3 Questions

Annabel Buzink

Annabel (24) is a cultural anthropologist studying a master’s degree in Global Health at the VU University Amsterdam. She spent three months on the island of Flores to conduct research for Simavi on menstrual hygiene management (MHM) amongst women in rural areas of Indonesia. What opportunities does she see to improve the situation?


What were your first impressions of the Menstrual Hygiene Mangement (MHM) situation in Flores?

“Many factors contribute to MHM problems here, it’s not just a simple lack of access to resources like sanitary pads. Sanitary products aren’t always easily available and women can be discouraged from using them. For example, if sanitary products are only available at one local kiosk, access will be further restricted if it’s a man behind the counter.

There’s also a lack of MHM knowledge. Cultural beliefs are a significant factor, as menstruation is still associated with impurity. Almost all the women I spoke to don’t wash their hair during their period because they believe it can cause headaches or psychological problems. Others reported they do not harvest and plant or prepare food during menstruation as it could  have a damaging effect on the result.”


What difficulties have you encountered?

“First of all, it’s difficult to conduct research in an unknown country where you do not speak the language. It is vital to be well-prepared in order to minimalise the loss of data due to time spent travelling between villages and communicating via an interpreter.

Secondally, MHM is a (culturally) sensitive topic. Most women will initially deny that they face difficulties during their period – but when asked if their neighbours or other women living in the same village face MHM problems, they say much more.  I tried to connect with the women and create a confidential and neutral environment in which they could speak more openly. To do this, I only involved female interpreters, assistants or field staff in the research.  I held separate focus group discussions with men to study their role in MHM.”


What opportunities do you see to improve the situation?

“Although access to water and toilets has sharply increased in Indonesia during recent years,  a gender perspective  hasn’t always been included in these WASH projects. Men and women have different WASH needs: for example, women need water to wash, a trashcan to throw away their sanitary pads and a clean and private space in which to change menstrual cloths or pads and wash. Therefore, it is important to consider MHM in the design of lavatories or environmental waste disposal, as well as WASH policies, training and guidelines.

The impact of these WASH interventions can be strengthened by including activities to improve access to sanitary pads and to create awareness on sexuality, reproductive cycle and menstrual hygiene among girls, women and men. Women often have no idea what happens to them when they have their period and they have many questions. During my interviews, they took the opportunity to ask me everything: why they have abdominal pain; whether they can drink coffee during their periods; whether I have anything against the headache. It is important to increase their knowledge, to avoid health threats and to view menstruation as a completely normal change in a women’s body.

In addition, I believe sanitary pads that are easy to use, inexpensive, recyclable and made from environmentally friendly materials could be a big help for women in rural villages. These women have nowhere to throw sanitary pads away, so they wash them down the toilet, creating blockages. Re-usable or environmentally friendly sanitary pads would be a lot more hygienic than the old clothes or double underwear that women often resort to. In addition, it could be possible to develop income-generated interventions in which these women themselves can benefit from producing MHM products.”

Start the conversation

Share this article

3 Questions

3 Questions to literally comprise 3 questions we ask someone with whom we collaborate: a public official, local partner, villager or donor.

More ‘3 questions’ Read next 3 questions

Related stories