What's with all the Period Drama

When Mandi Tembo joined a team of researchers working on reproductive health, she didn’t think it would lead to her hosting an Instagram feed full of provocative artistic interpretations of the female reproductive organs. But that’s the stunning thing about Mandi: she goes where the research takes her, and the importance of sexual pleasure to mental wellbeing is the next frontier of holistic sexual and reproductive health research.

Born in Harare, Mandi went to high school in the city before leaving to do her undergraduate studies at a liberal arts college in the United States. From there she did a Masters in Global Health and Development at University College London, followed by a PhD at the London School of Hygiene, which is where she specialised in menstrual health — because that’s what young women in Zimbabwe were crying out for.
“As far as I could tell, menstrual health wasn’t something you could study. We wanted to develop a community reproductive health service so we started by asking young people what they wanted. The boys asked for condoms, the girls wanted menstrual health products and information about menstruation. There was no material in Shona or Ndebele, no videos of people like me explaining how to use menstrual cups or to answer frequently asked questions.”

The work that followed put Mandi at the forefront of Zimbabwe’s period poverty movement. This campaign, which highlights the difficulty that many women across the world face trying to access menstrual products, education and hygiene facilities, has gathered pace over recent years. Initially Mandi got short shrift from communities in Zimbabwe — mainly from conservative families who felt that even the most basic information was too much for their girls and women.

Mandi understands this stigma all too well because she’s lived it herself. “I grew up in Zimbabwe with very conservative parents. When I got my first period there wasn’t a conversation about it at home. I was just told, ‘Here are your pads, don’t play with boys now,” and I was like, ‘But what does that mean? What’s the link?’”

Mandi’s early work focused on understanding Zimbabwean women’s experiences of periods. With her stellar academic experience, self-assured manner and open-mindedness, there wasn’t a better researcher for the job.

“Anecdotally, period poverty is all about a lack of access to products,” Mandi says. “There was a lack of rigorous evidence to show whether this was the main need. When we gathered qualitative and quantitative data, it showed that access to products is indeed a big problem. But it also showed that there is so much taboo and stigma, and a lack of information-sharing that leads to poor behaviour.”

One of the biggest surprises to come out of her research was the number of women who talked about significant period pain. The assumption was that girls were missing school or skipping work when they had their periods because they didn’t have products to use. But many reported being in too much pain to continue everyday life; others said they couldn’t afford pain medication and analgesics weren’t enough. This was a lightbulb moment for Mandi.

“We realised that there must be so many women living with endometriosis, which is such a painful and debilitating condition, who will never get a diagnosis,” she says. “The assumption in Zimbabwe is that periods are meant to be painful — that’s what I thought when I was growing up — but that’s not true. Knowing how much pain affects women’s lives was a new discovery. When we started talking about pain with women in this country there had to be an educational component because it’s hard to calibrate pain when you assume that pain is normal. Educating people to what is normal allows them to think more critically about their experience.”

Armed with this research, Mandi and her team set up community centres where women could access products and information. In a country such as Zimbabwe (a “low-resource setting” is how it is described by academics) access to products is the biggest challenge. There is also the added dimension of dealing with menstrual blood when you don’t have access to water, light — or indeed a clean, private bathroom.

Mandi is a fan of the menstrual cup as a solution as it only needs changing once a day, is easy to wash and doesn’t create a lot of waste; but her research reveals the limitations so many of us have experienced ourselves trying to get to grips with that fiddly piece of silicon.

“Many people who advocate for the cup say that if women just keep trying, they’ll get used to it. However, the findings from our work is that both menstrual cups and sanitary pads are viable options but there’s a clear preference for reusable pads rather than the cup.”

“Many young girls initially opted for the cup. They said, ‘Oh, this sounds interesting.’ Then they would come back and say, ‘Actually I need the reusable pads. My mum took my cup away because she thinks it’s inappropriate for me to use.’ It’s obvious that we need to educate the wider community too.”

Social taboos are a far bigger challenge than access to pads or cups. Questions that Mandi is asked by women and girls are as much about sex and body image as they are about menstrual cups and period pain. However, issues such as sex are harder to address because they directly confront the barriers and expectations that women must overcome in a conservative place such as Zimbabwe.

Undeterred, Mandi has made these culturally embedded issues the focus of her post-doctoral research fellowship, funded by Reckitt Global Hygiene Institute. Mandi’s Instagram feed, @thebleedread, is also the perfect example of “participatory data collection”: the scientific term for the intersection of art and science which encourages people to share their experiences by creating art. For issues that are difficult to discuss, art can provide a language.

This has led to Mandi’s latest project: an art competition, MWEDZI, which invited women to create a piece art or music to describe their menstrual experiences. The results made for a no-holds-barred exhibition at Harare’s Pikicha Gallery in November. It will, Mandi hopes, raise awareness about how painful and lonely periods can be for women in Zimbabwe. One senses this is only the beginning. Zimbabwe is an unlikely place to be pushing the envelope on female sexual health, but if anyone can get us talking, it’s Dr Mandi Tembo.

Charlotte Ashton
Instagram: @TheBleedRead