Menstruation should not be horrific moment for girls with disabilities!bsadmin
Girls with disabilities exist in their diversity based on disability types, economic status, culture, religion and ethnicity all of which have varied impact on their right and ability to manage their menstrual cycle in a dignified and healthy way. The world Health Organization pegs disability prevalence amongst girls and women at the rate of 19% compared to 12% among boys and men. Menstruation is a natural fact of life and a monthly occurrence for 1.8 billion girls and women of reproductive age globally, according to United Nations Children Education Fund (UNICEF). Despite this reality, many girls in Kenya and beyond experience period poverty leading to them missing out in education every month, a situation that is being addressed by different actors through various interventions.
While ordinary girls worry about affordability of menstrual health products, stigma that arises when they soil and stain their clothes during menses, lack of private changing rooms and inaccessible water, sanitation and hygiene (WASH) facilities, girls with disabilities have a lot more to worry about!. Those with physical impairments in their upper body and arms may have difficulties placing their sanitary protection materials in the correct position and washing themselves, their clothes, and the menstrual materials. Those with vision impairments (blind or low vision) may face challenges knowing if they have fully cleaned themselves, and those with intellectual and developmental impairments may need accessible and easy-to-read materials tailored to support them to communicate about pain that arises out of menstrual cramps and their needs as well as learning about Menstrual Health Hygiene (MHH).
Menstrual Health Management campaigns have been designed and contextualized to minimize period shame by packaging information about menstrual health in a manner that normalizes menstruation, however girls with disabilities are often left out in menstrual health management interventions. A local advert in Kenya begins with public health education on the basic tenets of menstrual health management such as placing the sanitary towels appropriately and changing them regularly and proceeds to demonstrate the confidence expressed by girls whose menstrual hygiene needs are met. While the content is extremely useful in reducing period shame, manufacturers of menstrual health products never get the feedback that girls who lack fingers or upper limbs cannot independently fix the sanitary towels as demonstrated in the adverts. What about girls who use wheelchairs and are in learning environments which lack accessible washrooms, where they cannot reach the switch to turn on the lights, the sink to wash and clean up themselves ,flash the toilet with ease or even transfer from the wheelchair to the toilet? For girls who are amputees, maintaining the sanitary towels in the required position for the entire menstrual period remains a goal that is too far from reach!
The struggle to effectively and efficiently manage menstrual health at times is countered by desperate and unconsented decisions such as performing hysterectomy to girls and women with disabilities. While hysterectomy could offer short or long term solution to menstrual health management challenges for girls and women with disabilities, if unconsented and performed without full disclosure of the consequences that arise out the procedure, it can lead to serious violations of human rights such as denying such women the rights to have children. Unconsented hysterectomy amongst girls and women with disabilities can lead to poor mental health outcomes and overall lack of complete wellbeing.
To address menstrual health challenges experienced by girls and women with disabilities, the following four measures can be taken. First, there is an urgent need to build capacity of health, education and WASH professionals to communicate with girls and women with disabilities on MHH by including disability modules in WASH in schools and MHH trainings. Secondly, there should be provisions for gender and disabilities in WASH programs in school sector standards and guidelines, additionally the concerns of girls and women with disabilities and accessible and easy to read versions of the programs should be available to ensure girls with various types of disabilities get menstrual health information.
Thirdly, Family members and caregivers of girls and women with disabilities need to be empowered to support girls with disabilities to manage menstruation safely and with dignity, furthermore, stigma and discrimination surrounding menstruation need to be addressed so as to appreciate menstruation as a natural physiological process. Finally, manufacturers of menstrual health management products should foster collaborations with organizations of Women with disabilities to ensure that the products conform to the unique needs of girls and women with disabilities.
As we endeavor to end period shame, we must endeavor to ensure that disability inclusion is at the core of the campaign messaging to ensure equitable menstrual health services for all.
By Mildred Omino
Mildred is a Disability Justice and Gender Justice Activist.
She writes on Disability, Gender, and Development from an intersectional and Intergenerational perspective.