DOI: 10.31038/AWHC.2020322

Background

The entire world was celebrating the New Year eve (December 31, 2019) but China officially informed to World Health Organization (WHO) about the unknown illness that later known as Corona Virus or COVID-19. The novel Corona virus labelled as pandemic by WHO in March 11, 2020 [1]. The impact of pandemic different to men and women and even more deeply and widely affected in the areas where countries are under conflict or post conflict or traditional [2]. In this response the variety of professional are working so hard around the clock where the 70% workforce (among 104 countries) represented by the women workers as a doctors, nurses, social workers, kitchen workers, security personnel and so on [3]. Each crisis situation intensifies the gender inequality and the COVID-19 further intensifies the affect against girls, women and menstruations [4]. This is supported by the idea of women are missing [5].

Roughly, half of this planet is occupied by the women no matter where they are. She could be anywhere but only visible as doctors, nurses or security personnel. Women are everywhere either at COVID-19 laboratory or kitchen of hospital or home or refugee camp or migrant workforce or conflict or anywhere. Indeed, women are everywhere but she is nowhere. The COVID-19 does not cease the menstruation of women regardless of women working in laboratory or patient at ICU or women under lockdown. Globally, the first time in a history that the demand of menstrual products as part of Personal Protection Equipment [6].

More importantly, the stigma, taboo and restrictions during menstruation is practicing across globe with variation on forms and severity. And globally, the menstruation as ignored and side silenced issue in development and human right till now. Furthermore, the dignity during menstruation or dignified menstruation is further unrecognized by the global community [7] . Paudel described the dignified menstruation as `as virtue of human being, each girl, women or menstruators deserved the dignity during menstruation. It is a state of free from any forms of abuse, discrimination, violence associated with menstruation no matter where the menstruator lives. In other words, there should not be difference between 25 and 5 days in a month, throughout the clock of 365 days because of menstruation’ [7].

Objective

The main objective is to assess the space for women amid COVID 19, Pandemic from the perspective of menstruation. The specific objectives are:

Objectives:

I. To understand the impacts of menstruation amidst COVID 19, Pandemic.

II. To examine the global policies and actions towards menstruation around the amid COVID 19 Pandemic, response.

Rational

The Secretary General Antonio Guterres constantly emphasised that the fighting the virus for all of humanity, with the most affected people: women, older person youth, low wages workers, small and medium enterprises, the informal sector and vulnerable groups. In a way, there is no visible need of menstruation and the other way round there is menstruation across all kinds of people.

Once the WHO confirmed the Pandemic for COVID-19, the global community starting from the UNs, governments, NGO and individuals are relentlessly are working for combating with amidst COVID-19 which is happening about a century after. In course of century development and human right discourse, world has been accomplished so many concerns related with women including for menstruation. The varieties of concepts around menstruation were emerged: in 2012, the UNICEF and WHO (Menstrual Health Management), in 2014, the UNSECO and Human Right Council, Water and Sanitation (Menstrual Hygiene Management) and in 2017 Nepal government (Dignified Menstruation). Additionally, the menstrual stigma, taboo, restrictions also discussed as factor for the construction and shape the power starting from childhood and it is a serious cause for provoking the gender-based violence [7].

Methodology

This quick review is under the qualitative, post-positivist world’s view. The data primarily secondary through the internet. The news, policy papers, statements etc. released by the various organizations and available in google during state of lockdown globally. Regards to timeline, it limits between the announcement as pandemic for Corona virus and till April 24, 2020 (total 44 days). However, the primary data also included through various webinar special focuses on menstrual health and hygiene and some observations of live press meets. In a way, the global perspectives assessed as provided by context.

Findings

1. Impacts of menstruation during response amidst COVID 19, Pandemic

Wuhan, an epicenter of The novel Corona virus of China and first city globally, where the front lines female workers were under physical and psychosocial pressure due to stigma and the government did not considered the menstrual products as essential supplies during COVID-19 response [8]. Likewise, the female front-line workers were talking birth controls for avoiding menstruation due to stigma and not supply of menstrual products [9] Jiajia, further shared the impact of menstrual taboo on urinary tract infections that associated with the discussion and supply of menstrual products.

