Introduction:
Menstruation is defined
by the English Oxford Dictionary is a process in a woman of discharging the
blood and other materials from the lining of the uterus at intervals of about
one lunar month from puberty until menopause, except during pregnancy. It is natural,
developmental process and symbol of reproduction.
Menstrual Health Management the absorption of menstrual blood on
to clean material which can be changed in privacy and also incorporate the
availability of soap and clean water, to wash re -usable sanitary materials and
the body, as well as suitable place of disposal for used materials (WHO-UNICEF, 2012) . The concept of MHM is emerged recently in
development though not clear and not enough to address the comprehensive needs,
priorities and rights of menstrual girls and women globally (Inga T.
Winkler, 2015) .
Because the global construction of menstruation is vary though associated with
stigma, restrictions, polluted, impure, dirty, contagious, secrecy, shame,
silence, inferior, humiliation, powerless etc. since civilization to date
(Patkar A., 2013; Lee J. 2003; Paudel R., 2015). More importantly, the
menstruation is beyond the infrastructure (Yesmin, 2008) .
The May 28 is identified the International Menstrual
Hygiene Day (MH day) and celebrated globally since 2014 (28 May, 2014) that created a
common space to all stakeholders who works around menstruation hygiene. The month of May symbolically represent the average
five days of bleeding during menstruation and 28 represents the average days of
menstrual cycle of a normal girl and women. Every year, it was celebrated with
slogans/themes: 'wherever she is in privacy, safety and with dignity' (2014),
'raise awareness about women who don't have access to safe water, hygiene and
sanitation' (2015), 'menstruation matters to everyone, everywhere' everyday can
be a good day' (2016),'education about menstruation changes everything' (2017).
In
Nepal, few organizations such as Action Works Nepal, Water Aid Nepal were
celebrated 2014 as 28 May by organizing various awareness raising programs at
their respective locations. The two more years also remained as disassociation
among actors or interested organizations marked 28 May, International Menstruation
Hygiene day with thinner connection with concerned line agencies. In February 2017, Ministry of Water Supply and Sanitation
organized a national consultation workshop along with Ministry of Women and
Children Development, Ministry of Education and Ministry of Health and other
local and external development partners and declared as Nagarkot Declaration
2017 (MoWSS, 2017) . It urged few
things: formulation of national policy on menstruation, build capacity of
actors as well as raise massive awareness around menstruation.
Followed by the consultation
workshop, the policy drafting committee formed under the leadership of joint
secretary. The committee initiate the concept of dignified menstruation in
order to address all kinds of needs, interest and priorities of girls and women
during period and beyond. It is a simply beyond the
infrastructure and hygiene. It is holistic approach where menstruation accepted
natural process and considered human right concern thus assures the needs and
priorities of girls and women during period such as health, education, shelter,
nutrition, law, safety, security, empowerment, environment, water supply and
sanitation (Sanitation, 2017) .
MHM-PA Alliance
The members of the policy drafting committee initiated the
MHM-PA (Menstrual Hygiene Management-Partner Alliance). As a result, in April,
2017, more than 30 organizations came together and formed MHM-PA in order to
work broadly around menstruation at local, national and global level as
partnering organization of government. The membership of this group is free and
any interested organizations or individuals can join and contribute accordingly
where CODEF played as secretariat. In general, the most of organizations
associated with big organizations due to having international organizations as
well as financial transactions such as WaterAid Nepal, KIRDAC, CODEF/WSSCC,
HELVITAS Nepal etc. More importantly, they are working direct on WASH (water,
sanitation and hygiene) and they are working around menstruation for few years
already. The X-Pose Nepal is small but working in advocacy as well as awareness
raising around menstruation for couple of years back where as Radha Paudel
Foundation (RPF) is massively involved in research, policy advocacy, campaigns
and trainings at local, national and global level without any specific funding
resource.
Methodology:
This is qualitative study, used
primary and secondary data through observation and reviewed of reports of member
organizations of MHM-PA Alliance. Total 14 organizations were submitted to
secretariat office by 12 MHM-PA members (CODEF/WSSCC, 2017) s as MHM-PA alliance
agreed to mark international menstrual hygiene day for a week, effective from
22-31 May, 2017. They were; i) CODEF(Community Development Forum), ii) Federation of Water Users, iii) IWRMP, iv) Rural Water Supply and Sanitation Fund
Development Board (Fund Board), v) Guthi,
vi) HELVITAS Nepal, vii) Nepal Red Cross
Society, viii) Putali Nepal, ix) Radha Paudel Foundation (RPF), x) Visible
Impact, xi) Water Aid Nepal and xii) X-Pose Nepal. In terms of locations,
activities were reached out in all levels; local, national and global level.
