Several colleagues have sent me the story of India’s Arunachalam Muruganantham, who wore his own sanitary pads, along with a contraption designed to mimic having a period, in order to better understand the problems of menstruation and the product performance required to manage it. It is an amusing anecdote, to be sure, and Muruganantham’s sympathy and determination are admirable.
What is more important, beyond the appealing narrative, is that Muruganantham has reverse-engineered a sanitary pad that is apparently similar to those commercially available from the multinational makers—and he is selling the machines for only $2,400. Thus, he has significantly reduced the barriers to entry, making it possible for small businesspeople to provide the pads in a local context.
Other notes from the story are also important. One item is the almost throwaway line about the apathy of NGOs regarding this question. Our remit under the ESRC-DfID project we now have underway in Uganda includes a report on why this problem is meeting with so much resistance in the development community.
I think there are a number of reasons. One is that, like many fields, development is dominated by men: they don’t want to think about menstruation and they don’t want to be told they have missed something important. They assume that anything having to do with “feminine care” is trivial. There are environmental objections, but, frankly, I think these are often a cover for a dismissive attitude toward menstruation, rather than true concerns over the waste. The trade-off between disposing of sanitary pads and the environmentally devastating impact of uneducated girls on fertility rates is something that needs careful thought, not a knee-jerk reaction.
I also think there is still a certain amount of resistance on the ground about the increasing focus on helping women, regardless of the project.
Most important, I suspect, is the concern about being seen to help the multinational corporations somehow by providing sanitary care to women who need it. Ideological concerns often trump compassion in the NGO quarter, in my experience.
When we first went to Ghana for the initial empirical work on this issue, we were introduced to both CARE and Plan as potential NGO partners. While our contacts in both the UK and the US were enthusiastic, the personnel on the ground were unsympathetic. Eventually, the Plan Ghana staff were extraordinarily obstructionist, causing us to waste large amounts of money and time when they would fail to deliver on partnership arrangements. It was very clear, in the end, that they were stonewalling because they did not want to be involved with a project about menstruation. The CARE staff were also highly skeptical—the men kept telling us there couldn’t be a problem because no one had ever mentioned it to them! —until one of the community activists, a wonderful man named George Appiah, went out in the field and asked. He came back emphatic about what a big problem the lack of pads was for girls in school and, after that, CARE was with us.
When we went to east Africa, we were again looking at these two organizations as partners. CARE in Kenya wouldn’t even discuss it, apparently because they didn’t want to be involved in something that used a consumer product (though they seem happy enough to distribute condoms and soap and mosquito nets). Plan in Kenya was the same way, but the office in Uganda was willing to work with us. So now we are setting up there and we’ll see how it goes. In general, the community in Uganda seems to be more tuned in to the problem. The government there has already done studies of their own and have seen the difference this provision makes. Unfortunately, these studies, like the ones Procter & Gamble did in Kenya, remain unpublished.
It may help the situation as people come to understand that there are real effects on productivity, health, and freedoms from not providing this care. Another important mention in the Muruganantham story is the A. C. Nielsen study showing that women who have no access to pads can’t work several days a month and also get more infections (from using cloth and not being able to clean it). So, with education, health, and employment jeopardized, maybe the nay-sayers at places like USAID will take a deep breath and consider they may have been wrong. That’s what this work is all about: determining whether the pads will make a difference, finding out what the best solutions are, and then publicizing the findings to the point where policy-makers and aid workers will have to get past their prejudices.