Breaking the Taboo: Ending Stigma Around Menstruation

It is very exciting to be speaking this week at the Women Deliver event in Copenhagen. The conference is the place to be for concrete discussion and examination of the rights of women and girls around the world and covers a host of topics from education, health and gender rights, to legal rights, land rights, and FGM.

Each topic presents an opportunity for change but, for me, one of this year’s standout issues is getting schools and local governments to consider how girls manage their periods. It can be an uncomfortable subject, but it’s a crucial one for measuring progress in girls’ education and rights.

Staggeringly, over 1 billion women and girls do not have access to safe and clean toilets to go to at all, let alone when they’re on their period. This means girls often go into bushes or hidden places when it’s dark to relieve themselves or change their sanitary wear, violating their dignity and privacy and often putting them at risk of sexual or physical violence.

During the day, attending school can become problematic if there is nowhere for girls to manage their periods in safety, with dignity. Imagine not being able to close the door on the world to deal with your period, particularly if you live in a culture that stigmatises that time of the month.  So some girls opt out of school, meaning that their education is compromised – the education that for them is often the only hope of a future free from poverty.

If they don’t complete their schooling, girls are at risk of early marriage, early pregnancy, and a continued cycle of poverty, alongside the ill health that comes from having to go without clean water and sanitation.

And that’s not all. There are so many taboos and stigma surrounding menstruation in many countries – myths that might mean they are not allowed to enter the kitchen, to cook, even to eat the same food or sleep under the same roof as their family in some cases. That’s totally unacceptable and an infringement of their human rights.

These facts and stats may come as a shock to some – but sadly it comes as no surprise to me.

Growing up in Kenya, I saw the effect of menstruation on my friends’ confidence.

Because some of them could not afford sanitary towels, they ended up using cloths and this affected their self-esteem. They would literally go into hibernation. Using cloths during menses is not safe because it leads to vaginal infections if the cloths are not well cleaned. They are also a source of embarrassment. Once in a while the cloths would fall out and the shame would affect the girls’ confidence. In 2012, a Kenyan television network aired a story on girls from Migori – a town in Western Kenya – who were prostituting to buy sanitary towels.

It broke my heart but I do understand that this is the reality for many girls out there. Girls want an education, and menstruation should never be a hindrance because it is a biological cycle that should be embraced, and not viewed as a shame.

This is still the case for many girls around the world. Elaine is 14 years old and lives in Madagascar. She’s lived in the area south of Antsirabe since 2001 when her family moved there, to escape a violent local tribe who had attacked her shopkeeper mother.

When she first arrived in Madagascar, there was no water point and only two old unsafe latrines, so she and her fellow pupils at school were forced to use open areas around the school to relieve themselves and, later, manage their periods – or to go home. Elaine would miss school for three days at a time during her period because there was no water to wash with nearby and finding water would take more than an hour.

However, since intervention by international NGO WaterAid and its local partners, Elaine’s school now has a new bathroom for girls. It has running water so they can wash and a locking door to maintain privacy. She now says proudly:

“I don’t miss school for [my period] anymore. I like going to school because I get learnings and I don’t get tricked by people because I am learned. Teaching is the best because this is the best heritage – the best thing someone can have is learnings.”

If that quote alone doesn’t encourage us to make a change, I don’t know what will. WaterAid’s #ifmenhadperiods campaign brilliantly captured the imagination of people around the globe last summer as it poked fun at what the world would be like if those in power—men—experienced menstruation like most females do. Would men hide away ashamed, miss school because no-one had thought to provide a safe toilet? Or, as WaterAid envisaged, would periods come out of the closet and be dealt with in a matter-of-fact fashion, even celebrated? We will never know.

But we do know that many girls face humiliation, embarrassment, restrictions on movement and food, missed education, and even violence because of societal and gender norms that tell us their periods are dirty and shameful. By tackling this issue head on we can help keep girls in school around the world, in turn empowering them to avoid early marriage, to participate in productive labour, and stay healthier, all of which reduces the likelihood of their children being born into poverty.

No woman or girl should have to manage her period without access to clean, safe, private toilets and washing facilities, and subsequently compromise their future – or that of their children. Menstruation is completely natural and an experience shared by half the world’s population. All of us—whether we are focused on education, sanitation, adolescent girls, or basic human rights—need to work now to bring this issue out of the shady margins of society and ensure that girls and women are supported to care for themselves during this time and at all times.



