Zulfiqar Ali Khan
” It was very scary to be bleeding without any injury. I felt terrified and ashamed to tell my mother. My elder sister then told me that all girls menstruate and that there was nothing to worry about,” said Alwina Sahar, 32, who is now working as a nurse in a private hospital in Karachi.
Almost half of our population menstruates, yet the myths and stigmas surrounding it portray women as impure and inferior.
According to a study conducted by the Aga Khan University in Karachi, 60 percent of the girls avoided socialization, limited movement and were prohibited from attending religious events.
“There is a long and deep presence of menstrual taboos in our society,” said Farieha Aziz, the co-founder and Director at Bolo Bhi, an advocacy forum working on internet freedom, privacy and gender in Pakistan.
“The need is to break the silence on the topic and start discussing it, so women can strive for equality at educational institutes, workplaces and their homes,” she added.
The topic is not even discussed between a mother and her daughter, let alone with male members of the family, Aziz noted.
The AKU study found that around 50 percent girls were clueless before they had their first period. Another study conducted by two scholars Nawaz and Khalid in Hyderabad, Sindh revealed that 71.2 percent girls, learned about menstruation from their mothers.
“For a woman, the process of bleeding has physical, emotional and psychological repercussions,” Ms. Aziz said, adding societal attitude has converted a normal biological function into a distressing and hurtful experience for young girls and women.
In February 2018, Bollywood film ‘PadMan’ challenging taboos and stigmas surrounding menstruation was banned in Pakistan. “We cannot allow a film whose name, subject and story are not acceptable in our society,” Dawn newspaper quotes a member of the Censor Board as saying.
Many Pakistani men do not even know and talk much about periods.
“To be honest, I have no clue what the experience of a period would be like,” said Sharaf Uddin, a 21-year-old university student. He said he would feel uncomfortable discussing menstruation with girls.
Rights activist Habiba Salman said “menstrual hygiene should be taken as a fundamental human right” as it directly impacts the health, education, mobility, access to information and the notion of equal rights and opportunities for women.
“The four main enablers to safe menstruation are education and awareness, menstrual hygiene management (MHM) products, improved sanitation and policy level interventions supporting safe MHM,” she added.
UNICEF research has shown that menstrual health affects girls’ education in Pakistan. A study conducted by Nawaz and Khalid in Hyderabad, Sindh revealed that 55.1 percent girls were absent from schools during menstruation.
According to the statistics of the Academy of Educational Planning and Management (AEPAM), out of the total 51.53 million school-going children, 22.84 million (44 percent) were out of school.
“School teachers, lady health workers and key family influencers like mothers and sisters can play vital role in educating women on hygiene, said Kiran Fatima, a development practitioner who has studied and worked on gender issues.
According to Real Medicine Foundation (RMF), more than 79 percent girls in Pakistan do not manage menstruation hygienically, causing gynecological and psychological complications.
“Menstruation is actually a sign that a woman is healthy,” said Dr Mumtaz Hussain, a gynecologist with over 30 years of experience. She said unlike other normal bodily processes, menstruation is linked with religious and cultural connotations that lead to misconceptions and unsafe practices.
“Unhygienic practices can cause risk of several infections and gynecological problems and can also leave women vulnerable to infertility,” Hussain added. She said poor menstrual hygiene can also lead to cervical cancer.
“Normalising menstruation as a healthy and positive part of the female life cycle is really important,” she added.
Hussain said both girls and boys should receive accurate, timely information on the biological and psycho-social aspects of menstruation and MHM through targeted education, media and key influencers within their families and community.
There are millions of girls and women who are unable to access necessary menstrual products due to accessibility and affordability.
A study by Integrated Rural Support Programme found that 66 percent of the girls and women used cotton or a cloth during menstruation, and only 17 percent used a sanitary pad while 49 percent reused the cloth.
“I don’t feel comfortable purchasing napkins from male shopkeepers,” said Marjan Mustafa, an educated housewife. She said shopkeepers mostly place napkins in unnoticeable places and when purchased they wrap it in black bags or newspapers, as if you are buying something illegal. “This further perpetuates the secrecy and shame associated with menstruation,” she added.
She said the high prices of quality napkins are also forcing women to use substandard products and plain cloth.
Lack of adequate water, sanitation and hygiene (WASH) facilities aggravates the issue for menstruating women.
According to UNICEF, only 64 percent of Pakistan’s population uses improved sanitation, with a wide disparity between urban (83 percent) and rural areas (51 percent). The statistics reveal that 46 percent female primary schools, 30 percent female middle schools, and 4 percent female high schools in Sindh, do not have latrines.
“There is no place to dispose pads at college. If I need to change my pad, I usually ask for leave,” said Naghma Jabeen, an 18-year-old student at Karachi University.
There are differences between sanitation infrastructure available for men and women in public places. UNICEF conducted an SMS poll via its U-Report PakAvaz platform and found that 44 percent do not have access to basic menstrual hygiene facilities at home, workplace or school.
“Even when disposal mechanisms are available, women and girls are also hesitant to dispose of menstrual products, to avoid being identified as having menstruation,” Jabeen highlighted.
The taboos associated with periods have persisted at the cost of women’s health, which is yet to be dealt under law. Nepal is the only country that criminalizes discriminatory practices related to menstruation.
Even today, in the Kalash community in Chitral, the ancient practices are so deep seated that women are isolated during their periods because of the notion of the so-called ‘impurity’ associated with menstruation.
“During menstruation and at childbirth, women are isolated to live in separate houses ‘Bashali’, built outside the village,” said Shamim, a Kalashi women who herself experiences the practice regularly. She said during these periods, women are not allowed to go home but they can work in the fields.
According to the research conducted by Elizabeth Mela of Aristotle University Greece, seclusion of women results in many restrictions in their daily life and participation in religious rites and festivals.
“During their stay in Bashali, they look very happy doing hand-crafts as they do not have to do any household chores. Food is brought to them and left outside the Bashali. So, for them, as I saw them with their cheerful faces, the Bashali period is like a holiday as they do not have to work,” Mela mentioned.