KUALA LUMPUR, Dec 20 – In 2019, a young woman in Nepal who was exiled to an abandoned hut because she was having her period died of smoke inhalation from the fire she started to warm herself in freezing temperatures. Her tragic story is an example of how deadly and dangerous period stigma can be.
Period stigma is one aspect of period poverty, which is generally perceived as a problem of lack of access to sanitary pads or other menstrual hygiene products.
While that is one component of it, period poverty encompasses many aspects of the inability to manage menstrual health and requires a larger society approach to addressing the problem, said Fatimah Al-Attas, coordinator of the Unit for Social Issues and Development Advocacy and Research at International Islamic University Malaysia (IIUM), during an online forum last October 11 on “Period Poverty, The Gender Pain Gap, and Endometriosis”.
Management of menstrual health involves a number of factors including knowledge and information. Girls and women need access to accurate knowledge that is provided in a timely manner and is age-appropriate.
From the onset of puberty when they get menarche (first period), girls need to be prepared for the changes that occur in their bodies, how to manage their menstrual cycles, and further along as women, be aware of what to expect when they enter the premenopausal and menopausal stage of their lives.
“So the gaps in period poverty can happen there – that we’re not getting the right knowledge or we’re not getting it in a timely way or the knowledge that we get is not right.
“We know that there are girls and women who don’t learn about menstruation until it happens,” said Fatimah, who is also an assistant professor in sociology at IIUM.
“By the time you get your first period, that’s a shock to you. You think you might be dying because you’re suddenly bleeding. So that’s an example of girls not having access to the right knowledge. Or as women, go through their lives not being prepared for menopause for example.”
Another aspect of menstrual management is access to proper materials and facilities. Materials must be safe and absorbent, with the most commonly used being disposable sanitary pads and other options include tampons, menstrual caps, reusable cloth pants, and period panties.
“It depends on how innovative we are as a society to come up with menstrual products but essentially as long as a product is safe, it allows women and girls to go out, go to school and go to work, to have a social life, then it should be okay.”
When it comes to facilities, clean water, proper disposal management and access to hand wash are crucial, Fatimah said.
“A lot of us are really lucky, because we live in urban areas where we don’t even think about these things, we just think that it’s always there, but there are people who do not have access to them in the Malaysian context and in other parts of the world.”
Menstruation also does not stop for natural disasters, she added, pointing out that access to facilities under such conditions are also important.
Additionally, women and girls must be surrounded by positive and respectful environments that are free from stigma and psychological distress.
In some situations girls are deemed “dirty” while menstruating, prevented from participating in activities because of their menstruation, or even made fun of at school by being told they are leaking for example, even when they are not.
“It creates a lot of anxiety and psychological distress for girls,” said Fatimah.
Inclusivity is also an issue when it comes to menstruation, as women who are menstruating are often prohibited from certain spaces and activities.
“This happens differently across different cultures. In some extreme cases, women are not allowed to enter public spaces when they are menstruating, in some cultures women stay in huts while they are menstruating, and in our world, sometimes women are discriminated for being menstruators, therefore not allowed to take on leadership positions for example,” Fatimah said.
“There are social, cultural and religious issues that shape how we understand menstruation, how we experience it, how we treat one another when we are menstruating and when we see or hear about others menstruating.”
One way to discern where our society falls on the spectrum of responses to menstruation is to observe how open we are when talking about menstruation whether in private spaces, corporate settings or in a public arena like parliament when menstrual leave is brought up. Can a respectful and where necessary, professional discussion about menstruation take place?
Culture Of Concealment
Fatimah said there is still a culture of concealment when it comes to menstruation, which at times is still erroneously associated with being dirty, weak, and shameful.
“Therefore, we don’t want people to know that we are menstruating, or we don’t want to talk about it openly.
“One of the ways we can actually address the culture of concealment is to create conversations like this, so that we can talk about periods in a way that normalises periods and also to have safe and healthy conversations that are based on accurate information.”
She added that more open conversations that are safe and respectful can help prevent menstruation stigmas that negatively affect women in their lives and the spaces they occupy.
