Doing Bad by Doing Good: Menstrual Hygiene and Western Myopia

My colleague at the University of Illinois, Dawn Owens-Nicholson (who works with me on the sanitary care project), sent me a link to a New York Times story on “The Taboo of Menstruation.”

The author, Rose George, author of The Big Necessity, is reporting on her experience following the Great Wash Yatra organized by WASH United to promote healthy hygiene, especially around sanitation issues, in India.  There is no question that this kind of thing is important, a very “big necessity” indeed.  However, the wishful thinking of not-for-profits doing this kind of work continues to perpetuate problems for menstruating schoolgirls.

The story opens with all the foolish superstitions the people in the villages believe about menstruation (among other things, it will ruin your nail polish).  I was a bit put off by this, as it seemed to make fun of the poor for being ignorant and superstitious, as if people in the West aren’t pretty silly about menstruation themselves.  But this concern was quickly wiped out by the revelation that this traveling show actually had a menstrual tent where the women and girls could go and learn to use cloth for their periods properly:  by washing it with soap, drying it in the sun, and ironing it.

I honestly don’t know what these folks are thinking.  What do they think the women use now?  Well, in fact, the story goes on to say (with no apparent double-take) that they already use cloth and it is often dirty–there is even a story about a girl having to have a hysterectomy because her cloth had lizard eggs in it.  These kinds of horror stories are common in the developing world.  This is partly for the same reason urban myths abound in our own culture–humans just will repeat and elaborate on a story like that.  But it is also because the cloths are hard to keep clean–soap is scarce–and they are usually dried in dark, secret places because of the need to maintain privacy about the girl’s period.  So the cloth dries in the very space where there are likely to be bugs and where the user can’t see well enough to even know the cloth has been invaded.

This business of “use soap, dry it in the sun, and iron it” is a mantra already among public health and sanitation experts in the developing world.  Saying it apparently absolves them of any responsibility for engaging in the actual conditions at hand, rather like saying confession releases you from sin or getting the patient’s signature means they can’t sue you.  In my experience, all the women and girls have already heard this song-and-dance so many times they can practically hum the tune.  They will parrot it back whenever asked because they know that is what they are supposed to say.

It is not that they don’t know what the best practice would be.  But they nevertheless do not do what the words say.  As long as soap is hard to come by and privacy in the sunlight impossible, these cloths will not be dried hygienically.

And who has an iron? Not many.  Even if they have an iron, they still don’t have a place to use it where no one will see.  I have specifically asked about this ironing thing many times:  females are simply too embarrassed to stand around ironing their menstrual cloths in full view of the rest of the family (and anyone else who wanders by).

So I guess these women are just supposed to “man up” and not care who sees their menstrual cloths.  Mind you, this is in India, a society that in the past few weeks has been jolted by protests about the level of sexual violence and the minimal protection offered women and girls.  Somehow, hanging your menstrual cloth out in full view of the village seems foolish to me, an invitation to abuse in a society where the men are given to taunting (and raping) girls who step outside the lines even a little bit.

Where is the big picture thinking here?

The article goes on to talk about how the schools never have a place to wash and change.  OK, so what are the girls supposed to do with a cloth then?  That problem is, right there, the crux  that keeps girls who have to use cloth away from school.  Yes, the community needs to build better toilets.  Yes, they need running water.  For most poor communities, it will be decades before they get those kinds of facilities.  In the meantime, it is crucial that the girls stay in school–for many reasons besides the one this article gives (to counter the silly superstitions).  So some compromise needs to be made in the short run. I’m saying the girls need disposable pads.

The author praises one teacher who used his salary to build an incinerator for burning the dirty cloths.  But the cloths are supposed to be washed and reused, right? And, in my experience, cloth is too dear to be disposed of after use.  So the incinerator must be for burning disposable pads.  A sensible solution, but one that contradicts the thrust of the article.

So the whole article is a mess of contradictions about the use of cloth, the ability to obey the instructions blithely handed down by international donors, the impact of the school facilities on the need to use disposables, and the use of incinerators.  I can only conclude that this muddle occurs because the NGO wants to remain “environmentally correct” in the eyes of the West even if its solutions make no sense for the conditions on the ground. In my view, this bunch of ill-considered, insensitive advice does nothing but undermine the overall mission to improve hygiene practices.

If everybody out there is so concerned about the environmental impact of disposable sanitary pads, they need to concentrate their reform efforts at home, where the problem is much bigger.  Poor schoolgirls in struggling communities should not be made to pay for the excesses of the West with recurrent indignity and lost education.

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