Why we need to engage men to end period stigma
Maria Hawranek: Behind you, there is a sign that says "The Shit Lab". How come you became involved in the subject of menstruation? And you didn't just stick to toilets? I know that football was a big part of your life, too.
Thorsten Kiefer: In my old life, I was a human rights lawyer. I wrote my LL.M. thesis on the human rights to water and sanitation, and later did advocacy work in this field, including for an international NGO based in Geneva and the UN Special Rapporteur. Back then, I was also a huge football fan. In 2010, there was the World Cup in South Africa. At the time, The Lancet, a leading British medical journal, published new data indicating that diarrhoea caused by dirty water, lack of sanitation and poor hygiene was killing more children in sub-Saharan Africa than malaria, HIV/AIDS and measles combined.
I thought that this was THE opportunity to get people to start talking about diarrhoea. I asked colleagues in various organisations: why don't we propose David Beckham to be a toilet champion? But they would knit their eyebrows, "Let's stick to education". Everyone preferred to combine football with pretty themes. Eventually, I called a friend who is the legal director of Bayern Munich and asked him if he could ask Bastian Schweinsteiger to become a champion for toilets and hand-washing in Africa. Bastian liked the idea and said “yes”. He was followed by Michael Ballack and Didier Drogba, who at the time was the greatest role model for any kid in Africa. Nine months later, we launched a campaign with football stars as role models for sanitation and hygiene in eight African countries to make people think, feel and act differently about sanitation and diarrhoea. I thought this would pass after the championships. But partners reached out to us, "We need more such campaigns!" Organisations from India have come forward, "We have an even bigger problem with hygiene, and we have a sport, cricket, which is really popular here. What can we do?" Before we knew it, we were transferring the concept to India.
Can you tell us about your first big sanitation campaign in India, which you carried out in 2012?
It was called the Clean India March (Nirmal Bharat Yatra), and it was a travelling carnival that started in central India and moved all the way to the North. 200 crew members, 30 buses, like a circus. We created festival towns where politicians would speak, with dozens of fun hygiene and sanitation games for children and adults. In some places, 10,000 people would show up every day. Our key partner in the government was the Minister of Rural Development, Jairam Ramesh. In India, everything related to sanitation is a big taboo and it is only dealt with by Dalits, the “impure”, the “untouchable”. If you are a brahmin, for example, you don't even talk about it. For a brahmin and a minister to become a sanitary champion was a big deal. He went as far as to say, "We have enough temples, we need toilets now." In response, Hindu nationalists would gather in front of his house and pee into his garden. He caused protests in the streets. He was very committed and yet the day before the campaign started, his assistant called us and said, "The minister is happy to be a toilet champion, but this whole menstruation thing is too much, you cannot talk about this at his press conference." We had a big stand-off at the end of which he gave us the ok. When he visited the campaign, he could see the enormous lines of women and girls were queuing up outside the menstruation information tent called the “MHM Lab”. This gave the minister food for thought. Six months later, menstrual issues became part of India's water and sanitation policy. It was a great step forward. But the enormous resistance we faced became one of the reasons why we decided to make menstruation a priority of our work.
And the other reason?
It was personal. During the campaign, we did workshops in schools and met a lot of girls. One such girl was Khushi. She lived near Bettiah, in northern Bihar, a very rural region that is among the poorest in India. She told us the story of her first period. She was walking to school, which was miles away from home, and suddenly felt something between her legs. She put her hand there and saw blood on her fingers. She told us that she knew immediately what that meant. She had cancer and was dying, right now. She turned around and, in a panic, ran home, praying to get there alive to say goodbye to her mom and dad. When she arrived, her mother explained to her that she wasn’t dying. She was a woman now. Try to imagine what Khushi must have felt. And what an entrance into adolescence it is! We know from research that the beginning of puberty, i.e., the moment at which girls get their first periods, is also the moment at which their self-confidence is at its lowest. Even for girls who are prepared for this moment.
I was deeply touched by this story and still am. I am also a father of a girl. We can’t let things like this can't happen in the 21st century.
Why should I, a woman, talk to you about my period at all?
Millions of women around the world continue to be excluded, stigmatised and held back from achieving their full potential simply because they menstruate. This all goes back thousands of years. When the authors of the Bible wrote that a menstruating woman is impure for seven days, I’m sure it wasn’t a woman who wrote that. And today, it's not women who exclude and stigmatise. Let's be honest: we, men, are the problem. You can't solve the issues related to menstruation with half of the population being out of the picture. We need men to be part of this conversation. To end period stigma and period poverty, we need to change to how think, feel and act about periods.
Why? Women's movements have been able to move so many things forward on their own. Maybe we'd manage also in this case.
