WSUP actions improve menstrual hygiene in Ghana and Bangladesh

Themes: Behaviour change Community management Gender Hygiene Public/shared toilets Sanitation

By Aklima Khatun in Dhaka, Shehela Ali in Chattogram, and Rachael Lithur in Accra

Women and girls living in low-income urban communities face additional challenges created by poor or non-existent water and sanitation services. On top of the threat of sexual violence, the very basic management of their menstrual hygiene is impacted by the conditions they live in. In large cities of countries such as Bangladesh and Ghana, WSUP has been supporting female residents, in actions that have improved their personal health and other aspects of their lives. Around Menstrual Hygiene Day 2023, we share here a couple of their stories.

Bithi’s parents passed away when she was young. She and her brother were raised by their uncle’s family, in the Maingate community, located in the 40th ward of the city of Chattogram, Bangladesh. Bithi currently resides with a total of seven family members, including her brother, uncle, aunt, and cousins. At the age of 16, she currently studies in the tenth grade. Her uncle, a day labourer, faces financial hardship.

Bithi’s menstruation cycles started at the age of 12, when she did not have prior knowledge about it. As a result, her first experience with her period was frightening for her. Bithi’s cousins assisted her in navigating the situation and taught her how to use rags for menstrual hygiene. However, Bithi’s family does not have their own toilet and must share a common, unhygienic facility with other families. This shared toilet is in an extremely poor state, lacking proper hygiene, cleanliness, lighting, ventilation, a functional door, and a secure lock.

Menstrual hygiene session for young girls in Chattogram, Bangladesh.

She has always felt anxious about using the toilet and managing her menstruation – around 30-35 people, including Bithi’s family, use this same facility. Persistent issues, such as waterlogging and dampness, further exacerbated the problems. Bithi was unable to use the toilet comfortably and without fear, constantly worried that someone might be watching her. She hesitated about where to clean, dry, dispose, and store her used rags.

The teenage student struggled to cope with the situation. During her period, Bithi had no guidance on how to handle various issues, such as changing materials, maintaining proper hygiene, managing her diet, engaging in physical activities, attending school, and discussing her experiences with others. The absence of her parents made her too shy to share her concerns with anyone, resulting in her missing school during menstruation. A WSUP project, “Improving WASH in VF Corporation Worker Communities in Chattogram”, was launched in 2020, with funding from VF Corporation, to address the realities of women and girls like Bithi.

Better hygiene practices

With the aim of enhancing sanitation and hygiene practices, the project built new toilets, provided repairs, and improved both water supply and hygiene education. Bithi and her relatives are amongst the ones who benefit from it. WSUP has built a toilet facility to serve 35 people from 10 families, including hers. Additionally, an adolescent group has been formed in the Maingate colony, and Bithi actively participated in its activities.

The toilet facility has been designed with women’s needs in mind, featuring running water, secure doors with locks, separate female chambers, proper lighting, and waste bins, making them particularly useful for women. WSUP has also organised hygiene sessions for the community, including menstrual hygiene sessions specifically for adolescent girls and women.

In the sessions, participants learned about the entire process of menstrual hygiene management (MHM), including the following guidelines:

  • Parents and teachers should provide emotional support to girls during menstruation.
  • Women and girls should use a clean, soft cloth or sanitary napkins/pads during menstruation, if available.
  • Wash and clean the cloth used during menstruation with clean water, soap, and antiseptic, if necessary.
  • Change menstruation materials every four hours.
  • Sun-dry the clothes used for menstruation and store them in a clean and safe place to prevent germs and infections.
  • Provide nutritious food to girls during menstruation to prevent malnutrition, along with extra food during this time.
  • Dispose of used napkins/rags and other waste into designated waste bins to avoid environmental pollution.

Bithi, from Chattogram, lives with seven family members. They now use a new toilet facility that has improved their lives

Sharing the knowledge

Bithi was eager to learn from these sessions and has made efforts to implement the knowledge she gained, occasionally seeking information from WSUP representatives, as needed. Now, Bithi and the other girls in her community use the toilet during menstruation and handle menstruation-related matters peacefully and without fear.

“I’m very grateful for WSUP for the knowledge I’ve gained from the MHM sessions, particularly regarding what we should and should not do during menstruation”, Bithi says. For her, both the construction of the new toilet facility and the hygiene sessions have been very important for her community and family.

Bithi now shares her knowledge with her friends and younger girls in her family, educating them about menstrual hygiene management. She has come to understand that menstruation is a natural phenomenon in every woman’s life and not a cause for panic or distress.

“I feel happy and much more confident with these positive changes in my life.”

Vulnerable women in Ghana

The capital city of Ghana, Accra, is a popular destination for many young people from different parts of the country in search of greener pastures. The most typical of these young people are women/girls who migrate from the northern part of Ghana to Accra for economic reasons. Most of these young women are without education and training and unable to secure employment. They end up in major market centers as head porters, commonly known as “Kayayei”, meaning  female porters or bearers.

Kayayei in the city centers often live in poor conditions and with minimal income from their daily head porting. They cannot afford decent accommodation and are without basic sanitation and hygiene.

Menstrual hygiene session for Kayayei women in Accra, Ghana

As part of its work on the HBCC 2 hygiene project, funded by Unilever, WSUP partnered with the Kayaye Youth Association and provided training for 50 Kayayei in Accra in soap making, in order to create sustainable livelihoods for them. This helped reinforce the promotion of individual and community hygiene practices, such as handwashing with soap, supporting prevention of Covid-19. The soap making training lasted three days, with each woman receiving a starter pack and an amount of money at the end.

Menstrual hygiene session

In March 2023, as part of the support to the Kayayei, one activity focused specifically on menstrual hygiene. Dozens of female workers gathered to listen about good menstrual hygiene practices and the sort of products they should use during their periods.

The session included the demonstration of how to use a different kind of sanitary pad, which can be made at home or bought for very accessible prices. Instead of the traditional disposable pads, the option shown to the women are reusable and made to last. After use, the cloth must be washed, ironed, and then be stored, ready to be used again.

One of the women who have been taking part in the WSUP activities, Amama Mbonwura, says that what the Kayayei seek in the capital is the opportunity of a better living standard. “My goal coming to Accra is to find an opportunity to acquire a skill for a sustainable economic livelihood and then return to the north”, says the a 25-year-old from Damongo, in the northern part of Ghana.

Amama lost both her parents after completing senior high school. “Being part of this training is like a dream come true. I look forward to using the skills to build a business to support myself and also teach my sisters and others, so they can also support themselves and their families.”

Women take part in the soap making training, provided by WSUP as part of the HBCC hygiene programme, funded by Unilever

In the past seven years, she has been making her way to Accra to work as a female porter, but regularly returning home in the North, where she is able to save some money. She admits that life in Accra as a head porter can be challenging, but it is still better than staying in the North the whole time, as there are almost no income opportunities for women in her community. Amama sees this soap making training as the opportunity she has been waiting for in order to improve her life.

Top image: Bithi with other girls from Chattogram. Credit: Shehela Ali