Monday, April 27, 2015

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No Pads, No School: Girls' Education Going Down the Toilet

Unable to access affordable sanitary care or facilities at school, schoolgirls are having to stay home during their period.
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Women work banana fibre, which can be used to make cheap and sustainable sanitary pads.

It is a widespread but unacknowledged problem that girls in Africa miss school and stay at home because of menstruation. According to UNICEF, one in ten schoolgirls in Africa miss classes or drop out completely due to their period, and substitute pads or tampons for less safe and less absorbent materials such as rags, newspaper or bark.

There are many aspects that link girls' attendance rates to their menstrual cycles. Firstly, the lack of affordable sanitary products and facilities for girls and women keeps them at a disadvantage in terms of education when they are young and prevents their mobility and productivity as women. Secondly, the lack of clean and healthy sanitation such as toilets and running water means that girls often do not have anywhere to change or dispose of pads safely and in privacy at school. Thirdly, the taboo nature of menstruation prevents girls and their communities from talking about and addressing the problem; raising awareness and education to eliminate the stigma of menstruation is a large part of the battle.

Dropping out

UNICEF reports that “in countries where menstrual hygiene is taboo, girls in puberty are typically absent for 20% of the school year”. Most girls drop out at around 11 to 12-years-old, and miss school not simply because they fear being teased by their classmates if they show stains from their period, but also because they are not educated about their periods, and their need for safe and clean facilities is not prioritised. The idea that monthly bleeding is something shameful, polluting, or taboo may also encourage girls to avoid social contact during their period. Additionally, the cultural implications of menstruation as a stage in a woman’s development may be used to take girls out of school – the idea being that if a girl is ready for motherhood, then she is ready for marriage.

In parts of sub-Saharan Africa, where enrolment rates are among the lowest in the world, the pressure on girls to drop out around puberty is particularly strong. Menstruation is a reason for dropping out that can be added to the potential threat of sexual harassment from male teachers as girls develop. In either case, the result is girls lagging behind with schoolwork and performing badly.

Improvements in sanitation can go a long way to combating the problem. In particular, building toilets in schools enables girls to manage their periods more easily. UNICEF’s attempts to provide "girl-friendly" schools with clean toilets with running water have met with significant improvements in girls’ education. According to the New York Times, “in Guinea, enrollment rates for girls from 1997 to 2002 jumped 17% after improvements in school sanitation, according to a recent Unicef report. The dropout rate among girls fell by an even bigger percentage”. In Guinea, Nigeria and Ethiopia, the instalment of thousands of toilets, training of teachers and introduction of school health clubs have shown substantial gains in enrolment rates for girls and a fall in their dropout rates.

South African promises

Steps have also been taken to address the needs for sanitary care in South Africa. In February this year, President Jacob Zuma acknowledged the need for pads in schools with a proposal that free sanitary towels should be provided to schoolgirls, although the details of this plan remain unclear.

At Mary Waters school in Joza, South Africa, where the $2 price of a packet of sanitary pads is out of the reach of many families, teacher Faith Coetzee has tried to combat the problem by having a stockpile of pads in the school that she funds herself. Alongside this, she hopes that establishing an education programme for girls aged 12-13 will encourage an open environment for discussing periods and how to manage them.

But simply providing pads does not solve the problem. Schools need places to put discarded pads, and the school is currently waiting for government distribution of sanitary towel bins. Coetzee makes the point that unlike condoms, which are free and easily available in school bathrooms and clinics, pads, tampons and other menstruation methods remain unaffordable and inaccessible for girls and women. While most people are able to make a choice about having sex, no girl can ignore or avoid the onset of menstruation.

Enter the corporations

Unsurprisingly, some corporate giants have dipped their toes into addressing the problem. Procter & Gamble, the owner of Tampax and Always, launched the campaign Protecting Futures in 2007 to provide girls in developing countries with sanitary care. Their project includes building toilets and installing incinerators as well as educating teachers and distributing free sanitary pads, acknowledging the critical fact that pads are no use if girls do not have private places to change or dispose of them safely. After starting the project in Kenya in 2006, they have expanded into Namibia and South Africa, and have installed clean water pipelines as well as a Health, Hygiene and Puberty education programme. According to P&G, Protecting Futures has reached 80,000 girls in Africa so far.

Despite the fact that these ventures sound promising, it is difficult to assess whether this is the right approach. For one thing, pads and tampons are expensive, and although P&G’s efforts have reached thousands of girls, their efforts alone cannot provide a sustainable solution to the lack of affordable products. Secondly, the waste they create is harmful for the environment, particularly as many African countries have poor waste networks and facilities. Lastly, there is a tension here between the fact that these supplies are badly needed and that these girls and women are forced to rely on a profit-driven corporate approach. P&G receive lower tariffs for their products from the Kenyan government – good for this project, but presumably with a view to opening trade in other areas with other products. There remains the contention that providing pads to African women and girls is merely exporting a Western culture of waste and overconsumption, which is neither sustainable nor desirable.

Rwanda's pad eco-system

In East Africa, a new exciting project combines sustainable enterprise, employment, and education to address the lack of affordable and environmentally-friendly sanitary care. Unimpressed by the results of hand-outs, Elizabeth Scharpf has set up in Rwanda what she hopes will be an ‘eco-system’ for the local economy to tackle women’s sanitary needs once and for all. 18% of Rwandan girls miss, on average, 35 days of school every year due to ineffective methods for dealing with periods and the fear of embarrassment. The lack of education about periods is pervasive. Sharpf has been asked the same questions about periods by 35-year-old and young girls: what is happening to me, and why?

