By Supo Balogun
A 2012 UNICEF report says that the average woman would menstruate 3,000 times in a life time from onset of menstruation, or what is terminologically referred to as menarche, to menopause.
That woman will also use 11,000 sanitary pads during the period. In Nigeria where the challenge facing the Water and Sanitation Hygiene (WASH) sector has assumed a life of its own, the prospects for the poor adolescent girl-child and adult female are better imagined than experienced. The statistics of the appalling state of affairs in the water and sanitation sector are as galling as they are revealing.
But beyond the immediate challenge of water and sanitation in Nigeria are the bulwarks which in particular are steeped against the menstruating adolescent school girl and are often couched in taboos, myths and superstitions.
Consider these myths: The findings of a 2015 research on Menstrual Hygiene Management(MHM) in some selected communities in Bauchi, Benue and Plateau graphically underlines the fact that old habits, beliefs and values die hard, no matter how despicable. In some communities in Bauchi State, menstruating girls and women are not supposed to cook food for men because this would ruin their herbs and charms (juju).
In Avarichi community of Ado Local Government Area of Benue, menstruating girls and women must not bath in Ogege River.
But a community in Plateau State may well carry away the trophy in this uncanny drama of the absurd: If a woman is menstruating, she is not allowed to go to the king; she cannot cook for the elders; she cannot greet her husband in the morning without first having her bath ; she is restricted from going to certain places because she is regarded as unclean.
Even more perpexing is the typical day for the menstruating school girl as disclosed by the study.
In Bauchi State, she does not go to religious places, does not take sweets or fry things nor engage in any hazardous chore.
Her counterpart in Benue, who often withdraws from family members because of a feeling of shame, is also restricted from traditional sacrifices to avoid defilement.
In Plateau, it is probably the dullest day for the female as she is restricted to bathing, rubbing creams and perfume because of the odour.
Yet, she needs clean water to do all these in the first place, but such water is a scarce commodity, in the urban and rural settings.
According to the UNICEF/WHO Joint Monitoring Programme (JMP) report of June 2015, Nigeria’s overall improved water coverage rate was 69 per cent of its estimated population of 183.5 million while improved sanitation coverage was 29 per cent.
The report said unimproved water sources are used by 31 per cent of the population while use of shared toilets, unimproved toilets and open defecation accounted for 71 per cent of sanitation practices. It also said institutional water and sanitation access rates are also very low, particularly in schools. The report said, for example, that an inventory of water, sanitation and hygiene facilities in 4,653 schools in 58 Local Government Areas across 20 states of Nigeria in 2014, revealed the poor coverage of schools with WASH facilities. There were sanitation facilities only in 1,726 schools (37%), water sources only in 851 schools (18 %) and both water and sanitation facilities in 701 schools (15%) of schools inventoried.
In the cacophony of confusion created by stone-age traditional practices and beliefs about menstruation is the kernel of the current campaign launched by UNICEF across many states of the federation.
In all the fora, the gospel being preached by UNICEF is MHM, which it describes as the process whereby “women and adolescent girls use a clean menstrual hygiene management (MHM) material to absorb or collect blood that can be changed in privacy as often as necessary for the duration of the menstruation period, using soap and water for washing their bodies as required and having access to facilities to dispose of used menstrual management material.
One such forum was the one held in Abuja between Aug. 28 and Aug. 30 to consider the practices of menstruating school girls and the environmental school challenges affecting menstrual hygiene management.
Also assessed was stakeholders’ involvement in MHM promotion in schools based on a study funded by the Canadian Government in which data were collected in 12 schools randomly selected from both rural and urban communities in three geo-political zones in Nigeria.
A total of 152 activities with 394 participants were conducted, with the findings showing that menstruating school girls in Nigeria face many challenges which affected their ability to manage their menstruation in a dignified and hygienic way.
The key findings, however, cut across religion and ethnicity and were related to various beliefs and cultures.
The findings showed that availability and adequacy of WASH facilities, adequacy and flow of Information on MHM and access to materials for hygienic management of menstruation all impacted girls’ experience of menstruation.
Participants believed that menstruation was a secret and unclean experience and expressed special fear that used menstrual hygiene materials could be taken for rituals that could cause harm to menstruating girls.