The activities mainly focused on 14 different districts of the country;
Lalitpur, Kathmandu, Bhaktapur, Dang, Rolpa, Banke, Surkhet, Jajarkot, Dailekh
Rukum,Dolpa, Kalikot, Jumla and Achham. The components of dignified
menstruation were covered or not, what are the major gaps in practice are
analysed and discussed such as health, education, shelter,
nutrition, law, safety, security, empowerment, environment, water supply and
sanitation.
Analysis and Discussions:
i) CODEF(Community Development Forum):
The
media interaction program with live was observed at the premises of CIN
(Community Information Network) in collaboration with CODEF (Community Development Forum) on 22 May, 2017 where 40
journalists from TV, radio and
newspapers attended. There were key speakers; Tika Dahal (people with
disability perspectives), Saru Joshi (breaking the silence), Anupa Regmi
(physiology of menstruation), Gunraj Shrestha
(relevancy of 28 May celebration), Radha Paudel (from the human right
perspectives). Except Radha Paudel, the
discussion largely focused on hygiene, unintentionally concentrated around
sanitary pads and breaking the silence.
Despite
having first program of this year, the different dimensions of dignified
menstruation such as health, education, shelter, nutrition, law, safety, security, empowerment,
environment, water supply and sanitation were heavily ignored except water
supply and sanitation.
ii) FEDWASUN
An interaction program
was participated and observed by the writer of this report. There were three
lawmakers from the Constituent Assembly though the discussion was so
superficial in perspective of dignified menstruation. It was more focused on
water supply in toilets and hygiene but not discussed health,
shelter, nutrition, law, safety, security, empowerment, environment.
iii)
IWRMP
IWRMP supported to radio program where interviewed
were taken with representatives from different organization, teachers, health
officers where they shared their views and work experience of their respective
organization through Jagarn Special Programme in Surkhet. The dignity of the
girls and women during menstruation is missing here. It developed an approach of Hygiene Literacy Class in the
community too. Total sanitation and hygiene promotion flip chart has developed which
has 12 chapter including Menstruation Hygiene (Chapter 7). Thus, the dignity
perspective of the menstruation largely ignored.
iv) Rural Water Supply and Sanitation Fund Development Board (Fund Board)
Two
panel discussions conducted by Fund Board in Kathmandu. The first was
concentrated on the slogan of the year 2017 entitled 'education on menstruation change everything' where the
joint secretary and spokesperson from the ministry of education from government
(Hari Lamsal), representative from LGBTQI (Lesbian, Gay,
Bi-sexual, Transsexual, Queer and Intrasexual) Durga Thapa and national association of people with
disability (Rama Dhakal) and social activists (Dr Aruna Uprety and Radha
Paudel) were there. The writers of this
report participated and observed the program. The half of the discussion lively
discussed on dignified menstruation.
The
second panel discussion entitled 'Can multi-sectoral approach be a game changer
to create safer and healthier experience for all girls and women' which composed of five panellists from Institute
of Medicine, Nardevi Ayurvedic Hospital, Activist
for people living with disability,
YUWA and Visible Impact. They were given different
perspectives on menstruation as breaking silence and focused on hygiene but heavily ignored the dignity of the
girls and women during period.
v) Guthi,
In collaboration with WaterAid Nepal, ENPHO. ACF International (Action
Against Hunger- Nepal) and Jasmine Group (Safety Sanitary Napkins), Guthi organized
public male sensitization program on menstruation in Langankhel bus park,
Lalitpur.
The public male personalities invited; Mr. Madan Krishna Shrestha, Ravi Dongol along with Deputy Director of Department of Water Supply and Sewerage; Senior Public Health Administrator, Ministry of Health and other stakeholders were male members of the group who accepted on wearing a pad and even shared their experience and their feelings without any hesitation. Approximately 100 public participation was observed in the event. The writers observed that event primarily breaking the silence and focused on infrastructure.
