STORIES

Period pains – The people fighting period poverty in Thailand 

By Laure Siegel

Photography by Luke Duggleby

Tens of thousands of women in Thailand lack access to safe and cheap sanitary products. Social stigma, limited access to information, male opposition to better education, and day to day precarity endanger their health and lives. 

27-year-old Varangtip Satchatippavarn has founded a company to produce safe sanitary products and works with advocacy groups who campaign to include the issue in the education system and to get men involved.

 “We suffer in silence and hide behind fake smiles. Why is such a simple and common thing so frowned upon by our society? It’s time you, your body, and our planet can finally have a choice. It’s time to be liberated,” says Varangtip, who goes by the nickname ‘Rung’.

After finishing her studies in biological science, Rung landed her first job at the National Innovation Agency at the Ministry of Science and Technology. In September 2019, she began to focus on gender equality and sustainability, and in late 2020, she launched her company Ira Concept, which aims to provide women with an inclusive choice of sanitary pads.

A period drama

“The sanitary pads sold in supermarkets are made of synthetic fibre and chemicals and one pad is as polluting as four plastic bags. Many women are allergic to those chemicals,” Rung says.  

Ira concept created safe ecological pads made of bamboo, corn fibre, wood pulp and polylactic acid (PLA), a bio-based plastic, making them biodegradable in one year. Conventional pads can take up to 500 – 800 years to fully decompose.

Thailand generates about two million tonnes of plastic waste a year, of which only a quarter is properly recycled. According to some estimates, the country is the world’s sixth-largest ocean plastic polluter. But young Thais are becoming increasingly aware of environmental issues and are also more open to talk about old taboos such as periods.

Rung chose menstrual pads because tampons and moon cups are not popular among Asian women. Moon cups are only available from eco or online stores. “There is a negative stigma about fiddling about with your vagina. We have been taught by our parents and conditioned by the lack of sex education that if you insert something into your vagina, you can break your hymen and lose your virginity. Pads remain the most appropriate option in this cultural context, which is difficult to change for now.” 

Most moon cups are made from organic plastic and can be used for a couple of years, which makes them a cheap, easy and ecological option. But they need to be emptied and sterilised with clean water several times a day to avoid the risk of bacterial infection and they cost 200 to 1500 baht (USD 5.80 – 43.65), a significant investment for many women.

Tampons present a similar risk of infection as moon cups, both of which can cause Toxic Shock Syndrome (TSS) in rare cases. The disease is a life-threatening condition caused by the release of harmful toxins from an overgrowth of bacteria.

In 2012, American model Lauren Wasser made headlines because she contracted the disease after using a tampon. She started suffering from flu-like symptoms, which culminated in a heart attack. Both of Her legs were consumed by gangrene and had to be amputated below the knee. 

Since then, Wasser has campaigned for the US government to pass the Robin Danielson Act, named after a woman who lost her life to TSS in 1998. The bill directs the National Institutes of Health to “provide for the conduct or support of research on the extent to which components in feminine hygiene products pose any risks to the health of women or the health of the children of women who use those products during or before the pregnancies involved.”

For Rung, advocating for long-term research on issues related to women’s health is as important as filling up the market with safe and competitive options. Her pads retail in Tops, Central Food Hall, Gourmet Market and Dear Tummy supermarkets across Thailand. But due to small scale production they retail at four times the price of mainstream fibre pads. Rung hopes for more access to mainstream markets to lower prices. 

Ira Concept also donates pads to communities who can’t afford to buy them or have no access to quality products. During the COVID-19 quasi-lockdown in Bangkok in the summer of 2021, an estimated 80,000 migrant workers, most of them Burmese nationals, were banned from leaving their work camps. Most employers failed to provide basic necessities, and after a few days, families ran out of food and water, and women ran out of sanitary products. Civil society organisations such as Bangkok Community Help and Covid-19 Relief Bangkok stepped in, and Ira Concept used ten percent of their July revenues to give sanitary pads to the latter.

Rung also created a program for the Karen Women’s Organisation (KWO), an indigenous women’s rights group serving refugees along the Thai-Myanmar border. For every pad sold, she offered another to the ethnic support group. Since the military coup in Myanmar on 1 February 2021, thousands of refugees fleeing airstrikes and shelling have crossed into Thailand, in dire need of food, clothes and amenities for women. As of April 2022, Rung has donated 15,262 pads.

A Karen woman living in an informal jungle settlement on the Myanmar side of the border, says, following an attack on her village by military forces, “The main problem is lack of water to keep clean. Some women miscarried when they had to run to save their lives. Some developed infections because they had to hide in riverbeds or in pit holes for days and nights. And then in the refugee camps, they are mocked and harassed by men because they don’t wear bras or cannot change underwear as they fled with nothing more than the clothes on their backs.”

Bread and jam

In Thailand’s Deep South, Luuk Rieng, an organization working for the well-being of Muslim children and women, is fighting a similar war. The group was founded in 2004 by Wankanok ‘Chompu’ Pohitaedao. It was Chompu’s way to cope after four of her siblings were killed in encounters between Muslim insurgents and the Thai military. More than 7,000 people have lost their lives in the conflict gripping Thailand’s three southernmost provinces since the early 2000s. 

As a consequence, many women and children were left to fend for themselves. “So many children lost their parents and had no home to go back to,” Chompu says. “Back then, I was a student and stayed in a rental house. I asked them to stay at my place. I brought more blankets from my parents’ house and got a bigger rice cooker to feed them. In the Deep South, many single mothers were forced to marry at around 13-14 years old to follow Islamic religious tradition. Marrying at a young age affects girls’ development since their bodies are not physically ready, they are not mentally prepared to start a family and they have no chance to access further education. Others lost their husbands to violence. That’s why many of them have to raise two to three children alone.” 