Vivian Onano is a Kenyan youth human rights activist and recent graduate of Carthage College. She has a dream to help create an inclusive world for all and is supporting WaterAid at the Women Deliver conference in Copenhagen. She tweets at @vivianonano.


Featured image: Amina and Rahama in front of latrines built by WaterAid with funding from HSBC Malta on 10 November 2015 at a senior high school in the Northern Region of Ghana. Image courtesy of WaterAid/ Nyani Quarmyne/ Panos. 

SDG 6: The secret to unlocking opportunity? Clean water and toilets

By Carolynne Wheeler, WaterAid

As a 21 year old woman in rural Nigeria, Kadoon Tilenen faces a difficult choice each time she feels the urge to relieve herself.

When you’re pregnant, that urge comes even more often – and when the only toilet is a rudimentary pit latrine shared by your husband, small child and large extended family, sometimes the only option is to head for the field instead.

But doing so is uncomfortable and risks her health.

“It feels very uncomfortable but sometimes I have no choice. In my condition, my stomach hurts me sometimes when I am in the bush bending and the grasses help to cover,” she said. “At night, I am afraid so I don’t go very far from the house. There are thorns that prick and sticks that injure me. Defecating in the bush disgusts me and makes me vomit a lot, especially in my pregnant state.”

Kadoon is one of nearly 1 billion people in the world who have no choice but to relieve themselves in the open.

She understands that this contaminates the environment and spreads disease, putting her own health at risk, as well of that of her child. But there simply isn’t any choice.

Kadoon Tilenene, 21 , farmer by their community open pit toilet in Agaku. Agaku is one of the communities in Benue that lack clean water supply. Their main water source is the river and rainfall. Open defecation is widely practiced in Agaku. Photo by WaterAid/Andrew Siebo
Kadoon Tilenene, 21 , farmer by their community open pit toilet in Agaku. Agaku is one of the communities in Benue that lack clean water supply. Their main water source is the river and rainfall. Open defecation is widely practiced in Agaku. Photo by WaterAid/Andrew Siebo

“We don’t have clean water and many people don’t have toilets so we defecate in the bushes around our houses. … Dirty water is used to cook, wash, bath, for drinking and everything water is needed for. People fall sick a lot and the entire environment smells. The air is bad,” she said. “Clean water and a toilet will make people no longer fall sick. The environment will be clean and we won’t see feces in the open. It will also help us save money and not spend it on hospital bills. I think people would use latrines if they had them.”

Delivering safe water and toilets and promoting good hygiene in communities like Kadoon’s changes the life cycle of a girl. Provide this from the moment a baby comes into the world, and she’ll less likely to succumb to infection as a newborn, less likely to have chronic diarrhea and illness as a young child, more likely to attend and stay in school – even once she begins menstruating, if school has a private toilet and hand washing facilities so she can manage her periods. A better education means she’ll be more likely to marry when she’s ready and have healthier, better educated children.

A life transformed – all because of these three things those of us in the developed world take for granted.

In September, the world’s leaders got together and pledged to deliver a toilet to every household, everywhere by 2030 as part of the new Global Goals on sustainable development. These goals set out a plan to end extreme poverty, eliminate inequalities and address climate change.

All of these goals rely on delivering safe water, decent toilets and good hygiene, including hand washing with soap for all. Without these, new mothers will continue to die of preventable infections; newborns will succumb to infection acquired in surroundings that are not clean; children will continue to be stunted by malnutrition caused in part by chronic infection and entire communities will miss out on the opportunities that come when populations are healthy and productive.

The work of the Global Goals has only just begun; 663 million people in the world do not have access to clean water and another 2.4 billion do not have access to safe, private toilets. WaterAid is among the organizations calling for clean water, decent toilets and good hygiene for all. Help us make sure we keep that promise to Kadoon and her young family.

Illustrations for the SDG campaign have been made for Girls’ Globe by artist Elina Tuomi.

The Role of Water in the Struggle for Rights

While A Spring of Hope’s mission is to bring water to impoverished rural South African schools in order to provide sustainable economic development to all in the community, our work has a significant and unique impact for girls and women.

One very critical area that is affected by lack of water is school attendance. Girls’ absentee rates are significantly higher than boys due to their role as water collectors. They often have to trudge several kilometers with jerry cans to unreliable government pumps or unsafe, polluted sources in order to acquire water for cooking and washing, losing days of school and work. If the water is of questionable quality and makes them ill, more work or school time is lost, with medical costs adding economic burdens they can ill-afford.

