This original version of this post appeared on Devex. Read it here.
Let’s imagine for a second.
You’ve been busy at work this month. There are deadlines to meet, meetings to host, and reports to finalize. You’ve been putting in nine-hour days and your kids have kept you busy at home. Still, you’re excited. You’re making a strong impression at work, and if this keeps up you’ll certainly get that promotion.
But on this day, you have to stay home. Not because your child is sick – or because you’re sick. Not because the office is closed.
Nope. You have your period.
You’re actually not allowed to go into the office for the next week or so. You’ll miss those deadlines and forget where you left off on those reports. That promotion – well, we can assume that your colleague (a man) who hasn’t missed a day this month will be first in line.
Imagine a reality where your period means exclusion, a world where your responsibilities go unfulfilled and you’re incapable of living fully because of something as biologically familiar as a period.
For many girls, this is the norm.
Like many news outlets, CNN ran a report on December 22nd reporting on the death of a 15-year-old Nepali girl. Smoke inhalation is all too common a problem in confined spaces where indoor cooking stoves are used. Rather, it was the location – a menstrual hut – and the fact that the girl from Western Nepal was taking part in chhaupadi. This is a common practice in some parts of Nepal where women, considered “unclean” during menstruation, are ritually separated from the rest of the community for the duration of their period.
This was the second such death within a month in this far Western part of Nepal. While the absolute numbers of deaths are low – notwithstanding the tragedy of each individual case – the wider issue at stake here is the systematic exclusion of girls and women from society. Exclusion from education. From health care. From access to basic services. From opportunity. All over something as biologically familiar as menstruation.
Chhaupadi is only one example of the many cultural practices that discriminate against women and girls during menstruation. In a recent listicle, Plan International USA highlighted the wide-ranging sets of beliefs surrounding menstruation across the globe. The list was a powerful reminder that stigmas and taboos combine in all societies in ways that create and reinforce harmful social norms. Tellingly, the listicle included examples of taboos from relatively prosperous countries like South Africa and even right here in the U.S., emphasizing the point that this is not just an issue for countries undergoing rapid economic development.
Recognizing the widespread nature of this issue is only part of the battle. As a child rights organization, how do we, at Plan, address practices of this kind? And how should we do so without descending into a cultural relativism that crowds out legitimate critiques of harmful social norms, norms that limit the rights, choices, and opportunities of half of society?
Part of the answer lies in Plan’s approach. Our work is coordinated through long-established local offices in 52 countries, driven by local staff drawn from the very communities in question. We seek to know and understand. We start by listening to communities and working with them. In doing so, we observe social mores and understand the reasons why stigmas develop.
And as necessary, we go much further, as our work shows.
A recent evaluation of Plan’s programming approaches in menstrual health shows the breadth of our response. In combination, the following steps showcase how effectively integrated solutions address discrimination of this kind by:
- Focusing on menstrual health-related stigmas and taboos, underlying gender inequalities, misinformation, negative cultural practices, and the culture of silence that surrounds menstruation. Experience suggests portfolio approaches work well when addressing stigmas and taboos, including using science to dissect taboos and faulty logic; applying social arts such as community theater to promote socially appropriate messaging; or more tailored training that targets specific influencers such as parents or community elders;
- Providing education and knowledge, not only for girls and women, but increasingly for men and boys so that menstruation, and the options for managing it, are understood broadly across society. Immediate steps here include a combination of practical tools and curricula (such as school guides,WASH plans , facilitators manuals and puberty books), alongside better targeting of key audiences (not only girls, but boys, women, local government officials, teachers);
- Driving improved access to menstrual health-appropriate sanitation and hygiene facilities, so that girls’ needs are met, especially when in school. This typically involves design solutions for facilities at schools and health clinics that promote access to and use of facilities that allow for menstrual hygiene management or which ‘nudge’ behavior. Examples include facilities that have: separate rooms for changing, places to hang reusable menstrual pads after washing, and access to water and soap for handwashing at or near a facility;
- Working with the private sector and other providers to improve the supply chain of menstrual health products so that local markets are created and sustained as demand rises. This generally involves the private sector as actors in supply chain management and coordination and/or product line partnerships with social enterprises.
In isolation, each of these steps is by itself an important stepping stone in building a society ready to address menstrual health, a society in which a period isn’t disadvantageous or harmful to a girl’s ability to learn, lead, decide, or thrive.
But the real power lies in combining these steps, a framework around which to work with communities so that the tragic case of the Nepali girl from Gajra village will swiftly become a thing of the past.