Learning about Menstruation in Shan State

Menstrual hygiene

Tin Htet Paing
UNICEF
UNICEF Myanmar/2019/Minzayar Oo

19 July 2019

Kutkai, Shan State - Seng Nan was playing with her friends near her house inside the camp for the internally displaced when she suddenly felt something unusual in her body. She quickly went into a latrine and saw blood on her underwear. She was 13 and didn’t know what to do. 
 
“I thought something bad was happening to me,” said Seng Nan, recounting the day she got her first period. Scared and confused, Seng Nan waited until her father and brothers had left the house before quietly approaching her mother. 

For many girls, menstruation is not a subject for discussion, even among close female family members.

In the absence of information and education on menstruation prior to their first period, girls can feel embarrassed, distressed and humiliated when they start bleeding. 

UNICEF
UNICEF Myanmar/2019/Minzayar Oo
Booklets which include menstrual health messages were distributed in the KBC-1 camp for internally displaced persons (IDPs) in Kutkai, Shan State, Myanmar.

It was when Seng Nan was 11 years old that her family took refuge in the Kachin Baptist Church Camp One in Kutkai, Northern Shan State. This camp currently houses more than 280 people like Seng Nan who have fled their villages to escape ongoing conflicts. 

Girls and women living in camps need a safe environment where they can discuss details of their menstrual cycle, how it affects their bodies, daily activities and emotions. 

Now 18, Seng Nan is one of the girls in the camp aged between 12 and 18 years old who participated in discussions in May, as part of a national campaign to raise awareness of menstruation organized by UNICEF and other water, sanitation and hygiene (WASH) partners in Myanmar. 

The girls and young women embraced the opportunity to become familiar with menstruation hygiene management, ask questions and share their personal experiences. Learning that menstruation is a sign of good health and vitality eased many concerns.

Discussing menstruation truths and myths

“The most common misconceptions about menstruation among women and girls in rural areas or camps are that they cannot wash their hair or eat sour food when they have their period. The fear is that if you do, your menstrual cramps will get worse, your period will stop, or you will fall sick,” explains reproductive health doctor Nyein Hsu Pan Lwin.
 
Warned by her mother about these so-called dangers, for many years Seng Nan believed the myths. Now she knows they are not true. Seng Nan is also frustrated with the continuing misinformation around menstruation.

“Many girls still see menstruation as a shameful thing. They are very shy to talk about it. Breaking that silence is extremely difficult. We need to discuss frankly and openly,” says Dr. Nyein Hsu Pan Lwin.

UNICEF
UNICEF Myanmar/2019/Minzayar Oo
An ethnic Kachin IDP girl walks in front of the housing rooms in KBC1 IDP camp, Kutkai, Shan State, Myanmar.

Privacy in cramped conditions

Nearly 250,000 people have been internally displaced by armed conflict and violence in Myanmar. Around one-third are vulnerable girls and women of menstruating age who struggle to get through their periods safely and comfortably. They have specific needs that are often ignored during emergency responses.
 
In the camps, families of perhaps five or six people live in a single room that is 10  by 15 feet. There is little privacy. Changing sanitary pads, cleaning oneself and disposing of sanitary waste are real challenges, as well as visiting the latrines at night to change pads because there is no electricity to light the camp pathways or inside the latrines.

Engaging men and boys to overcome period social stigma

Many menstrual hygiene challenges are rooted in gender inequality. 

At Pan Lort Camp outside Kutkai, which houses nearly 200 displaced people, 16- year-old Lisu girl explains, “I always drop my used sanitary pads directly into the latrines because it is convenient and discreet. I know that such a practice can ruin the plumbing and shorten the lifespan of the latrine, but I don’t know any other way to dispose it discreetly.”
 
Camp volunteer Jum Zang Dau Nan observes, “Male family members complain that women have ‘no shame’ when they see women’s underwear or reusable menstrual cloths drying in visible places.” 

Such comments cause the women to hide their damp underwear underneath other clothes or to hang them in hidden, unclean places where there is no sunlight, which can lead to health risks linked to reproductive and urinary tract infections.

Discussing menstruation with men and boys helps everyone understand what is happening and breaks the social taboos and stigmas attached to menstruation. 

UNICEF
UNICEF Myanmar/2019/Minzayar Oo
16 year-old Ti-N, an ethnic Palaung IDP girl with her friends in the Pan Lort IDP camp where she lives with her family in Shan State.

Sharing the learning

“My mother didn’t tell me anything about menstruation, so when the time came, I found that didn’t know how to talk about it with my own daughter,” explains Ngaw Ngar regretfully.

Ti-N, Ngaw Ngar’s daughter sometimes feels dizzy and weak when she has her period. At those times she doesn’t feel like talking or going out of the house or to school. When she is accused of just being lazy and giving excuses to avoid work or school, Ti-N feels misunderstood. 

“Talking with my friends helped me to learn that they have similar problems,” said Ti-N. “I realized it wasn’t just me.”

Low knowledge of menstruation can have a debilitating effect on girls and young women. The limitations may mean reduced mobility, fewer opportunities for livelihoods and at school, and dietary restrictions related to taboos.
 
Leading the WASH humanitarian response cluster in Myanmar, UNICEF regularly distributes hygiene kits of sanitary pads, underwear and soap to girls and women living in the camps, as well as supporting partners to deliver menstrual hygiene services, such as staff trainings, monitoring and reporting. The cluster also advocates for more investment in menstrual hygiene awareness and management in the IDP camps.

UNICEF
UNICEF Myanmar/2019/Minzayar Oo
UNICEF Staff member Ma Toe Toe Aung discussing menstrual health and management in the KBC-1 camp for internally displaced persons (IDPs) in Kutkai, Shan State, Myanmar.

“I have learned that menstruation is normal and healthy for women. It’s part of life and something to celebrate,” declares Seng Nan, who no longer feels embarrassed or scared to go outside when she has her period.