Of Blood and Field Work

Strap yourself for this ride: it’s a rollercoaster (pictures are clickable)

The period struggle is no surprise to menstruating individuals. We are aware of the biological problems that may accompany periods, the practical struggles of maintaining a daily routine with them, and the social stigma that is attached to them. As a country, we are also – fortunately –  changing the attitudes towards periods by either educating the people around us, demanding period awareness from educational institutions and workplaces, building organizations dedicated to spreading period awareness, and implementing community initiatives to address period-related issues. 

In my Fellowship journey, however, I’ve had the chance to venture into less chartered territory. I do find that a lot of resources are dedicated to helping communities, companies, and schools solve period-related issues. But one must consider how period stigma affects menstruating individuals that work to bring about this change. Depending on the local context, menstruating individuals in the development sector can be subject to various factors that intersect to create specific period-related issues, which not only affect their health and well-being, but their ability to do their work as well. Moreover, these issues are often consciously or subconsciously overlooked by their colleagues, and are hidden from communities for fear of retaliation. 

From my chat with Kanta Singh, Deputy Country Representative of UN Women India, I learned that a big part of advocacy is to be vulnerable enough to share our own problems. In writing this post, I hope to use that vulnerability to start a conversation about period-related issues and to encourage others to do the same. To that effect, I will not only share my own experiences about menstruation and fieldwork, but the stories of other women in the development sector as well. This piece is a reflection of the experiences shared during the multiple interviews I conducted, which I hope adds the weight that this post would otherwise lack.

One of the biggest struggles that menstruating people face while doing field work is a lack of access to basic infrastructure. Access to washrooms are often sparse, especially in very remote areas. One would have to visit a nearby government building, which could take upwards of 30 minutes depending on the field team’s location. The other option would be to rely on a local’s house, where the presence of a washroom is not guaranteed. My interviewees have had to change in spare rooms or outside the house, which can cause discomfort and compromise their safety. Moreover, disposing of menstrual products is a huge problem. When I was on a field visit recently, I remember having to spend 12-13 hours either walking or on a bus, which made using a bathroom difficult. When I did advocate for myself and asked to use the bathroom, I was taken to a person’s house. They had a good facility with a squatting toilet, which can make changing a little challenging, but the lack of a proper dustbin combined with the fear of the owner finding out led me to stuff my used pad in a pouch to hide in my bag. I then resumed field work and couldn’t dispose of it until I got back to my accommodation later that night. Another concern is access to period medication and sanitary products. Pharmacies are far and few in between, making it hard for field workers to get medicines and sanitary napkins in a pinch. And given that field schedules are often prone to delays and changes, it’s difficult to predict how much to pack. Menstruating individuals can experience field work delays up to a few months! Some have to pack a year’s worth of supply. 

Say that access is not an issue; hygiene and waste management are still huge concerns. The dustbins used to collect sanitary products inevitably end up in a dump, often ripped apart by dogs and inspected by locals. This led to one of my interviewees burning her used pads out of necessity. Poor washroom hygiene was one of the biggest concerns my interviewees had as poorly cleaned bathrooms can put them at the risk of infection. Even in government buildings, bathrooms were not cleaned regularly, which forced female employees to bring their own products and clean the toilets themselves. Buckets, mugs, or health faucets used for cleaning oneself may not be properly sanitized, and a lack of access to water is also prevalent. These conditions make using menstrual cups a difficult alternative, since they need to be washed between uses. All of these factors subsequently lead to a risk of  UTIs and RTIs (Baker et al., 2017). In fact, in Odisha, where I do much of my field work, the risk of UTIs in women is 45.2% (Das et al., 2015), caused by poor sanitation practices. In these circumstances, the safest option for my interviewees was to ration drinking water to clean themselves and their reusable products.

Finally, stigma is a huge barrier for menstruating individuals as it limits their capacity to do field work. They often do not attend community festivals for fear of offending locals, which means missing out on important discussions with authorities and being unable to build relationships with these communities. A few communities have harmful period-related practices that can cause discomfort to menstruating individuals and prevent them from entering community spaces. These practices are done to purify menstruating individuals, but they often put people’s health at risk. There is also a stigma attached to underwear; in some instances, women or female-presenting people are unable to purchase underwear from male shopkeepers. Finding a woman shopkeeper is futile; women from these communities are usually not allowed to own stores nor pocket money to buy underwear themselves. Women that do use underwear have to hide them after washing to avoid them being discovered by their families. This stigma exacerbates access issues, making periods more unmanageable especially when using standard period products. 

Additionally, colleagues and field coordinators may be ignorant to the needs of menstruating individuals and may even be uncomfortable assisting them. A menstruating individual advocating for their period-related needs can hamper their working relationship with their colleagues and seniors. Leaves and breaks are rare while long, uncomfortable journeys with little to no bathroom breaks are increasingly common. They create hygiene issues since, according to the WASH program at the CDC (Healthy habits: Menstrual Hygiene, 2024), pads are supposed to be changed every few hours to prevent microbial build up. My interviewees often had to take buses and bikes to field sites, which caused a lot of discomfort and pain. Not to mention, field visits are often last minute, leaving no time to stock up on supplies for the journey. 

These suggestions were expanded to include government healthcare facilities, who often have contraceptives on hand, but no period products. In general, government officials would benefit from period sensitivity training, and can become leaders in creating change for menstruating individuals. By ensuring that government offices are safe and clean, menstruating individuals from conservative environments can follow their seniors’ example and advocate for better menstruating conditions in their communities. Improving the general infrastructure in these communities will also have lasting effects on period health, effectively minimizing health and safety risks while making it easier for people to menstruate. This includes improving toilet and water access, implementing sanitation standards, building waste management systems, providing access to sanitary products, and installing incinerators for disposal. My interviewees also note that fertility is widely celebrated in communities. Why not have government officials create festivals to celebrate periods as a part of fertility? Periods are, after all, essential to maintaining a healthy reproductive system, and festivals are a great way to spread awareness about the importance of periods in fertility, conception, and fetal health. 

Finally, to all my lovely readers – advocate, advocate, advocate! Your voice is one to be reckoned with, and your willingness to speak up for menstrual health can make a difference. Help yourself or your menstruating friends by creating a list of items to include in their luggage or in team kits. Carry extras for your colleagues and look out for each other. Support them when they ask for period-related accommodations – an additional voice can do wonders! Take initiative to organize period awareness events at your workplace or institution and ask your HR for help. Collective organizing is a great way to shift perspectives, eliminate ignorance, and demand change. Every little bit can help menstruating individuals in your sector live and work so much better. For if blood is truly thicker than water, then period issues should be at the forefront of communal change. 

Citations:

Baker KK, Padhi B, Torondel B, Das P, Dutta A, et al. (2017) From menarche to menopause: A population-based assessment of water, sanitation, and hygiene risk factors for reproductive tract infection symptoms over life stages in rural girls and women in India. PLOS ONE 12(12): e0188234. https://doi.org/10.1371/journal.pone.0188234

Das P, Baker KK, Dutta A, Swain T, Sahoo S, et al. (2015) Menstrual Hygiene Practices, WASH Access and the Risk of Urogenital Infection in Women from Odisha, India. PLOS ONE 10(6): e0130777. https://doi.org/10.1371/journal.pone.0130777

Fry, W., Njagi, J. W., Houck, F., Avni, M., & Krishna, A. (2022). Improving Women’s Opportunities to Succeed in the Workplace: Addressing Workplace Policies in Support of Menstrual Health and Hygiene in Two Kenyan Factories. Sustainability, 14(8), 4521. https://doi.org/10.3390/su14084521