– BY SUMIT BANIK, RIMI CHAKMA & NABALESWAR DEWAN –

Chittagong Hill Tracts (CHT) is located in the south-eastern part of Bangladesh, which is the home to eleven different small ethnic groups who speak diverse languages. The region was isolated for over two decades (1972-1997) due to prolonged conflict which greatly affected their lives and livelihood. Geographical remoteness, poverty, taboos, lack of awareness, poor health services, lack of access to hygienic menstrual products etc., promoted unhealthy practices and unsafe management of menstruation in the region.

‘Even parents never discuss menstrual health management openly with their daughters’

In the society of indigenous peoples of CHT, there are many harmful norms, taboos and unhealthy practices around menstrual health management. Old and dirty clothes were used during menstruation. Most of the adolescent girls and young women don’t know how to deal with the used cloths. Even the parents never discuss about menstrual health management openly with their daughters. Hence, the adolescent girls and young women remain unaware about healthy menstrual health management. They get wrong information from different sources, don’t use clean materials or manage their menstruation hygienically and as a result they suffer from various menstrual infections and diseases.

According to the National Hygiene Survey 2018 (a joint venture of Bangladesh Bureau of Statistics, UNICEF Bangladesh and WaterAid), the majority of adolescent girls (50%) and women (64%) used old cloth for menstrual hygiene management. Use of disposable pads was more likely among adolescents (43%) compared to adult women (29%). Among those using old cloth, the majority of adolescent girls (52%) and women (62%) washed/cleaned the cloths with soap and water. Also, 8% of adolescents and 12% of women used unprotected water (surface water sources) for this.(1)

Key intervention: Reusable Sanitary Pad Making Training

Under the EU funded Our Lives, Our Health, Our Futures (OurLHF) Program we’ve tried to equip the adolescent girls and women (10-25 years old) in CHT with proper knowledge and skills for healthy and safe menstruation management. Our aim is to make them aware of menstrual health management to stay safe and disease-free and lead a healthy life with dignity. One of our valuable activities was the Reusable Sanitary Pad Making Training.

Reusable sanitary pads made with modern techniques can reduce environmental pollution to a much greater extent than ordinary pads. As part of it, we provided training on reusable sanitary pad making to around 12,000 girls and young women step by step under the OurLHF Program. Its objective was to enable the adolescent girls and young women to make the reusable sanitary pads with low-cost and locally available materials. They were also asked to share the skills with their neighbours.

How we transferred knowledge and skills

We transferred the knowledge and technical skills through a waterfall model; from top to bottom. From one capacity building adviser from Simavi Netherlands, to one capacity building coordinator from Bangladesh Nari Progati Sangha (BNPS), to three master trainers, to ten trainers and thirty program facilitators, to 300 female mentors, to 12,000 girls and young women.

To develop the module for the Reusable Sanitary Pad Making Training we consulted with a number of experts, did extensive literature review, conducted several field tests in three hill districts and made necessary adjustments based on their feedback. We designed three sizes of pads: small, medium and large. Materials that were used are cloths (cotton, blanket and water proof flannel which are soft and comfortable and have a good absorption capacity), yarns, needles, buttons, pencils, scissors and paper. We also conducted an informal market survey to see which materials are available at the local market, that are healthy and comfortable.

Results

The adolescent girls and young women were very happy as they learned to make reusable sanitary pads themselves. The girls’ club members demonstrated the pads at the clubs and took them to home to use. At home, parents praised their children’s creative work. The adolescent girls and young women said the pads were comfortable to use. They also shared them with their family members such as sisters, aunties.

Many girls and women are now using the reusable sanitary pads. As a result, they’re being able to move to public places (schools, college, market, temples etc.) during their menstruation, with dignity. Local administration and public representatives also appreciated the intervention and showed interest to promote the reusable sanitary pad among others (with external stakeholders). Local shopkeepers expressed an interest to sell the reusable sanitary pads at their shops.

Challenges

Obviously we experienced some challenges. For starters: managing all the materials locally was a problem. Although we thought all would be locally available, one item (water proof flannel) wasn’t available at the local market. We needed to collect it from Chittagong through a local vendor.

Making the design of the pad was a challenge too. To sew the pad, we needed to prepare the design on white paper and then cut the cloths at the preferred size before sewing. Girls in the age of 10-14 years at first struggled to make the design of the pad in paper, since many of them had never worked with scissors before.

Lessons learned

• Training on reusable sanitary pad making and sessions on menstrual health management helped the adolescent girls and young women to remove unhealthy practices and unsafe management of menstruation.
• Once the design work is done properly, everyone can sew or make the pad easily.
• Parents should discuss menstrual health management issues openly with daughters instead of being shy.
• People who work on similar issues should share their experience and good practices with other actors.
• Relevant stakeholders should be motivated to promote the reusable sanitary pad making intervention.
• Initiative needs to be taken to produce these pads commercially at low cost, and local shopkeepers at remote areas need to be engaged.

(1) http://bbs.portal.gov.bd/sites/default/files/files/bbs.portal.gov.bd/page/b343a8b4_956b_45ca_872f_4cf9b2f1a6e0/2021-02-18-12-34-38806de91fa4ca8d9e70db96ecff4427.pdf

For more information about Bangladesh Nari Progati Sangha, see: bnps.org/

About the authors
Rimi Chakma, Nabaleswar Dewan and Sumit Banik are currently working with Bangladesh Nari Progati Sangha (BNPS) as Master Trainers on the health, rights, and protection of ethnic adolescent girls and women in Chittagong Hill Tracts (CHT) of Bangladesh. They mainly provide technical support to the staff of the implementing partner organisations and field-level activities in the three hill districts. They attempt to highlight project impact through fieldwork, data collection and analysis, creative idea generation, and writing articles. They believe that equal opportunities for all, irrespective of individuality and nationality, are essential for the full development of human beings. They continuously strive for positive behavioural change & development of the CHT people, and provide theoretical study & training facilitation on reproductive & sexual health and rights issues.

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Also read:
Getting your first period in Bangladesh, by Sumit Banik

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