CHAPTER 1: INTRODUCTION
1.1 T HE PROBLEM OF POOR MENSTRUAL PREPAREDNESS
1.1.2 Menstrual preparedness in Zimbabwe
In Zimbabwe, as in many other sub-Saharan African countries, reproductive health knowledge is often shared too late and relates to the physical rather than emotional aspects of growing up. Menstruation in particular is often discussed post-ménarche. In these instances, the focus is placed on personal hygiene, rather than the future risk of pregnancy and the transition towards adulthood (FACT, MoHCC & UNFPA, 2017; Langhaug, Cowan, Nyamurera & Power, 2003). Ndlovu and Bhala (2016) highlight that sometimes the knowledge (or lack thereof) transmitted to girls amplifies feelings of anxiety around MHM; therein affecting their performance at school. In this way, girls do not receive adequate information about menstruation as it concerns their new reproductive capability (Sinden et al., 2015). Consequently, many do not know or understand what is happening to them when they begin menstruating, and instead of being a well-explained and well-understood rite of passage, menstruation becomes a time of stress, confusion, and shame (Sinden et al., 2015; Chang et al., 2010; Koff et al., 1981; Ruble & Brooks-Gunn, 1982). Adding to this, Schooler et al. stress that historically, “less attention has been focused on how [women’s] feelings about their bodies and reproductive functions affect these processes” (2005:324). This study contributes to this lacuna in the literature by demonstrating the interface between emotions, the body and reproductive functions (e.g., ménarche and menstruation) among Ndebele women in Zimbabwe.
20 cf. page 6
The study also examines the processual flows and stagnations of menstrual knowledge as well as the underpinning reasons for either. For example, it was found that there is an “absence of knowledgeable adults who are willing to discuss menstruation and can provide accurate information” in Zimbabwe (SNV, 2014:12). Delius and Glaser (2002) note that in Southern Africa, parents are uncomfortable broaching the subject of sex, and poor menstrual preparedness. In this way, parents are menstrual knowledge gatekeepers as they are able to block or facilitate the flow of menstrual information. In Zimbabwe poor menstrual preparedness can be linked to slow uptake of adolescent sexual and reproductive health and rights (ASRHR). In 2017, a study on the determinants of teenage pregnancies in the District of Hurungwe, Zimbabwe found that more than a third (39%) of the parents were not comfortable with parent-child communication around ASRHR issues with their adolescents. Also, 17% did not feel well-equipped with the information themselves, and also in some instances “feared sending the wrong message” (FACT, MoHCC & UNFPA, 2017:2) and promoting sex. In this same study, 64% of teenagers aged 12-19 years indicated that their parents neglected sex education information relating to reproduction issues and contraception (FACT, MoHCC & UNFPA, 2017:2). High education level, expansive personal menstrual knowledge level, and openness of menstrual knowledge gatekeepers may increase menstrual knowledge transmission from adults to children. Further to the knowledge gap among adults, gender is also a barrier to knowledge transmission on menstruation in Zimbabwe. A study in Masvingo, Zimbabwe found that that while “84% of schools reported having teachers to counsel menstruating girls, 63% of these schools had male counsellors, creating a barrier to girls obtaining the counselling and knowledge they need” (SNV, 2014:12). There is need to interrogate such statistics because gender would pose a barrier only if the 63%
of schools with male counsellors only had male counsellors and no female counsellors – a fact that is not specified in the SNV report. The factors of knowledge and gender do intersect in Zimbabwe to reveal that in men in Masvingo “displayed limited knowledge of the common physical effects of menstruation” (SNV, 2014:12). It is important to note that Masvingo is a Shona-speaking province. There may be some differentiation in Ndebele-speaking provinces like Matabeleland South because “Ndebele literature/oral traditions […] boasts riddles, folktales, proverbs and wise sayings and even praise poetry, which are so rich in sex education” (Bhebhe, 2018:1). Therefore Bhebhe (2018) challenges the mistaken, yet pervasive, belief that “it is a taboo to discuss issues of sex with teenagers” in Zimbabwe. This dissertation examines what processes of knowledge transmission on menstruation and sex takes place in the rural village of Sikelela (the fieldsite of this study), in Matabeleland South.
There are sectors of any society that treat adolescent sexuality as dangerous and therefore police it (Moran, 2004:740). One way in which this policing is done is through the disapprobation of formal sex education.
