Global Advocacy
Global Advocacy: Menstrual Discrimination
By Iniobong (Ini) Anselem
As part of SAHM’’s Global Advocacy efforts, I am pleased to introduce Iniobong (Ini) Anselem, a medical laboratory scientist/public health professional from Ogun state, Nigeria, and a consultant to the Advocacy Committee. Ini recently worked to address menstrual discrimination, a major issue for women around the world. Here is Ini’s experience. ~ Laura Grubb, SAHM Advocacy Committee Chair
Menstrual discrimination/stigmatization has existed from time immemorial. Despite education and exposure, it doesn’t seem it is coming to an end any time soon. To make this worse, little effort is being put into addressing this social problem. This is likely due to poor advocacy/awareness and stigmatization associated with menstruation in Sub-Saharan Africa, particularly Nigeria, where most individuals live below the poverty line. This has consistently affected probable solutions to managing period poverty, an increased economic vulnerability menstruators face due to financial burden posed by menstrual products.
For the past six years, I have lived and worked in the southwest region of Nigeria (Ogun state). My experiences regarding menstrual poverty stems from a comparison to what I had observed while growing up in Southern Nigeria (Calabar). Growing up back then, adolescent sexual/reproductive health issues were not topics one easily conversed on due to religious and cultural beliefs. It was common to find young people exploited in sexual practices due to financial struggles. It was also common to find young people had little or no knowledge about sexual and reproductive issues.
In my current position as a medical laboratory scientist, I have also seen a high prevalence of sexually transmitted infections (STI) among blood donors and most of these young people cited basic needs such as food, clothing, school fees and even the inability to buy sanitary products as factors responsible for unsafe sexual practices. Through research and observation, it became apparent that the average age of sexual debut was younger than 14 years. So, I thought it wise to address sexual/reproductive health issues among younger adolescents. I believe if we can address these issues while they are much younger, we might be able to decrease the prevalence of STIs. Bounded by religious and cultural barriers in addressing this topic, one feasible way to engage teenagers is through menstruation/menstrual hygiene. With the support of some individual donors through Young African Leadership Initiative (YALI), in 2021, we donated about 150 sanitary products to indigent girls in a selected public school in Ilishan, Ogun state to mark world menstrual hygiene day. Following the posts of the pad donation drive on social media, individuals contacted me to commend the outreach and share their experiences struggling with managing periods. It was obvious there is a growing need for more awareness/advocacy not just about menstrual hygiene but to address period poverty. It was surprising to realize that period poverty was still a challenge in recent times.
A 13-year-old menstruator Amina (a pseudonym), who lives in my neighborhood, shared the challenges she faces during menstruation. Often, she misses school when the diaper she uses to hold menstrual blood is washed and not yet dried. She finds it uncomfortable using pieces of cloth like menstruators of similar socioeconomic status. Amina, due to her heavy menstrual flow cannot use tissue, so she stays at home while managing her period with the use of a handkerchief.
Besides the handkerchief, she used wads of cotton wool, which she inserted into her vagina, but had to stop as it started causing pelvic pain, which prompted her to visit a physician. Amina is not alone in this struggle as there are many other girls like her. This brought memories of my teenage years, vividly recalling a classmate of mine who was absent from school due to menstruation, but since talking about menstruation was not a norm, we never quite understood her struggles until recently when she saw the post and shared her experience.
Like Amina, there are many others facing similar situations. Most of these menstruators engage in menial jobs to support their education and basic needs. Disposable pads are preferred as fabric is uncomfortable, but the cost of pads has skyrocketed to about 70% of what it used to be. With the current inflation backed by the pandemic, very few menstruators consider using disposable pads. Those who can buy them only use pads for the first few days of their period while the rest days they use tissue.
Therefore, my team organized a period poverty relief program, a maiden pad donation project by St. Anselem Care Foundation (SACF), (founded by Blessing Oqua, Uduak Anselem and myself) to meet the menstrual needs of indigent girls in public government schools in Calabar and Ogun state in May 2022. SACF is a nonprofit organization that caters for the needs of disadvantaged youth and young adults consisting of medical, health and public health professionals as well as social workers and administrators. Approximately 1,400 indigents girls were beneficiaries of this project. We ensured boys were part of menstrual hygiene education to reduce stigmatization regarding menstruation.
During our visit to one of the public schools for menstrual hygiene awareness, a beneficiary in her excitement said she has never used a sanitary pad since she started menstruating and looks forward to her next menstrual period. When asked how she has been managing her period, she said she often uses tissue when she can afford it, otherwise she has bags of old fabrics cut into pieces she folds in a pad-like manner to use. The downside to this is that it causes irritation of her genitals, and the thickness of the fabric prevents adequate airflow since she must use several fabrics due to her heavy menstrual flow. She missed an examination due to this situation and the poor sanitary facility within the school premises makes it almost impossible to change sanitary materials. There is also the challenge of disposing of used sanitary pads. Menstruators must wash off the menstrual blood before trashing the pad as it is alleged that used pad can be used for ritual purposes. So, pads are washed thoroughly using water until there are no traces of blood on it before disposing of it.
Prior to our school visits, we submitted a letter of intent to each school administrator after receiving approval from the Ministry of Education. With approval from the ministry of education and school administrators, our St. Anselem Care Foundation team of about eight volunteers for each location visited three randomly selected schools to talk about menstrual hygiene, stigmatization and making menstruation a normal experience as many adolescents and young adults have at some point experienced some form of stigmatization/discrimination during menstruation.
One form of stigmatization is being excluded from social activities like public cooking where there is a ceremony like a wedding, child dedication, etc., where a large quantity of food needs to be cooked for guests. Menstruators cannot be involved in such activities. Another social discrimination shared by a student who works part-time in a salon is that most clients do not allow her to braid their hair once they find out she is menstruating because they think it makes their head itch hence the braids do not last for a long time. This invariably affects her income as she must stay away from work for that period and, by extension, this affects her ability to provide for her family as they depend on her meager salary to feed them. There is also the discrimination to worship in some religious centers where a menstruator is not allowed entrance into the facility but asked to sit outside because she is unclean. Tradition demands that after menstruation, such an individual undergoes a special form of bathing to cleanse themselves from impurities using water that has been blessed by the church.
We hope to continue reaching out to young individuals and create awareness on the need to end period stigmatization, train girls on how to make cost-effective sanitary pads, provide menstruation bracelets and dignity kits to menstruators. We hope that through support from individuals with similar interests, this project can be achieved and not restricted to an annual event but done regularly as menstruation is not an annual exercise.
Resources including guides, tools and kits:
WHO Statement on Menstrual Health and Rights
