MHM FOR WOMEN AND GIRLS WITH DISABILITIES IN DHAKA
This research was conducted by Md. Arif Chowdhury and funded by Share-Net Bangladesh.
Slum areas in Dhaka city is a cluster of dense settlements where the number of people is gradually increasing very unsystematically and haphazardly in an unhealthy manner. Water, sanitation, and hygiene (WASH) facilities are important indicators to evaluate the living condition in the slum. Improper arrangement of WASH facilities at slums can make the environment of city surroundings unfavorable and vulnerable posing a great threat to public health. Thereby, the study targets to identify SWOT (strength, weakness, opportunities, and threats) of slums aiming to improve proper urban planning.
According to our research studied at Korail and Kallyanpur slums, (a) inconsistent/infrequent and inequitable supply of water; (b) insufficient/ inadequate number of lavatories with disputes in maintaining hygiene of sanitation system; (c) expensive sanitary pads; (d) poor road communication; (e) drainage congestion; and (f) irregular waste/garbage handling leading towards unhealthy surroundings are most common WASHrelated issues that affect females in general in slum areas. Menstrual Hygiene Management (MHM) through the use of available MHM products gets low priority because sanitary pads demand money. Only school going girls and employed young women are found to use sanitary napkins. Extra expenditures for their toiletries are also willingly financed by family.
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In the case of female living with different types of disabilities (i.e., mental and physical) mostly reported issues are (a) existing disabled-friendly toilet facilities are few in number; (b) rest of the toilets are far-reaching, (c) most facilities are located at high grounds, hence, frequent slipping accidents are common; (d) no pipe-line source inside the lavatories, hence, carrying heavy water pots is a must; (e) dependency is enforced on family members, by nature, on mothers; and (f) free medicine and medical facilities are not satisfactory, thereby, most of the health related expenditures are born privately by families. Apart from the issues mentioned above, adolescent girls with mental/learning disabilities are completely unaware of the menstrual hygiene management. Only cloths are used to absorb menstrual blood because it is believed to keep the stigma surrounding menstrual management silence. Besides, during menstruation, girls with disabilities experience physical pain associated with stomach aches and depression. No evidence was found of visiting doctors during such menstrual crises.
In general, strengths of the WASH and MHM facilities that are observed include (a) available family support to take care; (b) monthly allowance that family receives for each member with disabilities; (c) willingness of people to gain new knowledge related to disabled handling through training; (d) helpful neighbors and (e) considerable landlords. On the contrary, the major weakness is the absence of disabled-friendly schools that can handle adolescent girls. Other weaknesses include (a) lack of space for disabled centers, playgrounds, communication pathways; (b) insufficient free medicine support or medical services; (c) insufficient financial support from government as monthly allowance; (d) lack of disability-friendly structures in water collection point and lavatories; (e) absence of pipe water supply inside the toilets; and (f) taboo regarding MHM management.
Promising opportunities that are found in slum areas include (a) increasing literacy rate that can give female the confidence and space to voice their need for improved menstrual hygiene; (b) GO/NGO activities related to capacity building, awareness creation, income generation; (c) changing societal views on MHM issues through TV by advertisements, awareness programs, gender education for adolescents; (d) easy access and availability of MHM products; and (e) involvement of the male members of the family. However, threats coming from (a) increasing population demand management; (b) the risk of extreme climatic events causing uncontrollable hazards and damages; (c) the unhygienic management of menstrual pad disposals increasing the risk of diseases may become a huge challenge for Dhaka to deal with.