Men constitute half the population and, unfortunately, men still hold most positions of power in business and politics. We have to engage men to ensure that menstruation is seen as what it is: not just a women’s issue, but a human issue that concerns all of us.
We need men to tackle the stigma surrounding menstruation, which we believe is the root cause for all other issues. Yes, we have a problem with access to products, education and adequate infrastructure, but in our opinion, these are all symptoms of the fact that menstruation is surrounded by taboos and stigmas. If we talked about it more openly, without shame, we would have noticed long ago that education about menstruation should be part of the school curriculum and that we need to ensure that every has access to menstrual products. There is one reason why these issues have been overlooked for so long the silence, taboos and stigma surrounding periods.
Menstruation is one of those old, very strong cultural taboos that have been used for centuries everywhere around the world to exclude women from participation in society, exercising power and decision making, and that are still present in our communities today. It's time we make period stigma history. It is, after all, absolutely unacceptable and absurd that in our times, defined by space exploration, electric cars and online shopping, periods are still a thing we! As activists and advocates, we have to reach beyond our bubble and take the conversation to the mainstream of society. We have to talk about it with boys who enjoy watching gallons of blood in every other scene of "Game of Thrones", but become paranoid when they see a used tampon. We have to engage them, too. Men have a big role to play here.
What role is that?
Over the past decade, I've learned that when it comes to menstruation, a fellow guy with a beard just is a much better messenger to engage other men. When men hear from women about menstruation, they tend to push it aside as a “women's issue”. When the story comes from another man, they can’t do that. I realised that when I spoke at a social event for a private bank in Hamburg. The previous speaker, also a social entrepreneur, already talked about water and sanitation around the world, our leading topic at WASH United. So, I decided to talk about menstruation. Imagine this: a room full of multi-millionaires, mostly men in their sixties. When I used the word "menstruation", the room went so quiet you could hear a pin drop. And it remained like that throughout. There were three women in the room who came to me later to tell me how helpful that was to get men to take menstruation seriously. So, I'm trying to be an ally to all the amazing female activists and advocates out there by helping to engage men in the conversation.
The prevailing notion is that period-related problems such as period poverty and strong taboos are associated with countries in the Global South, mainly sub-Saharan Africa and Southeast Asia. In India, for example, 50 percent of girls do not know what is going on when they get their first period. In Uganda, half of them do not go to school for this reason. And yet, in both the UK and the US, many women still cannot afford to buy hygiene products and have to rely on rolled-up toilet paper, for example. In Poland, every fifth woman believes that she cannot pickle cucumbers during her period, and over 30 percent – that they cannot get pregnant. And what kind of problems related to menstruation do we have in Germany?
We have long had a feeling that something is wrong with period education – for example, when my son was supposed to have sex education in school, in sixth grade at the time, his teacher asked if a parent with a related profession could come and talk about sexuality and menstruation. A boy whose mother was a midwife came forward, she came and talked a bit about the topic. What if she hadn’t done that?
Two years ago, together with the start-up einhorn, we surveyed women, girls and teachers to get hard data on the state of period education in schools in Germany. The results shocked us. Only 17% of women felt well-educated by schools. For more than 30%, classes were too late and more than half say that it was embarrassing. 80% of teachers think that the materials available to them are insufficient, and nearly half believe that schools are doing too little to address the issue. You can see a huge gulf between the needs and the reality. We conducted another survey in companies, and it turned out that half of men do not know that women have certain challenges related to menstruation, such as cramps, which may require a break from work or medication. Half of the women said that they were uncomfortable in social situations during their periods. There is a huge problem with how periods make them feel. Menstruation is very much of an issue in developed countries, including in the heart of Europe.
In this context, do you really consider your goal of ending period stigma by 2030 to be achievable? Or is it just a catchy slogan?
Do I really think it's possible to create a world in which menstruation is normal, where there is education, access to products and no stigma for women and girls? Yes, absolutely! The progress we have seen in terms of fighting the stigma in recent years is staggering! For example, on Menstrual Hygiene Day in India, our campaign hashtags have been trending on Twitter. Thousands of young people publicly talk about an issue that still was completely silenced very recently. I am convinced that the stigma is a problem that we can solve within one generation. The issue of access to sanitary protection is also not difficult. Let's be honest, technologically speaking, it’s not rocket science. Sanitary products in various forms, reusable, almost cost-free, are manufactured on a mass scale, also in developing countries. In India, many women use cotton cloth, which can be a hygienic solution. I believe that it is possible for every woman and girl to have access to knowledge, products and an environment enabling a respectful conversation about menstruation in nine years' time. In recent years, we have been seeing an increase in the number of organisations and governments willing to tackle this problem. We have the technology and organisations ready to operate on a larger scale. Many of them are waiting in the wings.
