Menstrual Hygiene Management as the Most Neglected Health Issue in War-torn Southern Cameroons

Nena Helen (not her real name) is an 18-year-old Muteff school child. When the military stormed the village in October 2019 fright made villagers scatter in various directions, especially into the Muteff Ijim Mountain Forest. Nena Helen who was approaching her menstrual period was among the unfortunate villagers who would spend over 48 hours in the forest until they were assured the military had returned to their base in Fundong, the Divisional headquarters of Boyo division of the North West, in the former UN Trust Territory of British Southern Cameroons. Since the incident was unforeseen and unexpected, Helen didn’t take along any sanitary pads; that is if she even had. For the time she was in the bush, she had no option but to use pieces of old clothes to manage her menstruation. 

Nena Helen might have been lucky to have access to old pieces of clothes. Not the same fate for Rosemary Ayuk, 21, (again not her real name), who was kidnapped sometime in 2021 and held in captivity by suspected self-defense volunteers for a week in one of the villages in Mamfe in Manyu Division for attempting to go to school against their orders. Given the dire conditions in the bush, Rosemary had to make do with tree leaves to manage her menses during the time she was held in captivity with all the attendant consequences. 

Helen and Rosemary might have faced serious challenges because their periods came when they were far removed from their natural environments. Fien Hilda, 18, although living in a relatively calm environment in Tinifoinbi in Njinikom subdivision of Boyo had to contend with pieces of toilet paper because she could not afford the 1000 CFA F (less than USD2) needed to purchase a sanitary pad in that community. The travails of Helen, Rosemary, and Hilda may seem isolated incidences, but they are the microcosm of the challenges girls and women in Southern Cameroons have been going through since the outbreak of the raging deadly conflict with La République du Cameroun that has claimed over 10000 lives and displaced thousands more in the last seven years. 

Information from the Cameroon National Coalition of Adolescent Girls and Young Women holds that despite the role menstrual products play in maintaining hygiene and good health, ‘many women in Cameroon are unable to afford or otherwise lack access to this basic necessity, and as a result, some women and adolescent girls who menstruate have resorted to unsafe or unsanitary options, including the usage of clothes, dust, toilet paper, paper towels, socks, used paper bags, old newspapers or a single sanitary pad used for a longer period than recommended’.

This unaffordability according to AGYW, ‘has devastating medical consequences and may result in urinary tract infections, cervical cancer, vulvar contact dermatitis, yeast infections, bacterial vaginosis, and more’. This situation has been more prevalent in the war-torn Southern Cameroons. It is therefore lamentable, the National Coalition of Adolescent Girls and Young Women continues, that despite these challenges, ‘women and girls have continued to bear the brunt with indiscriminate increases in the prices of sanitary products as if menstruation was a luxury rather than a natural basic occurrence ascribed to females within the natural age which permits the process’.

The statistics are mind-boggling. A packet of the most basic disposable sanitary pads in Cameroon costs as high as 600 CFA F (about USD1) and over 1000 CFA F in some conflict-ridden rural communities of the English-speaking regions of the country. Given that the minimum wage is as low as 41,875 CFA F (less than USD80), which is grossly insufficient to meet basic needs and even more dire in rural communities, women and girls in those communities continue to bear the brunt of the conflict in disproportionate ways. Available research points to the fact that the average woman who menstruates has their period for a cumulative 3-7 days per month, uses between 10-35 pads a year and up to 16,800 sanitary products in the course of their lifetime at a cost of roughly CFA F 5 million.  Research holds that limited access to menstrual hygiene management products and facilities is the 5th biggest killer of females in our society today. 

In a spirited attempt to quickly reverse this trend and especially its disproportionate impact on young women and schoolgirls in the conflict-ridden Southern Cameroons, the Bamenda-based non-governmental organization, Center for Advocacy in Gender Equality and Action for Development, CAGEAD, has been shining the spot on the fact that since periods don’t stop for conflict, a lot more attention needs to be paid in addressing the thorny issue of menstrual hygiene management (MHM). The organization is functioning with the understanding that although the conflict has put a lot of pressure and stress on the originally scarce resources, adolescent girls and young women’s needs have been largely overlooked. As part of its humanitarian response to the raging deadly conflict in the two English-speaking regions, and given the fact that adolescent school-going girls face numerous difficulties in managing their periods (as well as experiencing increased feelings of shame and discomfort), CAGEAD since partnered with UN Women and AWDF to begin addressing such concerns in especially hard-to-reach and under-served conflict-ridden communities of Boyo, Mezam, and Donga Mantung divisions of the North West region. 

The CAGEAD initiative has been emphasizing key menstrual health issues in the concerned schools and communities: access to safe spaces, sexual and reproductive health education and services, and strategies that mitigate the stigma and shame surrounding menstrual health. Ensuring that adolescent schoolgirls have access to culturally appropriate menstrual products they would be comfortable using as well as having access to safe toilets and bathing spaces (WASH), the female students are also being trained on how to produce reusable and affordable sanitary pads. It is the belief of the Center for Advocacy in Gender Equality and Action in Development, CAGEAD, that integrating menstrual health into the humanitarian response to the conflict ravaging the once peaceful Southern Cameroons, enables female students to decide whether to spend the limited resources on menstrual products or other necessities. This also improves the educational attainment of female students. 

Beyond the isolated efforts of individual NGOs and other service delivery agencies working in the conflict zones of the North West and South West regions, the government of Cameroon has the responsibility to preserve the dignity and humanity of all people and to uphold human rights, including the right to menstrual health. For this reason, and to make sure what happened to Helen, Rosemary, and Hilda cited above does not become the new common, menstrual hygiene management products should be included in relief packages to make sure everyone can manage their periods comfortably, safely, and with dignity. This should be done with the understanding that internally displaced persons (IDPs), especially young women and adolescent girls, often flee with few belongings and lack appropriate menstrual hygiene infrastructure in an environment that is unfamiliar to them. 

A more appropriate way for the government of Cameroon to claim to understand and begin to implement the Convention on the Elimination of All Forms of Discrimination Against Women, CEDAW, would quickly implement the recommendations contained in an earlier petition curated by the National Coalition for Adolescent Girls and Young Women to the effect that government’s taxing of sanitary pads is a plain, simple tax on womanhood. Full stop. It argued that waiving the high taxes on sanitary products was imperative in accelerating the actualization of some of the Sustainable Development Goals, SDGs, especially Goal 3, which speaks to quality education, and where according to available research, 1 in every 3 girls miss school every week because of unaffordability of sanitary pads. Increasing taxes on sanitary pads as the government of Cameroon has done, is exacerbating period poverty, and negatively impacting the lives of women and girls. Beyond the fact that menstruation is not a luxury that needs to be taxed as obtains today in Cameroon, society rather spends more on treating infections caused by poor menstrual hygiene management like urinary tract infections, Cervical Cancer, Vulvar contact dermatitis, Yeast infections, bacterial vaginosis, etc. 

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