Menstrual sanitation is not just a ladies issue

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Menstrual sanitation is not just a ladies issue

by Caroline Marohasy


Students in Nairobi: poor menstrual care can stop girls going to school (kyhm54 under a Creative Commons Licence)

My home country, Australia, like many other Western countries, does not really want to support all forms of development. We always support causes like AIDS or infant mortality prevention, but not many people pay attention to other problems that are just as important like female hygiene and sanitation.

But it is essential, if we want to reduce poverty, to invest in projects that directly support women and girls. In 2012, the UN Secretary General Ban Ki-moon said that ‘the best result comes from investing in girls and women. When they are educated, they create more development in their families, communities and nations.’

Each year of primary education will increase a woman’s wages when she is older by at least 10 per cent. Each year in secondary education could be twice as much as that. And educating girls is still the single best policy for women having fewer children. But in Sub-Saharan Africa only 57 per cent of all girls go to primary schools. And only 17 per cent go to secondary school. A UNESCO study has found that about 150 million children now at primary schools globally will leave school before they finish. At least 100 million of those will be girls.

People do not talk about one reason young girls are not going to school: gender taboos and menstruation.

Ngeru, for instance, is a 14-year-old girl from Kenya. During her period, she has no sanitary pads. Instead, Ngeru uses cloth, or bark tree lining, or mattress stuffing.

These are not effective and humiliating. There are many health risks, including infections and genital sores. She will probably have blood on her school uniform or clothing. So Ngeru prefers to leave school than suffer abuse from other students and male teachers. She enjoys studying mathematics, but her education depends on her monthly cycle.

A study of the attitudes of Kenyan school-aged girls to menstrual health found that ‘one of the best ways to deal with menstruation is to go home’.

Many groups (the Kenyan government, African women’s groups, NGOs and important UN organisations such as UNICEF and the World Health Organization) have all stated in public that bad menstrual hygiene provision is closely related to the number of girls who go to school. The Kenyan government stopped taxing the imports of female sanitary products in 2011 to help reduce costs by 18 per cent. Many NGOs across sub-Saharan Africa, including Kenya, only provide sanitary pads.

But private attitudes toward menstrual health problems are very different. I recently met the head of sanitation for UN Habitat in Kenya. Menstrual health was not mentioned in any of their policy papers. They did not want to answer my questions about ‘the lady issues’. Similarly, the Inclusive Economic Growth & Social Development Unit said that they would not do anything about menstrual health because it was not part of their plans.

Top UN policymakers in Kenya have disappointing attitudes to this ‘lady issue’ in Kenya. And help from aid workers is often not effective.

Old-fashioned charity models (like Bono's) are not working. It is not sustainable to donate pads. Only a small number of women and girls would get them.

Organizations such as the International Monetary Fund, the International Development Association, the Asian Development Bank, and the World Bank all agree that to grow Human Development Indicators, we need to provide money for small, new businesses. These should be run and owned by local people who borrow money cheaply and have a long-term relationship with lender organizations. We should use this model for female sanitation provision.

In Rwanda, for example, an organization called SHE has a business model approach to local sanitary pad production. Their pads are about 30 per cent cheaper than commercial pads, and women are creating jobs for themselves. They are motivated to make more money after they repay their microloan.

Models like these increase the effects of foreign aid, which is sometimes very little. Australia’s commitment to aid has always been stable, but no-one knows if that will continue after the September 2013 elections. Also, in many cases, plans that aim to help one gender do not help the economy quite as much as plans that are for both genders.

It makes economic sense to make women’s health in the Global South important, so girls can go to school and then start working.

Female sanitation is not just a ‘lady issue’. We need to work on some of the less fashionable development issues. Female hygiene should be at the top of this list. It means getting people to talk openly about menstrual health – in all parts of the world – and adapting to new aid models which encourage small business enterprises like SHE.

If everyone sees the rights of girls and women, this generation of sub-Saharan Africans could experience improved education, health, livelihoods and equitable economic growth. These outcomes will grow and are sustainable. And there is nothing more important to development than that.

As this article has been simplified, the words, text structure and quotes may have been changed. For the original, please see: