See teaching girls in India to make washable pads (here, too) - Nineteenth-century Norwegian washable pads - Italian washable pad, probably from the 1890s
See Chinese belts and pads, from 2000 and 2005. - Chinese pad and panty pad - Japanese pad, older
More belt topics
Many American belts - See how women wore a belt (and in a Swedish ad). See a modern belt for a washable pad and a page from the 1946-47 Sears catalog showing a great variety - ad for Hickory belts, 1920s? - Modess belts in Personal Digest (1966) - drawing for a proposed German belt and pad, 1894 - ads for early 20th-century Japanese belts - belts and washable pads from the 1902 and 1908 Sears, Roebuck catalogs - belt from Jordan, Marsh & Co. catalog, Boston, 1891 - German belt (from Bilz), about 1890
Suspenders to hold pads (U.S.A., 19th century)
Snap-on style washable pad -Washable pad with belt - See how women wear a belt with a pad - see a Swedish ad showing a belt and pad - German pattern for washable pads, probably before 1900 - And see a menstrual sponge
DIRECTORY of all topics (See also the SEARCH ENGINE, bottom of page.)
CONTRIBUTE to Humor, Words and expressions about menstruation and Would you stop menstruating if you could?
Some MUM site links:
homepage | LIST OF ALL TOPICS | MUM address & What does MUM mean? | e-mail the museum | privacy on this site | who runs this museum?? |
Amazing women! | the art of menstruation | artists (non-menstrual) | asbestos | belts | bidets | founder bio | Bly, Nellie | MUM board | books: menstruation and menopause (and reviews) | cats | company booklets for girls (mostly) directory | contraception and religion | costumes | menstrual cups | cup usage | dispensers | douches, pain, sprays | essay directory | extraction | facts-of-life booklets for girls | famous women in menstrual hygiene ads | FAQ | founder/director biography | gynecological topics by Dr. Soucasaux | humor | huts | links | masturbation | media coverage of MUM | menarche booklets for girls and parents | miscellaneous | museum future | Norwegian menstruation exhibit | odor | olor | pad directory | patent medicine | poetry directory | products, current | puberty booklets for girls and parents | religion | Religión y menstruación | your remedies for menstrual discomfort | menstrual products safety | science | Seguridad de productos para la menstruación | shame | slapping, menstrual | sponges | synchrony | tampon directory | early tampons | teen ads directory | tour of the former museum (video) | underpants & panties directory | videos, films directory | Words and expressions about menstruation | Would you stop menstruating if you could? | What did women do about menstruation in the past? | washable pads
Leer la versión en español de los siguientes temas: Anticoncepción y religión, Breve reseña - Olor - Religión y menstruación - Seguridad de productos para la menstruación.

Menstrual Hygiene and Management in Developing Countries: Taking Stock,
November 2004
Page 2
(Pages 1 - 3)

By Sowmyaa Bharadwaj andArchana Patkar


Menstruation does not stop just because there is an emergency. Besides the practical issues of obtaining, washing and disposing of sanitary towels, women may have cultural issues to deal with. In some societies, women have to go somewhere private whilst they are menstruating. If the whole household is living in a single room or tent, this can be very difficult.

Paul Sherlock, OXFAM, GB

A less obvious but very felt practical need that also affected the self-respect of women in Ikafe was how as refugees they had to cope with the process of menstruation. Although after the first year or so in Ikafe some families had begun to be able to purchase clothes, it was certainly not all, and very few had more than one set. Old cloth to use during menstruation was simply not available. Pastoralists have traditionally used cow-hide but they now found themselves in Ikafe as cultivators, and cow-hide was not available. Other tribes were used to using leaves that were not found within the settlement. Many of those who came as refugees, especially people from the urban centres, had become used to either using pads, or otherwise pieces of cloth kept separately and used only for this purpose. In Ikafe, some found themselves unable to use anything.

Lina Payne, Social Development Consultant

This paper is a beginning. While our initial findings are not encouraging ­ neither are they necessarily comprehensive. Our rapid review has revealed some potential gems that merit further investigation, potential research and development and scaling up. These are detailed in Section 4 below. Wherever available, we have included contact details.

We hope that circulation of this stock take will encourage wider dissemination of action and initiatives that have actually dealt with the issue substantively. We also hope it will lead to focussed action at a practical level so that the scope of hygiene and environmental sanitation will soon address menstrual hygiene and management needs in a manner that is actually responsive to the practical and strategic needs of women and girls, while safeguarding the environment and addressing wider environmental health needs of the community at large.


4.1 Background: Perceptions, Associations

Over decades, women have been taught that having periods is shameful. They have indirectly, if not directly, absorbed the messages that menstrual blood is dirty, smelly, unhygienic and unclean. This message may be perpetuated by advertisements for menstrual products or "feminine hygiene" products. Even the term "feminine hygiene" implies that help is needed with hygiene. With all these negative messages it is natural for women to want to hide their blood and throw it away as garbage. To do otherwise is to go against what they have been taught as women. But menstruation is a natural physical process - a harmless by-product of a biological event.

Menstrual flow, simply put, is blood and tissue sloughed from the endometrium, or lining of the uterus. This blood is free of toxins and does it contain any bacteria except "good bacteria" which is found naturally in the vaginal canal. The existence of any sort of 'menotoxin' or toxin in the menstrual flow has never been proven by any reproducible studies. This menstrual blood, like any bleeding, can harbour viruses like HIV, Hepatitis B, and Hepatitis C. However, most transmission of blood-borne disease comes not from contact with the menstrual blood but from contact with blood either from the cervix or from microscopic tears in the vaginal wall.

On average, a woman loses about four tablespoons of blood each month. To deal with the "mess" of it, women over the ages have used materials like grass, sponges, cotton wads and other absorbents to catch the blood. The embarrassment surrounding menstruation is a somewhat universal phenomenon, found in most cultures of the world and with many associated code words, euphemisms and phrases used as linguistic substitutes. [See the MUM page for examples.]

4.2 Attitudes around the world towards Menstruation

In several Asian and African cultures, women were put in seclusion in special menstrual huts. These are still in use today in some parts.

The ability to bleed and not die equalled control of life powers in some religions. In goddess worship, a woman's menses determines the status of her power in the maiden, mother and crone figures. Menopausal women are sometimes revered and looked up to for their wealth of knowledge and experience.

The Roman author, Pliny, in his Natural History wrote that a menstruating woman can turn wine sour, cause seeds to be sterile, wither grafts, cause garden plants to become parched and fruit to fall from a tree she sits under. Aspects of this are echoed in Hindu socio-cultural practices.

A Hindu woman abstains from worship and cooking and stays away from her family as her touch is considered impure during this period.

Jewish tradition regards a woman as ritually impure during menstruation and anyone or anything she touches becomes impure as well. As time went on, more items were added to include her breath, spittle, footprints, voice and nail clippings.

Under Islamic law, a menstruating woman is not allowed to pray, fast or have sex. She is not allowed to touch the Koran unless it is a translation (as only the Arabic version is considered to be the holy book).

4.3 History of Menstrual Hygiene Products


1890 : First disposable pads "Lister's Towel" Johnson & Johnson [MUM says: the first ones might have been in Germany, here]

1920-30s : First commercial tampons [see Tampax, fax, Wix]

1920 : Improved disposable pad ­ Curads brand [here]

1921 : Further improved Kotex disposables [here]

1970 : First adhesive pads [here]

1996 : Development of menstrual cup [MUM says, not true; the cup started at least in the 1930s]

Even though there are no artefacts to prove it, in Ancient Egypt, there were laundry lists that indicate the existence of cloth pads, belts and tampon like items. A low status was accorded to those who chose the profession of washing the "loincloth of menstruating women", thereby proving that the practise of using cloth pads, was popular.

