Period Poverty: A Global Sanitation Crisis Affecting People Who Menstruate

Whether you are a female, a transgender man, nonbinary, and genderqueer or have gender dysphoria, Global Citizen estimates that every day over 800 million people are menstruating. People who menstruate will have up to 500 periods in their life, and they will need at least 11,000 sanitary products to cover the approximately 3,500 days of flow.

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The worldwide stigma, taboos, and myths surrounding menstruation is absurd and, unfortunately, very divisive. A combination of insensibility, poor mentality, and menstrual shame has led to period poverty, which consequently has become a global sanitation issue. Global Citizen best describes period poverty as the “lack of access to sanitary products, menstrual hygiene education, toilets, handwashing facilities, and, or, waste management” — essential items and products that should be considered as health necessities. 

According to UNICEF, a total of 2.3 billion people suffer from the absence of basic sanitation services adding that only 27 percent of those living in the least developed countries have a handwashing facility with water and soap at home. Managing periods at home is a major challenge for women and adolescent girls who lack these basic facilities where they live. “We envision a world where every girl can learn, play, and safeguard her own health without experiencing stress, shame, or unnecessary barriers to information or supplies during menstruation,” said Sanjay Wijesekera UNICEF Chief of Water, Sanitation and Hygiene. “Meeting the hygiene needs of all adolescent girls is a fundamental issue of human rights, dignity, and public health.”

When people who menstruate can’t access these facilities and products, they put their health at risk. UNICEF revealed that poor menstrual hygiene has been linked to reproductive and urinary tract infections. “Many girls and women have limited options for affordable menstrual materials. Providing access to private facilities with water and safer low-cost menstrual materials could reduce urogenital diseases,” the United Nations agency directed.

As reported by Global Citizen, every gender can benefit from menstrual hygiene education. To break stigmas around this natural process they suggest that every school educates boys and girls on how important it is to have healthy habits during this cycle, and most importantly to raise awareness on how much taboos can affect people who menstruate. 

“My dad told me my sister got raped because she was bleeding and crying at the same time. My dad never went to school so he didn’t know that girls start their periods that early,” says Alemayehu Belete, 17. “I explained it to him — and also to my little sister about menstruation and how she can use pads.”

In many countries, menstruation is seen as impure. In Nepal, females have to spend their cycles inside a primitive dwelling while in Uganda, girls skip school to avoid being bullied by classmates. The “Menstrual Health Management in East and Southern Africa” study revealed that “girls in some traditions are discouraged from touching their genitals or bathing during menstruation” and  are banned from “cooking, attending religious ceremonies, or engaging in community activities.”

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In Afghanistan, while menstruating, females can’t eat meat, rice, vegetables, sour foods, or drink cold water, nor sit on wet ground, and washing is forbidden. “Even women in the family don’t talk with the ones who have their period,” says 18-year-old Mahnaz. “They are not allowed to cook and they are ignored until the period is over.” 

A big problem affecting women living in poverty is the cost of menstrual products. “Some studies from Kenya find that schoolgirls engage in transactional sex to pay for menstrual products, particularly for the younger, uneducated, economically dependent girls,” the report says. According to the study, transactional sex increases their risk of HIV, unintended pregnancy and school dropout.

“In Africa, it is high time we throw aside the myths and misconceptions, and the negativity that, for too long, has surrounded the menstrual life cycle, from menarche to menopause,” said Dr. Julitta Onabanjo, UNFPA’s regional director in East and Southern Africa. “We need to be transformational going forward,” she added. 

Girls' periods affect their #SDGs, especially school attendance. #Tanzania's WomenChoice Industries produce affordable menstrual products to end period poverty. They're also the winner of our #SDGsAndHer Competition w/ @WorldBank, @wharton & @UN_Women! https://t.co/2w7MvOKTSt pic.twitter.com/KE6caBvSFN

— UN Development (@UNDP) August 30, 2018

The transgender community living in impoverished areas and people with HIV probably struggle the most. “Those living with HIV face a double stigma when it comes to menstrual health management,” said Laura Thuo, from the International Community of Women Living with HIV. “Lack of availability and affordability of menstrual products means that women and girls become more vulnerable to exploitation and HIV. When you’re living with HIV, you always think your blood is infectious, so you’re afraid of talking to anyone about menstruation.” 

“There are very few sanitary-ware options for the trans community,” shared Tinashe Sande, from Transgender Intersex Rising, Zimbabwe. “In Zimbabwe, you can’t find a gender-neutral toilet. You get told you’re in the wrong bathroom. And if you enter the male bathroom, there are no cubicles or sanitary bins.”

Besides a culture’s misconceptions towards the moon cycle, people who menstruate also face additional challenges with menstrual hygiene during natural disasters and conflicts. UNICEF also informed that “girls and women with disabilities and special needs face additional challenges with menstrual hygiene and are affected disproportionately with lack of access to toilets with water and materials to manage their period.”

To normalize menstruation, many agencies, activists, and advocates are asking all governments to eliminate the “pink tax” and make space in their agendas for a menstrual equity policy. “Politicians don’t like this issue because it’s not sexy,” said Dr. Varina Tjon A Ten, a former parliamentarian in the Netherlands and a professor at The Hague University, as reported by Global Citizen. 

Other organizations are taking the matter into their own hands and are providing young women with menstrual products to help them stay in school. “It’s simple, women and girls have human rights, and they have periods. One should not defeat the other,” said WASH United’s Hannah Neumeyer. 

UNICEF has also developed a comic book about menstruation for both girls and boys. “On one side is a how-to guide for girls, telling them everything they need to know about their periods, including common misconceptions and how to use pads. On the other side, a guide for boys teaches them about menstruation and how to support their female classmates,” the agency shared.