Girls and women undergo severe mental stress during menstruation

Discussions and discourses on topics such as menstruation and menstrual hygiene are shifting from hush-hush environments to open platforms. This shift in mindset has been facilitated by rights activists, rights groups, organisations and various governments that have strongly advocated for the rights of women. Girls or women of menstruating age should have access to sanitary napkins, proper sanitary facilities and access to safe environments during that time of the month. But across the globe and in Sri Lanka, a greater percentage of women and girls are deprived of these basic needs. In response, Opposition Leader Sajith Premadasa vowed to eradicate period poverty back in 2019 and advocated towards making sanitary napkins freely available to all women and girls. This pledge was reaffirmed during a recent event held in view of World Menstrual Hygiene Day. 

Creating a safe environment 

The event witnessed the participation of doctors, lawyers, midwives and political figures who stressed the importance of menstrual hygiene and why it should be a national priority. Speaking at the event, Consultant Anesthetist Dr. Kavya Botejue said that the first thing towards creating a healthy environment for women will be to break taboos around menstruation and talk about them openly. She said that menstruation is the most natural thing that happens in a woman and that it is a very normal occurrence. “Education is the second step in bringing about a healthy environment for women to talk about menstruation and menstrual hygiene. When we talk about menstrual hygiene, one thing is that there are symptoms that a woman can experience during this period. For men, every day of the month is similar for them. But that’s not so for women.”

She further explained about hormonal changes experienced by women during menstruation. “During menstruation a hormone called progesterone is being released and it can lead to several symptoms and feelings in our body. Therefore we can have a low mood, we may feel irritable during this time of the month, sometimes women may experience breast tenderness, feeling of bloating and related symptoms. In addition, there can be certain symptoms related to menstruation such as severe back pain and heavy bleeding. These symptoms have to be investigated. This is similar to heavy menstrual bleeding as well. We need to create an environment for people to come out and talk about these biological processes. If a girl or woman has several abdominal cramps they need to have access to simple pain medication such as paracetamol. Severe pain could be one of the reasons why girls don’t attend school during menstruation. If someone is having a severe flow they may need to have frequent pad changes and frequent visits to the washroom; be it at school, work or home. So there has to be an environment for women to feel safe enough to talk about these issues and they need to be supported by whoever is there in this environment,” Dr. Botejue underscored. 

Access to sanitary napkins – a basic need

Menstruation indicates that a woman is ready for motherhood. Therefore it is a special situation in the life of any woman. It means that the womb is ready to bear a child. Speaking at the event, Government Midwives’ Association President Devika Kodithuwakku explained the hormonal changes and related stress faced by girls and women during this time of the month. She explained how girls from impoverished segments of society wear a piece of bed sheet, an old towel or a piece of sarong as a substitute for a sanitary napkin due to lack of affordability. “On a menstruating day not every Sri Lankan woman would have the opportunity to wear a sanitary napkin. At present, only around 40% women have this opportunity. When they walk with makeshift napkins, they don’t have a proper balance. They walk to school or to work with a lot of fear. Girls tend to faint during the assembly as they are under stress. These are social issues.”

She further said that girls of school going age sometimes don’t have an opportunity to change their napkins or clothes. “They will wear it from 7.00am onwards until they return home, sometimes after tuition classes. After sometime they will feel uncomfortable. Some girls tend to avoid school during this time of the month because they undergo severe mental stress. If a girl is unable to change their sanitary napkins at least every four hours, rashes and other symptoms may develop around their groin. They may develop certain infections which may be detrimental to their health. As a result they may have to bear more expenses to cure these side effects. As such it is important that every girl and woman should have access to sterile sanitary napkins,” she added.
Kodithuwakku also shed light on how heavy taxation on sanitary napkins has discouraged women from purchasing sanitary napkins which is a basic need for any woman. She underscored that the government should in fact have a policy to ensure that every woman has access to sanitary napkins. 

Alarming statistics 

Back in 2019 when Opposition Leader Sajith Premadasa started talking about menstrual health and access to sanitary napkins on the political stage, he was labeled and mocked. But five years later, the Samagi Jana Balawegaya continues to champion the cause in terms of eradicating period poverty. Addressing the gathering, attorney-at-law Lihini Fernando said that most women and girls are prevented from reaching their full potential as a result of menstruation. “The UNICEF states that around 50% girls in Sri Lanka miss one to two days of school each month due to menstruation and this is a very sad situation. Approximately, 4.2 million people menstruate in Sri Lanka and only 30% have access to disposable menstrual products. Many of them cannot afford a pad. Lack of proper sanitation in schools, access to clean toilets is a problem. Around 40% of Sri Lankan schools don’t have adequate sanitation facilities that are girl-friendly. The government should prioritise providing a safe toilet for the girl child. Lack of infrastructure not only affects their health and hygiene but it also affects their education and future as well. 60% of girls use homemade products. They use cloth as they cannot afford to purchase a disposable sanitary napkin. A majority of women spend around 6% of their monthly income on sanitary napkins. This cultural stigma around menstruation further complicates the issue.”

Fernando further said that it is imperative to advocate for a proper response mechanism so that boys won’t feel awkward in a situation where a girl has bled due to heavy menstruation and is looking for a safe environment. “We need to create an environment in which a girl wouldn’t feel humiliated. Menstruation is a normal process of a woman, it’s part of being a woman. Neglecting menstrual hygiene would have severe consequences. Has the Sri Lankan government done enough to address this issue? Are there adequate policies and are the policies prevalent followed by implementation? Are we campaigning enough to raise awareness and normalise conversations around menstrual hygiene? Policies must be implemented irrespective of the political divide. It’s the society that should champion these matters because we need to protect women and the girl child,” she said while highlighting the fact that comprehensive menstrual health education should be integrated into the school curriculum to ensure that both girls and boys understand the fact that menstruation is a natural biological process. 

Echoing similar sentiments, former Parliamentarian Hirunika Premachandra appreciated Opposition Leader’s efforts for advocating against period poverty and for raising his voice on menstrual hygiene in the political sphere. She said that it is high time that men start talking about menstruation and menstrual hygiene on a bigger scale in order to break the taboo around such topics. 

A pledge to end period poverty 

Opposition Leader Sajith Premadasa reiterated the importance of having a practical approach to end period poverty. He reflected on how various countries including Scotland, New Zealand, France, Kenya and several states in the US have implemented programmes to provide sanitary napkins free of charge. “Programmes to facilitate free accessibility of sanitary napkins are being implemented even in countries such as Botswana. Then why can’t we implement these programmes? We need to have a strict political determination to embark on such a strategy.

Products associated with the menstrual cycle have been heavily taxed. When there’s heavy taxation on period products it could lead to a variety of socio-economic factors. From a risk of developing cervical cancer to absenteeism in schools, heavy taxation on sanitary napkins could also impact female unemployment. When people who are bleeding every month are forced to use dampened and soiled materials and are treated as second-class citizens, dignity takes a backseat. We therefore believe that time has come to make actions speak louder than words. Under a SJB regime we will work towards eliminating all taxes imposed on sanitary napkins.”
He further said that a future SJB regime would not only empower women to manufacture sanitary napkins locally but would also ensure that sanitary napkins are freely available for girls and women across all segments of society.