In the period of roughly 1700-1900, washing or changing underclothing was considered unhealthy. Women feared blocking the flow or causing intense bleeding. Then around 1880-1890, German doctors began proposing menstrual devices for women to wear to improve their health. American patents for menstrual devices began in 1854 for a belt with steel springs to hold a pad, but the products really didn't start gaining in popularity until the 1870's.

Pieces of cloth, called "Granny Rags," made from old sheets, pillowcases or other surplus material, then folded and pinned into underwear, served the average woman for years before the advent of commercially made disposable pads. Rags were washed after each use, hung out to dry, and used over and over. When odour became an issue, the remedy was to boil the rags 5-10 minutes to get rid of the problem. Women travellers either took their cloth pads home to wash them or burned them in the fireplace. England had special portable burners in the 1890's specifically to burn menstrual pads.

Tampon-like materials have been around since ancient times. Hippocrates wrote of their usage. Egyptians probably used grass or papyrus as tampons. An interesting fact is that the letters "O.B." in modern-day OB Tampons means ohne binde or "without a pad." In World War 1, nurses used large cotton pads to absorb blood from wounds of soldiers and would keep changing these as and when the need arose. The soldiers carried back this idea and the women soon started this practise to help deal with the menstruation bleeding.

4.4 Experiences in Menstrual Hygiene & Management

4.4.1 IRAN

The Department of Immunology and Microbiology, Iran, in collaboration with the University of Medical Sciences, Tehran conducted a study to test the level of knowledge of girls between 15-18, regarding dysmenorrhoea and menstrual hygiene. They found that 76% of the girls had adequate knowledge about dysmenorrhoea, but only 32% practised menstrual hygiene such as taking a bath and using hygienic material like sterile pads. 15% of the subjects stated that dysmenorrhoea had interfered with their daily life activities and caused them to be absent from school from between 1 to 7 days a month. The main conclusion derived in this study was the necessity of educating female students about personal hygiene associated with their menstrual period and to adopt a healthy behaviour, which includes: appropriate nutrition, exercise and physical activity, personal hygiene, and appropriate use of medications based on a physician's prescription

4.4.2 UGANDA

FAWE, Uganda conducted a campaign to dispel the silence around sexual maturation (SM), and to advocate for affordable sanitary towels to be available at the local market. The project is being piloted in the 5 FAWEU districts of focus; these are Kiboga, Kisoro, Nebbi, Katakwi, and Kalangala. Twelve primary schools were selected from each of the pilot districts. FAWEU has carried out workshops to open up dialogue on SM, to introduce hygienic sanitary towels and to seek solutions to the poor SM management, at school and community levels. The workshops revealed that poor menstrual hygiene and management of the adolescent girls stems from beliefs, myths and attitudes within the Community coupled with poverty. Many parents do not allocate any budget to sanitary materials. FAWEU is seeking strategic partnerships at community level to cultivate commitment on the part of all stakeholders to improve SM management. The result of the advocacy is the falling prices of sanitary towels on the open market. The workshop outcomes include increased demand of sanitary towels in rural areas, with local shops beginning to stock them. Lawmakers want the government to buy sanitary towels for female pupils in primary schools. The biggest number of school dropouts are girls, because of inconveniences during their menstruation periods.

4.4.3 KENYA

Girls are staying on longer in school in Kisumu District in Western Kenya, after a sustained set of activities around hygiene ( including menstrual issues) and sanitation. The schools have become more 'girl-friendly'. Fewer girls drop out of education once they reach puberty and boys are more willing to help to keep the school toilets clean and do other jobs they would not do at home. The schools - working with two NGOs (Africa Now (AN) and Sustainable Aid in Africa International (SANA) - have created a culture in which boys in School Health Clubs share the duties of cleaning latrines, sweeping classrooms and compounds and providing water to the latrines. The girls at the schools after the interventions said they were managing menstruation more easily and were more committed to remaining in school because new school latrines had been built.

Women in Kenya have praised President Mwai Kibaki's promise to waive heavy taxes levied on women's sanitary towels as a move which will greatly enhance women's reproductive health and reduce the costly burden of hygiene on poor women.


