Published June 21, 2020.
Thirteen-year-old Samantha (not real name) has never used a sanitary pad before since she started to menstruate some three years ago. She said, “I have always used rags for my menses because my parents can’t afford a sanitary pad.”
Samantha always used pieces of cloths and at other times when she got some money, she manages to buy a tissue paper that most times scatters.
She told our correspondent that when she first saw her period, she told her mum who taught her how to use pieces of cloths while it lasted. “It was no issue to me as I grew up seeing my elder sisters and mum use pieces of clothes for their menstrual flow,” she stated.
It wasn’t strange to the naive teenager that she used cloths as it was the same story with most people around her.
She continued, “It was not a strange thing in our community as most of the people that lived in my area had the same story.”
Though sad, it’s the reality of many Nigerian girls whose families cannot afford to buy them sanitary pads for their menses.
Menstruation is a blood flow a woman experiences on a monthly basis when there’s a shedding of the lining of the womb.
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Samantha is faced with the challenge of missing classes twice monthly at least not only because of her menstrual cycle, but also to escape derision from her male classmates.
She couldn’t complete her seven-day circle without getting stained as the cloths always shift from where she stuffed them.
She added, “The cloths I use for pad usually shift so my clothes get stained most times. My flows are usually heavy on the first two days, so I avoid going to school, so that my clothes won’t get stained and to avoid scoffs from the boys in my class.’’
Samantha isn’t the only one who suffers from period poverty, there are a lot of girls in her shoes who cannot afford and therefore do not have access to hygienic sanitary products. It’s common in her community, Kabusa village located in Lokogoma, Federal Capital Territory, Abuja.
Period Poverty is when girls cannot afford a sanitary pad or tampons mostly because of financial constraints. It is a cogent issue affecting women and girls who don’t have access to safe, hygienic sanitary products, and/or who are unable to manage their periods with dignity, sometimes due to community stigma.
Every May 28 is set aside to celebrate the ‘World Menstrual Hygiene’ Day.
According to reports by ActionAid, one in four women in their menstruating years’ experience ‘period poverty,’ from the inability to purchase the products they need, inability to be at work or school because of it. “More than 90,000 girls stay away from school because they cannot afford pads or tampons.”
Horrible period poverty
Khadijat who is a resident in Kabusa village is also a victim of poverty. The 17-year-old described life as tough because of ‘period poverty.’
Period pain is a tough one for women who experience it. Having to experience the pain and unable to access menstrual hygienic products make life unbearable.
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According to her, she experiences a painful menstrual cycle and it is even worse that she doesn’t have access to regular sanitary products.
Khadijat said, “Sanitary pad isn’t what we get access to all the time but my mum tries her best for me whenever she can. I get it once in a while and on days when I can’t get it, I use tissue papers or pieces of cloths.
“I miss classes because of period pain and when I cannot get a sanitary pad it is worse. I try not to go to school when I know I am having heavy flow because I would get stained. I wish to get sanitary pad every month so that if I get drugs for pain relief, I would be able to go to school without the fear of getting stained or shamed by boys.”
According to ActionAid, one in 10 girls in Africa miss classes because they don’t have access to sanitary products, or for lack of safe, private toilets to use at school. Women’s and girls’ health may be at risk, as they are forced to use dirty rags which can cause infection.
According to UNICEF, globally, 2.3 billion people live without basic sanitation services and in developing countries, only 27 per cent of people have adequate hand washing facilities at home. Lacking these facilities makes it harder for women and young girls to manage their periods safely and with dignity.
Findings from the Youth19 Survey showed that 12 per cent of students in years 9 to 13 who menstruate reported difficulty getting sanitary pads due to their cost.
For Mercy, the menstrual hardship is traumatic as she is faced with the challenge of not having water but also the inability to access hygienic sanitary products.
The 14-year-old is based in a community lacking water where the villagers have to travel to neighbouring towns to get water for cooking, bathing and domestic use.
She isn’t just battling with having to travel miles to get water for family use but also lacks water to clean up during her menstrual flow.
She said, “We don’t have water in our community and I have to walk several miles to get water to clean up and when I am having menstrual cycle. I try to have reserve water in the house when I am close to my menstrual period. Going to school during the period is a nightmare because in school, there is no water and we share toilet with boys.”
