Hajra Bibi, hunched over her hand-cranked sewing machine, sews sanitary pads for the women of her village in the mountains of Pakistan’s northwest, one of the many rural locations where menstruation is still taboo.
The 35-year-old mother sat in front of her little, doily-covered work table in the town of Booni, close to the Afghan border, and stated, “I am responding to a problem.”
“Before, the women of Booni were unaware of what sanitary towels were,” she continued. Less than one-fifth of women in Pakistan use sanitary pads, according to estimates by local charity.
Historically, women have used rags and cloth to absorb their menstrual blood; however, stigma surrounding periods and a lack of reproductive information have led to poor hygiene standards and numerous illnesses.
As in other rural regions of Pakistan, menstruation women were stigmatized and restricted in their activities.
The Aga Khan Rural Support Program (AKRSP), a Non-Governmental Organization (NGO) partnering with Unicef, provided Bibi with training in the production of disposable sanitary pads made of cotton, plastic, and cloth as part of a program designed to alter attitudes regarding women’s health.
As a result of her husband’s disability and the family’s low income, she decided to pursue employment. Each pad is made in around 20 minutes and sold for 20 rupees (13 US cents).
Her efforts first disturbed the local population.
“Initially, some questioned why I was doing this, and others insulted me,” Bibi recounted.
Now, however, “girls in the village may discuss their periods,” she remarked with pride, adding that she was working “for the fundamental needs of women.”
Infection and training
Unicef has issued a warning that women in Pakistan have in certain instances been denied access to menstruation information as a “method of maintaining their chastity.”
The 2018 report stated, “This negatively undermines their physical and emotional wellbeing.”
Historically, the women of Booni have used cloth. Still, according to Bushra Ansari of AKRSP, the taboo surrounding menstruation meant that many women were embarrassed to dry their clothes outside, unknowing that moist clothes are a breeding ground for bacteria.
In addition, female family members frequently shared menstruation rags, which increased the risk of developing urinary and reproductive tract infections, according to Dr. Wassaf Sayed Kakakhail.
“If there are three girls in a family, they all use the same cloth,” she added, adding that many women are instructed not to wash during their period.
In northern Pakistan, a notoriously conservative society, there is no sex education in schools, and the subject is rarely discussed in families, especially with women.
According to a 2017 Unicef poll, fifty percent of young Pakistani women were unaware of menstruation before their first period.
“Teenage girls told us they believed they had cancer or a dangerous sickness that caused them to bleed,” Kakakhail explained.
Mohammad Haidar Ulmulk, head of public health for the Chitral District, where Booni is located, asserted that the situation was under control.
“There may be holes, but we try to fill them,” he added, adding that hundreds of health workers in the region were attempting to assist young women.
Sister, mother, spouse
The situation differs in urban areas, particularly among the wealthy. Access to essential feminine hygiene items is difficult in the conservative Muslim nation, ranked 148th out of 149 by the World Economic Forum for gender equality, and where sexist perceptions persist.
In Karachi, a twenty-million-person metropolis regarded as the most liberal in Pakistan, sanitary pads is readily available yet pricey.
Many women still feel uncomfortable around leering store clerks and ask their husbands to purchase them instead.
“Some people like to purchase them late at night, while others prefer to do so in a separate neighborhood,” said Sajjad Ali, a 32-year-old business owner. In stores such as these, sanitary napkins are packaged in opaque paper instead of translucent plastic bags like other products.
“Periods are forbidden and shrouded in mystery,” said Seema Shiekh, an activist for women’s rights. However, she questions, “Doesn’t every man have a sister, wife, or mother?” After twenty years of struggle to introduce sex education classes in Pakistan, the first sessions are now being taught in public schools in Sindh province’s metropolis, Karachi.44[9In a country where the advent of menstruation is one of the main reasons girls drop out of school, one of their goals will be to eliminate the fear associated with periods.
Twenty-eight percent of women surveyed by Unicef in 2017 reported that they had missed school or work due to stomach problems or concern over stains.
Bibi, who works alongside 80 other women trained to produce sanitary pads, is hopeful that the situation in Booni will also improve. She reflected, “With this endeavor, I have raised awareness.”