Menstrual Health and Hygiene Project: MMDC & QAMC-LC

Menstruation is a regular monthly discharge of the blood and the mucosal tissue from the inner lining of uterus through vagina. When periods (menstruation) come regularly, this is called the menstrual cycle. Having regular menstrual cycles is a sign that important parts of your body are working normally. The menstrual cycle provides important body chemicals, called hormones, to keep you healthy. It also prepares your body for pregnancy each month. A cycle is counted from the first day of 1 period to the first day of the next period. The average menstrual cycle is 28 days long. Cycles can range anywhere from 21 to 35 days in adults and from 21 to 45 days in young teens.

  • 52% of the female population, 26% of the total population is of reproductive age.
  • 5-15% of women have abnormal menstrual cycle globally
  • 3 out of 10 girls are unaware of the menstrual hygiene
  • 90% of the girls miss out their school on average every month
  • 23% girls aged 11-18 drop out due to lack of sanitary supplies, fear of staining.
  • 79% of Pakistani women don’t manage the periods hygienically

Menarche is considered as one of the most important changes occurring in girls during adolescent years. In most societies, menarche is an indication of developing sexuality in a girl.  However, a  substantial  body  of  literature  suggests that menarche  and  menstruation  are  mainly  negatively perceived and experienced by  girls. Amongst many reasons for this negative perception, one is that menarche conveys conflicting societal messages. While  on  one  hand it  represents  the beginning of womanhood and sexuality, on the other hand, girls of this age are seen as too young to be sexually active  Other negative perceptions are related to being vulnerable and susceptible to  different  illnesses, and  to feelings  of  disgust  and  shame. Burrow study showed that girls expressed   largely   negative   views,   viewing   menstruation   as   embarrassing,   shameful and something to be hidden.

In many parts of the world, menstruation is also stigmatized.  This is  common  in low socioeconomic squatter  settlements  of  Karachi,  Pakistan  where  this  study  was conducted. This stigma is based on traditional beliefs that menstruating women are impure and on society’s unwillingness to discuss it as a normal event. Therefore, when adolescents are not able to share their experience menstruation becomes something shameful for them. These views, in turn, have implications for how girls manage menstruation.

Menstrual health and hygiene is critical to be taught to ensure healthy lives. This project of “Menstrual health and hygiene” was conducted in the school of Multan (Allied school). Girls of age 13-15 were included in this project to be given the awareness regarding the health, diet, sanitation, disorders related to menstruation. They were showed the ways as to how one can manage the pain, take care of the hygiene and not miss out their schools when experience menstruation. The staff also attended the session and asked us about the management of the pain. To this we explained the various methods the school can provide to the girls who are in their menstruating phase. The activity of “breaking the silence” was conducted in which we encouraged the girls to talk about the menstruation and we broke the taboo by conducting the “ Breaking the Myths” which involved various myths that were broken regarding diet, exercise, sleep, drinking etc.

The session was ended by providing the menstrual kit to the girls and having a question answer session with them to have a more clear view of the hygienic status. The kits included sanitary pads, soap and the guideline for maintaining cleanliness and preventing infection during menstruation.

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The questionnaires were handed over to the girls. 54% of the girls said that menstrual bleeding doesn’t affect their social or athletic life. 96% girls perceive menstruation as a positive sign. Pain scale of the menstruation, 33% suffers from moderate pain and 36% from severe pain while 18% from no pain. When asked whether they would take greater care of menstrual hygiene after the session, 98% responded with a yes. 70% of the girls thought that this session improved their knowledge on menstrual health and hygiene while 30% thought they’ve learnt a few new things.

A post evaluation video was made where girls expressed how much knowledge they gained plus the misconceptions cleared from the seminar.