She told Sunday PUNCH that sharing a toilet with boys made her and her colleagues uncomfortable for they knew it was unsafe for them and when blood stained their toilet, they had no water to clean it.
Mercy said, “We don’t have water to clean up the bloodstains, so the boys are irritated whenever they see it which makes them insult us the more. Many times, the pieces of cloths I use for my period fall on the floor while using the toilet and I don’t have a choice than to pick it. If it was a sanitary pad, it would stick to the pant. There would be no fear of it falling off from our pants.”
Mercy’s story is the reality of many of the girls in her community who have no access to sanitary products, water and a clean environment.
Alima started menstrual flow two years ago but she has already started to witness irregular menses.
According to her, she has also been a victim of period poverty.
She told Sunday PUNCH that she started experiencing irregular period about a year ago.
She said, “I observed that my period comes once in every three months.”
Alima wasn’t experiencing this situation when she started her menstrual cycle but overtime, she observed that things were no longer the same.
She is one of the girls who experience the side effect of period period early enough; some are asymptomatic till the situation worsens.
She said, “When I first started my period two years ago, I had a free flow without any hindrance. Although I am a bit worried about my situation, it is a huge relief to me that I no longer worry about what I will use for my period flow all the time.
“I was always using rags to pad the flow and stayed away from school at least for few days due to the period flow. I know that something is wrong with me but I am at the same time glad that I don’t have to go through that stress of looking for what to use as a pad. I have never used sanitary pad since I started menses two years ago.”
Sanitary pads amid COVID-19
With the outbreak of Covid-19 in Nigeria, the priorities of most families shifted to how to feed their households.
Fifteen-year-old Sade is one of those whose families have been heavily hit by the economic effect of the coronavirus pandemic that affected critical sectors globally and killed millions worldwide. Before now, her family could still afford to buy a sanitary pad once in three months but that became a luxury as COVID-19 emerged.
Sade told Sunday PUNCH that her father who worked as a guard in one of the private firms in Lagos lost his job in April due to the effects of the pandemic.
She said, “My mum used to buy me a sanitary pad at least once in three months. But she has even stopped buying it since she is now the one catering for the family. Whenever I told her about it, she would tell me that I should go and manage pieces of cloths and that the most important thing is for us to eat. I don’t like to bother her, so I make do with what is available. We all want a better life but the least I can do is to accept life as it comes.”
The girls identities are protected to avoid stigmatisation.
How other countries assist women on periods
In New Zealand, the government took steps to tackle period poverty by providing free products in schools.
Its Ministry of Education distributed free sanitary products following the government’s $2.6 million investment.
The Prime Minister, Jacinda Ardren, was quoted as saying, “We know that nearly nine to 18-year-olds may stay at home during their periods due to not being able to afford period products. By making them freely available, we support these young people to continue learning at school. There is more now to do with families hit hard by the Covid-19 pandemic.’’
Also Kenya has started giving out free sanitary pads in schools. Management teams at schools were responsible for buying and distributing the pads. The Plan International’s Kenya country director, Lennart Reinius, said it was a pioneering step to ensure that more girls could secure their right to quality education.
There have been various campaigns and advocacies that Nigeria should join the league of countries who give free sanitary products to girls. But till now, nothing has been done safe for some interventions of some Non-Government-Organisations.
In October, 2019, the House of Representatives demanded that sanitary pads be made available to schoolgirls regularly.
The lower legislative chamber also urged the ministries of health and women affairs to initiate ways of improving the hygiene of women and girls in the country.
The motion was moved by the Chairperson, Committee of Women Development and Social Development, Wunmi Onanuga and four other lawmakers. Onanuga said menstrual hygiene was vital to the empowerment and well-being of girls worldwide.
The lawmaker from Ogun State noted that 25 per cent of women lacked “adequate privacy to menstrual hygiene management.”
Efforts of NGO towards handy sanitary pads
Some NGOs have been advocating for hygienic menstrual cycle. One of such is Pinkitudeplace, which has been visiting communities to sensitise people and provide sanitary pads for girls.
The Chief Executive of the organisation, Emmanuel Odunusi, said in the course of his visit to communities, he discovered that lack of education about the issue contributed largely to their inability to afford sanitary pads.
He said, “Top of our observations during the exercise is that the young women are not educated on what menstrual hygiene and reproductive health are all about, thereby eroding the possibility of them using a sanitary pad.
