In a crisp morning during the winter vacation, the quiet of the school grounds set in the remote rural town of Independencia, in Cochabamba, is only broken by the sounds of a mountain stream trickling nearby, birds singing and three girls happily chatting.
The girls are sitting outside, overlooking the Andes mountain range. Chaperoned by the school’s librarian, the girls seem relaxed. However, Daysi Paco, 16, admits she was not relaxed when her physical education teacher had taken her aside with the other girls in her class to have “a talk”.
Daysi says they were stunned into silence when the teacher began to describe menstruation. She was 13 at the time. “I had never heard about menstruation before. We were all so shocked; all we could do was just nod,” says Daysi. “When I got home I asked my mother about it.” Her mother just said, “It’s normal.” Daysi, who has a particularly open and friendly manner, encourages her two friends sitting with her to also talk about their experiences.
Nelsi Cossio, 16, says she started menstruating when she was just 10 years old. “I cried as I thought something was wrong with me, but then my mother told me not to worry.” Reyna Vargas, 18, adds that it was her older sister, who was training to be a nurse at the time, who told her about it. “She said that during this time, I shouldn’t take a bath as I would get white spots on my skin. I was afraid to ask my mother.”
The librarian, Emiliana Guzmán, nods understandingly as the girls talk. She explains that most women find it difficult to talk about menstruation which is locally called malninchik, meaning “our sickness”. However, Guzmán, a mother of three daughters, was able to talk about menstruation to her two eldest daughters, aged 14 and 12; but her 11-year-old daughter, she adds, is too young. “I explained to the older ones that they should not take a bath during this time. I warned them that their body is open, so an infection could enter and their blood will clot inside and produce a cancer.” She adds, “Also, I told them they shouldn’t drink milk during those days as their blood will turn white.”
Reyna confirms that she follows her older sister’s advice and does not take baths during her menstruation. However, Daysi concedes the reason why she does not take baths during her menstruation is that she has no running water at home, only a cold tap outside. “I don’t feel like taking a cold bath when I am menstruating.” She also adds, “I avoid eating tropical fruits and drinking milk.”
Daysi explains that many girls find it difficult to manage their menstruation at school, as sometimes they run out of pads or cannot afford them and resort to using rags. Despite the difficulties, Daysi makes sure she does not miss school, but she adds, “I don’t do physical education as I’m scared I will stain my school uniform.” It does not help that their school uniform is white. Daysi also highlights that the school showers lack curtains or partitions. “Nobody uses them,” she says. The school also does not provide soap or toilet paper. “I just use soap at home.”
The taboo, misconceptions and poor management of menstruation the girls describe are consistent with a recent assessment conducted in Independencia, where Daysi and her friends live, and Tacopaya, both rural municipalities in Cochabamba. The research – the first of its kind in Bolivia – is part of a wider research programme initiated by UNICEF with the Centre for Global Safe Water at Emory University, Atlanta. The aim is to investigate the menstrual hygiene management challenges faced by female pupils in Bolivia, the Philippines, Rwanda and Sierra Leone.
The research in Bolivia found that the challenges of menstruation management had an impact on girls’ education and wellbeing. It contributed to their poor school attendance and class participation as well as their dropping out of school. Many said they suffered bullying and were ridiculed by the boys at school. This had a negative impact on their self-esteem and gender relations. Also, poor hygiene practices left girls susceptible to infections and their lack of understanding about menstruation led to high levels of stress and fear about pregnancy.
The findings of the study were consistent with the interview with the three girls. For example, one girl in the study is quoted as saying, “My mom told me that … you also shouldn’t wash clothes, as you’re touching cold water, she says that if you do that it (the blood) clots, (and) it damages your fallopian tubes.” The teachers in the study who did not share these misconceptions were usually not from the area, but as they were not locals, said that they found it awkward to talk to the girls about something so taboo.
The study also found that sanitation resources and facilities were inadequate. None of the schools in the research provided toilet paper, soap or pads, and some had no bins for soiled sanitary towels. Other schools did not even have toilets. The study quotes a girl saying: “There is no bathroom; we usually go far over there, under the bushes. That is the reason we’re late sometimes; (and then) the teachers locks the door on us.” Moreover, many girls have two-hour bus rides to school along twisting and turning, bumpy, dirt mountain lanes adding to their discomfort as well as their stress about leakages.
Irma Peredo, the UNICEF WASH Specialist, says UNICEF will work with its partners to support the recommendations of this groundbreaking study. “This is a new area not only for UNICEF, but also for Bolivia,” says Peredo. “This pilot study will lead to more investigations in other regions like the Amazon Valley and Chaco.”
Peredo adds that UNICEF needs to build on its technical support to the municipalities to ensure schools have adequate access to sanitation facilities and resources, including hygienic absorbent materials, as well as ensuring that girls have the necessary privacy. She also points out the urgent need to impart correct information to communities about menstruation. “UNICEF will support a culturally sensitive communication campaign that transmits clear messages about menstruation to destroy these harmful myths and that will also assist teachers and parents to empower girls to better manage their menstrual period. The lack of support for managing menstruation is a major barrier girls are up against when they start secondary education.”