Peshawar: More than 79 percent girls in Pakistan do not manage menstruation hygienically, causing gynecological and psychological problems that lead to trauma and shame suffered in silence, say health experts.

Afshan Bhatti, National Research Manager at Real Medicine Foundation (RMF), says unhygienic practices during menstruation cause Urinary Tract Infection (UTI), which may eventually lead to pelvic infection and cervical infection. These may lead to infertility among females.

“The basic reason behind lack of awareness about menstruation among the female population is that it is considered a taboo topic in our society,” Bhatti told News Lens.

Afshan Bhatti was one of the speakers on the occasion of “Menstrual Hygiene Management day” – observed annually on May 28. Organisers from different governmental and non-governmental organisations had arranged an event built around the theme “education about menstruation changes everything” at the University of Peshawar to create awareness and understanding about menstrual hygiene.

Menstruation, also known as a “period” or “monthly” is the regular discharge of blood and mucosal tissue from the inner lining of the uterus through the vagina. The first period usually begins between eight and fifteen years of age among females, signaling the onset of puberty.

“The topic is not even discussed between a mother and daughter, let alone with male members of a family,” said Bhatti, adding that menstruation should be seen as normal condition and discussed among male and female members of a family.

However, the fact that the hall where the event was held had women speakers and an audience comprised entirely of female student, suggested that it is not be easy to engage with men on menstruation. It was not accidental but deliberate that only women were invited to the event. Socio-cultural norms treat discussing menstruation openly, especially with men, a taboo.

This was evident from the fact that the organisers did not allow media in when male journalists turned up to cover the event. Media persons were provided a press release related to the event and organisers gave interviews after the event. Even for female students at the event who keenly listened to speakers, it was the first time they had an opportunity to attend such an event.

“The role of school teachers and Lady Health Workers (LHV) is vital to educating women on hygiene,” said Bhatti. “They can play a very important role in lessening the burden of hygiene related disease on hospitals through education on cleanliness.”

Talking to News Lens Pakistan, she said that like clean drinking water and improved sanitation, menstrual hygiene is a basic need of women for a dignified life.

“Menstruation is a sign of puberty among girls but affect their socialization with family and community and leave a significant impact on their education,” she said.

Romeen Khan, a participant, told News Lens it was for the first time ever that she had attended an event focusing on such a rarely-discussed topic. The discussion, she said, was useful, held in a women-friendly environment.

Muhammad Mushtaq, a cleric in Peshawar, said menstruation had been frequently discussed in Quran. It is a book, he stressed, which guides Muslims through all phases of life.

“It (menstruation) should not be considered taboo as every Muslim has been told to reflect on each and every aspect of life,” said Mushtaq.

According to a national survey by RMF, most girls have no knowledge about menstruation on reaching puberty. When they have the first cycle of menstruation without any knowledge, they are traumatized or suffer shame. This shame becomes private trauma because it is not shared with anyone.

“Some girls get extremely terrified as they believe it is a fatal disease,” said Afshan Bhatti. “Some girls even consider committing suicide to get rid of trauma due to blood flow from their genitals.”

Lack of awareness has created myths about menstruation among the general population – men or women. These include not take bath, not to run, carry weight or avoid eating specific foods while having periods. “None of these have any medical backing,” said Bhatti.

To create awareness about menstrual hygiene and break myths regarding menstruation, RMF has introduced the “The Girls and Boys Puberty Book.”

The brainchild of Dr. Marni Sommer, Associate Professor Socio-medical Sciences at the Columbia University in New York, the book aims to provide basic guidance to girls and boys regarding changes in body due to puberty. Local versions of the book had already been introduced in Ghana, Cambodia, Tanzania and Ethiopia.

According to RMF’s Afshan Bhatti, a local version of the book would soon be introduced as “Pakistan’s Book of Puberty.” The Book will be distributed (mostly) in public sector educational institutions in all four provinces and later in the Federally Administered Tribal Areas.

“Response from teachers and students in all provinces, especially Khyber Pakhtunkhwa and Balochistan, towards the book was surprisingly positive,” said Bhatti. “They found the book useful for girls and relevant to the local society.”

Afshan said that (RMF) was in contact with textbook boards in the provinces to add sections of the book, if not all, part of curriculum.

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