01 May 2024 by Limpho Sello

 Est Read Time: 8 min(s) 51 sec(s)

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UNFPA country representative, Innocent Modisaotsile, joins vibrant youth representatives for a snapshot at the ICPD 30 Youth Forum in Maseru. Photo Credit: Limpho Sello.

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“I know of a young girl from my village who started menstruating while she was still in primary school. She comes from an underprivileged family that could not afford sanitary towels, leading to her missing school during her monthly periods,” revealed Mathe Masupha.

Masupha, originally from Ha Koali in the Berea district, cited this case as a typical example of the inaccessibility of sanitary towels for underprivileged girls in Lesotho.

She explained that girls from her village still face bullying from their peers for staining themselves during their menstrual periods.

“They then choose to skip school for the days they will be on their period, and sadly, the days they miss have a detrimental impact on their academic performance. As their performance deteriorates, they become demoralised and eventually drop out of school,” she explained.

Masupha, a youth from Lesotho, emphasised during the International Conference on Population and Development (ICPD) 30 Youth dialogue that menstrual health should continue to be a priority beyond the ICPD 30 agenda.

The dialogue, held on 18 March 2023 in Maseru and facilitated by the United Nations Population Fund (UNFPA) and the Lesotho government, provided a platform for Masupha to address the persistent challenges surrounding menstrual health in Lesotho.

She highlighted that the inability to access sanitary pads remains a significant obstacle, often leading to ridicule from peers and difficult choices between attending school and managing menstrual periods.

Dr. Siyamak Saleh, a Consultant with the World Health Organization (WHO), echoed Masupha’s concerns, emphasising that 800 million people menstruate every day, yet half of them lack access to pads and tampons.

Dr. Siya, a well-known sexual health influencer, highlighted the prevalent menstruation-related stigma and discrimination faced by women, girls, and gender diverse individuals in many societies, despite menstruation being a natural bodily process.

He emphasised that the issue goes beyond mere absenteeism from school or education; it extends to being excluded from life itself, leaving individuals isolated and unable to participate in daily activities simply because they are menstruating.

“Menstrual health is a right, not a privilege,” he asserted.

Calls for Lesotho to prioritise menstrual health

In Lesotho, Masupha strongly believes that the government is not prioritizing the menstrual health issue as it deserves. She argues that elevating it on the national agenda would serve as a catalyst for achieving a more balanced society.

“I also wish to see the passing of the initiation bill into law because it is going to empower young men who will fully understand issues around menstrual health,” Masupha emphasised.

She envisions a society where a 12-year-old boy comprehends menstrual health and knows how to support his girl peers during their menstrual periods, believing that this could foster a balanced society.

“It should not be a situation where a young girl feels vulnerable during her period, forced to sit alone in misery while others mock and laugh at her. She should not have to feel ashamed to even reach for her sanitary pad to freshen up in the toilet,” Masupha asserted.

Tsotang, a male panellist in the forum, recalled an incident at his school where some boys mocked a girl who had stained herself during her menstrual period.

“As a prefect at that time, we were summoned along with class monitors and monitresses to receive comprehensive education on the matter,” Tsotang shared.

He quickly added that he now has a better understanding of menstrual health. Tsotang suggested that there should be menstrual health awareness programs specifically targeting boys to ensure they grasp this issue more effectively.

Another speaker, representing the disabled youth community, Mpeo Kherehloa, highlighted that some boys still lack the understanding that menstruation is a natural part of women’s monthly cycles, not a choice.

Kherehloa pointed out that as this challenge persists, it becomes increasingly difficult for visually impaired girls and young women, as it remains taboo for boys to approach them and make them aware if they have stained themselves.

“I believe it is crucial to impart knowledge and education among boys that what happens to us is natural, and together we can address it,” Kherehloa emphasised.

Contacted for comment on April 23, Mathato Nkuatsana, from the Ministry of Health, stated that the ministry’s role is to facilitate comprehensive education and information dissemination beyond the school setting, ensuring that the teachings are well absorbed.

“Our focus is on educating about menstrual cycles,” she emphasised.

Nkuatsana highlighted that while assessments indicate boys understand menstrual health, the main challenge remains the lack of access to sanitary towels.

She noted that this challenge escalates when individuals experience staining and face mockery from others.

She stressed the importance of ensuring access to sanitary towels for girls to prevent them from skipping school due to a lack of menstrual products.

“With access to sanitary pads, they are able to take care of themselves,” she explained.

Some girls resort to sex work to afford sanitary pads.

World Vision Lesotho reported that young girls in Lesotho, particularly those in rural areas, are faced with challenging decisions during their menstrual cycles.

World Vision Lesotho said these decisions, often stemming from the fear of embarrassment due to a lack of access to appropriate sanitary products, can have detrimental effects on their education and overall well-being.

These difficult choices, as described by Makena Malefetsane, often involve resorting to sex work to raise funds to purchase sanitary pads.

“It then becomes easy for a girl to resort to transactional sex to acquire the money necessary for purchasing sanitary pads, which are unaffordable due to the poverty she faces,” Malefetsane revealed.

He further noted what begins as a small endeavor to earn money for sanitary pads can lead to a progression into full-time sex work.

Fortunately, in this scenario, Malefetsane said sex workers have access to free condoms at clinics and other locations.”

“The harsh reality is that even though she can obtain condoms for free, she may not have the ability to negotiate their use, while simultaneously lacking access to free sanitary pads.

