Period Poverty Isn’t Just About Free Sanitary Pads

Period poverty refers to a lack of access to menstrual products, sanitation facilities, and adequate education about menstruation. It is also about lacking access to girl-friendly, functioning toilets.

The term “period poverty” was alleged to have come into existence in 2017 when Unicef and WaterAid reported that more than a third of girls in South Asia miss school during their period, mainly due to a lack of access to toilets and pads in schools and no proper education about menstruation.

To effectively manage periods, girls and women require access to Water, Sanitation and Hygiene (WASH) facilities; affordable and appropriate menstrual hygiene materials; information on good practices; and a supportive environment where they can manage menstruation without embarrassment or stigma.

According to the World Health Organization/ Unicef Joint Monitoring Programme 2012, menstrual hygiene management (MHM) is defined as:

“Women and adolescent girls are using a clean menstrual material to absorb or collect menstrual blood, that can be changed in privacy as often as necessary, using soap and water for washing the body as required, and having access to safe and convenient facilities to dispose of used menstrual materials.

“They understand the basic facts linked to the menstrual cycle and how to manage it with dignity and without discomfort or fear.”

MHM indicators include the availability of soap and water within girls’ toilet cubicles and the existence of waste disposal facilities.

In 2004, Kenya became the first country in the world to abolish period product taxes. In 2017, President Kenyatta signed a law mandating Kenyan schools to provide free sanitary napkins to all female students. in 2018, Kenya (population of 55 million) planned to supply 140 million pads to schools countrywide.

However, unreliable distributors and theft resulted in only a portion of the pads from the government distribution project making it to schools.

The Malaysian government removed the “pink tax” on feminine hygiene products on June 1, 2018, joining Australia, India, Canada, and Kenya as the handful of countries without a “tampon tax”.

On August 16, 2022, Scotland became the first country to offer free tampons and pads. The Period Products (Free Provision) (Scotland) Bill was passed on November 24, 2020, ensuring that schools, universities and local authorities must provide free period products to those who need them (in pharmacies and community centres).

On December 12, 2022, the new Malaysian Health Minister, Dr Zaliha Mustafa, announced that the Ministry of Health (MOH) would provide free sanitary pads to staff, beginning with her own office at the ministry building, and possibly extending it to the rest of her ministry.

This created a lot of negative reactions among netizens. Why MOH staff (only)? What is the budget? What is the ROI (return of investment)? At what opportunity costs? Could this money be more cost effectively spent?

I do not know how many Malaysians know that another ministry had already been giving out free sanitary pads! This precedent gives us a very good guestimate of how much this new “MOH pad project” will cost the taxpayer in a year.

On July 20, 2022, the Women, Family and Community Development Ministry said the government had so far spent RM2.39 million (77 per cent of its allocated RM3 million budget) on sanitary napkins for bottom 40 per cent (B40) students as well as educational programmes about hygiene.

On August 1, 2022, Sibuti MP Lukanisman Awang Sauni from GPS, who is now the deputy health minister, asked about the status of the monthly assistance of free basic personal hygiene kits to 130,000 B40 female teens as tabled in Budget 2022, and whether the assistance had reached teens in rural and remote areas and the Orang Asli communities.

Siti Zailah Yusoff, the then-women, family and community development deputy minister, said the federal government had allocated a total of RM10 million for the initiative under Budget 2022, with RM3 million going to the Women, Family and Community Development Ministry and another RM7 million channelled to the Home Ministry.

A total of 130,000 teens from selected B40 families had been given hygiene kits. They were from 1,024 secondary schools in urban and rural areas. The sanitary pads were to be supplied for a period of 12 months in phases through the district education department.

The second phase for the next eight months will be distributed to the same teenagers by the Prisons Department. (It was not clear from this report why the Prisons Department were involved in this distribution to the same students, rather than through their schools or education department).

RM10 million for the provision of pads to 130,000 B40 teens in 1,024 schools for one year (2022) works out to be RM77/ teen/ year or RM6.40/ month each. What about the next year(s) and the other B40 teens who were not selected?

How much then should be budgeted for the new “pad project” for MOH staff for 2023?

According to the 2021 MOH Annual Report, there were 256,147 MOH personnel as of December 31, 2021. The Malaysian health workforce is predominantly female in most professions, except specialists and assistant medical officers (AMO).