Perceptions of Hygiene Study, CEGIS/ UNICEF

This study was commissioned by UNICEF and the Department of Public Health Engineering Bangladesh, to inform a large rural hygiene, environmental sanitation and drinking water project covering plain land districts and the Chittagong Hill Tracts. The scope of the study was restricted to perceptions of mainly women and adolescent girls around hygiene behaviour in the areas surveyed. The key findings were:

Women and girls were shy when queried about this issue

Once comfortable they listed a host of problems that they faced

Women in hilly areas used two or more saris/cloths to absorb the flow.

They had to search for secluded spots by lakes or rivers to wash these cloths and rags

Spaces to wash and dry these rags/cloths were a problem

Damp rags were often reused, as drying in the open sunshine was difficult

Very few poor girls/women could actually afford sanitary napkins

In BRAC areas, there was a good demand for low-cost napkins BRAC

In August 2003, a social development team from DFID Bangladesh visited a BRAC Sanitary Napkin Production Centre in Maneckganj, Bangladesh as part of an effort to review existing initiatives linked to menstrual hygiene and sanitation in order to explore potential linkages with DFIDB's water and sanitation and health portfolios. This is what they found as reflected in their field notes:-

Production Centre: Well-organised operation located in a neat and hygienic property on the outskirts of the town. Employs mainly adolescent girls, some very young working in well-lit, airy and clean rooms supervised by one man and one woman. There seems to be special attention all-round to hygiene ­ all employees wear face masks at all times, rooms are scrubbed with phenyl, footwear is parked outside the rooms in racks, autoclaves and drying machines are used for sterilisation. We also observed some trainees ­ who attend the centre without pay in order to learn various skills (stuffing the napkins, sewing the loops, etc.) before they are enlisted as regular workers. The workers are paid 40 taka a day and enjoy no paid sick leave or holidays.

The production of the napkins is broken up into various steps requiring different skills. The workers seem extremely efficient and well trained and continued their specific task with ease while talking with us. After stuffing the gauze with cotton against a moulded shape, each napkin is individually weighed for precision before it is sewn to loops and passed into an autoclave for sterilisation. After drying, it is pressed into lots of 12 and sealed in a colourful blue opaque plastic packet. The entire operation is methodical and output oriented producing about 500 napkins per worker per day and about 6000 packets of 12 each per day. (BRAC has 6 such centres in Bangladesh).

Each packet is sold to the BRAC health workers responsible for distribution at 5 taka and s/he sells it in turn for 18 taka. A small percentage of the production finds its way into the local market where it is sold at 20 taka per packet and competes with the commercial brands, which range from 40 to 85 taka on an average. The supervisors explained that there is little or no profit made on this production due to the fluctuating price of cotton and gauze. Whatever the market price of these raw materials, BRAC has made a commitment to maintain the price of the finished product at 15 taka.

Demand and Supply and Disposal Issues

On the supply of and demand for the napkins ­ The managers at the BRAC district centre explained that distribution was mainly done through a door-to-door supply using a network of 800 BRAC healthcare workers in the district. There had been no real attempt to supply the napkins through commercial outlets as there was a perception within BRAC that women were embarrassed to go out and ask for these products in shops. They assured us that there was sufficient demand for the supply from these production centres and no surplus production at all. They stressed that the low price was maintained as BRAC was clear that this was an income-generating cum hygiene-related service targeting poorer women and girls and not intended for higher income groups at all.

On being queried about disposal issues BRAC workers reported that they did talk to users about digging a pit in their backyard and covering the napkins with soil, but that no systematic thought had been given to the issue.

Pages 1 - 3

See more Chinese belts and pads, from 2000 and 2005. Chinese pad and panty pad - Washable pads from Almora, Uttar Pradesh state, India - Nineteenth-century Norwegian washable pads - Italian washable pad, probably from the 1890s

© 2004 Harry Finley. It is illegal to reproduce or distribute any of the work on this Web site in any manner or medium without written permission of the author. Please report suspected violations to