“We have suffered in silence and hid behind fake smiles. Why is such a simple and common thing so frowned upon by our society?” 

To make their precarious situation worse, women suffer the consequences of social misconceptions about periods in their conservative communities. “Many people here want to keep this issue private. When you buy sanitary napkins at local grocery stores, you cannot find them on shelves.The shop owners hide them in boxes and will wrap or put them in a black plastic bag before handing them to customers. At the beginning, our group would be chased out of villages and shouted at by angry men who didn’t want us to bring this topic out.”

Chompu also lost many friends to endometritis, an inflammatory condition of the lining of the uterus. If left untreated, it can lead to fertility issues and septic shock.

“Women here are exposed to profound health risks from early sexual initiation. When they get an infection from their husbands, they have no idea what it is and feel embarrassed to see a doctor because most obstetricians in Thailand are male. They are not taught to discuss women’s health and they don’t have access to information on sexual well-being and hygiene. Many young girls don’t even know how to use sanitary napkins. Mum would teach you how to make sanitary pads from your old clothes, but that was it. We used this cloth pad for a whole day, washed it and changed it when it got too dirty. But some people didn’t wash it well, so it caused infections.”

To break the circle of shame and disease, Luuk Rieng founded a ‘Bread and Jam’ team of volunteers who introduce school students to sexual hygiene, menstruation, puberty, hormone fluctuations, body changes and mood swings, demonstrate how to use sanitary napkins, explain where to buy them and give some away. Chompu explains, “To break the period stigma and normalise periods, we want to expose the secret codename of pads, which is ‘bread’, so everyone can openly talk about periods and sanitary pads without shame and no longer exclude parties from period conversations.’

Chompu’s dream is to be able to provide ‘puberty kits’ containing sanitary napkins, information on how to use them and who to contact if in need of assistance, to as many girls as possible. “Many teenagers are under stress dealing with their periods and some don’t go out during the first three days of heavy menstrual bleeding. It doesn’t make sense for girls to spend three days a month not doing anything because they have their periods. I’ve asked many young people what they need. They didn’t ask for stationary or pencils, but for bras, clean underwear and sanitary pads. I think it’s time for Thailand, a developed country, to pay attention to this.” 

Rung has tried to approach schools with her products but has met resistance. “Schools don’t like to work with us, not because of the lack of budget in the public sector, but because stepping in would be an admission that there is a problem for female pupils”. Only a few university student unions have taken it upon themselves to set up boxes of free napkins.

Opposition political parties are slowly noticing the need to address this social issue. 

Patsarin Ramwong from the Move Forward Party is leading the Thailand Pad Project, which distributes napkins to underprivileged communities and advocates for the lifting of VAT on female hygiene products.

On 8 March, the Pheu Thai Party launched a campaign demanding the government give free access to menstrual products to mark International Women’s Rights Day and started doing so at its Bangkok headquarters. For a month, visitors could partake in forum discussions and stroll through an art exhibition curated by illustrator Juli Baker and Summer, film director Prim Issaree, and singer Pyra.

Project manager Chanan Yodhong told the Bangkok Post that “the average woman of menstruating age uses 15 to 35 pads a month, costing a total of 350 to 400 baht — which equates to 4,800 baht a year or almost 200,000 baht throughout their lifetime. This compares unfavourably to a daily minimum wage of 331 baht.” Chanan further mentioned that “around a third of women in Thailand lack access to sanitary pads”. He estimated the budget for free pads would come to 10.9 billion baht per year, or 0.6 percent of the government’s annual budget, while the government already collects around five billion baht from the seven percent value-added tax levied annually on sanitary pads and tampons.

 

Blood tax

In July 2021, the government tried to re-categorize period products as cosmetic products, opening the possibility to levy a 30 percent sales tax instead of the seven percent generic one. Kamori Osthananda, the Thai ambassador of The Pad Project, an advocacy group founded by students in Los Angeles, collaborates with Ira Concept and commented, “It is difficult to get rid of all VAT because it would require a change of legislation, but if there is VAT, it should be used for distributing free pads in school.” In an article for Thai Enquirer, she wrote, “The recent campaign #ผ้าอนามัยปลอดภาษี (#taxfreepads) brought our longstanding need for period equity to light. The government has since clarified that period products are controlled substances and that they would not be subject to a sales tax and only VAT. Period products must be accessible, if not free, as they are a basic healthcare necessity. We cannot be governed by a law that fails to acknowledge our bodies, one that does not hold in the highest regard for our safety, security and well-being.”

Kamori offers clear recommendations for stakeholders involved in the period-product industry, “The true value of being able to provide us menstruators the assurance of hygiene lies in your commitment to actively raise awareness to destigmatize the natural, biological process of menstruation; in your putting people over profit when it comes to alleviating period poverty; in your recognition that period poverty is often worst for those facing several disadvantages at once, due to gender, education or income status.”

Chompu is adamant that menstrual pads paid for by the state or provided free by brands should be the norm, “If it cannot be free, it should be affordable and there should not be a VAT charged on sanitary products. Corporate brands shouldn’t focus only on marketing campaigns but should care for women’s hygiene.”

Meanwhile, Rung has launched her own educational channel, where “we talk about vagina, sex, period, and everything in between”.

“Now the word “period poverty” is getting more media attention and more people are talking about it. We want to normalise conversations about periods among all genders,” Rung says, “Fathers, brothers, boyfriends should be an integral part of the discussion.” 

Laure Siegel is a French correspondent covering politics in South and Southeast Asia for Mediapart in France. She is also a regular contributor to Nikkei Asia and French-German public TV channel ARTE.