“From October 2019, my team and a couple of partners embarked on providing sanitary pads for over 200 girls in the Yola South Local Government Area of Adamawa State. Seeing the needs of these girls, we were motivated to further expand our operations and reach out to more young women in Adamawa.’’
He said he found out that if actions weren’t taken, girls and women would likely face more challenges in future.
He said, “From our observations, we can tell that if adequate actions are not taken, young women facing the challenges of using a sanitary pad would even face a greater challenge of possible infertility caused from infections.
“Also, the lack and unavailability of sanitary pads push menstruating girls out of school during their menstrual cycle leaving them to miss out on school and other academic activities.”
In the same vein, the Executive Director of PadUPAfrica, Ashley Lori, said one of the things fuelling unhygienic menstrual practices were myths surrounding them.
Lori stated that several girls didn’t have adequate knowledge of what menstrual hygiene was and all they knew were things their parents told them.
She said, “Many girls are experiencing serious period poverty and the things that they do are so despicable but one can’t blame them. A girl who could only afford to use tissue paper for her period did it because she had no options. When you have options then you can think of alternatives. Life is truly hard for some of the girls.
“We have a menstrual hygiene corner in our programme where people can drop in like N10 or N20 and there’s an arrangement with firms producing sanitary pads who sell at subsidised rates. We buy and distribute to girls in rural areas, especially in secondary schools.
“We are working further to see how the issue of the price will be dealt with. But it is a gradual process and we need to find a way to reach the manufacturers and find out how to reduce the price. Through advocacy, we encourage other agencies as a corporate social organisation, to ensure that every organisation buys a certain quantity of pads to be sent to schools and rural areas as their own CSR”
She said her group had reached 5,000 females and successfully distributed 10,000 sanitary pads and engaging in advocacy programmes across the country and Africa.
She said, “To get optimum performance of the girl child, they should be given free access to sanitary pads. Condoms are free and affordable. I believe sanitary pads should be made free and accessible to girls. Menstruation is compulsory but sex is a matter of choice. So, we should give adequate attention to the right things.’’
Lack of menstrual hygiene can infect womb —Gynaecologist
A gynaecologist, Dr Kayode Adebayo, said menstrual flow is a monthly affair for a woman of reproductive age, indicating that a woman is expected to see her menses every month.
He said, “We say reproductive age because in most cases girls start to experience their monthly circle at age 11 or 12 and continue the cycle from then till around 51. In some cases, menopause comes earlier than that age.
“Menstrual flow is the shedding of the lining of the womb which takes place in form of blood flow as a result of pregnancy not taking place.”
Adebayo said the blood coming out of the woman has a direct link with the woman’s womb.
He added, “When there is a continual flow from an inner cavity of the body to the outside that means there would be communication from outside through that blood flow to the inner cavity.
“The implication is that if the menstrual flow has a contact with anything that has germs and bacteria, the bacteria and other germs can flow inside the womb and infect it.
In that case, such a woman goes down with what is called endometritis; the infection of the lining of the womb. Because the tubes are directly connected to the tube, if it infects the tube where the blood passes, such a person comes down with infection of the tube and the womb. Such a person will now have what we call pelvic inflammatory diseases.”
The gynaecologist noted that when there was lack of hygiene in handling the menstrual flow, it could affect the womb. He added that to prevent such tract inflammatory diseases, it was advised that women should make use of sanitary pads.
He said, “We tell women to use sanitary pads for their menstrual flow. Sanitary pad is sterile which means that it will not allow any flow of bacteria into the womb. When people use tissue paper, it is dangerous. Tissue papers are not sterilised; they are generated from dirty papers, woods and meant for cleaning dirty things and surfaces not to be used for the menstrual cycle. Most people who use tissue papers for their menstrual cycle end up infecting their wombs.
“Some people use rags and say that they have washed it properly. There is no way you can properly wash a rag and not sterilise it. When we want to do a surgery, we specially sterilise those things before using them. Now imagine if someone is using a handkerchief or a rag for their menses.”
According to Adebayo, he daily attends to at least five women who suffer from complications from menstrual cycle. He said, “When the infection gets to the womb, it can cause irritation, pain, discomfort, vaginal discharge and infection like tube blockage. It can cause a delay in getting pregnant or even an inability to get pregnant. On a daily basis, five out of 10 women who come to me have issues with menstrual hygiene.”