Link To The Post Evaluation Video:

https://www.facebook.com/qamc.ifmsapakistan/videos/366802477155803

References:

Activity Reported by: Fatima Anwar

Menstrual Health and Hygiene Project: QAMC LC

  • image152% of female population, 26% of total population is of reproductive age , whereas talking about menstruation is considered a subject of shame and taboo.
  • 5-15% of women of reproductive age globally, have abnormal menstrual cycle globally.
  • 3 out of 10 girls are unaware of menstrual hygiene
  • 90% of girls miss 1-5 days of school on average every month due to their period.
  • 23% girls aged 11-18 drop out due to lack of sanitary supplies, fear of staining,

Menstruation, a natural process in women’s life needs special care from physical and psychological point of view. Negligence in menstrual hygiene can result in biological disorders for example different sorts of infections but unfortunately awareness concerning this area of life is not highlighted due to socio-cultural trends of our society. In present age menstrual hygiene needs more attention because of rapidly increasing active participation of females in different walks of life. One of the main reasons behind the issue is that menstruation is considered in many societies including Pakistan a hidden and secret issue. It is not openly discussed between mother and daughter. In many cultures menstruation is being perceived as unclean and embarrassing and also believed that it must remain hidden in communication. There is lack of adequate knowledge and proper facilities for menstrual waste management. Girls belonging to low income class and less educated families, don’t know how to dispose off sanitary material properly especially in time of immediate need. The focus on menstrual hygiene management is an essential part of promoting hygiene and sanitation amongst adolescent girls and
women who constitute approximately 45 per cent of the total female population. Menstrual hygiene promotion will be an indirect support to gender equality, national development, high literacy rate and MDGs accomplishment.

Menstrual Health and Hygiene Management is critical to be taught to achieve the Sustainable Developmental Goals 3, 4 , 5 , 6 , 8 and 12 to ensure healthy lives, inclusive quality education, gender quality, sustained availability of sanitation, economic growth and sustained consumption and production respectively. “Menstrual Health and Hygiene” project was conducted in two Governement Girls institutes of Bahawalpur. Girls of age 14-16 were given information on proper management of menstruation, various disorder, health and dietary reccomendations related to menstruation. They were guided on simple ways to ease the pain so they can actively participate in daily life activities. The topics of dangers of unsanitary habits and complete hygiene guideline were covered during the sessions. They were taught how to precisely measure the expected date of your next period to prevent accidents and emergencies. An activity ‘ Let’s Break the Myths” was conducted in which we asked the teenage girls to tell us about the myths about mentruation they have believed to be true. These myths were broken down as per no scientific evidence.

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At the end of the session the girls were distributed a “hygiene kit”. The kit had mestrual flow absorbents, sanitary soaps and a hygiene manual. The manual had complete healthcare and sanitary guideline required to maintain cleanliness and prevent infections during menstruation.

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To evaluate the impact of our project, quesstionnaires were filled out byt the girls which indicated that more than 87% of the audience benefited from the knowledge provided. Several misconceptions and taboos surrounding the topic were cleared. The girls who attended the seminar were advised to spread the useful knowledge to their female friends and relatives so the impact of our project would be increased. The project also included a a promotional video to spread the awareness to medical students about the importance of discussing menstrual health and hygiene through Ifmsa – Pakistan pages. Medical Students from different colleges participated in the video and expressed their views on why talking about mentruation is critical for female health.

Link to video : Menstrual health and hygiene: QAMC-LC

Activity Reported by: Ayesha Siddiqua 

Activity Coordinators : Ayesha Siddiqua, Haniya Waseem, Tabeer Warraich .

References:

DOs and DON’Ts of Health: QAMC-LC

Pakistan has been ranked 149th among 188 countries in the first global assessment of countries progress towards the United Nations Health related sustainable development goals. It reflects the health status of the country and as we all know that majority of the population live in villages so this difference is created by the periphery of this country. People living in cities are comparatively knowledgeable about the health and related issues. But still it is overwhelming and people of Pakistan need full attention regarding health issues both in cities and villages. Awareness in the country is prevailing but we need to accelerate it as health hazards are also accelerating with even greater pace. People know what is good and what is bad for them and their health but health isn’t their first priority and that’s an issue. We have to change the mindset and it takes some time but as medical students and as SCOPH heroes we are not going to step back. We have to emphasize the importance of health as their first priority.
According to WHO report no nation has reached the objective to end childhood overweight or to fully eliminate infections like HIV and TB. But actually they are getting it better the situation isn’t the way it was few years ago. Today Health standards are better and people are getting awareness and that is what we have to do in our country ” Health the first priority” and demonstrating ” Do’s and Don’ts of health”. So here we are focusing on following issues and spreading the concept of health, which has been highlighted by government and other research teams, targeting the periphery.
Pakistan is facing a double burden of disease (BoD), the burden is higher in the poor, and many of these conditions can be controlled at relatively low-cost interventions and best practices through primary and secondary care levels. Communicable diseases, maternal health issues and under-nutrition dominate and constitute about half of the BoD. In young children, diarrhea and respiratory illness remain as the major killers. Maternal deaths due to preventable causes like sepsis, hemorrhage and hypertensive crises are common. Pakistan is one of the three remaining countries where Polio is still endemic.
Moreover, Pakistan has an endemicity of hepatitis B and C in the general population with 7.6% affected individuals; the 5th highest tuberculosis burden in the world, has focal geographical area of malaria endemicity, and an established HIV concentration among high risk groups. Other vaccine preventable diseases and new emerging infections call for strengthening disease surveillance and response system uniformly across the country. Pakistan has one of the highest prevalence of under-weight children in
South Asia. Similarly stunting, micro nutrient deficiencies and low birth weight babies contribute to already high level of mortality in mothers and children.
The common underlying factors for non-communicable diseases including lifestyle, nutrition and smoking have not been addressed adequately. Access to and affordability of essential medicines is low. Moreover, there are geographical disparities in
coverage between provinces, districts and rural-urban area. Evidence shows that low income groups are likely to have lower levels of health, nutrition, immunization and family planning coverage.
Pakistan has a mixed health system, which includes government infrastructure, parastatal health system, private sector, civil society and philanthropic contributors. By such awareness we can enforce public health laws promulgated, related to smoking, drug safety, organ donation and transplant, safe blood transfusion, environmental protection, food safety etc. And this can lead to healthy communities.
In our project we the SCOPH heroesScreenshot_2017-07-01-15-49-43 went to a Basti in Multan (Ganji basti) on 2nd July 2017 and spread awareness regarding health and related basic Do’s and Don’ts. The interaction was started with some simple questions
       “what is Health?”
       “Why do we need it?”
       “What are the problems related to health?”.
They gave an account of all the associated issues and highlighted the major problems.
Hepatitis is one of the problem in that community so prevention techniques for hepatitis were told.
Screenshot_2017-07-01-15-44-22•Use of clean water and its benefits.
•Avoiding the reuse of surgical instruments and infected blades.
•Importance of vaccination etc.
Hepatitis A is one of the world’s most common viral infections. Although most patients recover within two months, the disease can produce significant morbidity, which can be largely prevented with appropriate immunization strategies. They were not well aware of vaccination so the importance of vaccination was highlighted. Benefits of balanced diet was demonstrated as they didn’t have any concept of balanced diet. Juices were distributed and awareness related to healthy food was spread. Unhygienic living conditions were Screenshot_2017-07-01-15-54-03observed so importance of cleanliness was highlighted. A wide range of discussion was done on various Health topics and it included a public talk related to Do’s and Don’ts of healthy life style and knowledge of non-communicable diseases moreover it will be repeated in the same community for evaluation and betterment. The same activity will be taken out in other peripheral communities so that no one remains unaware.
This activity was fruitful as awareness was spread in that community where people were not knowledgeable. It will include a lot of students and more villages for awareness regarding “Do’s and Don’ts of health” in future. The message of SCOPH will reach to so many people who are in need and betterment will be observed in evaluation
Event Report by: Ahmad Danial Bosan (local public officer QAMC-LC)

