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.”

Human Rights and the "Other"

Credit: International Network of Liberal Women

In recent weeks, Human Rights Watch and Bill Gates released two reports on global poverty and the most pressing rights struggles of 2013. In Davos, some of the highest-earning and most powerful leaders of the world convened for the World Economic Forum.

Yet, as I live my life here in Paris, having completed a Master's degree focusing on human rights at the end of last year while at the same time undergoing a heart surgery, I contemplate what human rights means to me personally versus others. How much overlap is there between developing versus developed nations? How can I fully live within and access my own rights in a country that is not even my own? What I have come up with as I train in the park near my pink cottage, sending resume after resume, networking, flying to Rome to be with my French boyfriend who works for the United Nations and is also seeking long-term employment in his own country, trying to build the rest of a dream after significant resiliency most of my life, is how blurred the line is between those in need of accessing and fully realizing human rights standards. These are the people I love, live near, and work alongside.

The past few days the American news has been shaped by an announcement that AOL had reversed a decision regarding 401ks to its employees after a media frenzy regarding CEO Tim Armstrong's comment that,

Two things that happened in 2012. We had two AOL-ers that had distressed babies that were born that we paid a million dollars each to make sure those babies were OK in general. And those are the things that add up into our benefits cost. So when we had the final decision about what benefits to cut because of the increased healthcare costs, we made the decision, and I made the decision, to basically change the 401(k) plan.

The mother of the "distressed baby," Novelist Deanna Fei, published an eloquent and very brave response to her husband's employer in Slate magazine. Her husband, Peter S. Goodman, is the Executive Business and and Global News Editor of AOL's Huffington Post. The Goodmans are known to me because Arnold and Elise Goodman, the grandparents of the "distressed baby" girl, were the couple who gave me very my first job in publishing when I was nineteen years old. I worked from their home as their Literary Agency Assistant, and the position was a lifelong dream for this rural girl from a chaotic childhood with little resources earning and financing my undergraduate degree in Manhattan. I filed their contracts, letters to their children, answered their phone calls from the authors of the What to Expect When You're Expecting series, sent out rejection letters, and learned about publishing from two people who had made a wonderful life from it. They had a beautiful apartment on the Upper West Side of Manhattan, two wonderful children, and to my young eyes they were living the good life.

Enter the life of their own grandchild. As an advocate for children's health, I was aghast reading the AOL CEO's comment but was not surprised. The state of healthcare in my own country is one of the most brutal abuses of rights in a wealthy and developed nation that exists. So is the cost of education. Enter where I live currently so as to actually complete a Master's degree before I turned 35. When I had my heart surgery last year, I was also a student who paid nothing to have that surgery. I had suffered from supraventricular tachycardia since I was seventeen years old but still went on to race ultramarathons and build running teams in support of women and children's health. But around the end of 2012, as my hormones shifted and I worked freelance while earning my degree and trained teams of ex-pat runners, I began to have heart episodes much more frequently. When my sisters' were visiting me last March and I looked up at my baby sister's worried face sprawled on a Parisian sidewalk in full-on tachycardia, I began to think the time had come to fix my heart. Then I read online that when I am pregnant someday my baby would also go without oxygen and experience the same horrendous effects I did when the tachycardia occurred plus it could affect the child's development; I knew it was time to have heart surgery.

Women Helping Women: Somalian Famine Refugees Find Relief in Neighboring Kenya

The people of Somalia are in need of so much. They need a stable government – or any government at all, really, having basically been without one for the past two decades. They need jobs, income, clothing, medical care.

But perhaps right now, more than anything, they just need a little rain.

An East Africa drought continues to plague Somalia and neighboring countries, causing a famine that’s estimated to have cost tens of thousands of Somalian residents their lives thus far. But thanks to a for-women, by-women program in northeast Kenya, some 2,700 Somalian women and their families have found a bit of relief.

Womankind Kenya, along with partners such as MADRE and Zenab for Women in Development, has provided food, water and anti-diarrheal medicine to these women and their families, in addition to counseling and medical services to women who have survived rape or robbery during the trek to Kenya.

“We counsel women who arrive traumatized from sexual violence, from being uprooted from their home communities, or from burying a child along the way,” said Hubbie Hussein al-Haji, pictured above, executive director of Womankind Kenya. “We ensure pregnant and breastfeeding women emaciated from famine receive the nutrition and health care they desperately need.”

Hussein al-Haji says the famine could be somewhat lessened if regional resources were adequately and sensibly used.

“While the worst drought in six decades has destroyed crops in the northeast, very close by in the south of Kenya, the farms are green and plentiful,” she said. “People are growing wheat, vegetables and more. But this locally-grown food is not getting to the people who need it. Meanwhile, the price of staple crops like rice, corn and wheat is shooting up. Drought means that poor people can no longer raise their own food for lack of water. If the prices go up, they can’t buy food either.”

In the meantime, women-focused partnerships will continue to help as many famine escapees as possible. MADRE recently utilized one of its partner organizations, a group of women farmers in Sudan, to deliver a crucial supplement to Womankind and the refugees it supports. Hussein al-Haji says that in addition to this help from outside organizations, creating more sustainable, locally grown food sources will be key to aiding famine victims and preventing future outbreaks.