The many meanings of menstruation: discussing menarche and womanhood with Zambian school girls
This post is a collaboration between Amie Jammeh, Tatiana Acevedo-Guerrero, and a group of 22 Zambian school pupils aged 12-17. They challenge the technical approach of “Menstrual Hygiene Management” by highlighting, through participatory visual research, how menstruation interweaves with gender and power relations, expectations around adolescence and love, and complicity between mothers and girls.
Menstrual Hygiene Management (MHM) has emerged as a growing domain of scholarship and development interventions. “Good MHM” entails the availability of clean menstrual management materials to absorb or collect blood, toilets with privacy, soap and water, and facilities to dispose used menstrual management materials.
Shortcomings in MHM are deemed major obstacles to the educational advancement of adolescent girls in the Global South. It is argued that adequate sanitation facilities in schools in low-income countries are as important as teachers and classrooms in the consolidation of academic success.
Research and interventions by the WASH sector and organizations conducting MHM have met with critiques from feminist approaches. These critiques have highlighted how MHM can reinforce imaginaries of superiority and “civilization”, since it portrays women and girls from the Global South as in need of education on how to manage their own menstruation in a proper and hygienic way (Joshi, et al., 2015; Bobel, 2019; Gaybor 2020). These scholars also highlight that inequities exacerbated by a lack of access to sanitation cannot be solved with technological fixes, such as the distribution of sanitary pads, but efforts have to be put in place to encounter the roots of gender inequalities and disparities (Lahiri Dutt, 2014).
This research contributes to the critical studies on menstrual health by talking about school-girls in their own terms, and seeing menarche and menstruation through their own contexts, eyes and views. For this, it engaged in photo-voice workshops and focus group discussions in two public schools located in peri-urban Lusaka, Zambia.
Pre-menarche and post-menarche girls were invited to take photos and also share narratives relating to their expectations, dreams, anxieties or fears surrounding their (first) periods, “womanhood”, and monthly menstruation. Photo-voice is anchored on three main objectives and intended results: to enable people to visualize and reflect about their community’s endeavors and problems; to foster discussion and knowledge sharing about essential matters during group or individual discussion of the photographs; to advocate for change through policy or decision makers.
Everyday gender and power relations in peri-urban Lusaka
Lusaka is among the fastest-developing cities in Southern Africa and the most densely populated. Squatter settlements grew rapidly with migration and today there are 37 colloquially referred to as “compounds”. 80% of Lusaka’s population lives in these “compounds” (with each household having an average of 5 to 8 members).
Increasing urbanisation in Zambia has catalysed changes in gender relations. These changes disrupt power hierarchies. In a context of economic instability and masculine unemployment, women have been entering the work force. Thus, many families are headed by women. Women are involved in small businesses either selling food or vegetables along the streets of the city or in the local markets. Community men are mostly engaged in services and on the informal labor market.
Despite women’s participation in paid labor, men are predominately considered as masters of the households. Therefore, a man who is unable to be the provider for the family is considered lazy and a failure. In this context, men who help their wives with household work are considered not “men enough” or they are accused of being “charmed” or “bewitched” by their wives.
There is a common phrase in Nyanja, a local language, that marriage is a “Shipikhisha club”, meaning “marriage is something that you endure”. Women “endure” marriage for “the sake of their children”. Families give priority to boys’ upbringing and give them more economic and social freedoms. Girls usually have early curfews, and restrictions on their movements are more severe than those pertaining boys.
Expectations around adolescence, menarche and monthly periods
The first period is an important event in the life of girls in peri-urban Lusaka. Adolescent girls receive chitenges (traditional clothes), gifts, and advice from their mothers.
It is common among girls reaching menarche to undergo a traditional initiation ceremony commonly called Moye in Nyanga Language. The initiation processes of Moye depends largely on the culture of the family, the ethnic group they belong to and place where they are raising the family. The girls whose families do practice Moye explained that initiation rituals have transformed deeply with time. Girls now spend only one week home after their first period and a party with food and music is organized after the seventh day instead of one to three months. During the initiation, they have discussions with their aunties, grandmothers or a medicine woman called Alangizi about the entrance to womanhood and the expectation that lies ahead of them. During the conversations they are taught about how to clean themselves and wear chitenges or pads. They are also told to keep their period a secret (no one especially men or boys should know about their menstrual status). The girls are strongly advised not to become pregnant.
During the discussions, as many girls pointed to the physical pains related to menstruation, some others showed pictures with different stories. While one stated that she did not feel any menstrual cramps, another explained how she did feel some pain, but upon arrival to school she was so distracted by being with her friends that she “forgot about it”.