“Women do not just exist in private spaces, women also exist in all spaces of life.”
Open conversations are vital to ensuring that women have support for menstruation in the places they need it such as at work, in religious and cultural spaces, and in parks or public spaces, which should have materials and facilities that are well-managed and easy to navigate.
The culture of concealment has also resulted in a dearth of research on period poverty in Malaysia, which is badly needed to address the issue and come up with solutions.
“There’s not been a lot of research on period poverty, I started one of the earliest research in Malaysia and that was only four years ago,” said Fatimah.
“When we were starting, our work was still very taboo and in some academic spaces men and also women were uncomfortable about me talking about my research, and that’s why I do advocacy work on top of my research.”
How Period Poverty Affects Vulnerable Populations
In Malaysia, there are women and girls who are very impacted by period poverty, especially in rural areas in Sabah and Sarawak, as they don’t have access to clean water, toilets, and disposal management, and are also isolated from many resources.
“We know that there are girls who are taken out of school as soon as they start menstruating because they don’t have access to toilets and sanitary pads,” Fatimah maintained.
“Then also just the general understanding of girls needing to stay in school is also not there, understanding of menstrual health is also not there in a lot of these spaces. So these are really the extreme end of things.”
Vulnerable women like the homeless, stateless refugees, and women with disabilities are also affected in disproportionate ways.
Homeless women, for example, might not have access to safe spaces for them to manage their menstruation, or to keep menstrual products, or lack access to toilets.
Her research on refugee women, particularly Rohingya women, have shown that they don’t leave their house when they’re menstruating at all, according to Fatimah.
“Sometimes they don’t have access to menstrual products as well. And because they are quite isolated from the general public, a lot of their issues remain unheard and unaddressed.
“And also, we know that there are issues relating to how we address refugees in our country, so they are vulnerable in those ways as well.”
There are also issues with women with disabilities in terms of consenting to their menstruation being stopped and how they manage their menstruation especially when they are in public spaces, according to Fatimah.
The urban poor are also not immune to the effects of period poverty.
“In the urban context, access to clean water is usually there, sometimes it’s just about managing how they have access to certain menstrual products depending on how they understand the need.
“For example, we have cases where women use one pad a day to save some money, but they don’t realise that it is very dangerous, that it can cause infections and things like that,” said Fatimah.
Different groups of people in the country experience period poverty differently depending on their vulnerabilities and conditions, said Fatimah, who added that in general however, Malaysia still needs to address the issues of inclusivity and a period-positive environment.
“That’s more of a national scale of things, and of course we must talk about doing a national level survey where the government has to keep records of cases and prevalence of certain types of period poverty.”
Period Poverty Needs To Be Addressed Collaboratively
Period poverty is an issue that needs to be addressed collaboratively by society, said Fatimah. Aside from the government, others can also play a role in tackling the problem.
“Imagine half the population menstruates and uses a menstrual product; it’s really a big industry to tap into, but we’re not very innovative with it are we? Menstrual products have just sort of remained stagnant or really there’s not a lot of creativity put into it.
“But there is a gap there, so that’s just one example of how different people from different industries, different areas, can actually work together to meet the needs of half of the population.
“On the research side, it’s important for us to do more work on this so that we can map out where some issues are happening, what are the gaps in the issues, and then how do we tackle it as a country.”
It is important to come up with solutions that are not just environmentally sustainable but also economically and socially sustainable, Fatimah asserts.
“When we talk about environmental sustainability, sometimes we’re just looking at middle- and upper-income people who think about or can afford to think about sustainability, but we don’t think about the larger population.
“So it is really important to understand the diversity of our people and where we are, and how realistic our solutions are in terms of ensuring that it continues on.
“Sometimes I criticise initiatives to give out free pads because I cannot see the sustainability of it. How do we ensure that we can continue to give out free pads for 30 to 50 years, because women will continue to menstruate for a really, really long time and a new population will also begin to menstruate, so what can we do about that?
“We must be a bit more practical in our solutions to addressing period poverty,” she concluded.