Assuming that just over half of 256,147 workers in MOH are female (i.e., 130,000 estimated), we might be looking at possibly RM10 million additional “period poverty expenditure” just for MOH female staff each year.

Has this “Pad Project” been budgeted and approved under the 2023 “appreciation incentives for medical personnel” (RM183 million) mentioned by the previous health minister?

Besides buying a 12-month supply of disposable sanitary pads for 130,000 females for one year, what can RM10 million be used for the Ministry of Health?

The 2023 federal budget (which had been proposed by the Ismail Sabri Yaakob government, but not passed before the dissolution of the 14th Parliament) allocated RM11 million to increase subsidised screenings for breast and cervical cancer.

Malaysia has a high prevalence of breast cancer, with one in 19 women at risk of breast cancer. It is the most commonly diagnosed cancer and the fourth leading cause of death among women of all ethnic groups.

According to the World Health Organization, from 2002 to 2012 in Malaysia, 5,410 breast cancer cases were recorded, the highest as compared to other cancer cases (2,245 cervix uteri).

Kuala Lumpur Hospital and Tunku Azizah Hospital in Kuala Lumpur will become reference centres for rare diseases, with an allocation of RM25 million.

For 2023, RM791.5 million had to be approved for the improvement and repair of 2,732 health facilities/ government clinics in neglected conditions, but still operating to provide health care services to the public. (RM10 million will restore 34 such clinics, at RM289,714 each)!

In 2016, RM2.51 million was distributed by MOH to 47 NGOs to conduct various beneficial programmes for the communities.

I think it is great to show our gratitude and appreciation to the MOH staff for their fantastic service and sacrifice, especially through the Covid pandemic.

Perhaps instead of subsidising pads to the ladies, we should give every staff in the MOH a RM100 gift as a one-off in 2023. This RM26.7 million would be money well spent and well deserved. It would be more memorable and meaningful than disposable pads.

Perhaps the whole issue of distributing free pads to anybody has to be re-evaluated for Malaysia? (except mums in labour wards or bleeding gynae cases in hospitals).

Period poverty is not just about sanitary pads. It is also about access to girl-friendly, functioning toilets with washing facilities, water, and bins for disposal of soiled pads.

Perhaps, the RM10 million for 130,000 B40 teens every year could be better spent to repair the toilets in their 1,024 schools, to make sure they are not blocked, or so dirty that they are unusable and impossible to keep clean.

There should be more sinks and toilets (that work) to cater for kids who have only a 10 to 30-minutes break. We cannot blame anyone for running away without flushing if the flush cisterns take 10 minutes to fill, if at all, or are broken? Why not have buckets in each toilet, and tanks of water outside, so kids can use to pour flush toilets and wash?

Low-tech pour flush toilets in the rural areas can be so well maintained by our long house dwellers – maybe schools in rural areas should install them, rather than the high tech cisterns that do not survive. Too many kids are pulling on them in a hurry to get back to class!

Simple bins (lined so cleaners can dispose them safely) should be provided for soiled pads so they don’t get flushed down or hidden behind the cisterns.

Companies selling period products can be induced to operate coin dispensers of such items, including disposable nappies should kids get dirty and need a change. Such dispensers selling products at the lowest price could be maintained by the school PTA or cooperatives, or any office (e.g. MOH).

For the really poor kids (most schools know who they are) perhaps, a fund for subsidised or free pads, but preferably the reusable ones.

It is time to review the colour of school uniforms for our female students. I have no idea why or who chose the colour blue (or for nurses, white). May I suggest a colour change for schoolgirl skirts or kurung in the near future?

Why don’t we use batik (we have such beautiful designs and quality) so that girls will not be embarrassed or fear their school uniform being stained during their period – as it will be less obvious.

A challenge to our innovative Malaysian entrepreneurs and designers! How about designing an eco-friendly, reusable sanitary pad/ panties for the future women of the world? Let’s have a competition. A million dollar price? Feminine hygiene products are a multi-billion dollar industry!

Every year, an average woman trashes 150 kilograms of nonbiodegradable waste. One sanitary pad could take 500 to 800 years to decompose as the plastic used is non-biodegradable and leads to health and environmental hazards.

Most of these pads have over 90 per cent plastics. Each pad is equivalent to four plastic bags.

Dr Tah Poh Tin is a public health specialist and paediatrician from Sarawak.

  • This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.

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