It’s Only Blood

by Anna Dahlqvist

  In 2012, a relatively extensive survey was undertaken among more than 1,000 students from different schools and districts in Uganda. At the time, 60 per cent stated that they are absent between one and three days during their period, while the teachers estimated the number to be 40 per cent. Based on an average, 50 per cent and two days per month, this means that they lose 24 school days per year, or 11 per cent of the school term. I have my numerical example.

  In studies in which the students also explain why they do not go to school, the same reasons are repeated: fear of leakage. The smell. Shame in general. They have nowhere to change menstrual protection or to wash themselves. Nowhere to throw away used menstrual products. They want separate toilets and washrooms for girls. They mention physical symptoms like stomach pain and menstrual protection that chafes during hour-long walks to school.

  * * *

  In a corner of Catherine Nakabugo’s office, empty egg cartons are stacked. Aside from these, the room is rather empty. There are no trinkets and nothing on the walls, only one desk and three chairs.

  The egg cartons are to be filled with eggs from the chickens raised by the school. Or rather, raised by the teacher Catherine Nakabugo. She is the one who runs a project to raise funds for students who struggle to pay school fees and buy school uniforms as well as other things they need.

  They have pigs and rabbits too; they grow fruits and vegetables. If I understand correctly, the students are supposed to take care of the practical work and this way also gain professional skills and widen their prospects. But I am not entirely sure. She speaks quickly, and then moves on to her other passion – the schoolgirls. That is what she says: ‘The girls are my passion.’

  ‘Every lesson, I have up to 60 students and, out of these, three girls are away because of their periods. It just doesn’t work! When they reach the higher levels and have important exams they’ll have missed three days per month for several years. It gets difficult to compete.’

  Catherine Nakabugo teaches maths at Mackay Memorial College in Kampala. The school has almost one thousand students between the ages of 13 and 18. Around a hundred live at the school while the others go home at the end of the day. In addition to maths, the animals, and the farming, she is deeply engaged in how the girls are affected when they menstruate, completely unnecessarily. She sees so clearly how they struggle to make their way around the obstacles that menstruation presents for them.

  ‘Many can’t afford pads and just use toilet paper or pieces of fabric. And, you know, those pieces of fabric cause skin irritations that sting and burn. If you bleed a lot you have to wear many layers. It’s like walking around with a diaper.’

  She helps them catch up on what they have missed as best she can. She also tries to make time to talk to them about what is happening in their bodies. Many know so little about menstruation, some nothing at all, and that on its own becomes a reason not to go to school during one’s period – a way to deal with something unknown and difficult. And they are, of course, scared of being laughed at or teased. The youngest are simply too scared to go to school while menstruating, Catherine Nakabugo says.

  A knock on the door. It is a fellow teacher who wants to ask a question. Then, after a little while, another knock. This time it is a teacher from another school who is supposed to get a tour among the vegetable plots and animals. Soon, soon, she will have time. Then she can take the opportunity to show me around the school too.

  Catherine Nakabugo pulls out a piece of paper and draws a sketch of a toilet that she thinks would solve one of the girls’ problems. The idea comes from an organisation called Water for People and involves a separate channel in the toilet that leads to a waste bin hidden behind it.

  ‘I find used pads tucked in between the bricks in the walls of the toilets. They crumple them up and push them in there.’

  But why? They are afraid that someone might see their pads in the bin, Catherine Nakabugo explains. Partly because it is embarrassing. But also because of the old myth that you can become infertile if someone sees your menses.

  ‘That’s what they said when I grew up, and I hear girls say it even today. Maybe they don’t actually believe it, but it still breeds insecurity and fear.’

  The menstrual blood is not just a symbol of fertility; it can also become a trap that leads to childlessness.

  The third time there is a knock, it is Barbra Chandiru, the top student who was given the honour of reading a poem at the ceremonious occasion when Uganda’s parliament discussed menstruation in May 2015, in connection with Menstrual Hygiene Day.

  I have read about her, the student who wrote a poem about menstruation and became something of a celebrity among those who work with the issue in Uganda.

  ‘People said they liked it,’ she says, after sitting down and putting her schoolbooks on the desk.

  In the poem, a girl’s carefree existence is shaken when she suddenly bleeds without understanding why. Her friends laugh, everyone laughs, and her beautiful dress is ruined, stained with blood. ‘Is it funny?’ she asks herself.

  Eighteen-year-old Barbra Chandiru’s mother tongue is Luganda, but she has a large English vocabulary. When she talks about menstruation, she uses the concept ‘social outcast’ several times. On the outside, not part of social life. Cast out.

  ‘But menstruation is completely normal,’ she says.

  Barbra Chandiru wants to become a lawyer or a journalist and asks with interest about the book I am working on. She explains that when she was writing her poem, she spoke to some friends and used both her own and others’ experiences.

  Catherine Nakabugo looks at her student encouragingly and exclaims:

  ‘I love menstruation!’

