In many Nepalese communities, menstruation in and as a social context is considered “impure”, and women are generally not allowed to stay with family when menstruating. In some rural communities, chaupadi is a common practice, where women are banished to live in isolated sheds when they are menstruating. With deep roots in a culture that encourages regressive and inhumane practices, it can be difficult to recognize menstrual shame. Meeting it is an impossible challenge, especially for a student with limited knowledge of the taboo, and in most cases they are taught virtually nothing meaningful about it in class.
The consequences of stigma can be difficult to understand as a young person. Traditions associate menstruation with shame, embarrassment and evil spirits. In some cultures, women bury their menstrual tissue to prevent it from being used by evil spirits. Undoubtedly, the roots of the transformation of this natural process into a taboo lie in religious and cultural aspects; however, it was and still is perpetuated through society and classrooms.
The physical pain and discomfort added to the fear of spotting are constantly and consciously on the minds of menstruating people. The stigmatization of this concept impacts the lives, health and safety of women and girls while strongly reinforcing gender inequality. A 2016 UNICEF report indicated that girls experienced shame, fear, confusion, teasing and a lack of accurate information and guidance, with 15-22% of them missed school during their periods. Additionally, menstruation can also be a determining factor in girls dropping out of school. In India, one in five girls drop out of school after menstruating. There are a myriad of reasons – it could be parents’ fear of their daughters accidentally getting pregnant or to indicate that a girl is ready for marriage as it is a sign that they have become a woman. A good contributor to girls’ absence from school is the lack of proper toilets and menstrual hygiene products. Schools should take measures to ensure menstrual health and hygiene management and access to sanitary products, and provide changing rooms to allow girls to manage their periods without discomfort to mitigate this absence at some level.
Schools are also responsible for providing their students with appropriate knowledge on the importance of menstrual health and hygiene management, making menstruation knowledge inclusive for all genders. They need to start supporting teachers, even male teachers and staff, and equipping them with the necessary knowledge and training in menstrual health, hygiene and reproductive health. Also, they need to make sure that all teenagers, even boys, get used to it and that students feel comfortable talking about it rather than being embarrassed and made fun of. Menstruating people need to feel safe when they have their period and should be able to easily share their discomfort with their teachers and friends rather than whispering about it and reinforcing the archaic mentality.
There is a need to understand, especially among policy makers, that sanitary products are essential items and not luxury items. The imposition of 15% customs duties, 13% VAT and an additional 1.5% VAT on customs duties on imported menstrual products limits access to an already costly necessity. Regardless of when a shift in mindset and policy occurs (hopefully soon), schools should be actively involved in providing sanitary pads to students of menstrual age as key drivers of this change. When the New York City Department of Education announced that 25 public schools would be equipped with dispensers filled with free feminine hygiene products for students, schools reported a 2.4% increase in attendance after the installation of distributors. We hear about menstrual product drives working to provide vending machines in different community schools, but that may just be a band-aid to the wound. Just as schools invest in building a new computer lab, they must allocate a budget each year for sanitary vending machines and refill pads and tampons the way they refill markers and chalk in classrooms. And this needs to be replicated in society where vending machines should be readily available to everyone and hopefully free of charge.
Undoubtedly, schools in our communities face a serious challenge in ensuring adequate facilities for menstruating girls. The World Health Organization reported that two out of five schools worldwide lacked basic handwashing facilities, while seven out of 10 schools lacked basic handwashing facilities in developed nations. The situation gets worse when we turn our attention to Nepal. UNICEF analysis suggested that nearly 78% of schools have access to improved water supply facilities, while 82% to basic sanitation facilities, and only 69% of schools have separate toilets for girls, while only 25% of schools in the country have fully functional water supply systems.
These statistics are certainly disturbing, but when it comes to the health of young girls, positive change is needed. Schools should prioritize building changing rooms with privacy to allow menstruating people to manage their periods without discomfort. These facilities must have access to hand washing stations with clean water and soap and sanitary disposal bins. A menstruating person should not be forced to go home or even miss school when they have their period because they do not have access to clean and safe changing tables.
Going forward, schools and policy makers must prioritize menstrual hygiene and management. We cannot have more absenteeism in schools because of the inconvenience of menstruation or the lack of people to support it. These fundamental yet impactful steps will not only help increase attendance rates, but will also enable students of all genders to understand the concepts of menstruation, which, in turn, will help break down stigma in the community. It’s about making sure girls feel safe and stay in school during and after their period. Schools in Nepal and around the world need to adopt a positive period concept. Interventions at different levels are needed to improve menstrual health and hygiene in people who menstruate and to break existing menstrual taboos in our community and minds.