School WASH facilities were also inadequate for menstrual management as findings from the study showed that only 41.7% of toilets had functional locks while just 25% of the schools had hand washing basins and soaps.
Most of the toilets/ latrines observed were dirty with broken doors and poor ventilation. The ratio of latrine compartment to students was 1:297 for girls and 1:1216 for boys compared with global recommended latrine to student ratio of 1:25 and 1:50 for girls and boys respectively.
The overall average ratio of toilets/latrine in the urban schools for girls was 1:214 and for boys 1:374 while the ratio was 1:168 and 1:272 for girls and boys respectively in rural schools.
Instructively, none of the schools assessed met the World Health Organisation standard of pupil to toilet ratio. Water for hand washing and cleaning up by girls was inadequate as only 50% of the schools had functional water source in the school premises.
Girls lacked knowledge about puberty and menstruation: most the girls stated that they had no prior knowledge about menstruation before menarche. Even after onset of menstruation, information on menstruation was from mothers, older siblings and peers.
There were also inconsistencies in the subjects that addressed menstruation as well as information shared in schools.
Surprisingly too, teachers, especially those in co-educational schools, were uncomfortable to teach menstruation and menstrual hygiene.
The resultant outcomes of the study were quite expected: Challenges that girls faced during menstruation included fear, confusion, anxiety, misconceptions, cramps, nausea, dizziness, general discomfort, headache, vomiting, loss of appetite, waist and stomach pains.
Tackling these myriads of challenges often taken for granted in other climes also informed the Zonal Workshop on MHM organised by UNICEF in Osun, Enugu and Kano.
Speaking at the Osun forum which held in Ijebu-Ijesa, a UNICEF MHM Consultant, Mr Olufemi Aluko, said denying women and school girls access to MHM amounted to human rights violation.
Aluko said the challenges being faced by girls and women in the management of their monthly period must be urgently addressed.
According to him, the stigma and taboo associated with menstruation are human rights issues which inflict indignity upon women and girls.
Also speaking, Dr Temitayo Ogunsanwo, the UNICEF MHM Coordinator in Osun, said research carried out by UNICEF in some selected schools in the country revealed that many of the girls were not knowledgeable about menstruation before their first experience.
Ogunsanwo said negative societal beliefs, attitudes and practices still existed on MHM in schools and communities.
She said the media, religious organisations, NGOs, traditional rulers, community leaders and other stakeholders should be engaged in breaking the silence and taboos around menstruation.
Mr Ayo Okelana, a participant and Executive Secretary of Cleannation, a non-governmental organisation, said there was the urgent need for government, media, private sector and individuals to be involved in breaking the silence and taboos surrounding menstruation.
Okelana said awareness about menstruation leads to better reproductive health, greater self esteem and better academic performance.
He noted that inadequate knowledge about menstruation had led to early or child marriage, harassment and teenage pregnancy among adolescent school girls.
Another participant, Mrs Adebanke Balogun, said the workshop had changed the orientation of many of the participants about menstruation.
Balogun, who noted that the forum had revealed that MHM was everybody’s business, said participants would share the knowledge of the workshop to women and girls, especially in rural communities.
The key recommendations by experts and other stakeholders to address the challenges include facilitation of accurate and sufficient information on MHM to disabuse the minds of people on the myths and taboos and encourage safe, hygienic and dignified management of menstruation.
Other key recommended actions were provision of appropriate and adequate water, sanitation and hygiene facilities in schools; support to access affordable reusable sanitary pads and mobilisation of policy and decision makers to promote open discussion of menstrual hygiene management to reduce stigma.
The implementation of these recommendations, it was stressed, should involve active contribution from girls, boys, mothers, fathers and both government and traditional policy and decision makers.
It is believed that if these recommendations are faithfully implemented, relief may finally be on the way for the Nigerian female, especially the girl-child in the nation’s 20,682,000 primary schools and 9,057,000 secondary schools.
And in a country seeped in myths, beliefs, superstitions and misconceptions, and where ignorance and poverty drive people to seek help from charlatans parading as herbalists and clerics, stakeholders, especially the conventional and the social media, must take it as a challenge to disseminate accurate information on menstruation and its management. (TNE)