  When I am given a tour together with the teacher visiting from another school, Barbra Chandiru tags along. Between the dormitories, where she lives during weekdays with the other boarders, clothes are drying on long washing lines in the sun. Do they also dry menstrual protection there? It is a silly question, I understand. Menstrual protection cannot be hung to dry outside, for all the world to see. That’s just the way it is. Such items have to be dried underneath, behind, or next to one’s bed. This is contrary to the mantra that I read and hear over and over again from those who work with menstruation: menstrual protection must be dried in the sun to keep bacteria and mould away.

  We pet rabbits and delight in little piglets. The plots for farming are placed between classrooms and other buildings, next to stone-paved footpaths. Catherine Nakabugo explains what she thinks is needed for those who menstruate to be able to stay in school.

  First of all, knowledge. Both girls and boys need better education about their bodies and puberty and that has to happen in schools. Today, the situation is dismal in many places, dominated by complete silence – and in that silence, the stigma thrives.

  ‘It would also be good if menstrual products were distributed in schools – disposable pads or cloth pads. One pack of pads is 3,500 shilling. What do you think you’d choose, if the choice is between food and pads?’

  It becomes time to wave goodbye and to attend to the visiting teacher. Catherine Nakabugo brings me to the principal’s cluttered office for a short presentation before clattering off down the stone-paved footpath, back to pigs and rabbits.

  * * *

  Free pads in schools have been promised by several politicians in Uganda. It also happens that schools receive pads to distribute. But there is no system, no plan, and it is not nearly enough. When parliament talked about menstruation and Barbra Chandiru read her poem, Speaker Rebecca Kadaga challenged Uganda’s government to make sure that every schoolgirl gets access to effective menstrual hygiene products. One of the ministers, a woman with special responsibility for rural issues, emphasised the lack of bins and, in her words, other ‘appropriate disposal facilities’ that the students are comfortable with. Yet another member of parliament raised the need for private spaces for girls, in terms of separate toilets and washrooms.

  The g
overnment is expected to act, and since a few years back they are at least familiar with the complex of problems. There are plenty of people, such as Catherine Nakabugo, who use all channels available to them to bring forth their message and demands.

  Back to Jinja, 80 kilometres east of Kampala. Emily Wilson at Irise International has been joined by her colleague Sarah Matindi. The sun has set and we sit inside the glass wall of the office, as if on a well-lit stage. Soon, I will take my place in the slow train of cars that returns to Kampala after the weekend.

  Education is a human right. According to the UN’s Convention on the Elimination of all Forms of Discrimination Against Women (CEDAW), the member states will ‘eliminate discrimination against women in order to ensure to them equal rights with men in the field of education’ and they will, in particular, take measures for ‘the reduction of female student drop-out rates’.

  Emily Wilson and Sarah Matindi agree that there is a lot of talk about girls’ rights from the politicians, but a striking lack of action. Pads are handed out in some places. But what happens after that? Nothing.

  ‘Everything is connected,’ Emily Wilson says, and continues: ‘The much too slow decline in maternal mortality and other issues that fall within reproductive health. Both politicians and civil society have failed to deal with the fundamental question – the view on women’s role and worth.’

  In the 2015 Global Gender Gap Index from the World Economic Forum, Uganda ended up in fifty-eighth place out of 145 countries. Sexual violence is widespread. So is the phenomenon of ‘sugar daddies’, as young girls engage in sexual relations with considerably older men in exchange for money and safety. Half of all women marry at the age of 18, 15 per cent already at 15 – which leads to many teenage pregnancies. And then there is the maternal mortality rate, for which Uganda has failed to reach the declared goals with considerable margins.

  The birds have quietened down and only the faint music from a café in the courtyard below can be heard now. We talk about women’s sexuality, which is impossible to separate from a conversation about menstruation. About how everything is connected: the potential danger of a woman who menstruates and can consequently get pregnant with anyone until she marries and can be controlled. About a patriarchal view of women’s sexuality that we carry with us. Menstruation is both threat and shame. Despite dedicating their professional lives to menstruation, they do not find it very easy to talk about in private – especially not with men.

  ‘It becomes so obvious that we always carry around an inherited system of patriarchal ideas that we have to negotiate,’ Emily Wilson says.

  She talks about the doctors she has met who say that having children is the only thing that helps against period pains. Girls who seek help are thus told that they will find relief only after they have married and become mothers.

  ‘Hormonal contraceptives that can help those who feel pain during their periods are only prescribed for married women.’

  All is to be solved with marriage and motherhood.

  ‘And ideas about the menstrual blood being dirty and polluting continue to circulate. Or that the girls can’t play and can’t run during their periods,’ says Sarah Matindi, who is responsible for education at Irise International.

  They consider the information sessions they offer to schools a kind of ‘ninja method’. By packaging it as information about menstruation, it becomes less controversial; but when they go out into schools they also take the opportunity to talk about sex, contraception, relationships, and gender equality. When the guard is lowered. Against the background of influential conservative forces – often with religious overtones – opposing all forms of sex education, information about menstruation has proven to be an opportunity to reach out with knowledge about protection against unwanted pregnancies and sexually transmitted diseases like HIV and to talk about sexual abuse, child marriage, and genital mutilation.