Another main theme that came up in the photo-voice workshop was infrastructure. At schools, there are sanitation infrastructures that “haven’t worked for years” and it is difficult to wash your hands or take a shower after sports, due to broken sinks and broken showers. Similar pictures were taken in the compounds, where the water supply is intermittent. Thus, some taps are broken and the supply is expensive. Some of the girls explained having to fetch water when there is scarcity in the taps. Poor water services contribute to anxieties as after menarche girls are in charge of discretely washing their menstrual clothes and underwear.
Despite some of the girls feeling uncomfortable and having to deal with flaky infrastructure, they also took pictures as evidence of the special care and support they receive from family during period days. They identified activities and relationships that brought them peace and comfort during the days in which they are menstruating.
Besides concerns with modesty and hiding menstrual blood, an important group of pictures made reference to expectations of womanhood related to love, marriage, families, and economic security.
Pregnancy is associated with menstruation and the girls’ mothers fear the “dangers of” pregnancy after menarche and warn them about not giving in to peer pressure and “bad” influences. It is worth mentioning that the focus is not so much on the loss of virginity as it is on teen pregnancy: “After my period my mother told me if you are having sex you should stop because you can get pregnant now” (Mulonda, 14).
The girls expressed the importance of love as they move into womanhood. For them, love is something “we look forward to: to find somebody to love, marry and have families in the future”. Love is described as “having someone who makes one feel comfortable”, “having a man to stand by me”, and “being married forever”.
Menstruation from the ground up
Zambia was included in UNICEF’s project “WinS4Girls”. This project entailed the adoption of MHM programmes in public schools and the state committed to “improved drinking water, improved, usable & single-sex toilets (at least two toilets per school), improved, usable & single-sex toilets (at least one toilet for 50 pupils)”. These government initiatives have not materialized on the schools of peri-urban and informal Lusaka. Despite the fact that some teachers have attended trainings or workshops on MHM, there have not been major changes in the curricula.
Although the infrastructure exists (sinks, toilets, and showers) students reported the intermittence of water, the lack of maintenance in toilets and drains, and the constant state of breakdown of the showers. While some of this is related to problems in planning school priorities (infrastructure is built but not maintained) and lack of funding (there is money to build but not to maintain), there are also general difficulties on accessing services in these specific compounds.
Reproductive health education as a subject is not a particular topic in the curriculum and topics such as menstruation and the details of human reproduction are left in the hands of the science teachers. There are, however, journeys of re-usable menstrual-pad distribution. In the visited schools, these pad distributions are done on special occasions such as Women’s day.
Why do MHM promoters and entrepreneurs continue to depict girls in the Global South as in desperate need for solutions to “manage” their own menstrual blood?
With the aim of talking-back to MHM literature and interventions, this research came to three provocations:
1. The importance of the bonds between mothers and daughters
Mothers showcase love, affection, care and guidance. Mothers also gift materials (chitenges, pads, shorts), cook their daughters’ favorite dishes and also do home chores in order to make the period days more comfortable.
Mothers are the ones concerned about the possibility of early pregnancy. One of the important findings is that some mothers alert against pregnancy but are more lenient in what concerns virginity.
This link of care and affection between mothers and daughters has not been explored by MHM initiatives. Parents from the global South are portrayed usually as ignorant of their daughters’ menstrual histories and sexuality or as intransigent and conservative.
2. The complexities surrounding sexuality, romantic love and marriage.
Households face economic instability as a result of urban inequality and the lack of employment among men. Women have been going out of the house to work in markets or as domestic workers. Both women and girls spoke about family problems related to male alcohol consumption/gambling. This situation coexists with persisting imaginaries of men as providers and heads of the family. Even though economic roles have shifted, ideals of masculinity have not.
As a result, expectations around sexuality and romantic love are complex. School girls see romantic love as a vehicle to obtain economic stability (having someone to “have your back”) and relationships are not always incompatible with school. As one of the girls explained, boyfriends can help with education costs. Any project aiming to study or intervene on the lives women in the urban south should first aim at understanding these complexities .
3. The reality of weak infrastructure in both the compounds and the schools.
Despite efforts to extend infrastructure, toilets and taps seldom work and students complained about the widespread lack of maintenance. This has to do with the fact that some of the development projects do not tackle maintenance issues in the long run. Public schools thus lack the funding to hire maintenance personnel.
Note: Written consent forms were discussed and signed by pupils and their parents to participate in the study.
Amie Jammeh is a scholar from the Gambia. She graduated from IHE Delft Institute for Water Education with an MSc in Sanitation. She received The Best MSc in Sanitation Thesis 2020 Award from the Bill & Melinda Gates Foundation for her thesis “The many meanings of menstruation: practices & imaginaries among school girls in Lusaka, Zambia”. She is now converting her thesis into an academic article. This post is a fragment from this article.
Tatiana Acevedo-Guerrero is a scholar from Colombia. She has a PhD in human geography.
Both Amie and Tatiana learned about menarche and menstruation from their mothers.