In the same vein, the leading the way organization, WHO, to defeat against novel Corona virus in many ways but missing to acknowledge the needs and urgency of menstruation. It released a document in 18 March 2020 on mental and psychosocial consideration where it displayed message for general population, health workers, team leaders of health facilities, elder adults and people in isolation where the impacts of menstruation (before puberty, puberty, reproductive age, menopause) missed at all [10]. The WHO is also shown inconsistence on what it believes on menstruation (2012) and health’s definition since 1948.

2. Examine the global policies and actions towards menstruation around the amid COVID 19 Pandemic, response

Followed by the WHO’s confirmation of pandemic for novel Corona virus, the global organizations, networks, governments, NGOs, individuals who are working around women’s menstruation, peace, right, empowerment etc. are releasing the petitions, statements through online. This study attempted to examine to what extend these policies or documents reflects the needs and importance of holistic approach of dignified menstruation.

WHO is the leading organization for the COVID-19 responses globally, keeps releasing the resource materials for prevention of novel Corona virus, management of Corona positive patients, promotion of human right through various aspects etc. However, the WHO remained silent at all to response the direct and indirect needs arise from menstruation. Before the COVID-19, WHO recommended for gender transformative policies to address participation, inequalities, gender-based discrimination on pay, employment but not speak how menstruation plays in enabling work spaces [3].

For instance the seven points forwarded by the NGOWG to the security council with the demand for women’s right must be centre for response to COVID-19 [11] . This document is just reiteration of the documents, policies because these points do not visualize the specific actions directly what, where or how? The points number two (Require rights-based and age-, gender-, and disability-sensitive pandemic responses) and the point three (Prevent and respond to gender-based violence) are just coming through decades but not represent the need of menstruation and the role of menstruation in heighten the violence against girls, women and menstruators.

“Point 2: Require rights-based and age-, gender-, and disability sensitive pandemic responses: COVID-19 responses must be grounded in data disaggregated by gender, age, and disability and intersectional analysis that recognizes the gendered impact of the crisis. Point 3: Prevent and respond to gender-based violence: Take necessary measures to prevent, address, and document all forms of gender-based violence, particularly intimate partner violence and other forms of domestic violence’’.

The gender analysis is very common jargon but it does not provide a single clue to intervene the needs associated with menstruation e.g. status of menstruation or choice of menstrual products. Likewise, during COVID-19 response, the girls, women and menstruators are working as frontline workers or at refugee camps or migrant workers or disable or transgender to anyone under the lockdown characterized by quarantines at home or shelter, isolation, travel restrictions, social distancing, and curfews. In this condition, maintaining the stigma, taboo or restrictions is merely impossible thus the chances of increasing violence are high but not recognize at all. In addition, the menstruators are double victimization from the existing the stigma, taboo, restrictions during menstruation and the laws imposed by the governments for COVID-19, Pandemic response.

The almost all organizations and networks included UNs, Asia and Pacific Region; INGOs are primarily recommended for SRHR (Sexual and Reproductive Health Right). SRHR primarily focused on family planning, safe abortion, maternal and child health, adolescent health [12].

The dedicated organizations on menstruation are responding COVID-19 through producing the masks, hand sanitizers. Their surveys were floating over internet and listserv for assessing the supply chain and needs or menstrual products. Few are busy in infographic on importance of hygiene related info and only very few organizations working for promotion of dignified menstruation.

Discussion

The organizations which supposed to stand for dignity, equality, respect have already been working for many decades such as 72 years for Human Right Declaration and WHO (1948), 41 years for Convention on the Elimination of all Forms of Discrimination against Women (1979), 25 years for Beijing Declaration and Platform for Action (1995), 20 years of Security Council Resolution 1325 (2000) but the accounting of women as human being is always missing specially the menstruation. The veil of silence around menstruation play as vicious cycle for sexism and gender equality and 80% of participants of 2015 survey experienced disadvantaged position in society due to menstrual stigma [9].

Focus not for the biological need; menstruation

The entire focus of COVID-19 response fully directed as requirement of men’s protection like Personal Protection Equipment (PPE) and other essentials. It is observed that almost all global or national authorities showed the men members while conducting the press meets and highlighted their needs, demands, and challenges. They seemed so serious for the death and infections from novel Corona virus and focused on medical supplies, equipment and explorations for it. The official relief package also comprised the items except menstrual products. For instance, Government of Nepal relief package for wage labor included 30 Kgs rice, 3 Kgs pulse, 2 Kgs salt, 2 Liters cooking oil, 4 packed soap and 2 Kgs sugar [13]. It is clearly shown that both either ignorance or silence or taboos embedded within the minds of authorities. The menstrual products are not considered as either important logistics or relief packages among authorities or except small or focused organizations. Authorities even ignore to listen the demand of menstrual products and compelled to talking birth control pills [8]. The psychological trauma and hormonal impact on her body is inhuman condition indeed. The oral contraceptives could create the other impacts on her body such as increasing rates of amenorrhea over time, irregular and unscheduled bleeding [14].

