The Tampon Taboo

Sign in Indonesia, Source: Flikr Creative Commons
For girls everywhere menstruation is a rite of passage. Menstruation is a healthy, normal bodily function that affects half of our population -- the overwhelming majority of our women, at some point in time. But for too many girls worldwide this shared experience is a source of shame, restriction and if badly managed -- illness. Menstruation is an age-old phenomenon and across the developed world we’ve built awareness, products and systems to manage menstrual hygiene to enable women to live their lives seamlessly. Even with such support we can still argue that menstruation is something we’d rather not talk about in the developed world  -- but in the developing world, the stigma around menstruation has led to an invisibility around it that can really hold our girls and women back.

According to the Geneva-based Water Supply & Sanitation Collaborative Council (WSSCC), even sectors such as water and sanitation which “routinely deal with unmentionables such as excreta, ignore girl’s and women’s need for safe spaces to manage menstrual hygiene and mechanisms for safe disposal of materials used to absorb menstrual blood.” As we all know, ignoring a problem -- or menstruation -- does not make it go away. NGO Plan International and A C Nielsen conducted a study and estimated that there are 355 million menstruating women in India -- but only 12% of them use sanitary napkins. The study even found that 23% of Indian girls drop out of school after reaching puberty, with irreversible effects on their health, well-being and participation in society. Millions of girls and women instead rely on old rags, dried leaves and grass, ash, sand or newspaper to manage their monthly menstrual flows -- shrouded by shame and disgust on a vital bodily function.

Columbia University,  Millennium Promise and the social enterprise, Be Girl also hosted pilots for menstrual hygiene products and one of their participants, Patience, a 15-year-old girl from Ruhiira, Uganda told them “you suffer a lot; in case you stamp [stain] the boys can make fun of you which causes you to lose your self-esteem […] it’s embarrassing when you are washing your soiled clothes. It makes you not even want to go to school.” The washing of stained rags or clothing can also bring shame, especially in areas of water scarcity. Be Girl reports that in rural Africa, 40% of school girls miss up to 5 school days a month, or 30% of the school year. WaterAid found that 82% of their surveyed girls in Malawi did now know about menstruation before it started; girls across their surveyed countries were found to be excluded from water sources during menstruation, and even prohibited from washing and bathing in some communities making what is often a difficult week even more difficult to bear.

Source: WaterAid
Given the success of feminine hygiene and menstruation products, and the important role it has played in women's empowerment history, it would appear that the private sector could have significant market opportunity if they can break this taboo for women and girls -- who are expected to require the products for more tham 50 years. Sanitary products must be designed to be affordable; disposable tampons and sanitary towels are often priced out of reach of low- and even middle-income families if supply is scarce. Euromonitor International found that women in India, with average earnings of US $750 per annum earns below the $1,000 per annum deemed necessary to easily purchase disposable menstruation products. Moreover, systems to support menstrual hygiene are necessary, products alone aren’t the solution: appropriately designed and managed community spaces and importantly education on female reproductive health.

To make this happen, WSSCC believes that breaking the silence around the taboo of menstruation is a crucial first step. Girls should be informed and encouraged to talk and discuss menstruation in an informed and positive manner to prepare them emotionally and physically for the onset of menstruation and their monthly menstrual periods. Families need the education to support their girls and women. WaterAid has also compiled a phenomenal guide, Menstrual Hygiene Matters, with nine modules and tool kits -- an essential resource -- to improve menstrual hygienic for women and girls in lower and middle-income countries.

WaterAid found that well designed and appropriate water, sanitation and hygiene facilities that address menstrual hygiene can make a significant difference to the schooling experience of adolescent girls
(Photo: WaterAid/ASM Shafiqur Rahman) 
As WSSCC spokesperson, Archana Patkar,  powerfully argues: “Women are the progenitors of the human race […] Menstruation is therefore something of which they can and should be proud, so each and every one of us should work to improve the lives and life chances for women who do not have access to clean materials, water and safe disposal facilities; who cannot talk about their experiences; or are never asked if they can help define a solution.”