Some way into the health project that Change is running, under the name of the HERproject, Nazneen Huq contacted a few select pad companies and offered them access to the factories if they, in turn, could offer pads for a subsidised price. Otherwise, the price of a pack of eight menstrual pads is around 0.50 US dollars, compared with the 70 US dollars in monthly salary or roughly 2 US dollars per day. The next step was to convince the factory management to subsidise the pads further.
‘Why would they do that?’
The question is rhetorical. The only reason would be that they could make money from it, Nazneen Huq notes.
‘What’s your thinking about the fact that your entire work force basically consists of women of fertile age and that most of them probably menstruate once a month? Does that matter to you?’ The representatives from the factory management were dead silent. Either they did not dare answer or they had not thought about it. Nazneen Huq focused on absences.
She quotes herself with the same conviction that I suspect she showed before the managers.
‘Check their absences! You’ll see that they’re away one or several days per month. And if you have 500 menstruating workers that means 500 working days per month, lost. Perhaps not everyone stays home from work when they are on their period? No, but say 100 then. How much does that cost you?’
This loss is hardly about the factories handing out sick pay. Rather, the already underpaid employees are the ones who lose some of their pay if they are away from work. For 25-year-old Sarita, for example, it was not possible to be at work during the first days of menstruation, not when the lump of fabric started leaking after just half an hour. She and her colleagues already live on – or, rather, outside – the margins, but Nazneen Huq had to convince the factory management of their own loss.
To help me understand, she draws a factory floor on a piece of paper. There are long rows of markings that symbolise workers. Each and every one of them has specialised in some small part of the chain of production. If one of them is away – Nazneen Huq circles one of the markings – it causes problems in the entire chain. It is true that they can probably be replaced, but by someone who is less skilled. They have quotas to fill and the production time is measured in seconds. That circled marking will serve as a brake.
The factory management understood and was prepared to take on part of the cost for the pads, just like the other 87 factories that have participated in the project so far. Some offered 50/50, others 60/40, but they all agreed to some kind of subsidy.
‘We didn’t want them to be handed out for free. Instead, we wanted the girls to learn to spend money on themselves so that they understand that they’re worth it.’
Nazneen Huq says girls, not women. Most of the textile workers are young enough to be her daughters. They are usually between 18 and 30 years old, but there are also younger girls in the factories – even though child labour is illegal.
Another condition was that the pads be sold in the factories. Many textile workers work long days, only to go home and take care of the household. They do not have time to go to the pharmacy or some other shop that might sell menstrual products.
In most factories, the absences have decreased since they began selling the subsidised pads, according to Nazneen Huq. They have not carried out a comparative study, but both textile workers and managers say so.
‘The factories continue to subsidise and sell pads, even after the project comes to an end, because they see that they profit from it. Otherwise they would never continue! And we talk to the women all the time and they tell us themselves that they spend less time away now.’
* * *
The project in Bangladesh reappears again and again in various international reports about menstruation in the workplace, even though it is small and lacks academic weight. The explanation is simple: there is no research into how menstruators are affected by not being able to manage their periods in a functioning manner in their working lives. Aside from the Bangladeshi example, I find a study from Senegal in which 96 per cent state that on a regular basis they do not work during menstruation. This is due partly to physical symptoms like stomach pains, but also to the fact that there is no place to change menstrual protection and wash in the workplace. In a report from a project in Pakistan, a factory worker explains that they have a similar problem in their workplaces.
Studies about access to toilets, water, and bathroom breaks from a menstrual perspective are conspicuous by their absence. There are, on the other hand, several examples of how employers have denied their employees breaks to visit the toilet, mainly in the US. The most famous example is the discount chain Walmart, which has been sued multiple times as employees have been prevented from going to the bathroom. In India, too, it has been brought to attention that some employers limit the number of allowed bathroom breaks to two per day.
Marni Sommer, researcher in global health and development at Columbia University in New York, has repeatedly tried to secure research grants to study menstruation at work. So far without success. She is convinced that the research is needed and has contacted the World Bank, among others. But the reception has generally turned out to be considerably cooler than when the research is about schools. Menstruation politics has yet to reach further than that.
Even if we can assume that it becomes easier to manage menstruation with age and experience, we can also say with certainty that the problems with access to menstrual products, toilets, and clean water do not go away after menstruators leave school. Today, it is estimated that 2.36 billion people in the world lack access to toilets, according to the organisation WaterAid. That is a third of the world’s population. 650 million do not have access to clean water.
Is there running water in the textile factories in Bangladesh? Enough toilets? Sometimes, sometimes not.
* * *
Later, Nazneen Huq reuses the piece of paper on which she drew a factory floor to illustrate how many, mainly in the countryside, fold menstrual protection from pieces of fabric cut from old saris: thicker in the middle and long enough to be fastened around the waist with a piece of string. She says that it is a much better alternative than the dirty and damp pieces of fabric stuffed with chemicals from the factory floor.
