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Celistine was outraged. She and her eight children had lived in a displacement camp in the middle of Port-au-Prince, Haiti, for 10 months after the 2010 earthquake. She told me all of the problems they were facing--ripped tents that let water in, security risks, hunger, no schools.

But what really infuriated Celestine, whose full name I'm not using to maintain her privacy, was that she and many other women in the camp had terrible vaginal infections and weren't able to manage their personal hygiene, particularly during menstruation.

The portable toilets in the camps were filthy, she said. They had to bathe without privacy and they used old rags during menstruation. Among all the necessities Celistine lacked, what she wanted most was sanitary napkins.

Purchasing materials and accessing clean facilities to safely and hygienically manage menstruation should not be a luxury, yet in many places around the world it is. Many women and girls have no option but to use dirty, unsafe materials to absorb the blood.

In rural India, for instance, old rags, husks, dried leaves, grass, ash, sand or newspapers are all used as substitutes for unaffordable and more hygienic products. In Kenya, a program working to increase access to sanitary pads in the Nairobi neighborhood of Mukuru found that some adolescent girls reported having sex with older men in order to make money to buy menstrual pads. 

Menstrual Hygiene Day Launched
In response, today, on May 28, a coalition of nongovernmental organizations is recognizing the first-ever global Menstrual Hygiene Day to help bring to light something that women often keep to themselves. Periods happen. They're normal. And women and girls have a right to continue going to school, working and maintaining their health and safety during menstruation.

Handling periods (or "menstrual hygiene management" as experts call it) isn't the first thing one might associate with human rights. Yet the link between realization of rights for women and girls and menstrual hygiene management could not be clearer.

Girls' right to education can be severely curtailed when schools lack bathrooms or clean water to manage menstruation or when students can't afford sanitary supplies. UNICEF has estimated that 1-in-10 African girls missed school during menses, which contributed to higher school dropout rates for some girls. In Burkina Faso, a 2013 UNICEF case study found that 83 percent of girls had no place at school to change their menstrual materials. In Uganda, one study found that girls missed as many as five days of school a month because of inadequate sanitation facilities at school, lack of hygiene products and physical discomfort associated with their periods.

Even if girls do go to school during their periods, they may feel less empowered to participate if they lack sanitary supplies. A study in Sierra Leone found that girls who worried about emitting odor or leaking through their clothes while menstruating changed their participation habits in class. 

Economic Equality Effects
Women's right to work and to economic equality can also be limited by lack of adequate menstrual hygiene supplies or facilities and by inaccessible health care to manage vaginal infections. A study in Bangladesh by HERProject, a global nonprofit initiative that works with businesses and civil society to implement women's empowerment programs in factories, found that 73 percent of female Bangladeshi garment workers interviewed said they missed an average of six days of work--and pay--a month due to vaginal infections, often caused by unsanitary menstrual materials. Missing so much work and pay is not only bad for these women's pocketbooks, it's also bad for economic growth.

Many women and girls around the world also risk physical violence when accessing sanitation facilities or when they are forced to defecate in the open, due to a lack of such facilities.

Geraline, who asked that her full name not be used for security reasons and who also lives in a Haitian displacement camp, recounted the fear she and other women experienced in trying to reach the portable camp toilets in a distant, insecure area. She told me: "We are scared. We have no security." Because of that, she sometimes avoided the camp toilets and instead defecated and changed menstrual materials in the open.

Bathing without privacy, especially during her periods, was also very difficult. "We feel bad because everyone can see, but we are obliged to bathe in the open, but we are very embarrassed and it makes you scared," she said.

Geraline chose safety over using the minimal sanitary facilities in the camps, even if that could contribute to vaginal infections. As she and Celestine made clear to me, menstrual management matters to human rights, health, safety and dignity.

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