“When a girl starts to menstruate, that's when the problems usually start,” said Ndeye Rose Sarr, UNFPA’s representative in The Gambia. 

As many women and girls know, periods can be painful. Physical symptoms such as cramping and soreness, combined with the stigma surrounding menstruation, can interrupt schooling, work and women’s and girls’ full participation in society.  

Ms. Sarr said period poverty, or the inability to access or pay for menstrual hygiene products, is an especially acute issue across The Gambia’s rural areas – one with long-term implications for girls when it comes to education. 

“Period poverty leads to girls skipping school for around five days every month because they worry about staining their clothes and being shamed. That’s between 40 and 50 days in a school year,” she said. 

To address this challenge, UNFPA has launched an initiative in The Gambia’s Upper River region, Basse, to produce recyclable sanitary products that will be made accessible for free in schools. Women factory workers machine sew the reusable pads, providing opportunities for income and employment.

In the schools, UNFPA takes “the opportunity to talk about bodily autonomy and comprehensive health education, so that girls know more about their bodies, what is okay and what is not okay”, Ms. Sarr said.

“I think we are making a difference.”

From period poverty to bodily autonomy

But according to Ms. Sarr, for Gambian girls, the arrival of their period may also wrongly signal to society that they are ready for marriage. 

“From the age of ten, she will begin to be looked at as a potential bride for an older man,” Ms. Sarr said. “And if she has not yet undergone female genital mutilation, there will be those in her community who will want to make sure she does.”

Female genital mutilation involves injuring or removing female genitalia or genital organs for non-medical reasons. The harmful practice, recognized as a human rights violation, can have dire health consequences such as chronic pain, depression and infertility – or even lead to death.

Although female genital mutilation has been illegal in The Gambia since 2015, Ms. Sarr said only two cases have ever been brought before the court, with no resulting convictions. 

“Rites of passage for girls are important, but we don't have to go to the extreme of female genital mutilation,” she said. “It doesn't have to be harmful or invade the bodily autonomy of the person.”   

Disrupting the cycle

Despite the recognition by many that female genital mutilation represents a grave violation of human rights, the practice remains deeply embedded in the cultural fabric of some societies – representing a risk to nearly 70 million girls across 25 countries.

Nationally, an estimated 73 per cent of Gambian women and girls aged 15-49 have undergone female genital mutilation. But in several regions, the practice is even more prevalent – as high as 95 per cent.

Ms. Sarr says it is generally perpetrated, and perpetuated, by women. “It is usually a grandmother, the keeper of tradition in the family,” she added. “Gambians living abroad will even bring back their children to be subjected to female genital mutilation.” 

Recognizing why people may subject their daughters to cutting can help advocates against it to shift attitudes and perspectives. UNFPA is working with communities around the world to create a grassroots movement that uses incentives and pressure to convince societies to abandon the practice. 

Ms. Sarr says that in The Gambia, where men are typically decision-makers, UNFPA is seeking to engage men and boys in the fight against female genital mutilation.

“They are husbands, traditional leaders and religious leaders who will indicate what to do and what not to do in society,” she said. “We have studies that show that, in countries where men have become involved, rates of female genital mutilation have gone down.”

Research also suggests education can play a role in disrupting this harmful practice. According to UNICEF, girls whose mothers had received primary education were 40 per cent less likely to undergo female genital mutilation compared to those whose mothers had received no education.

The protective effects of education regarding female genital mutilation represent just one more reason to uphold the right of girls to go to school – something that menstruation, unfortunately, can negatively impact.