And fabric from old saris certainly has the potential to work better than joot, supposing that there are opportunities to wash it with clean water and soap and to hang it up to dry in the sun. Otherwise, the problems remain the same – damp and dirt – without the dose of chemicals, that is. In the factories, there is neither space nor time to wash menstrual protection.
On the other side of Banani Lake from the upper-class neighbourhood Gulshan-Banani, where Nazneen Huq keeps her office, Karail is located. With approximately 40,000 inhabitants, it is Dhaka’s largest slum. Here, it is almost impossible to find those components: clean water, soap, and clotheslines in the sun. The conditions are similar for many of the estimated 863 million people across the world who live in slums – a group that is growing fast.
It only takes a few minutes to cross this part of the lake – as wide as a river – in one of the manned rowing boats that serve as a kind of public transport, run for and by Karail’s residents. It is Friday, a weekly holiday in Muslim Bangladesh, and many have the day off work.
On the floor of the communal bathrooms several women are on their knees, doing laundry in water they have carried in buckets from a tap. A group of boys show me the way to the nearest one. We walk on narrow, beaten paths between the sheds. But there is not enough running water for everyone; water shortage is a constant problem in Karail. So is the lack of privacy. The laundry hangs on clotheslines between tin roofs and drips onto anyone who walks below.
Most textile workers go to work even though it is Friday, explains Yasmin, who is sitting outside the shed she lives in, combing her mother’s hair. The textile workers leave Karail at seven in the morning and return home around eight in the evening.
‘It’s a good job,’ she says, and the boys w
ho showed me the tap and are following me around of their own volition seem to agree. They nod eagerly, in any case.
Yasmin’s mother is a maid, and Yasmin herself is in high school.
The lack of time is one reason why the textile workers rarely seek treatment for their genitourinary infections. According to law, there must be access to a physician in factories with more than 300 employees, but this is rarely upheld. When the workday is over at the factory, other tasks await at home. Doctor’s appointments after working hours are usually not an option.
Many also believe that their symptoms are part of being a woman, Nazneen Huq says, and therefore do not qualify them to seek care. Without treatment, the risk increases that minor infections could lead to complications and other more serious conditions.
* * *
The managers – are they always men? I ask. ‘Oh yes!’ Nazneen Huq seems amused when she describes how she sat down with a group of men in traditional Muslim headdress, a type of small white crochet hat, and with long beards to talk about menstruation. She tried everything to make eye contact, but they would not meet her gaze.
She becomes serious again when she explains how important it is that they understand that menstruation is an issue they have to engage in as managers. That in itself is a big step away from silence and shame, making it a work environment issue and therefore something that textile workers can raise with their foremen. Ideally, they can say that they need more toilets, waste bins, water, access to painkillers, and menstrual products to be able to work and stay healthy.
Nazneen Huq has to hurry on to her next meeting with one of the companies she works with: MQ. Is it Swedish? she asks. And Lindex? She works with them too. We are sitting together with two other staff members from Change in a big car that feels unwieldy on the streets of Dhaka with its many rickshaws, both bike and motor driven. Sidewalks with big holes are forcing pedestrians out onto the streets, where traffic runs slowly, like sticky syrup.
Nazneen Huq asks her colleagues in the backseat what the current situation is with bathroom visits in the factories. They aren’t restricted anymore, are they? No, they reply. They used to be, at least in some places, but it is not something they have heard about in the factories they work in now.
She talks about a factory manager who was overjoyed with the pads, simply because of what happened in the bathrooms.
‘Before, they used to have blocked pipes at least once a month because everyone threw away their used joot there.’
Back then, the waste bins were empty; no one threw away their bloody bundles of fabric there. Now, the bins are filled with pads and they do not have to put money into clearing the drains over and over again.
Suddenly, there is an opening in traffic. For a few seconds, the driver steps on the gas with all his weight. And then we are motionless again, while the rickshaw drivers pass by so closely that they almost brush against the car.
7
‘I JUST KEPT BLEEDING’
‘I thought I had injured myself.’ When 17-year-old Phiona in Kampala got her first period, she did not understand what was happening. She was 14. Twiine, another woman from Uganda, thought the same: that she had injured herself, somehow. Perhaps when she was gathering firewood? Could it have been the twigs?
‘I didn’t know anything, I just kept bleeding until I got home,’ says one of the students at the high school in Bangalore, India. She was crying from fear. Nor did Annie Kisaakye in the Ugandan town Jinja know anything about menstruation. She did not dare mention the blood to her mother: ‘I was afraid that she’d think I had been with a boy, and get mad.’
Blood that inexplicably flows from the body is more than a little scary. It is terrifying. Menstrual blood cannot be stopped with a plaster or bandage. The red fluid that signals sickness and death just keeps coming. And because it flows from the vagina, it is generally associated with sex and shame, regardless of a 10- or 13-year-old’s understanding of the function of menstruation.
‘Before I got my period I didn’t know anything about it … it’s a very secret subject; it isn’t supposed to be discussed with the young, those who haven’t had their periods yet,’ says one of the students who is interviewed in a study from Zambia.
