November 18, 2015 |

Menstruation: a source of stress or pride?

We gave women in South Africa disposable cameras to document their experience managing their periods.
Back of a young woman, simple latrines
“I had my first period at school,” recalled one woman from Durban, South Africa. “My teacher said that I must tell them at home and do not come to school the following day. I sat and did not go to school for the whole week.” Photos: PATH/Photovoice participants.

Imagine that you’re a woman experiencing a menstrual cycle with no privacy to manage it, no one to talk to, and no clean materials to manage your period with dignity.

In South Africa, and in many poor countries around the world, menstruation is rarely talked about, and can be a source of stress and embarrassment, as well as pose a safety risk for girls and women. In addition to the roughly 2.4 billion people who lack access to basic sanitation, and the nearly 1 billion who must defecate in the open, there is a need to call attention to the often taboo topic of menstruation.

A dresser drawer with assorted linens and toiletry products.
Because they are costly and sometimes hard to come by, women often use alternatives to disposable pads, such as sanitary rags, toilet paper, even scraps of paper or leaves. Photo: PATH/Photovoice participant.

In many low-resource settings, women must be resourceful and use recycled or old cloth as the primary tool for period management, though women and girls have also been known to use mattress stuffing, old rags, sheets of school workbooks, even dried leaves and ash.

Availability of sanitation facilities and disposal systems for menstrual care products are severely lacking in many developing countries. These factors—along with a need to manage pain from menstrual cramps, a lack of access to menstrual care products, or infections related to poor hygiene—may contribute to school absenteeism and dropout rates. According to one report in Uganda, girls in rural parts of the country miss up to eight days of school each term because of their periods.

A blue tub sits on the floor of a dark room along with soap and assorted items.
In Durban, South Africa, women were asked to photograph and describe their experiences managing menstruation with various sanitation facilities. Photo: PATH/South African Photovoice participant.

In an effort to improve safety, sanitation, and waste systems for women and girls with greater consciousness of their menstrual care needs, PATH staff gave women in three communities in Durban, South Africa disposable cameras to document their experience managing their periods. This participatory research method, known as Photovoice, allows community members to capture behaviors and cultural values that might otherwise be lost to research staff.

Following are some of these women’s responses when they were asked to share their struggles managing this deeply personal issue:

An outhouse in a public area.
“To dispose of the used pads, you put them in the separate dustbin outside the house. You don’t put it together with the main bag of rubbish in case somebody saw that,” recounts one woman from Durban, South Africa. “I mean, people come and look through the rubbish for things to recycle. If you put your dustbins out for the municipality to collect, you always see people coming and looking.” Photo: PATH/Photovoice participant.
A road leads to an outhouse.
“I was still staying at home and my mother was not working and she was unable to afford pads when I was beginning to have my periods. She caught me using toilet paper and told me to stop using it because it is going to damage me from inside. I stopped using it, but when I was starting I would tell her. She would say she does not have money and I would keep quiet…” Photo: PATH/Photovoice participant.

These challenges exacerbate the already difficult circumstances surrounding menstruation. And the implications are more than just personal. Disposable pads can block city sewer systems and the social, cultural, and physical constraints menstrual health creates for poor women and girls perpetuate their second-class status in society. The result is a culture of silence that forces many to cope in isolation.

Let’s shatter the taboos around menstruation. At PATH we are working on sanitation solutions that allow women to manage menstruation safely and with dignity.

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  • Nancy Muller is a senior program officer with the Devices and Tools Program at PATH.