University of São Paulo: USP students help homeless women have access to pads

Among the various public health problems highlighted by the covid-19 pandemic, some directly affect women, especially those living on the streets, such as lack of access to basic intimate hygiene products, such as tampons, for example. In Ribeirão Preto, this reality made the coordinators of the Pontes Project , which has worked with homeless people since 2018, to restructure their actions and start distributing hygiene items to the homeless population, including tampons, as many women reported the lack of the product. “Menstruation experienced on the street is extremely problematic and makes women even more vulnerable,” says Regina Célia Fiorati, professor at USP’s Ribeirão Preto Medical School (FMRP), responsible for the project.

Difficulties in accessing health services and infrastructure are also common to the homeless population. Places to clean themselves are difficult for everyone, but “women suffer much more from this lack of access and also from places where privacy is present”, explains the teacher, noting that women have “biological conditions that require adequate environments”.

Homeless women face numerous prejudices and suffer more violence, says the teacher, including the lack of access to health services at the primary care level, through which they could receive information about intimate health and sexual health. “It is at this level of care that they could be oriented about intimate and sexual health, but, however, primary health care services offer little access to homeless populations in general”, he points out.

The Pontes Project has been dialoguing with the primary health care services so that they can guide the homeless population about which services to look for to take care of the health issues they are experiencing and which services these people could receive. “That way they would have more detailed information about their own intimate and sexual health and also about periodic and necessary gynecological care”, he emphasizes.
Listen on the player below to an interview with professors Regina Célia Fiorati, from the Faculty of Medicine of Ribeirão Preto, and Yara Lúcia Mendes Furtado de Melo, from the Federal University of Rio de Janeiro.

This reality in Ribeirão Preto is experienced by millions of Brazilian women, both from urban centers and rural areas. These are people who experience the so-called “menstrual poverty”, a term that includes lack of access to various resources, such as intimate hygiene products, water, basic sanitation, infrastructure and information.

Absorbents, while essential for the menstruating person, are still seen as luxury cosmetics, costing little to some people but inaccessible to others. Recent researchof a tampon brand, with 1,124 young people between 16 and 29 years old and from all social classes in the country, highlights the lack of financial conditions to acquire tampons for about 29% of the interviewees. In social classes D and E, this index is even higher, reaching 33%. Considering that, throughout the fertile life, a woman menstruates 400 to 500 times and, in each menstrual cycle, uses an average of 20 to 25 pads at a price per unit ranging from R$0.30 to R$0.70, the approximate monthly expense is R$20.00. It is estimated that a woman uses 10,000 pads throughout her childbearing age, which can result in an expense of around R$8,000.

For Brazilian women, this cost is aggravated by taxes that represent, on average, 25% of the product’s price, a fact that, according to specialists, makes sanitary pads less affordable for the low-income population.

There are about 13.6 million Brazilians, approximately 6.5% of the population, who live in extreme poverty, and another around 51.5 million people in worse conditions, living below the poverty line, according to the report by the United Nations International Emergency Fund for Children (Unicef) and the United Nations Population Fund (UNFPA), based on IBGE data – through the National Health Survey (PNS), National Health Survey School (Think) and Family Budget Survey (POF).

Impact on school dropout
Also according to the UNICEF and UNFPA report, the absence of minimum sanitary conditions affects 713,000 Brazilian girls who do not have access to toilets in their homes; 88.7% of them, more than 632 thousand, live without even access to a common toilet on the land or property; 900,000 do not have access to piped water in their homes and 6.5 million live in homes without any connection to the sewage system.

And in the school context, these girls are still victims of menstrual poverty, increasing school dropout rates. In Brazil, one in four students has already missed school during their menstrual period, according to an estimate made by the World Health Organization (WHO). And, according to Bill 798/2018 of the City Council of Rio de Janeiro, students miss up to 45 days of class during the school year.

There are more than 4 million people in this condition in the country’s schools, 38.1% of all students, suffering from the deprivation of at least one of the minimum hygiene requirements to guarantee their rights during the menstrual period, including lack of access to absorbents, basic facilities and basic hygiene items such as soap and toilet paper. Of these, nearly 200,000 students are completely deprived of the minimum conditions to take care of their menstruation in the school environment.

health hazards
Lack of access to basic intimate hygiene items causes inappropriate materials to be used as substitutes. According to the tampon industry survey, 50% of the interviews had already needed to replace the tampons with toilet paper, old clothes or a paper towel, which is not safe for health and can cause infections in the urinary tract, kidneys, organ damage. female reproductives and, in the long term, infertility, in addition to hurting dignity, evaluates the professor of gynecology at the Federal University of Rio de Janeiro, Yara Lúcia Mendes Furtado de Melo.

Professor Yara recommends that, during the menstrual period, women “need greater care with hygiene and the use of a suitable absorbent with regular changes, to reduce skin contact with the moisture of menstrual blood. This contact can trigger many infections in the vulva, because the pH of the skin changes a lot”, in addition to increased sensitivity and even other symptoms, such as burning and itching, which cause abrasions on the skin and which can possibly lead to secondary infections.

Due to alarming data, initiatives are being taken to combat menstrual poverty. In 2020, the National Human Rights Council recommended the creation of a legal framework to overcome menstrual poverty and the guarantee of tax exemptions on intimate hygiene products. Currently, in eight Brazilian states , bills on the subject are being processed. In the Chamber of Deputies, Bill 128/21 , which obliges the government to provide free sanitary pads and tampons to women from families registered in the Cadastro Único for government social programs, is also underway. In addition, there is a legislative suggestion in the Senate for the free distribution of sanitary pads for homeless or low-income women at health centers. On May 14 this year, it was the São Paulo government’s turn to announce the state’s Intimate Dignity program to distribute menstrual hygiene products to students from schools in the state network.

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