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Master thesis research with Femme International

Between September and December 2017, I have conducted research alongside Femme International to collect qualitative data for my M.Sc. thesis in Human Security at Aarhus University in Denmark. In June 2018, I have finally handed it in and gave it the title “The monthly costs of bleeding – An exploratory study on the connection of menstrual health management, taboos and financial practices amongst schoolgirls in the Kilimanjaro region in Northern Tanzania”.

My interest in this field originated in the desire to understand the practice commonly described as “sex for pads” that I came across when I started to explore the connection between menstrual health and human security. Since I initially assumed this practice was a consequence of financial struggles, I started my research with a focus on the connection between MHM and financial insecurity. During my three months with Femmein Moshi, however, I realised that engaging in transactional sex or relationships is not exclusively a result of financial needs, but also connected to cultural practices, power and social structures within the respective societies. Just like most (reproductive) health behaviours, MHM is embedded in larger structures.

To understand the girls’ experiences, their voices and perspectives are central. I have gathered qualitative data to analyse various strategies that schoolgirls use to obtain MHM products or money to buy products. The main strategies I have encountered are support from family, teachers or school staff, friends and community members, work and engaging in transactional sexual relationships. Whilst these strategies all show a degree of agency, I am exploring the inhibitions through social structures and show the damaging consequences some of the girls’ methods can have. Additionally, their decision-making power is impacted by their identity, position in society and education system, other people’s expectations, and a variety of menstrual taboos.

The goal of my thesis is to illustrate the complexity and interconnectedness between MHM, reproductive and sexual health, financial insecurity, and underlying societal structures and cultural perceptions and practices. I am showing that attempts to improve MHM practices exclusively in relation to financial struggles or inaccessibility of menstrual products will fall short when underlying structures are ignored. Further, I argue that the pervasiveness of patriarchal structures entangled in Tanzanian society, the financial and economic disadvantages and the taboo of menstruation are forms of structural violence against women. They result in MHM practices that put women and girls at higher risk in terms of assault, direct violence and health problems.

For anyone interested in reading more, you can read and download the whole thesis here.

Katja Brama

Fieldwork Experiences: Menstruation, Human Security & Privilege

From experience, I have learned to give a brief definition of my field before elaborating why it is relevant in any context. The general ideas of Human Security have been around for a while but as a concept, it was made popular by the United Nations Development Program (UNDP) in 1994. Its two main aspects are ‘freedom from want’ and ‘freedom from fear’ and the UNDP defines its purpose as ensuring that ‘people can exercise choices safely and freely – and that they can be relatively confident that the opportunities they have today are not totally lost tomorrow.’ It is an approach that focused on the individual rather than the nation state and consists of seven security dimensions that are all interconnected: Economic, food, health, environmental, personal, community and political security. In an ideal – and unfortunately rather utopian – world, a balance of these dimensions would lead to a peaceful, stable and safe existence of all people and societies.

Although my research focus is the connection between financial (in-)security and MHM practices, my time here has taught me that connections between menstruation and all seven dimensions exist and that the surrounding cultural context is key to understanding the challenges that are a daily reality for many.

For some Human Security dimensions like environmental security, the connection to MHM is easily made: In Tanzania, trash is often disposed by burning it on the side of a road and adequate incinerators to dispose of menstrual health products correctly, do not exist.

Health security is another dimension that shows an obvious connection to MHM issues. Many WASH facilities are neither safe nor clean and the lack of access to safe MHM products leads to girls using pieces of cloth, toilet paper, gaze or extremely unsafe options like cow-dung to manage their periods. Whilst MHM products are in direct competition with other household goods, the use of those products is not only due to financial insecurities, but also connected to a variety of myths and a deep suspicion towards ‘Western’ products like disposable pads or tampons.

Katja with students at Ghona Secondary School in Tanzania

Many of the myths surrounding menstruation here are connected to personal security and community security and lead to exclusion of women and girls in a variety of ways. The most extreme example is the fear that contact with, or the sight of menstrual-blood could accidentally give people cancer, incapacitate them, curse them, make them infertile or kill them. Other myths are less dramatic but can have an equally excluding impact on the lives of people who menstruate. They are expected to not touch vegetables, fruit or water, not allowed to add salt to the meal they cook, they are refused the entrance to religious spaces, expected to not wash their hair whilst they bleed or follow extreme hygiene rituals – the list is long. One of the most damaging misconceptions in my opinion, is the assumed connection between the onset of menstruation and sexual maturity. Instead of explaining what is happening to their bodies, girls are merely taught to be ‘careful’, in other word, not to get pregnant. The attempt of managing their periods in a dignified way, for example by counting the days of their cycle, often leads their parents to the suspicion that they want to find their ‘safe days’ and have started engaging in sexual activities.

During my time with Femme, I have realized how little my own menstrual cycle impacts my life and my choices in comparison to many menstruating people living in countries of the Global South. In the words of one of my newly found friends in the Kili Hub: ‘I am in a privileged position as a menstruator’ – especially here. Nevertheless, we should not overlook that the stigma and problems surrounding menstruation are global and only enhanced in certain contexts.

Katja Brama

Introducing our YouTube channel!

Welcome to 2017!

Have you made any resolutions for yourself this year? Our team has set several goals for ourselves, as a way of keeping us motivated. This year, we want to reach 12,000 women and girls with the Feminine Health Empowerment Program across East Africa, and conduct important research about menstrual health and hygiene. One of our main goals is to find new and innovative ways of delivering menstrual health education across East Africa. This includes busting myths, breaking taboos and starting an important conversation about women’s health.

Another goal of ours is the launch of our brand new YouTube channel! We will be sharing videos from the field to show you our work and impact in East Africa, as well as short videos to introduce our team to you.

As part of our New Years resolution to deliver menstrual health education, our Tanzanian team will be sharing what they knew about menstruation before they started working for Femme. This is the first video in a series of Q&A videos with our team based in Moshi.

What did you know about menstruation before your first period?