Menstruation is nowhere and everywhere under SRHR

The history of sexual and reproductive health is already more than 25 years, fourth international conference on Population and Development in 1994 [15]. Despite having huge scope, it merely talks about the menstruation and its complexity and multifaceted nature on the life of girls, women and society as a whole [12]. The SRHR intervention package clearly showed the ignorance and silence around the need of menstruation (comprehensive sexuality education, counselling on modern contraceptives, Safe motherhood and neonatal health, safe abortion, HIV/STIs, SGBV, Reproductive cancers, infertility and sexual health and well-being). It is concluded that menstruation is very everywhere and menstruation is nowhere. The entire elements of comprehensive SRHR package have indiscernible relationship with menstruation but it is vague to understand the position of menstruation or no observable discussion at all. It is assumed that the ignorance and silence among SRHR actors including WHO even today.

Menstrual Hygiene and products are not demystifying the stigma, rumours and restrictions around menstruation

The menstrual hygiene and products are essential elements of the dignified menstruation which get more attention since 2014. However, the hygiene and products do not guarantee of the dignity of girl, women and menstruators at all. As like China, due to stigma, taboos and restrictions around menstruation, either the demands of menstrual hygiene and products heard or incorporate in to the essential logistics of COVID-19 response or distribute properly to the needy people. For sustained supply of menstrual hygiene and products, incorporate in to the policies and plans, the breaking silence, bursts the myths, rumours and restrictions, is urgent.

The female frontline workers do not represent the women who are vulnerable amid COVID-19

The half of the earth’s population scattered as poor, rural, refugee, migrant worker, women in informal sector, disability, sexual minority, women at isolation, quarantine, conflict and so on. They are living with travel restrictions, limited spacious rooms or tents or quarantine or camps or abusive partners or strange people. The resources for living such as food, toilets, water, soap, hand sanitizers, menstrual products are limited or could be unfilled. It is concluded that the almost all discussion do not account the women who are living except as front liners. They also menstruate about 3000 days in life and about seven years of reproductive life. They also have so many issues with before puberty, puberty and menopause.

Conclusion

Since 2014, menstruation gets more space in both development and non-development sector globally but the dedicated funds or programs yet to planned for achieve the 2030 agenda, `Leave no one behind’. The holistic approach of dignified menstruation could be the tool to address all issues related with menstruation including SRHR, human right and empowerment. Because of talking about dignity during menstruation allow to discuss about the stigmas, taboo, restrictions during menstruation that is supported by the Jiajia Li [9].

Globally the gender-based violence is increasing; 30 in France, 25% Argentina, 35% in Singapore [16]. The menstrual stigma, taboo and restrictions have significant role for the power construction thus the silence of the menstruation is a key underlying cause for increasing gender-based violence.

Recommendation

This COVID-19 is not only the challenge but also the opportunity to understand the complexity and multifaceted nature of menstruation before, during and after the crisis. In the twenty first century, the world has to learn and ready to shift for not only COVID-19 management but also shifting around peace, human right, and empowerment. The global community encourages leaving the blaming and naming around menstruation and having to move forward for the sake of planet as whole.

In specific manner, the following things need to consider in coming days:

• The disaggregated data has to have the menstruation and choice of products.

• The dignified menstruation and gender analysis policies and plan instead of gender analysis in silo. That guarantees the revision of logistic plan or essential supplies for crisis.

• The SRHR elements also need to revise to include the dignified menstruation

• The activities have to plan and implement by endorsing the indicators of dignified menstruations or beyond the infrastructure, hygiene or products.

• Without robust feeling of confidence and dignity, hard to report or fight back against gender-based violence. Thus, mainstreaming of dignified menstruation in to empowerment and human right would be the catalyst tool to prevent and response of the gender-based violence.

Delimitation of the study

This study delimited within 44 days of the emergency of COVID- 19, internet-based desk analysis.

Funding

This is no any funding or any assurance for the study.

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