When a young girl finds stains of blood on her underwear that marks a new chapter in her life towards womanhood. A chapter in her life which, often, the girl isn’t prepared to face. Traditionally, the girl is told to hide and not talk about it. A phase the girl will have to face every month and find appropriate sanitary material.
It is a phase when she might feel discomfort and pain. A phase when she is told that it is a shame and dirty, and often missing school is seen as the best option. She will be under stress trying to find water and usable toilets. This young girl is often between 12 and 17 years of age. Girls and young women living in less developed countries are the ones suffering the most during their menarche and their menstruation. Talking about it is a burden. Mothers would barely communicate about this with their daughters. The girls struggle with it by themselves or with the help of their friends. Many girls are kept at home during menstruation which may lead to school dropout. In many parts of the world, mostly in less developed countries, menstruation remains a taboo, hidden and unspoken topic (UNICEF 2017).
Celebrating the International Day of the Girl, which began in 2012, allows the international community to put greater focus on the world’s 1.1 billion girls and understand their challenges and fight for the respect of their rights as citizens of the world. Girls and young women continue to be the most vulnerable group and target especially in conflict areas. They are also being increasingly used as weapons of war where there is civil unrest and terrorism.
In addition to giving them access to education and health care, so much work is needed to ensure girls’ rights, especially during puberty, by ending cultural and harmful practices such as Female Genital Mutilation and Cutting (FGM/C), banning child marriage as well as breaking the silence on issues around menstruation.
In Eritrea, talking about menstruation is strictly behind closed doors and men and boys shouldn’t even know or notice anything about it. It is generally perceived as a “shame”, with the exception of the Kunama ethnic group where girls who have their first menarche are given a ceremony celebrating their entry to womanhood.
Breaking the silence on menstruation is the motto of this year’s International Day of the Girl in Eritrea. On the occasion was announced the findings of a research on Menstrual Hygiene Management (MHM) in Eritrean Middle Schools. Led by the Ministry of Education (MoE) in partnership with UNICEF, the Ministry of Health (MoH) and the National Union of Eritrean Women (NUEW), the technical committee that was in charge of the research, provided details of the findings and a set of recommendations based on the study carried out in 11 middle schools nationwide, representing 8 of the 9 ethnic groups.
Dr. Pierre Ngom, UNICEF Representative in Eritrea, said at the ceremony held in Asmara Palace on October 11th, that a basic understanding of MHM by all is crucial. Ensuring that girls in school have access to water, sanitation and hygiene (WASH) facilities, access to information and support, fighting against the negative perceptions about menstruation and giving access to MHM material and pain management solutions are all factors that contribute to the development of girls and towards achieving the Sustainable Development Goals (SDGs). Dr. Pierre stressed that the question of MHM can be closely linked to six SDGs such as goal 4, Ensuring inclusive and equitable quality education and promoting lifelong learning opportunities for all, and goal 6, Ensuring availability and sustainable management of water and sanitation for all. Goal 4 is actually key and girls continue to be challenged during their menstrual period. According to UNESCO (2017), about one in ten girls on the African continent misses school during her menstruation and many would even drop out.
The findings of the study come at an important juncture, which gives guidance on areas for improvement by engaging concerned stakeholders, i.e. the NUEW, the National Union of Eritrean Youth and Students (NUEYS), MoE and MoH. NUEW is providing low-cost pads through its factory in Mendefera in addition to communication materials. MoH focuses on health facilities and MoE on lessons in schools. Nonetheless, greater synergy is required among them in addressing the taboo around menstruation. “We have been silenced on this issue affecting our girls at school although we were well aware of it”, said Mr. Abraham Tekle, head of the technical committee from the MoE. Understanding and identifying the personal challenges and needs that girls and young women face was the primary mission of the research.
As part of UNICEF’s program in WASH in Schools Programs (WinS4Girls) project, funded by Canada, Eritrea is amongst the 14 countries benefiting from this project focusing on research and programming in MHM (MoE 2017:9). Within a scope of 11 community schools dispatched nationwide, 23 girls in grade 7 and 8 who had at least 3 menstrual cycles went through in-depth interview while about 90 participated in focus group discussions. Mothers, fathers, boys, teachers, members of schools’ administration and health workers were all interviewed and participated in focus group discussions.
