Hi Susannah,

Really interesting comments, and fascinating to learn how similar problems exist in Western Europe, but less visibly so. The importance of public sanitation cannot be overstated - in Bangladesh, the public sanitation crisis is severe and most women and girls have literally no options if they need to use the toilet while out of the home. We've been doing some interesting advocacy work, influencing Dhaka city's mayors to take up MHM-inclusive and accessible public toilets as a cause, and this is gaining momentum, but there's a long way to go. I'm now thinking how we can use the concept of SRPS to conduct research that can strengthen our advocacy, in the same way that the National Hygiene Baseline Survey was critical to convincing education authorities on the importance of good school sanitation.

I like these presentations/papers very much. It is refreshing to see provision for safe washing and drying of menstrual cloth as a criterion for success (Bangladesh National Hygiene Baseline Survey)rather than a sign of 'backwardness'. I was also pleased to read the description of pants-free cloth use (Chadha p3), using string. It might not be everyone's preferred method, but it grants independence from industrially-produced stretch panties.
The conceptualisation of Sanitation-Related Psycho-social Stress (SRPS) is neat - and well-overdue!
I relate all these excellent studies and initiatives back to my experience here in Western Europe, where we have so much to learn. SRPS is not studied here, as far as I know, although it's a real problem, comparable perhaps not to the same degree, although for the same reasons to those reported in South Asia and with similar outcomes.
For example: there used to be many public toilets in my town. It was unheard-of for anyone to urinate or defecate publicly, unless drunk and under cover of darkness, in which case they risked being arrested. In the past year, the seven installations have been reduced to one, and people have to walk a long way to it, often finding it closed. The result is that men over 60 and others who cannot hold urine or faeces for long simply avoid going into town, opting to drive to supermarkets instead, where toilets are provided for customers. The town has become somewhat desolate (there are other factors).
Again, in my job teaching children who find it difficult to attend school due to anxiety or ill-health, of those (boys) whom I have asked, all report that they would hold onto urine and faeces all day long rather than use school toilets. One had to go home to use the toilet during our lesson; he said 'none of the school toilets have locks on the doors'.
As for MHM, water for washing out cups, pads or sponges or for rinsing the genitals within the cubicle of a public toilet is almost unheard-of. Re-usable pads are in circulation but never seen drying in the sun. Disposable pads and tampons are put 'out of sight and out of mind', ie into incinerators, down flush toilets or onto landfill - never composted. Westerners will recognise the eye-covering gesture of the man in the Masika documentary ( 0:58) confronted by a menstrual item.
In the urban West, open-air defecation, urination or menstrual changing is not an option to those seeking a clean, private place. We need to take public sanitary provision just as seriously here as in India or Kenya rather than assume that because the problem is, as yet, invisible, it doesn't exist.
So all of these initiatives, in education, in infrastructure, in open discussion and acceptance of real people's needs and practices, are valuable for us in the West too.

Hello everyone,

Just attaching my presentation here, in case anyone prefers a quick summary of the paper on 'Mainstreaming MHM - Lessons from a decade of programme and policy work'. I am also linking to a copy of the Bangladesh National Hygiene Baseline Survey, which is the first ever nationally representative survey of hygiene behavior in Bangladesh conducted by ICDDR,B with support from WaterAid. The survey had a component on menstrual hygiene management which I referenced in the presentation, and gives some really interesting insights into MHM practices and perceived impact on school attendance - www.psu-wss.org/assets/book/bnhbs.pdf.

Thanks!
Shahrukh

Dear all,

I have now received the presentation by Vinod Mishra also as a pdf file. I am attaching it below.
And here's the slide that caught my attention as it summarises a whole range of issues so well:



If you have questions about this presentation, please put them here and I will forward them to Vinod.

His e-mail said:

++++++++

Sorry for delay in reply, Please find attached my presentation during WEDC on MHM.

Best Regards,

Vinod


Vinod K. Mishra
Country India National Coordinator
at Water Supply & Sanitation Collaborative Council ( WSSCC), Geneva
(An international organization within United Nations system works to achieve sustainable sanitation, hygiene and water supply for all people)
Coordinator, Key Resource Centre, Water & Sanitation, Centre for Good Governance, UAoA

Dear Vishakha,

Thanks for your post, welcome to the forum. Could you please tell us more about this study (do you have a URL for it?) and about your own work with menstrual hygiene management?

Dear all,

At the recent WEDC conference (see here ), there were several papers on menstrual hygiene management (MHM).

I have attached them below. The titles were:

Menstrual health management in
disasters: understanding the silent
need in recovery using case studies
from Assam and Odisha
Krishnan, S. (2235)





Universalization of sanitary napkin
use is not menstrual hygiene
management
Chadha, D. (2131)




Mainstreaming menstrual hygiene
management: lessons from a
decade of programme and policy
work
Mirza, S. Y. (2163)




Social and psychological impact of
limited access to sanitation: MHM
and reproductive tract infections
Mishra, V. K. (2140)




Putting girls at the centre of
menstrual health management: Girls
for Girls
Kidney, M. (2224)




Training on Menstrual Hygiene Management:
Addressing the practical needs of women and girls in WASH
Water Supply and Sanitation Collaborative Council (WSSCC)
- for this one I don't have any materials, we could ask WSSCC if they could post what they used?


The presentation by Vinod Mishra (Country National Coordinator, WSSCC India) was very well received. He was even asked to repeat his plea in the closing session: he urged all men to "start small" and help break the taboo by speaking to their daughters, wives, female friends and relatives about this topic, and supporting them.

Here are two slides from his presentation that I took with my phone camera and used in twitter (you see also Julie Fisher who was the session chair):





A couple of further points:

1. The topic of menopause was raised. I liked the slide above which showed the different "life stages in a woman's life". The menstruation part is from 14-45 years typically but there are also other important stages which have connections to WASH, like menopause where women again have special needs.
2. Someone showed a photo of Indian girls with school uniforms with white pants. Someone in the audience said "have you thought about changing the colour of the school uniforms to make it less obvious when there is a blood stain?" (good point, I thought).
3. The issue of reproductive tract infections from lack of menstrual hygiene management came up. This could be a useful entry point for discussing the importance of MHM. However, one should also be wary of falling into the trap of reinforcing partriarchial messages here (i.e. "a girl is only seen as a future mother; if she can't be a mother then there is something wrong with her"). About this issue, see also the article "Why Using Patriarchal Messaging to Promote Toilets is a Bad Idea": thewire.in/2015/06/07/why-using-patriarc...-is-a-bad-idea-3402/

I hope that others who attended the WEDC conference will also share their learnings on MHM here. I will also e-mail the presenters and ask them if they could post their presentations. Personally, I like presentations very much, and I think they provide a better initial entry point than a full paper does.

Regards,
Elisabeth