Improving Menstrual Hygiene in Zimbabwe’s Schools

My name is Marvellous Chimhutu and I am a student at Young Africa Academy, located in the Epworth suburb in Zimbabwe. I am a 15-year-old girl, the eldest in a family of five (two boys, two girls, and our mother Lisana) and currently doing my Form Three secondary education.

I am part of a group of learners who have been participating in CARE-supported guidance and counseling lessons since Form One.

Where I come from, people do not talk about pads and menstruation.

It is considered taboo to discuss these issues, and for a girl like me it requires bravery to ask for help. I discovered that this was not unique to me and my family. Many girls at school have challenges preparing for our first periods and we aren’t taught how to manage them.

Marvellous Chumhutu. Photo by CARE.

Like all other girls of my age, when I started having my period I felt stuck and didn’t know what to do. While l was very excited at the thought of growing up, I didn’t know how to manage it and was afraid of being laughed at if I spoiled my uniform at school. One time when it happened, I hid myself in the toilet waiting for the bell to ring so that I could escape and go home. I stayed at home for the whole week until the period ended.

What excites me and my friends is that the lessons we’ve received have raised my awareness of adolescent sexual reproductive health – among other issues and needs specific to being a girl. The most common issues have been around menstrual hygiene. The major challenge for me was getting pads to use, and then to know where I could discard the used ones at both at home and at school.

Our teacher, Ms. Warikandwa, noticed that most girls would be absent for days when they were on their periods, so she had to do mass counseling sessions to teach us how to prepare. I learned to keep myself clean. Later in the term, we all had lessons about menstrual hygiene, both boys and girls. We now know that it is a natural process. We have also tackled the topic in science and I proudly aced it.

The boys have stopped laughing at us when we spoil our uniforms (they now find the teacher for us).

We used CARE’s Community Score Card (CSC) as a platform to present our need for menstrual hygiene support from our families and at school. We were able to demonstrate to our parents, teachers, and school administration that periods were contributing to absenteeism and poor academic results among girls. After that, we made plans to construct an incinerator, install mirrors in the toilets, and for the school to keep emergency sanitary wear for us at school in case we need them.

The school was very supportive, and I feel proud that I was one of the advocates in this process. Now we have special bins to dispose of used sanitary wear and an incinerator.

My confidence has improved when I participate in class and sports because I can manage my periods.

I am also happy that I can also share information to help my sisters and friends at home. l thank my teacher for being there for me, I have all the information I need. I wish every girl could be empowered with the same knowledge and information that I have.

The App Empowering Young Women in Uganda

In Uganda, young women and girls face many sexual and reproductive health and rights (SRHR) challenges. For example, a high unmet need for contraception leads to dire consequences like unplanned pregnancies and sexually transmitted infections.

Challenges that limit provision of SRHR services to adolescents and young women include lack of privacy and confidentiality, knowledge gaps, cultural and social stigma, biased service providers, and inconvenience in accessing SRHR services despite their availability. Although there have been improvements in creating a youth-attractive environment for SRHR services and access to tools, more work is needed.

We are constantly reminded of the need to provide avenues where young people – including women and girls – can access sexual and reproductive health and rights services that are equitable, appropriate and effective.

At Reach A Hand Uganda, we help to address this need through our youth empowerment centres, and now, we have introduced the SAUTIplus app.

The SAUTIplus app is an innovative part of the SAUTIplus ecosystem,  helping to fill existing gaps in information. Uganda is experiencing a smartphone boom, with over half the population now owning one, and this number is increasing day by day.

Internet penetration in Uganda is at 41.6% – with 19 million Ugandans connected to the internet. In 2017, the Uganda Communications Commission recorded that the total number of mobile phone subscriptions was 23,529,979, up from 21,039,690 the previous quarter.

The SAUTIplus app was revamped two months ago to further engage Uganda’s high youth population and, at the time of writing, has 1,600 downloads on Google Play Store. The iOS version is in its final stages of going live.

