Thousands of girls in the hilly districts of Bangladesh go through difficulties during menstruation due to a lack of adequate menstrual hygiene management
Amtali Thanchangya para is a remote village in the Sadar upazila of Bandarban. The village lacks modern civic amenities. The locals dream of living in the midst of pure nature. They are highly dependent on the gifts bestowed upon them by nature.
Jharna Tanchangya (pseudonym), 12, a student of grade seven at a local school, is the daughter of Surendra Tanchanga. On a Sunday, Jharna was sitting for a maths exam when she suddenly felt severe pain in her abdomen. In the suddenness of the incident, Jharna returned home after the exam and noticed blood on her legs. There were blood stains on her uniform as well. Without any mental preparation, Jharna experienced menstrual bleeding for the first time in her life. Her only preparation was hearing about such physical changes from her older sisters.
Jahrna's family had not prepared her for this day. She learned about changing clothes from her older sisters of the community.
A miserable darkness descended on Jharna's life after her mother passed away when she was in the sixth grade. The absence of her mother confused Jharna during her next menstruation. Although hesitant, Jharna shared her experience with the community sisters. They advised Jharna about the matter but she still did not know why menstruation takes place or what happens if it does not occur. But one thing Jharna knew for sure was that after a certain age, every girl starts menstruating naturally.
Although it was the first incident in Jharna's life, she did not feel the need to consult a doctor, nor did anyone in her family think about it. Jharna continued to manage her menstrual cycles with the little knowledge she had. From the very beginning of her periods, she became accustomed to using old clothes as sanitary napkins. However, washing the clothes she used during menstruation was a matter of embarrassment for her. Jharna, as a result, tried to wash her clothes in disguise - within the folds of larger clothes. As time went on, Jharna decided to talk about menstruation with her peers.
Days later, a new tragedy struck Jharna. The first one or two months of Jharna's period were regular, but later she started menstruating twice a month. Due to irregular menstruation, she began to feel physically weak. Being hapless, she sought the guidance of a local health worker who advised her to see a gynaecologist atn Chattogram. Jharna was prescribed a set of medications, due to which her menstrual cycle returned to normal.
In the eighth grade, Jharna participated in a menstrual health awareness meeting organized by a local NGO. They were the first to demonstrate how to manage menstruation cycles properly. Moreover, they taught her that clothes used during menstruation should be dried under the hot sun to kill all germs. Among the many social customs in the hilly districts, girls menstruating were forbidden from visiting temples. However, the Bhante did not prohibit Jharna from worshipping.
Although this is the first menstruation experience of one Jharna, thousand other girls in Bandarban go through similar first times during menstruation. The lives of thousands of such girls have become uncertain due to unhealthy menstrual management.
With financial aid from the European Union (EU), extensive work is being done since 2019 by Simavi Netherlands and Bangladesh Nari Progati Sangha (BNPS), in collaboration with 10 local development organizations in the Chittagong Hill Tracts. 12,000 unprivileged young women and adolescent girls of Bandarban, Rangamati and Khagrachari districts have been connected through `Our Lives, Our Health, Our Futures' (OurLHF) Programme. The initiative is working to support and empower young women and adolescent girls in the three districts to manage their menstruation with dignity, and safeguard their sexual rights and reproductive health without violation, coercion or discrimination.
According to Bangladesh National Hygiene Baseline Survey (BNHBS) 2014, only six percent of girls received education related to menstrual hygiene at school. The study also indicates only 36 percent heard about menstrual health management before their first period began. It is also the family's responsibility to educate their teenage daughters about this. At the same time, it is necessary to create a supportive environment in the educational institutions as well as to play a conscious and sensitive role.
Only 10 percent of adolescents and 25 percent of older women use sanitary napkins during menstruation. The napkins need to be changed every six hours, otherwise bacterial infection and various life threatening diseases of the reproductive system can occur. Other research has shown that menstrual hygiene awareness is still in the dark. Our society is not ready to accept the idea of open discussions with family members about the topic.
Unhealthy menstrual health care, unavailability of materials needed for healthy management and poor sanitation infrastructure are hampering educational opportunities, health and social status of women and girls around the world. As a result, millions of females are prevented from reaching their full potential. Every year, May 28 is celebrated globally as World Menstrual Hygiene Day to break the silence and raise awareness against negative social norms surrounding menstruation. The celebration of this day was started in 2013 by the German-based non-profit organization 'Wash United'. Since the first celebration in 2014, the day has rapidly gained popularity all over the world. This year, the theme of the day is 'Pandemics do not stop menstruation: it's time for action'. The national and local government agencies, individuals, NGOs and media outlets jointly launched a campaign to uphold political priorities surrounding the topic and take effective measures by highlighting the developmental aspects of menstrual health to concerned authorities.
While the socio-economic condition due to the current global crisis is stagnant and people are unable to go to health centers, it has become equally difficult to ensure hygiene. Women's lives are being disrupted due to the obstacles. Additionally, this is a major obstacle in the way of success of the country's health sector and Sustainable Development Goals (SDGs).
There is no end to the shame and embarrassment of a common and natural phenomenon like menstruation in Bangladesh but change is impossible without a conscious and sensitive role - government initiative, help and support. The government, private sector, and an active role of the media are required to coexist to bring forth a change in this long standing stalemate.
This article has been authored by Sumit Banik, a public health activist and trained, and Promit Banik, a student of Masters of Public Health at NIPSOM. They can be reached at [email protected].