KUALA LUMPUR, Sept 2 – While period poverty is often associated with low income populations, it also disproportionately affects individuals facing the added burden of systemic barriers. However, mainstream discourse and proposed solutions to the problem often fail to take into account the specific circumstances and unique challenges of women and girls from communities that are vulnerable or marginalised.
Through a newly published report, Towards Dignified Menstruation For All: A Human Rights Imperative, chief children’s commissioner of the Human Rights Commission of Malaysia (Suhakam), Farah Nini Dusuki, said the commission aims to bring the issue of period poverty, which has “for too long remained in the shadows” to the forefront.
In order to truly comprehend the breadth and depth of the issue, Suhakam conducted field research and consulted with women from a wide range of communities and in diverse circumstances throughout the country.
“We spoke to various stakeholders across the country, from rural Sabah and Sarawak to urban Kuala Lumpur, to women in prison cells and halfway homes. Many of these voices had never been heard, said Farah during the online launch of the report last August 1.
“What is particularly significant is that this report uncovered not only the realities of period poverty, but also broader challenges related to SRHR (sexual and reproductive health and rights).
“We explored intersections with legal frameworks on abortion, disability rights and access to health care under the Persons with Disabilities Act and other relevant instruments.”
The following are the report’s findings on how diverse groups of women and girls experience period poverty:
Women And Girls In Detention
As of August 2024, the total number of detainees in prison facilities across Malaysia stood at 81,731, comprising 77,294 male detainees and 4,437 female detainees.
A significant number of these women are incarcerated for nonviolent, poverty related or survival driven offences. Nearly 41.7 per cent of them are pretrial detainees, which includes both individuals awaiting trial and those undergoing ongoing court proceedings.
According to information provided to Suhakam, the Kajang Prison Department received an annual allocation of RM112,500 specifically for menstrual products.This translates into the distribution of approximately 15,000 units per month, where each unit consists of one pack of sanitary pads.
Kajang Prison houses 4,515 female inmates. Based on the monthly distribution, each inmate receives an average of 3.3 packs per month. Even when accounting for the fact that roughly 20 percent of the inmates may be menopausal, this supply remains insufficient to meet the menstrual needs of menstruating inmates.
To supplement this shortfall, the Prison Department has reportedly accepted donations from NGOs. For instance, in June 2024, HAYAT Malaysia, in collaboration with Pertubuhan Keluarga Kasih (Kekasih) and Suci Cup, distributed 70 menstrual cups, a reusable alternative to pads, to inmates at Pokok Sena Prison.
During Suhakam’s prison investigation in February this year, its officers were informed that each female inmate was provided with ten sanitary pads per month.
Suhakam also received complaints of toilets being locked from 8:00am to 2:30pm, preventing inmates from accessing toilet facilities during those hours. This restriction hinders inmates’ ability to change menstrual products or attend to personal hygiene, potentially resulting in infections or other serious health concerns.
Simultaneously, further concerns were raised regarding the limited provision of basic hygiene items such as soap, toothbrushes, and toothpaste, which inmates reportedly receive only once every six months.
In April this year, Suhakam also made a visit to an immigration depot in Sandakan, Sabah, said Farah. “We found that each menstruating individual was only given three sanitary pads per month. Although they were allowed to request for more, this initial provision clearly is insufficient to meet basic needs.”
Migrant Workers
Period poverty is an issue, particularly among women working in plantations and construction sites. Many employers do not provide adequate facilities or support for women migrant workers to manage their menstruation with dignity.
Furthermore, women working at construction sites often face challenges in accessing proper sanitation facilities to change their sanitary pads. In some cases, toilets at construction sites are not enclosed, thus compromising their privacy.
Additionally, some remote sites lack access to nearby facilities altogether, prompting workers to create makeshift ponds where both men and women bathe, further highlighting the lack of gender-sensitive infrastructure.
As a result of poor hygiene conditions and lack of clean water, some women migrant workers have suffered from infections such as hepatitis B and abnormal vaginal discharge.
Malaysia does not offer specific provisions for SRH care for migrant workers. According to a study cited in the report, employers did not perceive meeting the SRH needs of women migrant workers as their responsibility. Without a perceived benefit such initiatives were often rejected.
This suggests that women migrant workers are denied access to affordable health care services normally accorded to citizens. Consequently, they have to pay higher prices, which are beyond their means.
Refugee Women And Girls
In May 2023, Suhakam in collaboration with Host International and the Federation of Reproductive Health Associations, Malaysia (FRHAM), organised a programme to gather data on refugees’ access to health care, hygiene, and reproductive health services.
The data which was obtained from 74 respondents revealed that respondents lack awareness of the risks associated with child marriage and the significance of pregnancy prevention
Many refugees, especially those who have grown up unaccompanied, are often unaware of their SRHR. Many of them lack access to accurate information about menstruation and the physical changes that occur during puberty, with most learning these details from peers rather than trusted sources.
Additionally, they are denied access to the affordable standard health care services accorded to citizens. As a result, refugee children may struggle to understand their bodies as they develop.
Organising awareness programmes is challenging, as sensitive topics like sexual health and empowerment are often hard to address due to cultural or social taboos surrounding words like ‘sex’ and ‘empowerment.’
The moment refugee girls reach menarche, they are not allowed to go to school. One of the key reasons is that the parents fear that their daughters would engage in premarital sex.They ae instead prepared for marriage.