On the app, information is available day or night. With a few taps of their phone, young women and girls can quickly find answers to their burning questions about sexual and reproductive health.

It’s the young people at Reach a Hand Uganda producing the content for the app and answering the questions – with support from the Programs and Communications departments. We understand the needs of the young women and girls and can craft our responses to reach the users in a relatable manner.

Users are able to see answers to questions other young people have asked and read tailor-made stories addressing issues faced by girls. Questions can be submitted on the website (hopefully soon to be added to the app) and the questions and answers can be viewed on either the app or website. The questions can be anonymous to maintain a safe and confidential space.

The app provides accurate information on SRHR, rather than simply promoting abstinence, which has proven an ineffective method of protecting young girls in Uganda.

The section named ‘Senga’ is a reference to a trusted relationship between a woman and her father’s sister (auntie). This relationship is commonly one where information regarding sexual and reproductive health and rights is passed on, but there can be a gap in appropriate or accurate information. This is where the SAUTIplus app comes in.

‘Senga’ provides an opportunity to view answers to questions you may have had yourself, smashing the common myths and misconceptions surrounding SRHR in Uganda. “My boyfriend says we don’t need contraception because he will pull out at the last minute. Is this a good idea?” is an example of one of the questions asked by a young girl on Senga.

The SAUTIplus app is providing a platform for women and girls to take charge of their sexual health. The knowledge the app provides is giving power to young women.

With power comes increased agency and the ability to negotiate within relationships – for example, with regards to contraceptive use to prevent pregnancy. No topic is taboo on the app. This includes menstruation and menstrual hygiene, a key SRHR challenge Reach a Hand have identified among young women in the country.

The for-the-youth attitude of the SAUTIplus app means it is an engaging platform for young people to access reliable information. Multimedia content, including photos, videos and blogs, provide a plethora of youth-friendly, easily digestible resources on SRHR.

The app is in continuous development, striving to meet the changing needs of young women in Uganda. It aims to create a positive relationship between young people and SRHR information, showing that information is a tool of power and not something to be dismissed. 

Learning to Honour our Sacred Menstruation

I can still remember how I felt when I got my first period. I was scared, confused and really not sure what was happening to my body. My mother took me aside and explained that I was becoming a woman.

She taught me how to use a sanitary pad, but emphasized that this was a deeply personal experience to be kept private. As an obedient daughter, I didn’t share my menstrual matters with anyone – not my siblings, not my friends, not my father, no-one. It was my secret to bear silently.

Young girls are taught from their first period that menstruation is taboo and dirty.

They are taught that however natural it is, it’s also shameful, disgusting and a source of impurity. I learnt early that menstruation was not to be discussed openly, and I understood that no-one should be made aware of it.

All of this appears deeply illogical when you consider that nearly half the world’s population will go through menstruation in their lifetime. How has modern society managed to convince us all that menstruation, a natural bodily process, is a social and spiritual abomination?

As a woman in her late twenties, it is only now that I have decided to change my perspective regarding menstruation.

The emotional and spiritual work I have been doing in last two years has helped me realize that menstruation is something beautiful, sacred and worthy of celebrating. This realization has required a process of unlearning the beliefs and ideas I held about menstruation. It has also required me to embrace my body and love it in all its phases and manifestations. I’m learning to tap into the sacred power of menstruation and to understand what it means to be divinely feminine.

Menstruation is a gift. Think about it.

It is a process that allows us to give birth to new life. It’s a function of the wondrous uterus, a self-cleansing and purposeful organ. Menstruation is an experience that unifies women across the world. It reminds us of our great feminine abilities. How can we not celebrate this? Menstruation is deserving of more recognition and appreciation.

In many ancient cultures, menstruation was seen as a sacred and precious time. Due to the connection of the cycle to the moon phases, menstruating women were believed to harness great ‘shamanic’ and spiritual power. Anthropologists suggest this may explain the use of menstrual huts in certain cultures, originally intended as safe spaces for women to retreat at the ‘height of their powers’.

