Healthy Periods: A Doctor's Global Perspective

Guest blogger Saki Onda is a Masters of Public Health student in the global health department at the Harvard School of Public Health.

The ability to manage our menses safely, comfortably, and with dignity is a luxury that most people who menstruate, in industrialized countries take for granted.

My personal experience with menstruation has always been a positive one – around the age of eight my mother sat me down to explain periods and cooked sekihan or ‘red rice’ when I did reach menarche. In my home country of Japan, this steamed sticky rice and azuki bean dish is prepared on special occasions that call for celebration – one of which is when a girl reaches menarche, although this custom is less frequently practiced nowadays.

Being of Japanese origin but having grown up in international communities in the U.S., France, and the U.K., I have become aware of varying attitudes, practices, and taboos towards menstruation. As a physician and current Master of Public Health student with a focus on reproductive health, menstrual hygiene management (MHM) has become an area of growing interest.

I came across Aisle when researching organizations and social entrepreneurs working in the area, and Madeleine Shaw was kind enough to agree to a video chat about the issues surrounding MHM and their partnerships with organizations in low-income countries.

Historically, scant attention has been paid to MHM, perhaps because its impact on development and public health are not immediately obvious, and there is no direct morbidity and mortality in the way that maternal and reproductive health has. That said, a new study from India claims that in that country, 70% of all reproductive diseases in that country are related to poor menstrual hygiene.

In addition, people are surprisingly uneasy when it comes to topics surrounding menstruation. I remember approaching a female editor of a ‘green’ newsletter series at my graduate school to suggest doing a piece on menstrual cups and reusable sanitary pads, but was effectively told that readers would be uncomfortable reading about menstrual blood.

However, there is growing literature and public health discourse on MHM, although significant gaps still exist. In 2012, WaterAid published their first edition of a 354-page report titled ‘Menstrual hygiene matters: A resource for improving menstrual hygiene around the world’, and November 2013 saw UNICEF’s second annual virtual conference on MHM in water, sanitation and hygiene (WASH) in schools. Madeleine also pointed to the active community of MHM professionals and advocates, including the myriad of partners involved in the upcoming ‘Menstrual Hygiene Day’ on May 28th.

The significance of MHM is that it has implications for a wide array of issues including education, sanitation, poverty, and female empowerment, to name a few. It also potentially allows segueing into more sensitive topics like sexual health and gender-based violence. Achieving good MHM is complex – available, accessible, appropriate, and cost-effective menstrual hygiene products are needed, along with adequate sanitation and disposal facilities, as well as awareness and education.

Additionally, men and boys have long been excluded from women’s health dialogue. Madeleine shared a fantastic story about schoolboys’ compassion for their female peers once they realized the reason that these classmates were missing school for a week every month.

There has been exciting progress in addressing MHM globally in recent years, and I look forward to following the continuing efforts from non-governmental organizations (NGOs), policy-makers, academics, and social entrepreneurs in this field and to get involved myself in my future career in medicine and public health.