Girls are often accused of aborting pregnancies. They’ve been labeled as disgusting, impure, even cursed.
In primary school, many girls are tormented as they struggle to manage their menstrual cycles. The shame and stigma can be unbearable.
Then a more vicious cycle begins when they are pressured to exchange sex for sanitary supplies or encouraged by parents to get married so their husbands can purchase their pads. In extreme cases, the parents resort to selling their daughters into marriage.
These are among the life-derailing obstacles being tackled by the private sector and humanitarian organizations that work to end the exploitation of girls in pursuit of education.
Increased levels of absenteeism, higher rates of school dropout and poorer learning performance are among the significant effects that Menstrual Hygiene Management (MHM) has on a girl’s education, says Jaya Murthy, Chief of Communication for UNICEF Uganda.
“Statistics show that due to menstrual periods, girls lag behind boys in school by missing four school days per month, which equates to around two weeks of learning or 104 hours of school each school term and about 48 school days missed annually,” Murthy says, citing a study from 2012. “On average, a girl pupil will miss 11% of her learning time in school due to menstrual periods.”
Murthy also refers to a report by the Ministry of Education and Sports (MoES) in Uganda that estimates 23% of adolescent girls in the 12–18 age group drop out of school after they begin menstruating.
It was widely publicized during the campaign for the 2016 Ugandan general election that incumbent President Yoweri Museveni said he would provide girls with sanitary pads. After the election, his wife, Janet Museveni, who was appointed Minister for MoES, announced that the ministry had not received sufficient funds to fulfill the campaign promise her husband made.
On NTVUganda, the first lady mentioned the government has not given up hope on the program: “We haven’t got the funding yet,” the minister said during the interview. “When we get it, we will do it. We’d like to see it done.”
That was a year ago this month.
In the meantime, many groups have been on a mission to ensure that a girl’s natural journey into womanhood does not upend her future.
As a young student, Sadat Nduhira recalls how his classmates were teased when blood stained their uniforms. “It made the girls feel like they weren’t fit to study in the same school with other students,” says the artist who now runs the Elseed Art Foundation in Kampala.
Nduhira remembers the girls who dropped out of school. “The next thing you know I’d find out that they got married at very young ages to older men,” Nduhira says. “Their academic dreams would get destroyed.”
Such was the fate of one of his cousins. His sister, however, was able to get by using old clothes, toilet paper and banana fibers found in the countryside.
“It was and still is a big challenge for girls coming from very poor families who couldn’t afford to buy a packet of sanitary pads,” says Nduhira.
Taking a cue from his sister, Nduhira returned to schools in and around Kampala in 2016, and he began teaching girls to sew their own reusable sanitary napkins with baby towels, cotton clothes, terry cloths and sheets of polythene.
“It has become a source of income for young mothers and girls,” Nduhira says. “They are able to sell the pads at reasonable prices to those in need in their community.”
Nduhira, who donates his time and resources in the after-school program, would like to do more to assist girls across Uganda, but he operates on limited resources and a small budget.
When respondents ranked the top five items that were essential for children to enjoy an acceptable standard of living, they reported a visit to a health facility, two sets of clothes, three meals a day, toiletries to wash daily, school fees, uniforms and equipment. Sanitary supplies were nowhere on the list of 18 essential items published by the Uganda Bureau of Statistics.
According a World Bank poverty profile assessment published in 2016, Uganda had a per capita income of under US $170. That means many citizens were surviving on $3.27 a week, well below the international poverty line of $1.90 a day.
Western imported sanitary napkins could set back a family at least a week of pay. For example, the online retailer Jumia sells top brands for about $5 to $6 per pack.
Maka Pads, short for “menstruation, administration, knowledge, affordability” were designed to fit the needs and budget of everyday Ugandan families. The biodegradable handmade pads sell for about 67 cents for a pack of 10.
Of the 32 brands sold in the country, it’s the only product manufactured locally with local materials, according to the Maka Pads Project at Makerere University, College of Engineering, Design, Art & Technology. The late environmental activist and Makerere professor Moses Musaazi created the highly absorbent products made of papyrus fibers and shredded paper.
At one point, the U.N. High Commission on Refugees (UNHCR) was one of its best customers. The agency partnered with Maka Pads from 2007 to 2016 to distribute the sanitary napkins to women and school girls throughout Uganda, in turn employing refugees to produce and package the product.
Now the sales are confined other NGOs and schools, says Juliet Nakibuule, Maka Pads manager. “The major objective of innovating Maka Pads was to contribute toward improving girl-child education through MHM,” she says. “However, plans and strategies are underway to rebrand the product to meet the needs of the high-class clientele and thus widen the target market for Maka Pads.”
Girls in northern Uganda requested sanitary pads from WoMena, a Denmark-based NGO started by public health professionals Maria Hyttel and Marriane Tellier. Instead, the organization provided the girls with menstrual cups.
The menstrual cup, made of medical silicone and folded then inserted to cover the cervix, can collect two to three times more blood than other products, explains Tellier, who serves as executive director for WoMena.
Myths had to be dispelled to introduce Ugandan women to the concept of menstrual cups. First the girls had to overcome fears that menstrual cups would disappear inside their body, enlarge their uterus or cause infertility. These are concerns that Hyttel, Tellier and other experts document in a 2017 qualitative study, “Drivers and Challenges to Use of Menstrual Cups Among Schoolgirls in Rural Uganda.”
Many users experienced difficulty with insertion during the first couple of cycles, but after that, they feel more comfortable, Tellier says.
Womena has provided more than 4,000 cups, free of charge, with the help of supplier partners, says Tellier. “We first need to demonstrate that they are appreciated by Ugandans, before manufacturers will risk providing wider distribution.”
The cups, which cost a market price of roughly $5, should be washed in a little bit of clean water every six to eight hours; after each cycle, they should be washed in disinfectant or boiled with a brief drying time, Tellier says. “The cup can last up to 10 years and become cheaper after a few months.”
Womena is partnering with AfriPads, which provides environmentally sustainable reusable sanitary products, to provide organizations with a customized MHM curriculum that will help reduce the shame and involve families in the conversation.
At the Impevi Settlement camp in Uganda, 94% of refugee girls had discussed menstruation with their families after the project, Tellier says. “Before it was considered too taboo to discuss openly.”
One girl said wearing the cups gave her a sense of freedom. She was able to stay at gatherings for a long time, sleep with no problems and a ride a bike without looking back.
Header Image: WoMena