How many menstruators do not understand what is happening when they get their first period? There are no statistics that cover all the billions of menstruators in the world, no estimation of menstrual preparation at a global level. Many of the studies are from different parts of India and offer a range from 15 to 85 per cent. Among teenagers in north-western Gujarat state, in one of the wealthier parts of India, 37 per cent stated that they knew nothing before they got their first period themselves. Fifteen per cent thought that they had been stricken with a serious and perhaps life-threatening disease.
In a slum in the South Indian city of Bijapur, 80 per cent lacked knowledge of menstruation when the first period came. In the northern state of Uttar Pradesh, which shares a border with Nepal, the corresponding statistic was 66 per cent. A study among university students from different parts of the country gave the lowest number of 15 per cent – who knew nothing when the blood came.
There are also statistics from the neighbouring country Pakistan which show that only half of all first-time menstruators have prior knowledge. Fifteen per cent have been taught to manage menstruation. Outside of the Indian subcontinent, in a study from Senegal, almost 40 per cent answered ‘No’ to the question of whether anyone had prepared them for menstruating. The most common emotion at the time of the first period was fear. In the Senegalese study, 85 per cent of participants, both young and old, wanted to know more about menstruation.
At the Norslund school in Falun, Sweden, in 1987, I was 12 years old and waited eagerly. Peering curiously at others in the changing room after gym class, in the hope of clues. Was there a way to tell? My knowledge of menstruation may have been limited, but I had heard about it both at home and in school. Basic information about the menstrual cycle, menstrual protection, and menstrual pains. Yet I was not unafraid. The blood. Is it the right colour? Should there be so much of it? Is it supposed to smell like this? And the clots? Other questions I would not be able to put into words until many years later. Why are there not better menstrual products? Why don’t we talk about PMS and menstrual pains? Why are we ashamed?
Menstrual knowledge is difficult to combine with one of the fundamental, global rules of menstruation: the one about silence. Certain things manage to get through. Secrecy. Cleanliness and dirt. Sex and boys. But facts bounce against false notions and numerous myths. The image of what happens inside the body is blurry. The strategies for managing the blood are haphazard.
* * *
The rain floods the street in Nairobi in just a few minutes. It comes suddenly. The period of intense rainfall should be over, but this year it is dragging on. Outside the open door that leads to ZanaAfrica’s office in the Kenyan capital, there are two shoe racks. Inside, four women are sitting in front of their laptops, unperturbed by the violent rain. One of them is Catherine Onyango. She is a project manager at ZanaAfrica, an organisation that, like Irise International in Uganda, works to make sure that menstruation is not an obstacle. One million girls in Kenya miss six weeks of school every year, it says on the organisation’s website. Four out of five girls in East Africa lack access to health education – that covers the body and puberty – as well as menstrual pads.
‘The pads serve as a key to the girls. It becomes a way to build trust and to get them to talk to us,’ Catherine Onyango says.
We enter a small meeting room with striped armchairs, talking about the rare weather while waiting for her colleague, Faith Wangoki Muthoni.
In Kenya, with its roughly 45 million inhabitants, ZanaAfrica reaches around 10,000 schoolgirls every year with its combination of free pads and education. The target group is vast in a country where the young form a large majority. According to Catherine Onyango, education is the critical component. Without it, the pads are just temporar
y plasters – albeit very appreciated. Just like other material solutions, such as water, toilets, and waste disposal, they only go so far. At least without time for questions, conversations, and recognition.
‘Many are just told that they shouldn’t talk about their period and that they should stop playing with boys. We talk to them about the menstrual cycle, menstrual protection, health problems, various aspects of puberty, relationships, gender equality, and sexual abuse.’
The curriculum in Kenya does not offer much guidance. Catherine Onyango says that opportunities for further immersion are missing. Moreover, many teachers choose to cut the parts about reproduction and sexuality. Partly because they are under great pressure due to the severe shortage of teachers with which Kenya, like many other countries in Africa, struggles. And partly because they feel uncomfortable talking about menstruation and other puberty-related issues. Their hope is that the families will take responsibility for guiding the children into their teens. Catherine Onyango sighs.
‘It used to be older relatives – like grandmothers – who prepared the girls.’
But family patterns are changing quickly in Kenya. Many people are moving from the countryside to the cities, the spread of HIV has torn households apart, and 75 per cent of the population are under the age of 30. Living with older relatives is no longer the rule. A void is left between the private and the public when parents put their faith in the school to teach the children about puberty. The school passes it back to the parents.
On the table, there are packs of pads that Zana-Africa produces and then both sells and gives out for free. ‘Nia’, it says in purple, then: ‘Live your purpose’. The text is accompanied by the customary drops that indicate the level of absorbency. Five of them. In the product description, it says that Nia ‘inspires and ignites girls and women to realize their full potential across their lifetimes’.
It's Only Blood_Shattering the Taboo of Menstruation Page 9