Rural And Indigenous Women And Girls
Many indigenous women find disposal pads highly expensive and resort to using cloth as an alternative. While there is nothing inherently wrong with using cloth, women should have the autonomy to choose menstrual products that are most suitable for their needs, preferences, and comfort.
The limited availability of disposable pads in remote and rural areas further exacerbates the issue. When sellers do obtain and resell them in these areas, the prices are often significantly higher than the original cost.
Indigenous women lack awareness in SRH, and overall health matters. Some women wear pads for extended periods due to limited access, which tend to result in infections in the vaginal area.
Many of them rarely undergo regular health screenings due to limited access to health care facilities. Additionally, most clinics are situated far from their respective villages. To reach them, villagers often need to travel in 4×4 vehicles, as the roads are uneven and inaccessible by standard sedans.
In some areas longboats are required and the journey can take several hours to reach the nearest government health clinic.
Similarly, transportation costs also present a significant barrier. In some communities, villagers must hire a driver which can be costly, particularly for families with an average monthly income of only RM300 to RM500.
Access to clean water remains a significant challenge in many rural communities. Their primary sources of water are rivers and rainwater collection, which they rely on for drinking, cooking, and hygiene. During the drought season, this scarcity becomes even more severe.
A health care provider shared the experience of a pregnant patient who expressed deep anxiety, admitting that she did not know how she would care for herself due to the lack of water during the dry season.
While some villages are connected to government-supplied piped water, the supply is often rationed. It was reported that in some areas, water is only available for three days a week, while on the remaining four days, villagers are forced to seek alternative sources, such as rivers or rainwater when available.
With regard to waste disposal, villagers either bury or burn menstrual waste. They refrain from discarding it indiscriminately in the jungle due to cultural taboos and traditional prohibitions (pantang larang).
Many school-going girls also miss school during their periods due to a lack of menstrual management skills. They fear being teased if their period leaks onto their uniform.
Notably, indigenous girls are often taught how to manage menstruation only after reaching menarche, leaving them unprepared. Since many girls rely solely on their mothers or peers for information and lack access to the internet, they often have limited knowledge about menstruation.
Women And Girls With Disabilities
“In February this year, we received a distressing complaint from the parents of a child with disabilities, alleging that she was raped and sexually harassed by a guru agama (religious teacher) at the school,” said Farah.
“The World Health Organisation (WHO) has reported that children with disabilities are almost four times more likely to experience violence than children without disabilities.
“We have engaged with the Department of Social Welfare (JKM) on the implementation of the eDKK, the Electronic Child Registry, which is established under Section 118 of the Child Act 2001.
“Now, this registry records the names of individuals convicted of sexual offences against children.”
The incident highlights the added vulnerability of children with disabilities and the complications involved in their care.
In some primary schools, it has been observed that parents or caregivers of students with disabilities may choose not to send their children to school during menstruation.
This is often due to a preference for managing menstrual care at home where they feel more confident in providing the necessary support. As a result, some students may miss up to a week of school each month, contributing to learning gaps.
A doctor who has worked extensively with children with disabilities shared his experience of receiving requests from parents to remove the uterus of their daughters with high support needs, especially those who require life long care.
These requests are often made for two reasons. First, menstrual blood can cause discomfort and distress for the child, making it challenging to manage, and secondly, there is fear that the child might become pregnant as a result of sexual abuse.
However, the doctor expressed concern that performing a hysterectomy may, in fact, increase the risk of sexual abuse, as perpetrators might view these girls as easier targets once they know pregnancy is no longer a consequence
The doctor also emphasised the need to avoid hysterectomies unless medically necessary and recommended exploring alternative methods to manage menstruation.
In addition, the doctor shared a disturbing case from New Zealand, in which a couple persuaded medical professionals to perform multiple irreversible procedures on their daughter.
This includes the removal of her breasts, uterus, and ovaries, as well as the shortening of her limbs under the rationale that these interventions would make it easier for her to be cared for, due to her high-support needs.
The Malaysian Persons with Disabilities Act 2008 [Act 658] falls short in specifically affirming the right to bodily autonomy for persons with disabilities.
To align with the United Nations Convention on the Rights of Persons with Disabilities (CRPD), of which Malaysia is a party, the Act would benefit from amendments to explicitly include protections for bodily integrity, informed consent, and freedom from coercion, especially for women, girls, and those with high support needs.
Furthermore, there is a need for targeted education and support for caregivers, particularly in situations where caregiving roles shift, such as when a mother passes away and a father or another family member assumes responsibility.
Notably, transitions in caregiving can create gaps in knowledge, comfort, and capacity to manage the menstrual health and bodily autonomy of girls and women with disabilities.
Therefore, it is essential to promote a shared responsibility model, ensuring that all caregivers regardless of gender are equipped with the necessary awareness, skills and sensitivity to provide respectful, informed and dignified care.
Homeless Women
At present there is no official data available on the number of homeless women in Malaysia. However, factors such as the rising cost of living and unemployment suggest a high likelihood that the number of homeless women is increasing, particularly in major cities like Kuala Lumpur.
Homeless women in Malaysia face significant challenges in managing their menstruation due to the lack of safe and accessible facilities. They often rely on public toilets, toilets in restaurants, or the closest petrol stations to their location.
However, at night, these options are limited or unavailable when shops are closed, further compounding their vulnerability
