Susan Davis

By Susan Davis, Executive Director, Improve International

As I sat in a seminar about Menstrual Hygiene Management in Schools at Emory University earlier this week, I kept thinking about my trip to Vietnam to visit CARE’s projects.  As we drove all over the beautiful country, my fellow travelers and I marveled at the flocks of school girls walking or biking along the side of the road in their pristine white school uniforms (called ao dai, see photos here).  We thought it would be hard to keep the uniforms clean because of the dirt on the side of the road, but we didn’t think about problems they might have managing their periods.

Most women know the fear and embarrassment of visible blood stains on their clothes. For many girls in developing countries, the implications of not being able to deal with “the curse” are much worse. As a fellow female, I’m ashamed that I haven’t focused on how important it is for girls to be able to better manage their periods so that they can stay in school and pay attention while there.

Fortunately, other people are bringing more clarity and the power of evidence to this issue.  Bethany Caruso and her team at the Center for Global Safe Water at Emory University collaborated with UNICEF to look at the challenges girls face in menstrual hygiene management in three countries (see an overview of the program here)  In the Philippines, Bolivia, and Rwanda girls face similar challenges:

• Fear, shame and teasing from boys
• Lack of information
• Lack of access to pads (many girls use rags)
• Inadequate or no school toilets

All of these can lead to girls skipping school or being distracted while in class,  unplanned pregnancies, and infections.

There are a variety of unrelated factors that lead to these challenges, but the water, sanitation, and hygiene sector could help by making sure that girls’ toilet facilities are private and girl-friendly (which might mean they are far from boys’ toilets, have locking doors, more space, mirrors and sinks inside, and contain covered trash cans for bloody toilet paper or incinerators for used pads).  Training of teachers and girls on how to use the facilities is also important.

“Gender equity” has been a buzz-phrase in recent years, but as Bethany said, “instead of equity of inputs, we need to think about equity of outcomes.”  To achieve better health and educational outcomes for girls, the water, sanitation and hygiene sector must consider its role in addressing these important findings.

Related resources

Celebrating Womanhood: Menstrual Hygiene Management report

TED Talk. Arunachalam Muruganantham: “How I started a sanitary napkin revolution!”