Hi,
I find two issues shared here:

i. On MHM:
Attitudes towards Menstruation: while in some parts a celebration is done on onset of puberty and in other it is kept a secret.
www.quora.com/Why-do-the-some-people-cel...berty-in-South-India
community
I have worked with different communities and experienced:
1. Raised MHM awareness through school/ Peer Educator strategy
2. Co-funding thru convergence with Govt. schemes as they have their own targets on MHMs
3. Increase of use of sanitary pads @ penetrating Price: 0.33 USD/8 pads


ii. Decomposition of Human Waste through Chemical Substance.
Dear Thilde, Can you share more about this, what type of chemical & the amount?

Thanks,
Saurya

Hi Ina
You have indeed raised an important aspect of hygiene promotion. Just to say that MHM is no more a taboo particularly with the younger generation and those who are attending educational institutions. Unfortunately in the School Sanitation and Hygiene Program MHM is being talked about only very recently. In fact the school going girls could be an important conduit for promoting MHM among other family members. This will call for coordination among the agencies handling water and sanitation, education, health and women's programs. Another source for promotion would be the women's groups formed in different countries for promoting income generating activities among women. In India these are called self-help groups. Providing sanitation pads at reasonable cost will be helpful. Recently I had an interaction with a fairly large group of rural married women and young girls and found that around 60% of them were using low cost (but hygienic) pads and the cost of the pad was an important factor. The rate of adoption is slowly but steadily increasing. BBSamanta, India

Ina, thank you for this wonderful report, its a great input in my new design for a latrine that has a unit for managing non biodegradable waste. Most latrines in my country have no structures to handle such waste. A few just have buckets and surely some ladies find it hard to dump there the pads. I don't blame the designers for not considering the issue of pads seriously during design because it has been kept a secret, few ladies can freely share their experiences.
Osbert

Interesting points, Kris.
I think it would be a pity if the discourse on menstrual hygiene management was dominated only by "a hidden marketing of sanitary pad products". I guess that could be the case in some instances and that's not desirable - although there are practical reasons for that. (and couldn't one also say "handwashing campaigns are dominated by a hidden marketing of soap products?" What if Unilever is sponsoring handwashing compaigns? Problematic?).

Anyway, what I personally find most relevant in the MHM discussions in connection with WASH is not the spreading of fecal-orally transmitted diseases, that's true. But it's the issues around:

• taboos (which affect women more than men)
• empowerment of girls and women; puberty education; and therefore hopefully ultimately less gender-based violence
• school attendance issues of teenage girls (where MHM plays at least a small part, I am not saying it is the major part)
• diseases that might be spread by unsanitary pads - here I am not an expert but I would guess urinary tract infections could be one of them

See also this recent post by Madeleine Fogde which I think supports what I am saying: forum.susana.org/forum/categories/145-fe...ga-from-germany#9364

I think if we can break taboos around menstruation (and reproductive health), then taboos around toilets and sanitation will be easier to break as well.

Also even if MHM was to a large extent "only" a solid waste issue (an issue which menstrual cups do not have compared to pads, as they produce no solid waste; one silicone menstrual cup lasts a women five years or more), then it would still be part of the S in WASH, i.e. solid waste management is part of sanitation.

I might concur with you that it may not be a "priority WASH topic" but it is quite an important WASH topic nonetheless.

Thanks for not being afraid to speak out and raise a "non popular" opinion in your view!
Debate is to be encouraged, it makes the forum an interesting place to be.

Greetings,
Elisabeth

This might not be a popular opinion right now (and comes from a man...), but I do not think that MHM is necessarily a priority WASH topic.

As Thilde has mentioned, not in all cases do people involved in it (even the women) consider it relevant to WASH infrastructure, and rather deal with it as a solid waste issue. The toilet only comes into the picture because it is the common place were people can deal with it privately.

Now granted, it is a hygiene issue in the broader sense, and WASH programs could certainly have a more inclusive view on that, i.e. a "bathroom" is often as much of an personal hygiene and laundry place as it is a toilet. Pure latrines and hand-washing facilities are maybe appropriate for public places like schools, but certainly not for a home.

Edit: to clarify what I mean: the health/hygiene aspect of WASH mostly deals with the prevention of spreading diseases though the fecal-oral pathway. Improper disposal of sanitary pads can be an issue in that regard, but this is usually not even the main focus of MHM focussed discussions (which is all too often dominated by what seems to be a hidden marketing of sanitary pad products).

Dear Ina,
To share some experiences: In our sanitation research project in peri-urban southern Ghana, engineers have invited different user groups to discuss household sanitation preferences, including adolescent girls. Not even in this fora, did issues of menstrual waste and disposal come up.

Only when approaching the engineers to ask if they actually probed the girls or others for this, did they think about including this issue in their data collection and subsequent design plans. The engineers were all men...

From our other studies in the same communities, we know that women burn or bury the menstrual waste - they never dispose of it in toilets or in sewage. Toilets are mainly pit latrines, which are 'emptied' by pouring chemical substances into the pits to decompose the fecal matter. So pads are not allowed there.

Women in Ghane are also very worried that someone might see the menstrual blood, so its safer to take home and burn. Thus, there are no solutions to the disposal problem integrated in public nor private toilets.

Regards,
Thilde

Thank you Rachel and Osbert for your reply!


yes, indeed, blockages and full pits are frequent due to sanitary pads. I find this report really good in regard to systems and MHM.


Still interested if in any household sanitation projects the issue of blood and pad disposal come up by the user or the engineers / designer?

INA

Hi Inajurga
The question of menstrual Hygiene, has remained a secret in most areas. Most sanitary facilities are designed with out considering the need for disposal of sanitary napkins. In most areas they are thrown in pit latrines and this increases costs of emptying and disposal. There is need to involve women when designing water and sanitation structures.

Osbert.

Ina,

No one has replied to your questions yet?

I would love to be informed. Transformation Textiles believes including MHM is an essential to include in household-based WASH programs.

We would love to be involved and are prototyping some approaches to be used this fall in Kenya.

Please keep me informed, if I have missed a new post that answers these questions.

Rachel

MHM in WASH in Schools (WinS) is gaining momentum, with good practices on girl/child-friendly design of school facilities and curricula for education emerging. Although by far not standard practice and still a lot to do, what about private facilities?

How can we assure the integration of MHM into household-based WASH programmes?

I recently discussed with Lindlyn Moma, advocacy officer WaterAid SouthAfrica, that there is a huge gap when it
comes to integration of MHM into programs promoting water, sanitation and hygiene at household level.
The gender perspective stresses absolutely rightly the importance of privacy and safety for women when it comes to WASH facilities. Within this context is MHM explicitly and adequately addressed?

Question:
Have you in your WASH projects targeting households integrated and addressed menstrual hygiene management?

Such as by addressing women's needs during menstruation (such as water & soap requirement, disposal, drying of rags, etc) and involved women during the design such as of urine-diversion toilets ?
Or have conducted research ?
has it come up in CLTS triggering ?

Or have you avoided MHM, because it is too much of a taboo ? or have you not had, because you miss information on how to ?

Looking for your experience and ideas.

(references: SuSana Factsheet on gender perspective :
www.susana.org/docs_ccbk/susana_download...l2012-03-15-tmsx.pdf