Education helps replace myths with facts on Menstrual Hygiene Day in Nepal
In Nepal, menstruation is associated with deeply rooted beliefs and practices. Although these have been changing with time, there is still a wide-spread lack of knowledge and openness to talking about menstruation. The motto of Menstrual Hygiene Day (MHD) 2017 “Education can Change Everything about Menstruation” was a befitting way of further breaking the silence and replacing myths with facts about menstruation.
SNV’s Sustainable Sanitation and Hygiene for All Programme (SSH4A), funded by the CS WASH Fund in eight districts of Nepal, celebrated Menstrual Hygiene Day with an eventful week of interactive educational activities and radio talk shows in 34 rural and municipal communities. These involved adolescent girls, the police force, faith healers, community leaders, teachers, women’s groups, health workers, and district WASH stakeholders. A total of 600 women and 300 men participated in these activities.
The main events focused on engaging with Female Community Health Volunteers (FCHVs) who are the frontline workers for basic health promotion in communities. Here, the health offices led interaction programmes with FCHVs to share and discuss about the biological process of menstruation, hygienic management during menstruation, and past and current cultural practices.
FCHVs from the remote and mountainous district of Jumla recalled how not so long ago they were forced to spend their days of menstruation outside their house in a small cramped hut, barely large enough to crawl through. Muna Rawath (aged 41) remembered, "That was the most terrible night of my life, when I spent the whole night in the Chhaau Goth. At that time I was only 12 years old. Now we do not sleep in the Chhaau Goth, but I still do not participate in religious work during this period.” When asked, why, Muna Rawath responded with a shy smile. Other women chipped in, “It is because of lack of knowledge. Now we will start to overcome this barrier from our own home.”
In the mid-hill districts of Rolpa, Rukum, and Salyan, FCHVs similarly traced the changes in practices over the years. Common beliefs have been that bad blood is being removed from the body, that menstruating women are impure, and that if they stay at home or touch domestic animals, the family members or animals would become ill or die. Therefore menstruating women have been considered as untouchable and prohibited from sharing the community water sources, to bath, to use the family toilet, or to participate in religious events. In recent years, there has been significant transformation in such practices and menstruating women are allowed to stay at home, use the family toilet, eat nutritious food, use water facilities and participate in marriage ceremonies. They are however not allowed to visit the sacred room for the gods in the house or visit a temple to worship and they do not enter the kitchen for cooking.
In a separate session with a women’s group in Salyan District, Indra Kala (aged 36) shared her personal experience of overcoming her fears. During the local election campaigns, her husband was away from home and she had to milk the cow herself while she was menstruating. She could not sleep and was afraid that some misfortune may occur in the coming days. One day, two days, a week passed and yet nothing happened and her husband also returned safely after the election campaigns. From that day, she reflects that these are traditional social and cultural barriers and now she wants to break the silence about such traditional practices and encourage menstruating women to stay at home, use the kitchen, and touch the gods’ room. At the end of the event, Indra explained, “Now I understand clearly that menstruation is a natural process and a gift to women from nature to be able to become a mother, and hygienic management during menstruation is necessary to prevent reproductive health problems.”
Incredibly, Ram Bahadur Rawat, a famous religious leader in Tamti village of Jumla District, was also willing to look at menstruation a bit differently. He believes in god and supernatural powers and community people visit him when they suffer from health problems. Ram Bahadur’s wife has to follow the traditional restrictions during her menstruation so that the gods do not punish him and he does not lose his ability to help people who visit him. After participating in the MHD event, he agreed to at least try and let his wife prepare his prayer materials also when she is menstruating and see if it has any adverse impact.
In the low-lying terai belt (the plains) of the south, the challenges shift from cultural restrictions to poor hygiene. The president of the local NGO RRPK shared data from an earlier campaign the NGO had conducted on a “healthy uterus”. As a part of the campaign, it was found that 800 out of 1200 women examined had internal infections which could be linked to poor menstrual hygiene.
Discussions on hygiene in all districts showed that use of cotton cloth was the most common practice, although sanitary napkins were increasingly being used amongst young women. The interaction events also highlighted the importance of proper washing and drying of cloths in the sun to maintain hygiene. Radha Devi Sah, an FCHV from Mahottari District in the terai shared her pleasure at being a part of the MHD event, “Being a health worker, I have gained a lot of knowledge on menstrual hygiene management. We will discuss about MHM in mothers’ group meetings, find out more about the local hygiene practices, and focus on how to increase hygienic practices at the community level”.
For many FCHVs, the event was a novelty. As Jaykala Jha from Sarlahi District in the terai shared, “It is the first time I am participating in such an event; I have gained a lot of knowledge about menstrual hygiene, but it is still a big challenge!” Hence, in line with the spirit of MHD 2017, continued education on menstruation is important to enhance knowledge on menstruation as a natural process, to break barriers and encourage open dialogue, and to promote hygienic management.