Overcoming Menstruation Stigma in Cabo Delgado Province, Mozambique

TEXT: Jana Merz – 18. May 2020

Lack of information around menstruation leads to harmful myths and discrimination of girls and women. We show how things can change - albeit slowly - in this story from Cabo Delgado Province of Mozambique. 

The Cabo Delgado Health Promotion Program is funded by the Swiss Agency for Development and Cooperation and implemented by the Provincial Government of Cabo Delgado and Helvetas. Simavi provides technical assistance to the menstrual health management component.

Nanhomane B village: Private latrines and honest conversations

Home to approximately 775 people from 140 families, Nanhomane B was one of the first villages in the northernmost province of Cabo Delgado in Mozambique where Helvetas implemented the menstrual health management component of the Cabo Delgado Health Promotion Program.

Each household now not only has an improved and private latrine made from local materials, including a private bathroom for the women, but the community also speaks openly about menstruation.

Before the implementation of this program, menstruation was a topic that was not discussed - says Regolo Medona, the governmentally appointed leader of the village. Conversations on the topic were forbidden - between a husband and a wife and even between a mother and a daughter. It was believed that it would cause a death in the family.

Antonio Neto Aluar
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Ramija Elias
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Nanhomane B, Ancuabe
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Nanhomane B, Ancuabe
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Before the construction of the latrines, women would have to go to the field where they would dig a hole and discard of the capulana - a type of a sarong worn primarily in Mozambique -  they use to manage their menstruation. They would also walk to the water point, which lies a kilometer away from the village, to wash themselves.

The new private bathrooms also provided the women a sense of privacy, not possible in the common bathrooms. The lack of privacy caused deep unease for the women, who were taught that their menstruation should not be known to anyone and felt ashamed by the menstrual blood and coagulant left in the latrines. They would also feel uneasy leaving their cloths to dry, with some women opting to place them under their mattresses or under the floor mats next to their beds, or against their bodies, rather than leaving them hanging in the shared area of the latrines.

Antonio Neto Aluar speaks of how he would sleep badly due to his wife placing her cloths under their mattress to dry. He thanks the program as his wife now puts her cloths to dry in the privacy of her newly constructed latrine, and his mattress is no longer damp, allowing him to sleep well at night. Antonio himself did not know what menstruation was until he was 38 years old, with no information ever being transmitted to him, until the implementation of this program. The topic was never discussed with his wife or his children as it was a secret, but now it is openly spoken of within his household.

Hesitant to talk, Ramija Elias still feels uncomfortable to discuss menstruation openly. Her mother, who Ramija sees as her person of confidence, a strong believer in the myths and misconceptions that shroud the topic, prohibits her from going to the field to work during menstruation in fear that this will cause the crop to stop growing. Ramija is also not allowed to cook family meals during this time. It is believed that if a menstruating women adds salt to the food, the teeth of the person who eats the meal will fall out. While she now has a bathroom at home, she speaks of the time before when the women and girls of the community would have to go to the water points, which are situated one kilometre away from the village, to clean their capulana cloths. They were taught by their elders during their rites of initiation that menstruation was a secret that should not be shared with anybody. When men or boys came to the water points, the women and girls would hide their cloths and any other signs that may allude to the fact that they were menstruating, out of a feeling of shame and embarrassment.

«Menstruation is a natural phenomenon and therefore should be treated as such, not hyped up nor hidden.»

Adelaide Yawinre, from the community of Nanhomane B, Mozambique

Nojica village: The "Great Secret" or a natural physical process?

In the village of Nojica in Montepuez, the stigma surrounding menstruation is still strong. 8 women, 15 men and the children of the community participated in a village meeting in January this year, and despite the number of people present, very few spoke, with the little who did still referring to menstruation as a “great secret”. Before the implementation of the Health Promotion Program, the community went to the field to use the bathroom, meaning that menstruating women would suffer greatly due to the lack of sanitation as well the lack of privacy, needed for their peace of mind but also due to the large stigma surrounding menstruation. The program’s promotion of latrines has not only improved the health and peace of mind of the women in the village, but the sanitation of the village as a whole, with the community describing it to have previously been littered with improperly managed human waste.

While she is now open and comfortable with the topic, when Adelaide Yawinre first started menstruating she fled to the forest. She was scared and confused as to why she was bleeding - there had been no open conversations and education on the topic. She tried to stop the bleeding with leaves in the forest but, to her dismay, it wouldn't stop. Upon her return home, while the community knew what was happening, no one talked to Adelaide about it, as it was considered a grand secret that mustn't be talked about, causing her to feel isolated, frightened and alone. Thanks to the menstrual health management training and information provided by the Health Promotion Program, Adelaide is determined to ensure that her daughters and granddaughters are taught what menstruation is, as well as how to look after themselves, so they do not have to suffer the same way she did.

Rosa Lucas
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Communidae de Nojica
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Communidae de Nojica
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Nojica, Montepuez
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Before the implementation of the health program, Rosa Lucas would have to travel the two kilometers to and from the well to clean herself as well as her capulanas. In the shared space of her home, she would hide her cloths out of shame and discomfort. Now with the construction of the new private bathroom for herself, complete with a decorative palm tree which Rosa proudly shows off, she can clean herself at home with privacy as well as having a safe place to dry her clothes without having to feel uncomfortable. When she first started menstruating, Rosa endured harassment and discrimination, isolated during her time of menstruation by her peers who believed she had an illness. Another misconception came from her mother and grandmother, who told her menstruation was a disease caused by spending time with boys.

Despite having suffered greatly due to this discrimination, Rosa wishes to continue this practice with her own daughters as she believes that it is tradition. The practice of girls being harassed and told they have illnesses before telling them what is actually happening when they start menstruating has been passed on for generations in her community. She also believes that it teaches girls “the valuable lesson to not run around with boys”.

In conclusion, the Health Promotion Program has made great strides in terms of not just how the women in these communities manage their menstruation, but also in how menstruation is perceived. However, the stigma surrounding menstruation is an issue that is difficult to eradicate due to how it has been ingrained into culture through generations of tradition, which was prominently seen in the community of Nojica. Therefore, while the Health Promotion Program has made a great deal of progress, there is still so much to continue to do to move forward, progression that must be made without destroying culture and tradition, but rather evolving it to be more just to all. 

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