What's stopping them?
Dramatic underfunding. Our sector is excited when a government pledges a million dollars to this end. As a one-time donation. Think about it: we're working on an issue that affects half the world's population! The largest philanthropic sponsor in this field is The Case for Her, a collective of just two passionate women from Sweden. They are amazing, but the fact that they are the biggest philanthropic investor is a joke. So yes, I believe that we can create a world in which menstruation is normal in nine years, but not with the funding we have now. We need to mobilise the resources needed to scale our action NOW.
How exactly is celebrating Menstrual Hygiene Day going to help? Because, you know, there's also Chocolate Day and Koala Day.
When we came up with this day in 2014, nothing was happening in terms of advocacy and awareness at a global level. We realised this when we came back from our big campaign in India. We were wondering what we could do about a matter around which was surrounded by such a thick layer of taboos and stigma. How do even break through such a crust? My colleague Ina, the international coordinator of MH Day, came to the conclusion that scattered voices here and there would have no chance of success. But what if we bundle the voices out there, like a laser beam. What if there was a dedicated day of action? The cycle is 28 days long, the period usually lasts for 5 days, so May 28, Menstrual Hygiene Day. It even rhymes. In addition, the weather in Germany is always good around that time (laughs). We didn't ask for anyone's permission. If enough people think something exists, it exists.
I was wondering how you can establish such a day.
There are two ways. You can come up with such a day and get official recognition by the United Nations. Then it’s run by UN agencies. The large UN agencies have many advantages, but agility, flexibility and creativity are not always their forte. We work very closely with all major UN agencies who celebrate the day around the world, including on the official UN twitter channel.
Menstrual Hygiene Day is a movement any organisation and individual can easily join and add their voice. We managed to bring together more than 700 partner organisations from all over the world who speak with one voice. We always set broad themes like “It’s time for action!” that are relevant for all partners, no matter what they focus on. We also provide a whole lot of communication materials, which organisations can combine with their own logos and their own, locally relevant messages. Our focus is on strengthening the movement, not our own organisation. You will not find WASH United’s logo anywhere on the materials. I'm one of nine people at WASH United, and half of us work on the campaign. We can have such an outsized impact because we fully focus on empowering our partners.
Then tell me how this Menstrual Hygiene Day moves the needle.
Our first task was to make society perceive menstruation as an important topic, hence our first campaign hashtag was #menstruationmatters. Then we tried to involve politicians and decision-makers to increase the political relevance of the topic. Our next job is to translate this social and political weight into financial commitments. The year of COVID-19 made it more difficult, which is why we are still focused on strengthening the political relevance. But we cannot wait until the end of the pandemic for governments to step up investment in menstruation. To end period poverty and stigma by 2030, we need more investment now.
In which countries are you seeing results? And of what kind?
In seven years, we have grown to a movement of nearly 700 partner organisations, from tiny NGOs in sub-Saharan Africa, which comprise one or two people, to the World Bank and various government agencies around the world. A year ago, we generated 4,100 articles about Menstrual Hygiene Day – and I'm only talking about online media, there's still radio, TV and newspapers, as well as 151,000 social media contributions, which are not likes or comments, but personal publications of posts on the topic. Through digital channels, we reached more than 410 million people with a positive, taboo-breaking message. If you hired a creative agency, you would have to pay about 60 million dollars to achieve such results. Our movement achieved that for less than a percent of this amount. It's a very efficient way to build awareness and make people think and communicate differently about this matter. The topic was trending in India, Nigeria, and Kenya. In Kenya, more people took part in Menstrual Hygiene Day than in the US. About 60 percent of our partner organisations are from sub-Saharan Africa, so the movement is very much led by countries in the Global South. More people are getting involved, more people are talking about it, more governments are taking action. Activists take advantage of this day to invite politicians to speak, and they are happy to come because they know there will be media and people. We direct the spotlight. It is then that many of the steps taken are announced, such as the abolition of taxes on sanitary products in Tanzania or the announcement of Kenya's menstrual policy and strategy. Two years ago, Procter & Gamble announced on this very day that it would educate 50 million girls about menstruation. Our create pressure to act – and people react to that pressure.
What's that on your wrist?
A Menstrual Bracelet. It’s a global symbol for menstruation and MH Day. 28 beads, five of which are red. By wearing it, people around the world show that periods are nothing to be ashamed of.
Thorsten Kiefer – founder of the non-governmental WASH United (Water, Sanitation and Hygiene) organisation, initiator and coordinator of Menstrual Hygiene Day, activist. A lawyer specialising in human rights. Member of the Ashoka association.
Author: Maria Hawranek
Illustration: Marta Frej
The text was published in "Gazeta Wyborcza" on 28 May 2021
