When Toilets are Bargaining Chips: Promoting Periods in the Face of Stigma

By Caitlin Gruer
April 13, 2018

Water Sanitation and Health Program Manager Caitlin Gruer with Corporate Partnership Manager Katherine O’Hare at a newly constructed school bathroom in Bolivia.

Until a few years ago, it had never occurred to me that toilets could be bargaining chips. 

Useful? Sure. Necessary? Definitely. Bargaining chips? Not so much.

Fast forward to the summer of 2017.  

In partnership with Kimberly Clark Corporation, we had just started a menstrual hygiene project in four schools in Bolivia. The goals of the project were to ensure that girls and boys exercise their rights to health and education; improve their basic hygiene and menstrual hygiene management; and reduce their impact on the environment.

The project had two components: 1) the construction of new, private, safe, hygienic, single-sex bathrooms for girls and boys; and 2) training girls, boys, teachers, and their communities on menstruation; sexual and reproductive health; and basic water, sanitation, and hygiene (WASH) practices. 

Our first step was to meet with the local government and target communities to get their support and buy-in. This phase is critical for ensuring participation and sustainability, and is standard in all Plan International USA projects. 

In three of the municipalities, the local authorities were completely on board. However, in one we faced resistance. Menstruation and sexual and reproductive health are taboo topics, and the local government did not want us to discuss them with young girls.  

But, they did want the toilets—so the toilets became our bargaining chip. 

In the end, we were given the green light.  They wanted the toilets more than they did not want us to talk to girls about menstruation.  

Unfortunately, this is a familiar story.  

Globally, there is a stunning lack of understanding about menstruation, and in many places it remains an extremely stigmatized topic. This context means that often it is simply never mentioned, which results in many girls having no idea what is happening to them when they first get their period. It means that women and girls feel they have to hide their periods because they think it is something shameful or dirty, and in some places, that menstruating women and girls are excluded from certain activities.  

It also means that local governments, leaders, teachers, and communities often balk when we propose programming related to menstruation. 

Despite this resistance, we know that educating girls and boys, teachers, parents, and communities about menstruation is absolutely critical. By providing comprehensive community education, we can correct misinformation, combat stigma, and begin to transform social norms.  First, though, we need a foot in the door, and getting that is not always easy.  

Sometimes, like in in Bolivia, that entry point is the construction of sanitation facilities, or the distribution of menstrual hygiene products. For better or worse, local governments and communities like tangible results and things to which they can easily point. New toilets or pads fit the bill.  

In the end, it is a win-win. We are able to provide education and to combat stigma, while also addressing the practical barriers that women and girls face in managing their menstruation.  

Sometimes, a pad is more than just a pad, and a toilet is more than just a toilet.