A few months ago a 14-year-old girl came to my clinic with her mother. The girl was suffering from vaginal discharge, itching and lower abdominal pain. She started menstruating about four months earlier.
On questioning her, I discovered that the girl had used clothes and tissue paper during her period, so it was not difficult to find the source of her discomfort and diagnose a pelvic infection. When I spoke with her mother, I discovered that she had not spoken to her daughter about menstruation and how to properly manage it, nor was it discussed in her school.
I treated the girl and educated them both on menstrual hygiene. I told them that if they could not afford pads, she should use clean clothes that have been boiled in water to disinfect them. I told her to use clean water, not just soap, to wash herself, and that her underwear should be cleaned every day. I am glad to say that the girl has recovered fully and now understands how to take care of herself, especially at that time of the month. I urged the mother to support her daughter and talk to her about her period as a normal part of being a woman.
As a physician, I often see girls in this age group with infections and discomfort caused by poor menstrual hygiene. Most of them have no money to buy sanitary products. They receive little or no information about how to manage their period and are reluctant to talk about it because of a culture of secrecy and shame around menstruation. Most of these girls avoid school during their period, setting them back in terms of their studies and future success. This is a very high price to pay for something that is completely normal.
I fully support Nigerian Civil Society Organisations (CSOs) that are now advocating Menstrual Hygiene Management (MHM) teaching in schools and debunking myths and taboos around menstruation. We urgently need a national initiative to educate the whole population and ensure all girls have access to menstrual products and clean, safe places where they can change their pads and dispose of them, especially in schools. We need to include boys in the education about menstruation because this will help to get rid of the culture of secrecy and shame that is having such a terrible impact on girls’ lives.
Speaking as a doctor, husband and father of two girls, we have to stop the silent suffering of Nigerian girls and women around menstruation. I feel it is my duty to speak out for the many girls who I have treated and the millions more who are missing school or have suffered health complications because of lack of support.
The United Nations (UN) estimates that one in 10 girls in Sub-Saharan Africa avoids school during menstruation, with some missing out on 20 per cent of their education. UNESCO says that menstruating school girls in Nigeria face many challenges that cut across religion and ethnicity and are not confined to specific beliefs or cultures.
As this is an issue that affects all women and girls across the country, it deserves government attention. Educators, health officials, policymakers and government at all levels have a responsibility to create menstrual hygiene policies that include provision of free sanitary products to girls in schools and support those who are disadvantaged. They should ensure access to water and safe places for girls and women to manage their period at school and other public places, and most of all they must provide education to girls and boys, as well as their teachers and parents, about menstruation.
Nigerians need to know that secrecy and shame is a real danger to girls’ health and that they deserve proper support.
Dr Tijani Salami is a physician, sexual and reproductive health expert.
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