Do I have any privacy for my Menstruation?
Asrafi Bintay Akram ।। Menstruation is a natural part of the reproductive cycle of women. Owing to structural barriers like stigma, lack of products and facilities, gender inequality, and discriminatory norms, menstruation is considered a hidden, neglected, and the shameful issue of a woman in Bangladesh. Consequently, menstrual hygiene practice affecting factors are not identified properly. Generally, some factors like social stigma, parental preference, education, economic status are identified that affect the menstrual hygiene practices of women. But space (place) impacts women directly during menstruation extensively but that is still less addressed.
Bangladesh is one of the few countries where the government is actively engaged in MHM (Menstrual Hygiene Management) but it has no specific guidelines for MHM and thus it follows WHO’s prescription that is included clean blood absorbent materMenstruationials, adequate privacy, soap, and water facilities, and a convenient disposal system with dignity.
In the normal situation in informal settlements, girls and females are not prepared and aware of good practices so they face many difficulties and challenges at home, schools, and workplaces on account of lack of privacy (space) with dignity in menstrual hygiene practices. But every girl and woman has the right to get structural facilities so that they can properly manage their menstrual hygiene. But this issue is mistreated. Normally, girls or women need private space for two critical purposes. Firstly, for changing absorbing material, secondly for cleaning menstrual clothes for reusing those. In this Covid period, since male members are remaining at home, it has become challenging for the girls and women to maintain privacy in MHM. At the same time, deficiency of financial support, girls and women dearth proper materials for MHM which make them subject to physical tortures and social taboos. Last year, in the first month of lockdown, WaterAid Bangladesh surveyed girls and women and tried to identify how they faced challenges for managing menstruation which they never faced before. The findings of this survey identified that girls and women want adequate facilities for menstrual management at the family level.
Privacy and personal safety are closely connected with space. As proposed by WHO and UNICEF joint Monitoring Program (JMP), good menstrual health management means girls and women will use clean menstrual blood absorbing material which can make changes in necessary privacy during menstruation. UNICEF identified two challenges in this good management practice for marginalized women. They are- physical cleanliness and privacy for cleaning and drying menstrual cloths. That means managing privacy with dignity for girls and women is a very tough job because in our country cleaning and drying menstrual clothes in an open space is a social taboo.
A female experiences almost 300 days of menstruation in her life span (WaterAid Bangladesh, 2020). 46.8% of the total population is women of 15-49 ages, among them 57.35% uses old rags during menstruation (BBS, 2017; BDHS, 2011; BANBEIS, 2015; National Hygiene Survey, 2018). As opposed to, under the Census of Slum Areas and Floating Population 2014, the total no. of female dwellers in the slum is 10, 86,337. Among them, 10 years and above adolescent girls and females are of 50.20%.
How are their settlements? WaterAid Bangladesh (2020) revealed in its research that in the informal settlement like slum is full of crowd. It is quite impossible to uphold privacy within the physical proximity where 5-7 people live together most of the time. Besides, there has a scarcity of water and hygiene health facilities. Since, at present time the male members of the family stay at home for various reasons like infection, lack of employment, and shut down of school, etc. so it is very difficult to change menstrual blood absorbing cloth in pursuance of their needs. From my research, I have been informed that during menstruation the females of slum use the shared washroom when the males are out of the home. Subsequently, the absence of private space and not using the toilet frequently make them anxious.
According to the report of WaterAid Bangladesh (2020), in this circumstance, females wait when the males will go outside or for off pick hour (time of less use of toilet) to get the facilities of the toilet. Miles et al. (2018) opined that shortage of water and attached washroom cause genital infection of women. On the other side, under the inadequacy of space for drying menstrual cloth, the poor women are at health risk.
Following the national hygiene survey 2018, reusing menstrual cloth should be washed with soap and dried in the sun. Only 12% of adolescence and 18% of females have done this work as per the survey. In this regard, the specialist of Gynecology and Obstetrics and Surgeon of Bogura Dr. Farhana Yesmin Rumpa has said “It is better to use a sanitary pad. If anyone doesn’t use a disposable pad she can use cloth but have to clean with water and soap and antiseptic. Then dry to under the light of the sun. Anyone, however, uses a disposable pad or cloth, she has to change every 4 hours. Because bacteria come out with menstrual blood. So if the cloth is not clean properly the bacteria has the chance to grow there which roots genital infection. Immediately it creates itching on the skin and fungal infection. Later on, after a few menstrual cycles, she can have a Leucorrhoea (a white discharge of mucous material from the vagina). In our country, there are lots of patients with Leucorrhoea because of unhygienic menstrual management. If it continues for a long term it grounds Cervical Cancer.”
The number of Leucorrhoea patients in Bangladesh is not recorded. But every year 8268 women are being diagnosed with Cervical Cancer. About 4,971 women are dying of Cervical Cancer each year (International Agency for Research on Cancer, IARC, BBC Bangla, 2021). Menstruation is not considered a physiological issue in this country. This issue has been constructed socially. Therefore, even in ordinary times, persons’ negative comments about drying women’s menstrual cloth in open spaces make them panic. As a result, they hide their clothes under other clothes or in a dark place day after day so that nobody notices them. This fear of being insulted or frightened makes their monthly management unhealthy. Contrariwise, in this pandemic situation, the proximity at the house or settlement itself poses challenges in women’s little management only for social reasons. This year, the slogan of World Menstrual Hygiene Day (28 May) is to make more activities and investments in menstrual health and management. But are we still able to ensure a healthy and normal menstrual cycle for a low-income woman let alone more?
Asrafi Bintay Akram: Assistant Professor, Department of Sociology, Hajee Mohammad Danesh Science and Technology University, Dinajpur
(The views and opinions expressed by the writers are those of their own and do not necessarily reflect the views and opinions of Feminist Factor)