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August 16, 2019

Ending the stigma: How to start a menstrual health revolution in Myanmar

Having your first period universally means becoming a woman. In Myanmar, it also marks the start of a journey of shame.

I have lived in Myanmar and advocated for menstrual health for two years as part of an organisation I founded to fight the period stigma in the country. In that time, I have witnessed a 12-year-old girl burst into tears when I interviewed her about the challenges she faces in managing her period. Boys at school knew she’d started menstruating and had been saying she smelled bad. My female colleague once recalled how she experienced her first period: no one explained to her what it was, but what she did know was that it’s shameful. An 18-year-old once told me that if she sees man in the shop when she’s buying pads, she'd rather rush out to another shop than face the shame that comes with being seen buying menstrual pads. I have had my 35-year-old beautician ask me which hole babies come out of - she didn’t know because her teachers, female relatives and girlfriends had all considered it a shameful thing to discuss.

Shame is fed by ignorance. Today, only a fourth of Myanmar youth have received formal sexual and reproductive health education. Although it is part of the school curriculum, most teachers skip it because they feel unequipped and embarrassed to openly discuss it in their classes. Women are even further disadvantaged because social norms dictate that they shouldn’t have access to sexual education to begin with. As a 13-year-old boy, for example, put it in a survey on adolescent health, ‘you should not give reproductive health information to girls because they will get interested in sex.It is no surprise that 97% of 18-45 year-olds believe that should not lose her virginity until marriage. 

As a result of a lack of sex education, only a minority of Myanmar people know what menstruation is: 80% of Myanmar’s young women believe that menstruation is dirty and mistake it for a monthly purification process women have to go through. Tellingly, a common Burmese phrase describes menstruation is ‘rotten blood’, which has enormous implications. Not only do such phrases deny the fact that menstruation enables the female body to perform its most noble function of hosting and giving life. Instead, it tarnishes the menstrual cycle with an inequality-inducing narrative: women’s bodies are dirty, men’s bodies aren’t. These myths around women’s alleged impurity only reinforce women’s inferiority in Myanmar society. For example, everyone in Myanmar will tell you that a man’s clothes shouldn’t be washed with or hung up to dry next to a woman’s skirt because it is stained with unholy particles, which, crucially, would affect their ‘hpon’ - a religious concept that grants higher spiritual and social status to men in Buddhism, which is practiced by 90% of Myanmar’s population. As one male interviewee said to me, ‘In Myanmar society, males weigh 80 and females weigh 20. It is our culture, no one can change it.’ 

Culture is certainly a powerful word in Myanmar that can be invoked to justify nearly any shortcomings. In order to ‘protect Myanmar culture’, people avoid asking too many questions and dread answering mine. ‘Why shouldn’t men know about menstruation? Why would you tell your daughter to hide her menstruation even though you don’t think it’s shameful? Why wouldn’t you challenge your mother when she says you can’t shower every day on your period?’. The answer invariably is: ‘It’s Myanmar culture’. 

Yet, after talking about menstruation with more than five hundred Myanmar girls, women and men, I realised that there are people out there who want to change how their culture limits and impacts them. But change is difficult. 

So what does it take to change deep-rooted discriminatory cultural norms and start a menstrual health revolution? Having recently launched Myanmar’s first ever campaign (So What!?) to encourage a nation-wide discussion on menstruation, here’s how:

Firstly, we need to raise awareness on how the menstrual health stigma negatively impacts girls’ health and education. The good news is that everyone in Myanmar wants their daughters to be healthy and educated. That’s a great start. Unfortunately, in a study in 2018, one out of four girls showed signs of urinary tract infections at any given moment, partly because they avoid changing their menstrual products so they don’t have to be seen by boys on their way to the bathroom. A lot of girls admit missing school on the heaviest day of their period - not because they don’t have products to manage their period (90% of them do), but because they don’t want to risk having blood leaking out and staining their clothes. Those who do attend school are heavily distracted by concerns that boy will find out that they are menstruating. When parents, the media, institutions understand the negative consequences of harmful cultural norms, they listen.

Secondly, we need to change the narrative around menstruation. This involves breaking the taboo and encouraging people to face the discomfort of discussing what menstruation really is: life blood. I have seen young women’s eyes light up when they start understanding that menstruation enables them to perform their body’s most noble function of giving life. Their feeling of shame is instantly replaced with a sense of pride, comfort, freedom and relief, and a desire to spread the word - a drastic change in confidence which the young women who have been writing to us to thank us for the campaign have also experienced.

Only breaking the menstrual health taboo will allow us to fundamentally change the narrative around women’s bodies and the function of menstruation for the better, which in turn, grants them a more respected position in society, elevates their self-esteem and ensures that they are more informed and supported when it comes to managing their period. Relieving them from the stress and discomfort they continuously experience as a result of period shaming will reduce unhealthy menstrual health behaviours and empower them to realise their full potential - at school, in their workplace and beyond.

Wouldn’t you say that makes it worth questioning what your culture sometimes makes you do?

Pan Ka Lay thanks the SPRING Accelerator for their support. SPRING is a 5-year UK Aid, USAID, Australian Aid funded programme, implemented by Palladium, that helps 75 social businesses from 9 East African and South Asian countries develop innovations to transform the lives of adolescent girls and marginalised communities.

Image credit: Pan Ka Lay website