We urge the government, relevant stakeholders, and development partners to prioritise providing access to both these essential items and educating on their proper usage,” Malefetsane emphasised.

Sanitary pads as a free commodity

While discussions about subsidising sanitary pads have occurred in Lesotho, other countries like Scotland, Kenya, and New Zealand are already providing free sanitary products for schoolgirls, as noted by Dr. Siyamak Saleh.

In this educational video posted on Instagram, Dr. Siya explains that Kenya has significantly enhanced girls’ education by distributing free sanitary pads, with officials announcing a plan to distribute 140 million free pads.

He mentioned that Scotland has made period products freely available, becoming the first country to offer tampons, sanitary pads, and other menstrual products at no cost.

Additionally, he said New Zealand addresses period poverty by providing free sanitary products to all schoolgirls. He quoted Jacinda Ardern, stating that over 90,000 girls miss school because they cannot afford pads or tampons.

In Lesotho, Mampho Letšaba expressed gratitude towards the government and its development partners, including the United Nations Population Fund, for providing free access to condoms and sexual and reproductive health services.

However, she emphasised the importance of adding sanitary pads to the list of freely available commodities.

Letšaba highlighted that the cheapest sanitary pads range from M5.00 to M17.00, but they are often quickly depleted. Consequently, she said some individuals resort to activities they should not be involved in due to the urgent need for these essential items.

She added that in some instances, some people use one pad for a maximum of three days, and such unhygienic practices can lead to vaginal infections.

“When they resort to using fabrics in the villages, she may not know how to properly wash them, and there is still stigma surrounding menstruation in the country. This stigma makes her feel embarrassed to hang the fabric outside to dry,” she explained.

“Moreover, a girl child still feels uncomfortable discussing menstruation with her father because fathers often do not make time to address women’s issues with their daughters. This ongoing issue requires urgent attention and prioritization by the government,” she emphasised.

Correct use of sanitary towels

Representing key populations, Makena Malefetsane highlighted another menstrual health challenge: the prevalent incorrect use of pads and unhygienic practices, particularly common among the sex work community.

“I want to emphasise their correct use because with this population of sex work they use anything and some very dangerous to their health just to attend to the nature of menstruation on the time when they are on duty.

“Some of the things women who do not have access to sanitary pads use things that cause them  infections. They use materials or fabrics that cause friction and cause blisters which easily allows the transmission of sexually transmitted infections.”

In December 2023 Uncensored News reported a story of one sex worker who shared that one night she inserted that sponge when she was on duty but because she was intoxicated by the time she arrived at her crib she forgot to take it out.

 “I took a bath the next day and forgot that I still had a sponge inside me. I spend days with that sponge inside my vagina until I had a very bad smell from it,” she said.

“I thought it was STIs until I remembered that I inserted a sponge. I then had to find out ways to pull it out of my vagina. I bathed and after that the smell got better.”

The World Bank says when girls and women have access to safe and affordable sanitary materials to manage their menstruation, they decrease their risk of infections.

Spotlight on lack of disposable bins

Mathato Nkuatsana from the Ministry of Health highlighted another issue: many schools still lack adequate facilities for girls to freshen up and dispose of used sanitary pads.

“This is where you will find that a girl walks around with a used pad in her school bag, which might accidentally fall out. These are some of the issues we need to address. What measures is the Ministry of Education implementing to ensure that schools are menstrual health-friendly for girl children?” she said.

Sekhotseng Adam Molapo, the Director of the National Curriculum Development Center (NCDC) at the Ministry of Education and Training, said she was not in a position to indicate whether or not schools have enabling facilities and equipment that allow for appropriate freshening up and disposal of used sanitary pads.

“At this point, I can’t say there is evidence of such initiatives. Schools are aware that they need to have special bins, including she-bins, for the disposal of certain items as recommended by the World Health Organization (WHO).”

According to the WHO, an enabling environment for women’s menstrual health means that menstruation is viewed as healthy and normal.

It further explained that women have easy access to toilets and disposal infrastructure that are secure, hygienic, physically accessible, and provide privacy.

Meanwhile, Nkuatsana said addressing menstrual challenges is a multisectoral and national issue where they can involve other stakeholders.

She mentioned that on their side as the ministry, they aim to formulate a menstrual health guideline that will also serve as a valuable tool in guiding their partners.

“The guideline will facilitate the creation of menstrual-friendly facilities where girls can safely dispose off their used pads and ensure proper burning procedures with precautions and safety measures in place,” she said.

On her part, Molapo highlighted that menstrual health education is integrated into sexuality education.

She explained that within the curriculum, learners are taught how to take care of themselves and how to address the challenges that come with body changes and development, including menstruation.

Speaking about how they address bullying in school that happens to girls during their menstrual period, she said: “Bullying is one of the signs of school-related gender-based violence, which occurs for many reasons, not only menstruation.

“So, gender-based violence is something that we strongly do not tolerate. We teach them about inappropriate behavior and how to report it. For instance, when they are on their menstrual period, they should feel empowered to report any bullying or mockery they experience due to accidental staining,” she said.

Molapo mentioned that there are support structures in schools where learners can report instances of bullying, including period-related bullying, when groups of individuals make fun of their situation.

“Even when they urgently need sanitary towels, they know where they can reach out for assistance because we have informed them of such resources to ensure their learning environment remains conducive even when nature takes over,” she explained.