Helped by UNICEF, Scharpf has set up the Sustainable Health Enterprise (SHE) to combat the issue including through making eco-friendly pads from the use of banana fibre. The fibre is an absorbent material made from the trunk of the banana tree that is routinely chopped down after each harvest, and so is both eco-friendly and efficient. As well as providing employment for local men and women through the manufacture and sale of the pads, she is spreading information about periods via the sale of the products by health workers, and building safe and clean toilets. Scharpf, whose driving goal is to "equalize the playing field in terms of access to opportunity", hopes to reach a million women with the SHE program.

As Scharpf says in an interview, "menstruation is one of those things that people don't really want to have anything to do with", and that most of the population is "left hanging after donation supplies run out". Sharpf was helped by the fact that Rwanda is small, had existing networks of community health workers and women’s groups, and business-friendly policies – an unusually beneficial combination in East Africa.

In terms of establishing the large-scale infrastructure needed for sanitation, addressing the obstacles to girls’ education is a monumental challenge that needs to be met, requiring substantial research, resources and attention, not least from the governments in charge. Although the focus here has been on schoolgirls, the same issues apply for women, and unless this problem receives a higher profile, both girls and women will continue to be held back by something out of their control. 

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Also doing great work to address the need for pads for girls in school is Dr. Moses Musaazi of Technology for Tomorrow and Makerere University. He has developed a very successful model that uses papyrus and waste paper to create affordable and appropriate sanitary pads, called Makapads. One great addition to the pads, and which directly addresses the needs of school girls, is that pads for schools come with a pair of underwear. It is common that not only do girls not have access to pads, they often do not have underwear either! The production facilities are providing employment to dozens of local people. UNHCR has partnered to create production facilities in camps that directly supply pads to the camps and also provide employment. There is some good work taking place in Uganda to address this major challenge.

A very insightful article. Gender differential help is often ignored in places where topics like sanitation are of a bad overall standard. However, often it there is no easy solution which addresses both the needs of men and women.
Although not female targeted, is an example of a sustainable and discrete solution to excrement. The problem with tampons and pads is definitely that they are not sustainable, and often not bio degradable. There are also cultural specific sensitivities to consider for example has no one looked at what the beliefs and taboos are to do with menstruation in different areas. I'm sure these differ widely and have to be considered for example is it not in Madagscar (may be wrong) where industrial factories who employ mainly young girls , have a big problem with spirit possession. Bad spirits it is believed, reside in stagnant water, for example toilets. Therefore despite their gendered, sanitary toilets, they are often trashed with waste everywhere. the girls are perturbed and often suffer from violent spirit possessions. This is an example of a western imposed model of sanitation, which clearly does not work.

Perhaps pads (which are expensive and environmentally undesirable) are not the answer? In UK, it's called a Mooncup, in USA, it has a different name but this re-usable silicone cup is a real investment because it lasts about 5 years so one of these would see a girl through most of her schooling. They can be rinsed and then, occasionally boiled in a small amount of water to streilize them. It is much more cost-effective and waste disposal is less of an issue.

Super infroamtive writing; keep it up.

I can't hear anything over the sound of how awesome this atrilce is.

Thanks for sharing. What a pealurse to read!

Good article, its important that we talk about menstruation and the challenges girls and women in Africa are facing. Providing free pads does not address the deeper issues girls are battling with. Many of them are suffering emotionally and physically due to a lack of information and hollistic support. Providing girls and women with hygienic, sustainable and inviromental friendly sanitation needs to be part of a bigger campaign which addresses girls' spiritual, emotional and physical well being. With this in mind Beautiful Gate a NGO in Cape Town has started a pilot project called 'The Dignity Campaign' which through a variety of workshop addresses issues which school going girls are faced with. Part of the campaign is providing participant with an Mpowering Cup, a south african designed and manufactored menstual cup. The feedback from participating girls of 'The Dignity Campaign has been overwhelming. 

As the founder of YOUth Shift Africa and Girls Shift Africa (Kenya) I am well versed with the problem of African girls lacking access to appropriate menstrual aids. Either there is nothing due to lack of money which puts the girls at risk of school drop out, social maginalization etc. Or they revert to using old socks, rags, discareded newspaper, leaves, bark, anything absorbent they can find which puts them at risk of contracting infections/disease. Or there are the commercial sanitary pads and tampons which not only cause economical dependency but of course have a huge environmental price too. And then there are the re-usables, such as washable pads, silicone cups (Mooncup, Ruby Cup etc.) and sea sponges which are great on first thought but not vialble either in most places due to lack of sanitation. Few schools and homes have running water or in many places even enough water at all to afford safe cleaning of these options.So what really is the solution here? The most promising seems to be the local production of bio-degradable absorbents/pads as indicated in this excellent article. But when will these become mainstream and available to the common African school girl? We're not yet through with the problem!

Fascinating article. The responses are also informative with ideas to follow up. Definitely need resources allocated to research to find the most hygienic and healthy menstrual sanitary products - especially if local products can be used and big corporations avoided. So many positive spin-offs.