In honouring menarche, different cultures celebrate a girl’s first period. They view it as a right of passage in to womanhood and mark the occasion with a ritual or cultural practice. Menstruation is given the respect and the regard it is worthy of.

What if we chose to look at menstruation differently?

Let us remove the stigma and shame. We have an opportunity to embrace and acknowledge something beautiful and fascinating. Beyond the biology, menstruation is a spiritual time that allows women to connect to a deeper part of themselves. It’s a time to release old and negative energies, and begin a new phase of self-growth and reflection. To me, that sounds like something worth celebrating.

?Read more menstruation posts on girlsglobe.org ?

Tampon Tax and the Fight for Menstrual Equity

Are menstrual products a necessity or a luxury?

In the United States, products are taxed based on whether they are ‘necessities’ or ‘luxuries’. Products deemed luxuries include a sales tax – on average this tax is 6.25%. Products considered necessities do not. Medications, shampoo, ChapStick and Viagra are some examples of products exempt from the tax.

Products not considered necessities, and therefore not exempt from sales tax in the majority of American states? Tampons and pads.

Currently, only ten states have removed menstrual products from the list of taxed items. Nevada is the most recent to do so – their exemption came into action January 1, 2019. Other states include New York, Illinois, and Florida, plus Washington, DC.

In an interview from 2016, former president Barack Obama spoke about the issue: “I have to tell you, I have no idea why states would tax these as luxury items […] I suspect it’s because men were making the laws when those taxes were passed.”

For those who do not menstruate, this may not seem like a significant issue. But as Obama agrees, it is an issue of gender inequality and access to healthcare.

“The basic idea is that women should not be at a disadvantage in the health-care system and this is just one more example of it, which I confess I was not aware of until you brought it to my attention,” he explains.

The financial burden of sales tax on menstrual products is a significant health and economic issue.

According to the office of California assemblywoman Cristina Garcia, “women in California pay about $7 per month for 40 years of tampons and sanitary napkins.” That’s a total of more than three thousand U.S. dollars per year. Garcia pointed out that this issue “is not insignificant […] especially if you’re on a tight budget.”

The added cost of sales tax on menstrual products leaves many with a difficult choice: buying menstrual products or buying food. Women are largely already at an economic disadvantage due to the gender wage gap and poverty. Around 14% of girls and women in the USA – compared to 11% of boys and men – live below the poverty line.

“Having your period when [you’re] poor means that once a month you have the added stress of finding a way to pay for these essentials,” Garcia said in a Facebook post.

Several campaigns and organizations are bringing awareness to the issue of menstrual equity in the USA.

There’s PERIOD, a non-profit organization promoting the belief that menstrual care is a basic right. Distributing Dignity provides bras, tampons, and pads to women in need. Period Equity is a law and policy organization fighting for menstrual equity.

There are also awareness initiatives, such as Menstrual Hygiene Day, which highlight “the challenges women and girls worldwide face due to their menstruation.”

Most recently, the issue gained global attention when Period. End of Sentence won an Oscar for best short documentary. The film tells the story girls and women in Hapur, India where a machine was installed to create affordable sanitary pads. It also discusses the girls’ and women’s experience with menstruation stigma.

Efforts towards gender equality must include menstrual equity.

Menstrual products are undoubtedly necessities and not luxuries for those who need them. As long as women are required to spend more on essentials, we will remain at an economic disadvantage.

In Conversation with Natasha Salifyanji Kaoma

Allow us to introduce you to Natasha Salifyanji Kaoma! Natasha is a Zambian medical doctor and the founder of Copper Rose Zambia – an organization working to advance adolescent sexual and reproductive health.

We sat down with Natasha to talk about starting her own organization, the taboo around menstruation and abortion, and how she takes care of her own wellbeing in her work. 

“I noticed a menstrual hygiene problem in my school. Not because the girls couldn’t afford the products, but most people didn’t know what was going on with their bodies.”