Poison Prevention Campaign  (Awareness Walk & Toxi-posium): LMDC-LC

Over the past few decades, our modern-day society has grown to the point where a large majority of commonplace formulations are not only readily available, but for the most part inexpensive. Be it various drugs, pesticides, herbal remedies, toiletries, or oils, the ease of access is a radical improvement in the quality of life of our community, but the increasing use of these everyday items has often masked their potential for abuse and harm, and that potential has made the common household more dangerous than it should be, particularly in our already-divided society. Readily accessible and normally beneficial pain medication is being abused to commit suicide through self-poisoning, particularly by domestically abused women of our society. Pesticides and various herbs and plants are being used against family members as homicidal agents. A substantial proportion of poisoning has been unintentional, with infant and child poisoning occurring through easy access to bleach, detergents, mothballs, other such household items and even certain plants and flowers which may contain fatal active ingredients. Use (and possibly overuse) of certain drugs by mothers such as oral contraceptives can cause side-effects which may be long lasting, and pregnant women using teratogenic drugs without proper knowledge of its effects can cause harm not only to themselves but also to their unborn child.
In the light that poisoning is one of the most common causes of death in Pakistan, an initiative was taken by IFMSA-LMDC in a collaborative effort with the Forensic Medicine and Toxicology Department of LMDC to have a Poison Prevention Campaign consisting  of two main activities, spanning from the 13th to 15th March 2017. The whole college was adorned in posters regarding the event.17523235_1429805480404632_4031578106802926947_n

On Monday 13th March’17 an awareness walk on Poison Prevention was done at Lahore Medical and Dental College ( LMDC). About 120 students along with faculty members participated in this event.
17264107_1937019309917937_50908560646542182_nThe awareness walk aimed at advocating the need for poison prevention measures to be taken by the general public and how medical students can work towards spreading this awareness motto amongst others and highlighting specific ways to prevent it. Faculty members and students, held placards with various messages. The slogans had  statements like “Tobacco companies kill their best customers”, “Only take medication from Doctors prescription”, “Don’t go for self-treatment, ” Children can’t eat what they can’t find,”Don’t let another light go out”, “Think before  you eat ” and  ” Zahr say agahi , mein hai zindagi”.  Th walk was featured in Dawn News, which coherently made the word reach the nation.

On the 15thMarch’17 a Toxicology Symposium took place in the LMDC auditorium with an attendance of approximately 200 . The event started with a word of warm tidings to everyone by the Principal of LMDC and by the Head of Forensic Medicine and Toxicology, Prof.Aamir Bashir. Welcome notes were delivered stressing the importance of toxicology and the need to have such platforms of discussion.

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The presentations commenced; starting from student presentations. Mahnoor Mohydin from LMDC presented “10 Famous Cases of Poisoning, with detailed cases on Mustard Gas and Cleopatra’s snake bite”  and Hira from KEMU presented the relationship of age and gender in types of poisoning as seen from studying autopsy reports . Notable presentations were also done by esteemed Professors.  Prof.Khalid Gill presented the psychological aspects of suicide . Prof Zahid Bashir  shed light on the toxicological analysis. The HOD of Forensic Medicine Prof. Arif Rasheed Malik  discussed Alcohol intoxication. The HOD of Forensic Medicine  from FMH Prof. Khalid Chaudry  talked on kerosene poisoning. The Head of Peadtrics LMDC Prof  Rizwan Waseem on Child Poisoning and lastly  Dr.Saad on dental cases of poisoning . There was a huge variety of topics, which enlightened the students and  attending.
There were small video clips which were played in between the presentations which depicted suicidal, homicidal and accidental poisoning cases.

The Poison Prevention Campaign  proved to be a success17265251_1937530616533473_2139879768127092345_n and will hopefully inspire further poison prevention measures and awareness activities.
The presence of more and more potentially harmful substances has made it all the more necessary to educate both students and members of the community of the dangers that these remedies and items possess, to increase awareness of different methods to manage such cases and provide care to the affected person, and to increase diligence on the part of the community on the handling and use of these substances. These considerations will surely pave the way to making our homes safer.

Report by: Mahnoor Mohydin (President LMDC-LC)