At the onset of puberty, boys and girls embark on the transitioning journey of growing into adults. During puberty, boys and girls experience many changes ranging from physical to psychological, and menstruation in girls is just one of these many changes. Contrary to the common expression, the first incidence of menstruation does not necessarily mean that the girl has become a woman overnight, nor does it deserve to be met with stigma, discrimination, or shame.

Menstruation is a complex experience: both a rite of passage for almost all girls, and yet, a deeply personal and unique experience.  It is identified by many disadvantaged and poor women and girls as a driver of gender inequality and disempowerment, as it poses barriers in a woman’s ability to engage in education, decision-making, and complete ability and autonomy to exercise their rights.

Menstruation  is  an  integral  and  normal  part  of  human  life; indeed,  of  human  existence.  Menstrual hygiene  is  fundamental  to  the  dignity  and  wellbeing  of  women  and  girls  and  an  important  part  of  the basic  hygiene,  sanitation,  and  reproductive  health  services  to  which  every  woman  and  girl  is entitled.  Though it is also a natural part of the reproductive cycle, it remains taboo and is rarely talked about in most parts of the world. As a result, the practical challenges of menstrual hygiene are made even more difficult by various socio-cultural factors.

I remember, when I was growing up, my friends who were two or three years my senior would whisper-shout stories to me of how dirty girls are when the menstruate as we walked home from school.  Disgusted more so by their disgust than anything else, I actively avoided all girls, lest I learn that they were having their periods. I am not proud of the actions of me and my friends as we laughed at the expense of any girl in our class who was unfortunate enough to have accidentally stained her uniform with blood.  As a grown young man, I am haunted by the memory of these girls’ discomfort, and how it was not uncommon for them to not show up to school for the next few days.

According to a study done by UNICEF in 2013, 1 in 10 school girls in Africa miss school or drop out completely due to lack of access to menstrual materials and other sanitary products.

This critical unavailability of sanitary products is a major barrier to education for girls of school-going age. The inability to effectively manage menstruation contributes to absences of up to 4-5 school days each month, equating to as much as 20% of the academic year intentionally skipped, simply due to menstruation.  As this imbalance in education grows between genders, many of girls drop out of school entirely, making them more susceptible to a higher-risk lifestyle, including the likelihood of early initiation to sex and its associated risks of HIV and STI infection, early marriages, teenage pregnancy with additional adolescent maternal health complications, gender-based violence characterized by social and gender inequality, and further limiting their future career and economic opportunities.

Additionally, many women and girls from poor backgrounds rely on crude, improvised materials like scraps of old clothing, pieces of foam mattress, toilet paper, leaves, and banana fibers to manage their menstruation – all of which are unhygienic, ineffective, and uncomfortable.  Such circumstances have continued to deprive young girls and women of their right to health, education, and dignity - and as a result, opportunities for these girls are impinged.

The need for respectful and dignified healthcare includes menstruation, but even today, cultural practices and taboos around menstruation negatively impact the lives of women and girls, whilst reinforcing gender inequities and exclusion.  All women and girls have a right to undertake their periods without shame or discrimination, but in practice, this is not so easily achieved.

My organization, Uganda Youth and Adolescents Health Forum, implements a campaign dubbed “Ensonga”: a native Luganda word that literally translates to “periods”.  The campaign aims at promoting dignity with relation to menstruation, and creating a supportive environment for women and adolescent girls to be able to experience and manage their menstruation in a hygienic way regardless of where they are.  This means promoting privacy and safety for menstruating women and girls whilst breaking myths, silence, stigma and taboos around menstruation.  Through community awareness initiatives that target schools, teachers, parents, communities, and policy makers, Ensonga additionally provides a wing for skills empowerment, in which vulnerable girls develop practical vocational skills through the production of reusable sanitary pads.

Ensonga project has reached out to over 2000 people in over 6 schools located in Wakiso and Kampala Districts of Uganda.  We have worked with adolescent girls and boys both in and out of school, their teachers and parents, through leaders, and decision-makers.  At least 15 vulnerable girls have also undergone the practical training in production of reusable sanitary pads, and we hope to expand this reach wider in the coming years.

My own boyish cruelty – where I had mocked my peers without really understanding why - inspired an additional component to the Ensonga Campaign.  There is a fundamental need to create menstruation awareness among boys and men, so as to ensure that women and girls are not forced into secrecy and isolation on the subject.  By making menstruation a subject for public discussion, we can eradicate the stigma against it in male communities so they can support the dignity and health of women and girls everywhere.

Education about menstruation is, across Africa, sorely lacking.  Unbiased information regarding menstrual health should be promoted and integrated into school curricula as a core component of sexual and reproductive health education for young people of all genders.

The destigmatization of menstruation with dignity and non discrimination is both a driver and an enabling factor for positive change, as it enables women and girls to achieve their potential and meaningfully engage in discussions that challenge traditional gender roles.  And I hope that through this project, no Ugandan girl will ever feel as sad or as small as the ones who I so foolishly taunted when I was too young and too foolish to know better.


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