It can be incredibly challenging to work on issues considered to be taboo, sensitive or ‘controversial’, but Natasha clearly isn’t going to let societal norms in Zambia – or anywhere else in the world – stand in her way. 

“I believe that women, if empowered, can change the narrative of the African continent.”

This video was made possible through a generous grant from SayItForward.org in support of women’s advocacy messages.

My Menstruation is not a Sin!

Throughout the world, menstruation shares a common universal feature; women have historically been shamed because of it.

Although female sexual and reproductive health has started to become more important as a topic of study and discussion in the last few decades, many women to this day experience an overwhelming level of stigma around menstruation.

In many low-middle income countries, access to sanitary products such as pads and tampons is extremely restricted, forcing young girls and women to use inappropriate products, such as a piece of old cloth or banana leaves. A dire consequence of using unsanitary products is the development of genital and urinary tract infections that can, if unimpeded, cause severe complications.

While this is a truly worrying situation, it is not highlighted enough as a public health issue – primarily due to the stigma and shame surrounding menstruation.

The lack of proper sanitary products and/or facilities often forces girls and young women to miss school. This in turn affects women’s long-term economic development. This is not only seen in low-middle income countries; in the UK for example, girls and women often cannot afford the sanitary products they need – a problem known as ‘period poverty’.

In many countries across the globe, menstruation is considered dirty and repulsive. In some cultures, it’s even seen as a sign of ‘loss of virginity’ – insinuating moral and ethical depravity. In many countries, women and girls are ordered to leave their homes for the duration of their menses to prevent ‘desecration’ of their homes. In all these scenarios, girls and women find themselves ostracized, humiliated and expected to accept this without question or debate.

Even in parts of the world where the situation may not be so extreme, some degree of stigma remains around menstruation – large enough to prevent girls and women from seeking medical care because they feel too ’embarrassed’. Within the bounds of such societies, menstruators may not seek medical help and may not be able to recognize important health-related problems should they arise.

In the UK, almost 80% of adolescent girls have experienced a distressing symptom relating to their menstrual cycle but have not approached a medical professional for advice.

A large contributor to these misbeliefs is the lack of education and awareness on menstruation. This leads to an inundation of false conceptions and misrepresentations. Due to the restrictive social norms in many parts of the world, it is a topic rarely discussed within the family structure.

Not only does this mean an uneducated society when it comes to female sexual and reproductive health, but it also means that many young girls have no or very limited knowledge on what to expect and how to react when their menses start. Instead, they become more confused, isolated and unable to manage their menstruation in a safe, clean and dignified manner.

Many countries have addressed several of these demanding issues. In Kenya for example, free sanitary products are available and in neighbouring Ethiopia, menstrual hygiene clubs have been established in many schools.

How we are trying to help

The Swedish Organization for Global Health (SOGH) – in association with Uganda Development and Health Associates (UDHA) – has launched a project titled Ekibadha: Our Periods Matter, in recognition of this extremely important matter.

The UDHA Dignity Project

The project aims to understand and highlight the difficulties women and girls in rural Uganda are facing regarding their cycles. The project is in its first stages, but our goal is to develop a community-based initiative that involves the entire community which will be sustainable – economically and environmentally.

“Men should be more involved” said one of the women we interviewed last summer in one of the rural villages in Muyage District. We agree! Men need to be part of the conversation, this is not just a ‘women’s issue’.

To learn more about the project, please visit www.sogh.se/ekibadha-our-periods-matter/

How you can help

You can help us take this project forward. We are currently raising funds to support preliminary data collection, which is fundamental to shaping and guiding the project. Data will also give us the basics to apply for institutional funds. Click here and help us out, every penny is worth it! https://www.gofundme.com/MHproject-Uganda

Interview with a woman in Muyage District about menstrual health by SOGH and UDHA.

For any further information or to get personally involved please email us at MHproject@sogh.se. You can also help by spreading the word, sharing this article on social media.

#OurPeriodsMatter #BloodyIssues