Photo Credit: A Spring of Hope
Photo Credit: A Spring of Hope

According to the UN Women Commission, women and girls represent 75 percent of household water collectors. In some countries, the proportion is as high as 90 percent.

A fresh, clean water source at schools can be used for food preparation, sanitation and growing prolific gardens that provide healthy and nutritious meals for the students. Additionally, the burden of collecting water is lessened and girls are more likely to maintain their studies.

Another area which A Spring of Hope is striving to improve, which also adversely affects girls, is sanitation. In South Africa, 913 schools have no sanitation facilities and 11,450 are still using pit latrine toilets ( While poor sanitation and pit latrines spread disease and are unhealthy for all, menstruation offers additional challenges to girls.

Globally, about one in ten female students do not attend school during menstruation or drop out because they do not have access to sanitation facilities they feel are private, clean, and safe.

In addition, inadequate sanitation facilities pose a safety risk for women and girls, who often suffer harassment or sexual assault when toilets have no locks or doors.

Photo Credit: A Spring of Hope

A Spring of Hope is attempting to provide solutions for these sanitation issues by providing waterless toilets to our partner schools. Waterless toilets are a revolutionary waste containment system which is environmentally friendly, requires no water, and helps eradicate the spread of disease.

Universal access to water and sanitation is imperative to achieving gender equality and promoting women’s empowerment. It is also about the increased access to rights–the right to own property, own land, education, and free choices. A Spring of Hope is contributing to this ongoing struggle for rights by helping schools become self-sufficient, strong community centers. It’s not “aid” or giving material goods away, it is partnerships that are behind rights-based development.

Little BIG Africa: Water and Sanitation Post-2015

2015 is sure to be a historic year for girls and women.  Worldwide efforts are ensuring that they will be a focus of the next set of development goals, voices speaking out against FGM are growing louder, the Malala effect is continuing to spread, and child marriage is finally being given the global attention it deserves.


Women collecting water from an unprotected water source in Manafwa. Photo Credit: Eleanor Gall
Women collecting water from an unprotected water source in Manafwa.
Photo Credit: Eleanor Gall

Amongst this positive momentum, it’s crucial that one area doesn’t get left behind – as it’s an issue that is already lagging in its progress.  Halving the number of people worldwide who do not have access to safe water and sanitation is the least on track of all Millennium Development Goals – according to a UN report published last year – and 2.5 billion people worldwide still lack basic facilities.

The effect of this on females is colossal.  In communities where the responsibility for collecting water rests on the shoulders (or rather on the heads) of women and girl children, the task takes hours each day.  For girls, this means hours out of the classroom and hours at risk of abuse.  Inaccessible clean water has huge implications on women’s health, from their chance of giving birth in a safe environment to their ability to stay in education once they start menstruating.

Lack of global investment and government failure to plan countrywide programmes are cited as key reasons behind the slow progress.  Chris Williams, executive director of the UN-based Water Supply & Sanitation Collaborative Council (WSSCC), believes “Many countries have really good strategies or targets … but their ability to translate that into decentralised implementation programmes is really weak.”  It seems that water and sanitation programmes are not reaching people in the areas of the world that need them most.

One organisation working directly with communities being overlooked by larger programmes is Little BIG Africa – a grassroots NGO focusing on water, sanitation and hygiene in rural Uganda.  LBA has worked in partnership with local communities in Manafwa over the past ten years to implement projects that give the hope of a healthy life to girls and their families.  They believe that regular monitoring is key to successful projects and each of theirs is visited at least 3 times a year.

A young girl collecting safe water from a source that LBA has protected. Photo Credit: Eleanor Gall
A young girl collecting safe water from a source that LBA has protected.
Photo Credit: Eleanor Gall

Since 2004, LBA has protected 68 water sources, constructed 80 water tanks at primary schools, and carried out thousands of hygiene and sanitation sensitisation sessions – through art, drama, music, dance and stories individuals gain the knowledge to become change-makers in their own families and wider communities.

Protected water sources greatly improve the health of whole communities (at the moment 44% of Ugandans drink water that is unsafe for human consumption) and mean that women and girls no longer have to travel up to 8 miles a day carrying 20kg of water.