The idea was to analyse the perception and attitudes not only of girls but also of the rest of the community in regards to menstruation as well as monitoring the WASH facilities in those schools. According to the findings, only 50% had sex-segregated latrines, only a third had hand washing and many have challenges in finding access to water. Lack of proper toilets is the biggest cause of girls’ absenteeism during their menstrual period and even some teachers and parents would advise the girls to stay at home during that time. Female teachers are also keen on taking sick leave during their menses due to lack of facilities i.e. affecting pupils’ education.
Absenteeism of female students impacts on the girls’ education and many would face distress on this issue. “If she has a piece of cloth, she can wash and come back to class, but our school toilet has no water and the only solution is going home”, said a girl in rural Bilen community (MoE 2017:22). In addition to the lack of WASH infrastructure in many schools which leads to absenteeism, many young girls would not participate fully in class for fear of stains or being noticed. “With menses? Woow, how can we stand in front of the class?” said a girl in semi-urban Afar community (MoE 2017:36).
“Empowering girls to accept and manage this natural phenomenon with pride and dignity” as Minister Semere Russom of Education stressed, would need the concerted efforts of all members of the community. Certainly, the societal attitude towards menstrual hygiene is more enshrined in rural areas and this is where communities play a key role in breaking the taboo, Mrs. Senait Mehari, Director of Socio-Economic Affairs of NUEW, added in her speech on Wednesday 11th. As a result, the study aims at engaging all layers of society and especially parents and boys.
Despite the issues, in terms of WASH facilities, breaking the taboo and eliminating cultural practices around menstrual hygiene management remain the most important tasks and through the research, one can notice that most communities in both rural and urban settings share similar beliefs and practices. For instance, in many parts of the country, girls and women are told not to wash themselves throughout the duration of their menstrual period as it may cause more flow of blood or pain. This actually creates more discomfort, social isolation due to odour, and it may even lead to infections.
Besides, the majority of fathers and boys, responded in the research by referring to menstruation as “women’s affairs, dirty and a shame”. Naturally the girls and women isolate themselves as they are considered to be carrying the “evil spirits”.
Moreover, there is food restriction forced on girls during their cycle. Traditionally drinking milk and eating dairy products are not allowed. The girls are also not allowed to stand next to the cattle, nor in the kitchen when the family food is being cooked. Religious beliefs also play a key role where women during their menstrual period are not allowed to enter the church or the mosque and instead sit outside.
On the brighter side, especially in cities and towns, parents are showing more openness to talk to their daughters. One school out of the 11 had all necessary equipment in terms of WASH and even emergency pads available in latrines. However, the average shows lack of understanding, and instead tradition continues to be enshrined deeply shaping girls’ attitude towards handling menstrual cycle and hygiene. Access to sanitary pads may also be a cause of isolation for many girls who would use cotton cloth; it certainly requires constant washing –this is one, to be done behind closed doors. In addition, in some communities, once the girl has her menarche she is thought to be ready for marriage and, therefore, going to school is no longer an option.
Girls and young women living in patriarchal societies are already surrounded by challenges in terms of gender equality coupled with their natural system that many fail to understand. To change the trend, stronger outreach through specific classes in managing menstrual hygiene starting from grade 6 would be beneficial. Having a focal person, preferably a female teacher in schools, who also works as a mentor, providing access to sex-segregated latrines with WASH facilities and raising awareness amongst communities should be done urgently. A small guide booklet for girls in middle schools has been created by the MoE in partnership with UNICEF Eritrea, entitled Your Body as You Grow, a great initiative which requires translation into different local languages for greater outcome. Involving teachers and health workers on this matter and creating girls’ discussion groups would benefit new generations of girls to be prepared for the natural change and learn how to manage their new phase towards womanhood… As written in the guide, “a menstruating girl is like a flowering plant”!