‘Period poverty’ in Panama impacts the country’s indigenous peoples

By Greta Magendantz

Photo by Kenneal Patterson | A Guna woman holds her baby in a tight corridor between homes on Gartí Sugtup.

GARTÍ SUGTUP, Panama – “Mañana vamos a beber café,” a man yells down a narrow dirt road in Gartí Sugtup, an island community in the Guna Yala comarca, both hands cupped around his mouth. A cacophony of whoops and cheers in response erupts from fishermen, street vendors and school children alike. 

Aldolphino Davis, the founder of the Kuna History Museum in Gartí Sugtup, explains with a wide smile that this means the community will begin the Sergu-ed tomorrow morning in honor of Isabella Martinez, 12, who began her first period two days ago.

The Sergu-ed is a celebration surrounding a Guna girl’s first menstruation. When a member of the community begins a period for the first time, a 10-day long party ensues. On this early June day, local men will search for the largest bihua leaves to build a series of walls using the palm-like brush. A traditional kayak will be installed in the structure signifying the navigation from the current phase of Isabella’s life to the next. And in the coming days, she will be bathed in it many times by the women of the community.

The start of menstruation is an exciting and sacred time in this region of Panama. Yet despite this, menstruators in Guna indigenous communities are not free from the state of “period poverty” that plagues Panama. In fact, indigenous people, including the Gunas, are impacted the most deeply of all, experts say.

“The costs of menstrual products in Panama make it difficult for women to access quality products,” said Joice Araujo, Panamanian women’s rights activist and policy analyst. “In the indigenous communities, there is even more of an economic strain. They have to choose whether to spend their money on things like food and transportation, or on menstrual products.” 

“Period poverty” is a term used to describe the struggle many women and girls face because they lack access to adequate menstrual health management supplies and education, said Jessica Williams, chief development and communications officer of Days for Girls International. The Washington-based organization, which focuses on access to menstrual products and education, notes that 500 million people worldwide experience some form of period poverty.

Photo by Kenneal Patterson | Isabella Martinez, 12, undergoing the Sergu-ed ceremony.

For menstruators in indigenous communities, their relatively limited monetary income and isolated neighborhoods exacerbate the state of period poverty. Kelly Hernandez, a Panama-based reproductive health educator and advocate, says that the situation is undoubtedly worse for indigenous menstruators than any other group in Panama. “This is due to the economic situation and also to the location of their communities,” she said. “The more remote you are, the less chance of getting these essential products.” 

The taboo around menstruation, which has developed among the Guna in more recent years, has also exacerbated period poverty. “If our silas finds out that we are talking about menstruation to outsiders, we could get in trouble,” one woman from the community said as she sat outside her home cutting pineapple with a large knife.  

Silas, the Guna chiefs of each community, were not eager to speak about menstruation resources in their districts. “If you want to ask the women about that, you can go door-to-door,” said Paolino Contreras, one of the community’s four silas, none of whom is a woman.

While this hesitancy is not unusual, it has an especially detrimental impact on native peoples whose school systems do not thoroughly explore reproductive and sexual education.  

Eloida and Loida Smith, sisters in the Cagandi community, shared about the lack of knowledge spread by anyone on these topics. “It’s not something we discuss in schools or even in families,” said 27-year-old Loida Smith, the older of the two sisters, through an interpreter. “She was the one who taught me about all of these things,” Eloida said, gesturing toward her older sister. “All I know is what she knows, and all my girls will know is what I know.” 

In the absence of affordable and hygienic resources, many women are forced to figure it out on their own – a reality that modern women shouldn’t have to grapple with, say activists. “There are numerous examples of women who use rags, cut up diapers, or otherwise try to ‘make do,’ sometimes going without period products, in order to feed their families and themselves,” said Bridget Crawford, a law professor and researcher at Pace University in New York City. “We have to start recognizing menstrual products as the necessities that they are.”  

A number of activists, researchers and healthcare professionals are at work in Panama to eradicate period poverty across the nation. Like many other countries, there is no system supported by the Panamanian government that addresses period poverty and its complexities. “There is no integrative plan that includes making these products available in schools, workplaces, healthcare offices, as well as educating young ones on menstrual health,” said Araujo.   

In addition, the government’s data-gathering resources have not been employed in considering the gravity of menstrual inequity. “There are no studies or investigations in Panama that address the situation of access to menstrual supplies,” Sanchez said. Because of this lack of information, the government has not offered any type of systemic financial support for menstruators. “In Panama, menstrual supplies are part of the free market,” Sanchez said. “They are not placed as basic needs,” she said, explaining that menstrual products are charged the standard national tax rate of 7 percent. 

Without cooperation from the government, education seems the best viable route to combat menstrual poverty. Organizations and individuals are in the process of spreading reliable information about menstruation, opening the door to more in-depth conversations and minimizing the stigmatization around the topic. “Education is the main tool for change to guarantee human rights,” said Sanchez. “It is in it that we could eradicate the myths and taboos that exist.”  

This was part of the reason that Floating Doctors, a Panamanian non-governmental organization that focuses on providing healthcare for indigenous communities, was created.   

“We wanted to make sure that people in native communities get treatment for their health, but also that they have the knowledge about their health,” said Auerlio Tejeira, outreach coordinator for Floating Doctors. When indigenous youth have the opportunity to learn more about reproductive health, they take it seriously, he said. 

Tejeira described their anatomy education program as one of the most important initiatives the organization has to offer. Each weekend, Floating Doctors travels to a different indigenous community. The staff then provides medical assistance and knowledge out of the facilities within the local neighborhoods, eliminating the costs, stigmas and other difficulties of traveling to a medical facility.

“Floating Doctors is really glad to say that we are educating these young people because they are open, they are interested in this,” Tejeira said. “Every time we enter a new community, they are really wanting to hear more about the education piece.”

Hernandez is the organization’s main reproductive educator. She has developed a curriculum for Floating Doctors that includes topics from basic hygiene to the menstrual cycle to human trafficking. Hernandez gives her seminars to people in indigenous communities in their home environment, making people of all ages feel more comfortable participating.

“There were circles where the average age of the attendees was 30 years old, and that made me understand that it does not matter [the] age,” said Hernandez. “People are always willing to learn and listen as long as there is an open space where their doubts and concerns are heard.”

Tejeira added that hearing from an educator who is also indigenous allows for native peoples to be more open to learning. “She can get in touch with them and they will listen to her because she is native,” Tejeira said of Hernandez. “She can talk in her slang and they will understand better. (…) She is very connected to the youth because she is part of the community, they love to listen to her.”  

Photo by Kenneal Patterson | Two Guna schoolgirls talk outside of their school building and hide from the camera.

But young indigenous people are given the opportunity to learn about sexual and reproductive health less often due to the remote and traditional nature of many indigenous school systems.  

“In any school, workplace, community, city, state, country or part of the world, menstrual equity can be a powerful lens for measuring gender justice,” Crawford said. “When half the population does not have access to the basic hygiene products and information they need in order to attend school, go to work and otherwise participate in society, then that society will be less rich, diverse and productive than one where everyone has a fair chance, without regard to menstruation.” 

Araujo argues that until affordable, accessible menstrual products are available to all who need them in Panama, the citizens’ most basic rights are at stake. “It affects their human rights, the right to self care and the right to self-autonomy. The rights of girls and women are being destroyed.”

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