At a school with no water girls are far more likely to drop out when they start menstruating and are forced to leave lessons to collect hundreds of litres of water per day.  As well as the obvious effect of missing education, girls on the long and isolated routes to water sources are at real risk of sexual abuse once they leave school premises.  LBA tanks are helping to change this reality for girls in Manafwa.

For LBA, the importance of bringing women into development discussions is taken very seriously.  At every community meeting held, on every committee set up, females are warmly welcomed and encouraged to engage.  Sitting at the heart of the family and the home, women know what works, what doesn’t work, and what their family needs.

The lives of girls in rural areas are under a spotlight this year, with huge potential for action.  However, it is crucial that access to water remains firmly on centre stage.  If women’s education and health are to improve then their access to water must be made more of a priority post 2015 – it can no longer be left trailing behind.

Smaller-scale, community-led, well-monitored and sustainable initiatives like LBA are making tangible differences to the health and lives of girls and their families in rural Uganda.  Theirs is the kind of work that must be celebrated, invested in, and replicated.

To read more about LBA visit their website to sign up to their newsletter, and follow them on Twitter/Facebook/Instagram/Flikr.

Why I’m Walking For Water in New York

Thirteen-year-old Solo from Madagascar struggling to lift a jerry can of dirty water. Credit: WaterAid / Abbie Trayler-Smith

Today I walked. I walked for the sheer joy of the sun on my face and the solitude I crave to think and rejuvenate my body and mind.

I walked without fear, pain or exhaustion. I walk when I can, and wherever I want. I am not on a mission of survival. I walk for fun. For fun you ask? You bet, but try explaining that to the nearly 750 million people in world living without access to clean, safe water.

Women Walk for Water
Every day, the lives of millions of women and girls are defined by their need to walk in search of life’s most basic necessity: clean water. Their relentless, backbreaking chore of carrying water is a matter of survival, not a choice.

Too many strong women in developing countries are shackled to the burden of water collection. The time spent lugging heavy water containers weighing up to 40 pounds (18 kilograms) is time spent not earning an income, learning new skills or caring for young children.

What’s even more tragic are the girls who lose the will to continue in school when they reach puberty. In addition to frequently arriving late to school after their long walks for water, the shame and humiliation of managing their monthly periods without toilets and water becomes unbearable – their solution is miss school or drop out completely. This is just wrong! And it’s not a solution.

I have no worries about where to find water, whether it’s safe to drink or if I might be attacked while walking alone to remote ponds or rivers at dawn and dusk. For me, having safe water and a toilet is just something I take for granted multiple times a day without so much as a thought.

Hallie Tamez
Hallie Tamez will walk six miles through New York carrying a jerry can on November 21. Credit: WaterAid / Katherine Crider

For most of us it’s hard to imagine enduring a long and painful walk each day in search of water. So that’s why on November 21, 2014, I will be doing just that! My #Steps4Water will take me on a long and painful six-mile journey across Manhattan carrying 40 pounds of water in solidarity with the women and children around the world who undergo this journey every day.

I am doing this because I believe in the power and potential of women and girls to contribute to their world in ways far beyond collecting water. Every girl deserves a chance at a future with choices, not a future defined by the daily struggle for survival.

On November 21, I’m not walking for the sheer joy of the sun on my face and the solitude I crave to rejuvenate my body and mind. I am walking to highlight the daily experiences of women and girls living without clean water and raise awareness of WaterAid’s biggest #GivingTuesday challenge yet to raise $150,000 on one day for safe water and toilets for the world’s poorest families. If we do, that $150,000 will be matched.

At WaterAid, an international NGO dedicated solely to improving access to clean water, sanitation and hygiene education, we believe women should have time to run businesses and care for families, children should be in school and find joy in play in a safe environment.

We believe babies should live to take their first steps and that communities with the right support have the ability to manage their own water supplies. We believe everyone, everywhere can have water, toilets and hygiene by 2030.

It’s time for each of us to step up. If you are in Manhattan on November 21, take a walk with me, take a photo and upload it to social media with the hashtag #Steps4Water. If not, take a walk wherever you are and share the story of women and girls who can do so much more than carry water – they just need the chance. Together, we can all contribute to unlocking the potential of women and girls and seeing more babies live to become those strong girls and women stepping up towards a brighter future. Water is just the beginning.

Written by Hallie Tamez, Associate Director of Major Gifts, WaterAid America


Why does menstruation matter?