As such it is unsurprising that the formalising of home-based sex education (Bhebhe, 2018) through parent-
child communication is met with resistance. This is because, traditionally, parents “have little or no role in sex education” (Muyinda et al., 2003:160). In Zimbabwe, the paternal aunt assumes this role. For girls she is responsible for preparing girls for adulthood, focusing on issues such as menstruation, future sex and marriage. There is a ‘Let’s Chat!’ Community Level Training Manual for parent-child communication on (A)SRH developed by the United Nations Population Fund (UNFPA)21. I was involved in the update of this manual in 2017. A trainer of trainers (ToT) is trained in parent-child communication and goes on to train a community cadre known as the Behaviour Change Facilitator who in turn trains parents on how to chat openly with their children about around ASRHR. I attended a ToT training workshop in 2017 where the stakeholders highlighted the divisive tension around contraceptives. The development community (e.g., UNFPA, UK Aid, Irish Aid) is transmitting the message that contraceptives and sex should be discussed openly by parents and children. However, some schools and churches contest this. Hodes (2017), Mkhwanazi (2014a; 2014b) and Macleod (1999a) alike all iterate that there is a collective societal anxiety akin to a moral panic22 around what Macleod describes as “teenage pregnancy and its ‘negative’
consequences” in South Africa (Macleod, 1999a). The same is true for Zimbabwe. To better understand this collective anxiety in Zimbabwe, we can turn to Hof and Richters who state that:
In order to understand why teenagers become pregnant, and whether they are willing to use contraceptives to prevent this, teenage sexuality must be explored in detail. The willingness to use contraceptives is dependent on the kind of sexual behaviour that is socially acceptable to men and women. […] Men are hardly blamed for the occurrence of sexual intercourse since they are believed to have an uncontrollable need for sex. […] Their sexuality is seen as the fulfilment of male sexuality (1999:58).
Male (teenage) sexuality is promoted whereas the opposite is true for adolescent girls and unmarried women, who must strive towards maintaining their purity and suppressing their sexuality. Sexuality in girls and women is equated with loose morals (Pande, 2020a). According to the Zimbabwe National Adolescent Fertility Study this sentiment is echoed by adolescent girls (MoHCC, 2016). It found that 77% of adolescent girls see “contraceptive (condom and pills) use is a sign of promiscuity” (MoHCC, 2016:56). It is therefore unsurprising that schools and churches are weary of such intergenerational dialogues like parent-child
21 https://zimbabwe.unfpa.org/sites/default/files/pub-
pdf/Parent%20Child%20Communication%20Mentors%20Manual%20final.pdf
22 Cohen in his book “Folk Devils and Moral Panics” coined the term moral panic defining it as “a condition, episode, person or groups of persons [that] emerges to become a threat to societal values and interests” (Cohen, 2011:1).
communication for fear of promoting early sexual debut and promiscuity.23 Discussion around menstruation and menstrual preparedness are a gateway into further dialogue about sex and sexuality. Thus, it follows that when adolescent sexuality and ASRHR is shied away from and silenced, gender is subliminally swept under the rug.
In their study, also in Masvingo, Ndlovu and Bhala (2016) highlight that sometimes the knowledge (or lack thereof) transmitted to girls leads to amplified feelings of anxiety around MHM. This is said to affect their performance at school. There is also knowledge, attitudes and practices (KAP) that uphold that painful period pains are a signifier of infertility or that blood-stained materials ought to either be disposed of (by burning) or dried privately to avoid witchcraft (ukuloywa in Ndebele/Zulu). This in effect leads to
“unhygienic practices like drying [underwear or re-usable menstrual pads] under the bed”24 when there is need for sun-drying to ensure that germs and bacteria are destroyed do not breed in the material (Ndlovu &
Bhala, 2016:4). Mtigwe et al. (2014) in a study for improving access through transforming education (IGATE) led by a Netherlands Development Organisation (SNV), found that 5% of rural girls in Zimbabwe do not have underwear and that even with access to sanitary wear they are still likely to miss school during menstruation. Muduma (2014) concurs; stating that in Bulawayo (a provincial city adjacent to Matabeleland South province of Zimbabwe; see Fig. 1 on page 15) there are girls who lack both underwear and sanitary wear for effective MHM. Where girls cannot afford commodified sanitary wear like disposable pads, they manage their menses in other ways, for example: by using cloth or re-usable menstrual pads (RUMPs)25. A baseline study in Masvingo, Zimbabwe found that 80% of the girls in the study would be open to using RUMPs and this was taken to be “an indication that the majority were not happy with what they termed
‘homemade materials’ in their current quality” (Bhala et al., 2014:16). RUMPs are a form of MHMMMs.
The use of RUMPs is pertinent in revealing that even in the absence of single-use sanitary wear such as disposable pads and tampons, women and girls still have recourse to alternative MHMMMs. This suggests the aforementioned fixation on sanitary wear as an intervention in the modern construct of the global development agenda around “menstrual hygiene management” (Bharadwaj & Patkar, 2004; Kirumira, 2004; Dasgupta & Sarkar, 2008; House, 2012; Caruso et al., 2013; Long et al., 2013; Anusree et al., 2014;
Bhala et al., 2014; Patavegar, 2014; SNV, 2014; Sinden et al. 2015; Tamiru et al., 2015; Hennegan &
Montgomery, 2016; Kgware, 2016; Ndlovu & Bhala, 2016; Phillips-Howard, 2016; Sommer et al., 2016;
23 See page 40-2 for further discussion around formal education in Zimbabwe, where the discourse of desire is found to be missing for girls.
24 A UNESCO report on MHM highlights that “Drying in the sun has been promoted as good practice to kill bacteria.
But as the link between MHM and infection has not been studied sufficiently, the possible risk of not drying in the sun has not been quantified” (2014:33).
25 Ndlovu & Bhala, 2016; Mtigwe et al., 2014
Sommer et al., 2017) fails to take into account localised MHMMMs that precede the global development agenda. As a consequence, interventions such as the solitary introduction of sanitary wear without engagement with local KAP fail to meet the need for multi-tiered holistic menstrual preparedness for girls;
the needs of which are nuanced from one locality to another.