The public male personalities invited; Mr. Madan Krishna Shrestha, Ravi Dongol along with Deputy Director of Department of Water Supply and Sewerage; Senior Public Health Administrator, Ministry of Health and other stakeholders were male members of the group who accepted on wearing a pad and even shared their experience and their feelings without any hesitation. Approximately 100 public participation was observed in the event. The writers observed that event primarily breaking the silence and focused on infrastructure.
vi)
HELVITAS Nepal
Despite involvement at
national level activities, the partner organizations conducted different
events; rally, quizzes, essays and elocution, competitions programme on
menstrual hygiene and Chhaupadi related theme for promoting awareness and to
break the silence on menstruation in its working districts, Dailekh,
Achham,Kalikot , Jajarkot and Surkhet. with students, teachers, parents,
representative from health post, and representative of local political parties.
The celebration with different Programme in different schools supported to
break the silence on menstruation and was successful in creating awareness on
several misconceptions and practices associated with menstruation.
vii)
Nepal Red Cross Society (NRCS)
NRCS organized few activities such as
interaction program on menstrual hygiene, to mark May 28, International
Menstrual Hygiene Day in various villages of Solukhumbu, Mahottari, Rautahat,
Bara, Kathmandu, Parbat, Kalikot, Jajarkot, Achham, Bhajyang of its working
areas. All activities focused on hygiene during menstruation.
viii) Putali Nepal
Putali Nepal organized
training on Ruby Cup in cooperation with Hands in Outreach (HIO) to 21 women
who are part of their literacy
program. Ruby Cup is an
alternative and eco-friendly menstrual cup that can be used as a safe method to
deal with periods. The information about the Ruby Cup contained details about
the products material, it’s usage (insertion, removal, emptying, cleaning and
storing it), frequently asked questions, like “Do I lose my virginity using the
Ruby Cup?” or “Will the cup overflow?”. Also offered more generals trainings on
MHM addressing these and related issues during which we use the Menstrupedia
Comic book as well. Likewise, Putali Nepal also organized Menstrupedia training
in school. The first session was given to 16 girls and in the second
training 31 boys
participated. All in all, all activities are focused on sanitary products
specially on Ruby Cup and hygiene.
ix)
Radha Paudel Foundation (RPF)
RPF organized various programs at local, national and global level
by giving radio interview, article writings, panellist and participated in many
programs. All in all, programs focused on dignity and human right of girls and
women during menstruation. RPF also emphasis that theChhaupadi is a form of
menstrual restrictions which is visible in west Nepal but practicing across
country regardless of caste, education, religion, region etc.
x) Visible Impact
It has organized educational interaction program focusing on
menstruation, health facilities in schools and role of men. It has touched the
few parts of dignified menstruation but not in holistic manner.
xi) UN Habitat
UN Habitat organized
programs in schools and village councils in five different districts of Nepal namely
Arghakhanchi, Bajura, saptari, Siraha, Jhapa. According to secondary
information, the video show, interaction, discussion were programs for breaking
silence and improving hygiene and sanitation during menstruation. The dignity
or human right component was not the core of the discussion.
xii)
Water Aid Nepal
As an
International non-governmental organization, has part of various activities
through partner organization in Kathmandu and outside. However, it largely
focused on menstrual hygiene, water supply sanitation but not health,
shelter, nutrition, law, safety, security, empowerment, environment.
xii) X-Pose Nepal
The cycle rally was organized by X-Pose Nepal. It was first cycle
rally on menstruation where more than 200 cyclists participated from various
walks of the life. It started from Basantapur Darbar Square and ended at Patan
Darbar Square followed by small corner assembly. It was focused on awareness
raising on menstruation, specially breaking the silence around boys and men in
Kathmandu through observation and media coverage. Only two speakers out of six
linked the menstruation with human right. It didn't speak on other aspects of
the dignified menstruation.
Conclusion
and Recommendations
Conclusion: The
talk around menstruation is started in Nepal in 2017. The government, NGOs and
individuals are initiated the culture to work collectively to fight against the
taboos of menstruation. Its just beginning and long way to go to get tangible
impacts in the life of girls and women as well as in society. The discourse
just started from the point of hygiene and sanitation and the course has to go
further wide and depth to assure the dignity of the girls and women during
period.
Recommendation:
1. This is the high time to abolish restrictions around
menstruation and empower girls and women since childhood. Therefore, government needs to call for urgent
action to all stakeholders who are working about health, education,
empowerment, human right and SDGs in order to address the different dimensions
of the menstrual rights.
2. The government also need to develop guidelines to monitor the
activities of NGOs at central as well as provincial level.
3. The research and policy attention is lack around dignified
menstruation therefore it has to increase significantly by government.
4. NGOs are also hold accountability to redress the violations
of human right and disempowerment. Regardless of their mandate of project, the
message of dignified menstruation has to disseminate across their project as
cross cutting concern.
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