Her Turn alumni

Written by Ola Perczynska, Her Turn Program Manager, and Danielle Preiss, Her Turn Social Media Coordinator

We used to call menstruating girls and women ‘untouchable,’” Sita, 12, told us after participating in a Her Turn workshop. In her community in rural Nepal, women and girls are traditionally considered impure during their periods. When Sita got her first period, she had to stay home for 11 days. She couldn’t go to school, or even touch a book.

Sita’s situation is common in much of Nepal. A recent study from 15 districts revealed that 95% of adolescent girls follow some form of restriction during their periods. Practices vary by community: some girls can’t go to school or participate in religious rituals. Others endure a more extreme form; they are forced to sleep outside in huts or animal sheds, a practice called chaupadi.

Menstruation doesn’t affect access to education only in Nepal. Girls around the globe miss school during their periods, or drop out altogether. In Sierra Leone over 21% of girls are absent from school when menstruating; in Nepal and Afghanistan the figure is close to 30%. In India 23% of girls aged 12-18 drop out of school entirely after their periods begin; those in school miss an average of five days a month.

Because this normal body function is so taboo in much of the world, stigma alone keeps girls out of school. They fear harassment from boys and the embarrassment of a leak. Teachers themselves may not know enough about puberty and menstruation to teach their students. In one Nepali school, a 15-year veteran health teacher told us he knew nothing about it before reading our Girl Guidebook. In this atmosphere of silence and shame, girls have nowhere to learn about menstrual hygiene – in one study 80% of girls in Burkina Faso and Niger were scared at their first period.

Traditions and stigma are only part of the problem: A school sanitation crisis afflicts the developing world. In the least developed and low-income countries, only 45% of schools have adequate toilets. In Tanzania only one school toilet in a hundred has soap. In Nigeria, 600 students have to share one toilet. In Nepal only 36% of schools have a separate toilet for girls. Sita’s school didn’t, which is part of why she used to miss school every month.

In the developed world, we take pads and tampons for granted. In poverty stricken or remote locations, girls rarely have access to these supplies and make do with simple cloths. But to keep them clean, a girl needs access to a clean and private toilet, with soap, a necessity that many girls lack. Some alarming reports indicate that half of adolescent girls in Kenyan slums trade sex for pads.

So imagine being a 10-year-old girl in a developing country. Nobody explained to you what will happen during puberty. You’ve seen boys laugh at girls during their periods. When yours comes, you have no private, safe toilet to use at school. You can’t afford pads, so you use cloths. It’s hard to keep these clean, and to make sure nobody sees them. You still don’t know what is happening with your body, just that nobody wants to talk about it and that you are now considered ready to marry. Keeping up with school gets harder because now, every month, you miss several days, too ashamed that someone will find out. You eventually drop out, are married off, and know you no longer have life options.

This is the grim reality of too many adolescent girls; it needs to change. An integrated approach, already adopted by many organizations, has to be the norm in policy and programming. To keep girls in schools, the construction of girl friendly – safe, private, hygienic, and separate – toilets must be accompanied by programs that raise community awareness and knowledge of menstrual hygiene, make menstrual materials available in schools, and appropriately change the school curriculum.

And changes are happening. A growing number of initiatives locally produce affordable reusable pads – one in India sells production machines, instead of just pads, to women’s groups across the country. Last May the international development community celebrated the first Menstrual Hygiene Day – a great sign that organizations are becoming more aware of the issue. This November, we’ll host a month of action through Day of the Girl Summit to talk openly about menstruation (look for our campaign on Twitter with the hashtag #PointPeriod).

We too have witnessed inspiring changes in own work – the subject is no longer taboo for over a thousand girls with whom we have worked. When a boy in health class in a rural Nepali school asked about menstruation and the embarrassed male teacher went silent, one alumna of our workshops raised her hand and explained it to the class. Our participants educate their mothers too – like a mother who told us she worried every month about how much blood she lost, until her daughter quieted her fears.

But a lot still needs to be done to break the taboo. This is not just a women’s issue; girls’ education is everyone’s issue. We now know the cost of not educating girls. As we fight to end barriers to education like child marriage, and celebrate Day of the Girl worldwide for the third time, let’s not forget that a healthy body function can also hurt girls’ education. It’s time for change.

Learn more about the importance of menstrual hygiene on Girls’ Globe.

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