It’s funny how some of the most ubiquitous aspects of the human experience can be the most taboo subjects to discuss. Menstruation is experienced by over 50% of the world’s population at some point in their lives, dominating up to one week a month of their lives for often more than 40 years. This is more than just a mild inconvenience. Period pain interferes with the daily life of around one in five women. According to Professor John Guillebaud pain can be ‘almost as bad as having a heart attack’. That’s to say nothing of the psychological effects of menstruation. The fear, shame and embarrassment that you might inadvertently alert other people to the bloodbath between your thighs. Considering the extent to which they affect so many people’s lives even in more ‘progressive’ societies, periods are openly discussed very little.
Though it is present just about everywhere, the stigma and cultural taboos surrounding menstruation are far more serious in low-income countries. Young girls and women therefore have minimal access to information and guidance, leading to a high prevalence of misinformation and myths. One study by Femme International found that 80% of girls in Nairobi did not know what their period was when they started. Parents are often either unable or unwilling to buy sanitary products for their daughters, forcing many girls to resort to such alternatives as old clothes, blankets and even leaves. Even more alarmingly, a 2015 study in Kenya found that many girls relied upon their boyfriends to purchase these products and had been using sexual acts as a form of ‘payment’. 1/10 of 15-year-old girls reported having already engaged in what researchers termed ‘transactional sex’.
The already dire situation of women and girls in poverty is made even worse when they are uprooted, for example by the outbreak of fighting or a natural disaster. Though humanitarian teams arriving in the aftermath of an event go some way towards addressing menstruating women’s needs, the low priority that these needs are given and the lack of standardisation mean that many women are excluded even from measures designed to help them. For refugees in Jordan living in camps, sanitary pads are not included amongst the lists of ‘essentials’ to be purchased with vouchers. Refugees are similarly prone to being overlooked by both small groups of volunteers distributing handouts and major humanitarian organisations.
As much as we may like to think that this is a ‘third-world’ problem, this is not the case. In 2015 volunteers at Darlington Salvation Army Food Bank discovered that many homeless women had – not unlike the Kenyan girls – been using such items as newspapers and handkerchiefs in the place of sanitary products. These women could not afford tampons or pads but were too embarrassed to ask for help. Many paid for this embarrassment by suffering regular urinary tract infections (UTIs) and vaginal infections, for which they needed antibiotics and sometimes even hospital treatment.
Amidst all this doom and gloom, it is important to acknowledge the progress that has been and is being made. On the subject of the Darlington food bank, volunteers are now distributing free sanitary products to homeless women. Grassroots women’s groups such as Supporting Sisters have also called specifically for donations towards sanitary products for refugee camps. On a larger scale, issues of menstruation are increasingly being acknowledged and addressed by NGOs, researchers and even the media. The International Rescue Committee are currently working with Columbia University to build a cross-sectoral ‘toolkit’ addressing the menstrual hygiene needs of women in crisis situations. Initiatives such as Camilla Wirseen’s ‘The Cup’ (distributing menstrual cups to girls living in poverty) provide young girls not only with the physical products they need but with safe spaces to ask questions and share their experiences.
Overall, it does seem that things are heading in the right direction – albeit slowly. Research revealing the shocking cost of menstruation to the least privileged has brought the issue into the spotlight. This has pushed people to dismiss their discomfort and prejudices, and face head on the struggles that have always gone unspoken. Still, there is a long way left to go. Such deeply ingrained societal taboos cannot be eradicated overnight, or even over a couple of years. Unfortunately, this is most true of those countries and communities where change is most desperately needed.
Though the U.K. is not one of these countries, the cost of menstruation continues to put an additional strain on those living in poverty. Despite the admirable efforts of grassroots campaigners to change this, only three of 191 MPs contacted by the Darlington food bank responded positively. This encapsulates a general sense that issues of menstruation are of less concern to the people ‘at the top’. That is, when the primary victims of these issues are people at the bottom.