the issue by helping women set up small businesses that make and sell reusable pads and MHM kits using locally available materials.

Femme International is another charity trying to improve MHM in developing countries. It delivers education programmes across East Africa in schools and communities and distributes reusable menstrual management products.

Executive director Sabrina Rubli says girls are often so desperate to purchase pads they skip meals or take on extra work to save money. “From a policy level, governments need to recognise the impact menstruation has on schoolgirls, and commit to providing sanitary pads to girls,” she suggests.

In 2015, the Ugandan government committed to giving sanitary pads to adolescent girls. However, this year it backtracked, saying the policy was unaffordable. When the feminist activist Stella Nyanzi voiced her opposition to the move over social media in February, she was imprisoned.

Although more progress is needed, Mahon believes change can happen within a generation. In Nepal, WaterAid has seen some girls it has worked with abandon chaupadi beliefs, while the creation of better WASH facilities at school and receipt of MHM training is enabling them to attend school regularly.

One girl told the charity: “During my menstruation I am not allowed to touch mangoes or other fruits. I am told that the mangoes will rot and won’t grow if I touch the tree. But I touched the tree during my menstruation – I even plucked the mango from the tree and ate it. The fruit didn’t rot, it didn’t die.

’’It made me realise that all of this is lie.”