According to a 2015 study conducted by the Burnet Institute, Indonesian adolescent girls encounter a wide range of obstacles when dealing with their menstrual period which affect their school life.[1] Challenges stem not only from a lack of access to hygienic conditions in school (i.e. available washrooms, fresh pads, clean water), but also from a lack of understanding from their peers, including boys. Additionally, as the topic is perceived as taboo or private for many, it can pose potential health risks if issues are not properly addressed. Now, there is increased acknowledgment of the positive outcomes menstrual hygiene management (MHM) can have on low and middle-income girls’ physical and mental health.
To evaluate the current knowledge, attitudes, and practices of MHM in Tangerang middle schools in Indonesia, Untold Research conducted a large-scale study including a survey of boys and girls enrolled in middle schools, a survey of boys and girls currently not enrolled in school, four focus groups with in-school students, school observations, and in-depth interviews with teachers, school administrators, and even Ministry of Education officials.
The biggest barrier found to proper MHM – and general sanitation – is the lack of student access to soap. While students are either always (84%) or sometimes (16%) given time to wash their hands before eating and most facilities (87%) have water for hand washing, neither soap (87%) nor a soap substitute (100%) is always available. School visits and conversations with school administrators revealed the challenge in keeping soap available for students as many, specifically adolescent boys, like playing with it, from bubble wars in the bathroom to using liquid soap as hair gel. Many administrators expressed frustration with this challenge, and some shared their creative albeit not fool-proof solutions, like securing special dispensers, adding water to discourage misuse, and removing it at the end of the day to avoid students taking it home.
While lack of soap is a serious hygiene problem, it presents a particular challenge for menstruating girls in Indonesia. When it comes to disposing of soiled pads, common practice – informed by their Islamic faith – is to wash the soiled pad before disposing of it, even if it is a disposable pad. This, obviously, runs counter to ideal MHM and sanitation practices and is compromised even further due to the lack of regular access to soap. Only two in five girls (42%) correctly wash their hands before and after changing their sanitary pads which is vitally important to reduce the probability of transferring bacteria from their hands onto the pad and then into their genital area.
Certainly, there is much progress to be made on educating girls on proper MHM as well as a myriad of other complicating factors to proper hygiene for both genders, however, until soap is available in each and every school bathroom, all other initiatives to improve sanitation in schools will have a limited impact.
“The most important thing to explain is when to change the pads and why. To dispose, they should be put in the garbage bin in the toilet room, wrapped in plastic. In our culture, it should be washed before putting into plastic bag. I think the students should be taught to be put in plastic before throwing away. But if water is not available, then put into a plastic bag without washing. The most important thing is to wash their hands after.”
- Health officer
[1] Burnet Institute, et al. “Menstrual Hygiene in Indonesia.” Burnet.edu, Feb. 2015.