It was almost surreal

Breaking taboos and raising awareness about menstrual hygiene in Afghanistan

By Zahida Stankezai
From left to right:  Deputy Minister of Women’s Affairs, Minister of Public Health, Minister of Education , H.E. Rula Ghani (First Lady) and Adele Khodr UNICEF Afghanistan Representative. Inter-ministerial and multi sectoral approach to address MHM in Afghanistan
UNICEF Afghanistan
21 November 2018

Just over a year ago this was unimaginable, First Lady, Her Excellency, Rula (Bibi Gul) Ghani patron of girls’ hygiene, key line ministers from the Ministries of Education, Public Health, Women’s Affairs as well as prominent religious scholars, today openly spoke about menstrual hygiene and the dignity of girls and women, at the launch of the first ever National Guidelines on Menstrual Hygiene in Afghanistan.

The Guidelines includes a package for teachers, as well as a comic book and simplified adaptations for adolescent girls. The material will be used by the Ministry of Education and other partners to raise awareness amongst girls on MHM and provide adequate and timely information to girls across the country.

Inadequate information on menstrual hygiene management, persistent taboos and stigma, limited access to hygienic menstrual products, and poor sanitation infrastructure, challenges the educational opportunities and health status of girls and women around the globe. As a result, millions of women and girls do not reach their full potential.  Menstruation matters to everyone, everywhere, and it is a matter of dignity and humanity. Addressing issues related to menstrual hygiene are not only important for girls and women, but also for the overall socio-economic development and growth of a country.

Misconceptions & myths

In Afghanistan, while menstruation is biological and a normal phenomenon, UNICEF’s 2016 Formative Research on Menstrual Hygiene Management (MHM) in Afghanistan, found that lack of knowledge and facilities is a major reason why girls often miss school while menstruating, sometimes even dropping out of school. One of the most striking findings of the 2016 study is that 70 per cent of girls do not bath or take shower during menstruation for the fear of infertility.  Additionally, over half of the schoolgirls in Afghanistan did not know about menstruation before getting their first experience, leaving them shocked and frightened when it occurs. Moreover, less than half of the girls in Afghanistan are taught about menstrual hygiene in school and majority of adolescent girls never discuss menstruation with their mothers, teachers and classmates.

The traditional society in the country considers a girl who starts her ‘menarche’ as being ready for marriage and child bearing. Menarche signifies girls’ growth to adulthood, which is perceived by families of girls, both in an out of school, as a sign of girls’ readiness for marriage. As such, in some instances, girls reported hiding their menstruation from family members due to fear that families would stop them from going to school or marry them off.

The abyss of menstruation - child marriage

“It is extremely difficult and almost impossible for a young girl to complete high school and achieve her dreams in this traditional society, where even parents believe that the beginning of menstruation is a sign that the girl is ready for marriage and having kids”, says Halima Zarine a grade 10 student from Khost Province, southern Afghanistan. Halima lives in a Qala (a huge courtyard where many families of a clan live together) with her extended family comprising of my grandfather, uncles and their families – making it a ninety–member Qala. Halima has 6 sisters and 8 brothers “I have been witnessing my sisters and cousins being forced to quit school and get married right after their period starts”, says Halima with sadness.  “My father and uncles believe that if a girl is single after the start of her menstruation, it’s a sin for parents and Allah would punish them. I was always concerned about myself as I didn’t want to leave school.”

Halima Zarine was happy that she received the MHM related information from her teacher Durhkani Khosti in the school, in Khosti Province, which were aimed at raising awareness about menstruation. She said: “I learned that menstruation is a normal and natural process for girls, and it certainly does not mean for girls to get married immediately, because early marriage can have adverse consequences from both the health and education perspective. My mother attended a similar session with other women in the community gathering. My teacher Durkhani Khosti is a member of the women’s shura and my mother learned from her about MHM form Islamic perspective and she knew the myth was not correct.” It is all about cleanliness and hygiene. 

She added: “My mother and I talked to my father who wanted me to drop out of school. We spent a long time talking to him before we could finally convince him to allow me to continue my education. My mother was a great support in this battle, as she started sharing the problems my sisters faced during their pregnancy and their health issues with my father. Moreover, she told my father that the schools have facilities where girls can manage their menstrual hygiene with dignity”.

Halima is now happily attending school and “I keep advocating with my family members in the Qala; students at the school; and girls at community; to change perception and let the girls continue their education. It is a tough job to talk about this topic especially with men, but at least I can inspire girls of my age to fight against these erroneous beliefs.

The first steps in a long journey

Some 50 school teachers and 25 mothers have already attended MHM classes conducted by Durkhani Khosti. Halima is one of the 2,350 girls who attended MHM classes conducted by Durkhani Khosti and learned about personal hygiene, menstruation management at home and school time, and how to access, use and safely take care of sanitary hygiene products.

“She encouraged us to discuss the issues with our mothers and sisters and suggested for peer support. It takes time but other girls my age are slowly realizing their rights, and with the support of their mothers and the teachers are slowly convincing their fathers to ensure that girls do not miss out on education due to menstruation”.  

Thanks to the partial financial support from the People and Government of the Republic of Finland, UNICEF Afghanistan supports the Government of Afghanistan to address Menstrual Hygiene Management related issues through different settings. Specifically, with the Ministry of Education, efforts are being made to include Menstrual Hygiene Management into the curriculum, as well as provide separate water and sanitation facilities in schools, for girls, so that girls can manage their menstruation in privacy and with dignity and enjoy the learning environment.

UNICEF believes that a confident, strong, informed girl who is supported by appropriate water, sanitation and hygiene facilities at her school will stay in school until 12th grade so that she can grow into a healthy and informed woman who can share her well-being with her family and community.