  They are not alone in using the ‘ninja method’. Rather, it seems to be a popular strategy among several similar organisations in Uganda as well as Kenya and India. Probably also in other places. Everything is connected. Menstruation cannot be separated from that which is often considered to be even more sensitive. And it is necessary to turn to both girls and boys.

  Free pads are no solution, as Sarah Matindi and Emily Wilson have pointed out several times. Irise International nevertheless runs a production of cloth pads. The difference is in the overall picture, they argue. The pads only gain significance when they are combined with information and the combatting of taboos and stigma. And they would not give them out for free. Instead, they seek production that is as inexpensive as possible, so that even those with very limited resources can afford them. The idea is that this becomes more sustainable in the long run than the donations that are dependent on the resources and goodwill of the state, companies, or non-governmental organisations – selective measures that change with the trends in the aid world.

  * * *

  Many hours earlier, when the sun is still blazing down, I sit next to Annie Kisaakye with the pads from Irise International lined up on a table. We have moved in under a marquee where staff are greeting parents visiting the boarding school Iganga, 100 kilometres from the Kenyan border. Around us, families are gathering and preparing for a picnic on the grass. A little further away, a group of students are eyeing the gate; they stretch their heads high and try to see over each other. Behind it is a sign with the school’s core values: godliness, patriotism, hard work, respect, responsibility. In that order.

  A woman walks up and asks how the pads are made. Perhaps she can make her own? A pack of three pads is 7,500 shilling, the equivalent of about 2 US dollars and twice as much as a pack of eight disposable pads. But these last for at least six months, Annie Kisaakye points out, and picks up a pack of pads with a pattern of smiling suns and fluffy clouds. On the night pads, half-moons are smiling back.

  She has been here before and led sessions with the students. In total, they are close to a thousand, all girls between the ages of 13 and 19. Now, the plan is to approach the ones with the money – the parents. It is slow.

  I use a toilet where there is no paper, water, or waste bin. Where am I supposed to throw away my tampon? It will have to be in a bin in the schoolyard. I hold the tampon carefully behind my bag, trying not to bloody my hands.

  In the meantime, Annie Kisaakye has become involved in a discussion with a woman who seems upset. Why? Does she think it is inappropriate to sell pads here? It turns out that she thinks the pads are way too expensive. A boarding school does not equal wealthy students. In Uganda, it is common to send children to boarding school, regardless of the financial circumstances. This woman explains that she comes from a village where most people would never be able to pay 7,500 shilling for a pack of pads.

  ‘She told me about a girl who got her period when she was only eight years old, and had to quit school because her parents couldn’t afford pads,’ Annie Kisaakye says when they have finished speaking.

  The woman had read in the newspaper that 15 per cent of girls in the part of Uganda that she comes from drop out of school when they get their period. Her indignation is also about that, not just the expensive pads.

  ‘I suggested that she should get in touch with one of the local politicians and try to make them act.’

  The small kiosks on the school grounds sell Feather-brand disposable pads. As I am leaving, with a soda in hand, I talk to some of the older students. They tell me that they use precisely this brand. I ask whether they learnt anything they did not already know when Irise International visited and talked about menstruation. Mainly how to stay clean, they say. But also some things about the menstrual cycle and about pain during menstruation. And that there are no safe periods!

  They had not talked about menstruation before in school. Nor have they talked about it at home. Our mothers are too shy, they say.

  ‘Menstruation is a part of us,’ says Rosette Napudo, who states her full name without hesitati
on and seems completely relaxed when talking about menstruation, in contrast to the shy mothers.

  When I return, the table with the pads has been moved again, into the shrinking shade. Many are still waiting for their families when we pack up the pads and walk down to the road to catch the bus back to Jinja.

  4

  A COMPREHENSIVE SET OF RULES

  ‘I just got a stomach ache. It didn’t even taste good.’

  Kushala makes a wry face. Then she laughs. She can do that now, in hindsight. But at the time, when she bought an entire papaya and patiently tried to eat the big, sweet fruit, it was not so funny.

  The plan was to make her period come earlier than calculated, with the help of the papaya, so that she could come along on the trip to the temple. Everyone else from the children’s home was going and would be away for several days.

  ‘It was so boring to stay here,’ Kushala says. Without understanding the words, I feel like I can see the drawn-out, teenage ‘sooooo booooring’ in her eyes.

  She is 13 years old and at some point she has heard that papaya can bring on menstruation. I think of my basketball tournament in Finland and the painful tampons. Of how we try to navigate within the system of rules around menstruation – be it about secrecy or temple regulations.

  The warden of the children’s home outside Bangalore, in the South Indian state of Karnataka, does not bend the rules when it comes to menstruation, including the one about not visiting the Hindu temples. She remembers that Kushala wept in despair, that she begged and begged to be allowed to join the others even though she was on her period. The papaya plan came to nothing.

  * * *

  At the end of 2015, 20-year-old Nikita Azad wrote a post on a feminist Facebook page: ‘Women are denied entry to the temple because of the belief that menstruation makes them impure.’ It was a reaction to a statement made by Prayar Gopalakrishnan – one of the people responsible for the Hindu temple Sabarimala in Kerala, southern India – about the need for a ‘machine’ that can tell whether women are menstruating for the question of women in the temple to be up for discussion.