Too poor for menses; period!

Some of the pupils of Kinango Primary School in Kwale County where more than 150 girls out of 328 cannot afford sanitary towels. The girls have resorted to using rags as an alternative.

Photo credit: Wachira Mwangi | Nation Media Group

What you need to know:

  • More than 800 million women menstruate daily and majority cannot afford sanitary towels, toilets and water to manage their menses in a dignified and healthy way.
  • Without access to menstrual hygiene materials, latrines and places to change, safe water and sanitation, and good hygiene practices like hand washing with soap, the school environment is unhealthy, gender discriminatory and inadequate.
  • While a story we published last year, The menstrual holes of Tana River, saw donors march into the county to triumph over the shame of the 21st Century, girls in Busia engage in prostitution for as low as Sh50 to buy sanitary towels.

Anyone who menstruates requires proper access to menstrual materials, safe and hygienic facilities and the right to manage it without shame or stigma. Unfortunately, some women and adolescent girls live in period poverty.

Research shows that more than 800 million women menstruate daily and majority can’t manage their menses in a dignified and healthy way.

American Medical Women's Association defines period poverty as inadequate access to menstrual hygiene tools and education, including, but not limited to sanitary products, washing facilities and waste management.

Period poverty is an underlying issue that contributes to the persistent high numbers of teenage pregnancies.

Studies have also shown that absence of an environment supportive of the girls’ menstrual hygiene management (MHM) hinders them from attending school.

Of the 250 girls interviewed in a study – Menstrual Hygiene Management and School Absenteeism among Adolescents in Ghana: Results from a School-Based Cross-Sectional Study in a Rural Community by Shamsudeen Mohammed et al., 60.4 per cent said lack of a private place to manage periods at school kept them off.

A majority (82.2 per cent) missed school due to menstrual pain, found the study whose findings were published last year in the International Journal of Reproductive Medicine.

Another 70.3 per cent were deterred by the fear of staining and being teased, while 63.4 per cent stayed away due to non-availability of pads.

Another study Menstrual hygiene management in rural schools of Zambia; a descriptive study of knowledge, experiences and challenges faced by schoolgirls by Joyce Chinyama et al. attests to similar challenges.

Girls in six rural schools in Zambia were interviewed.

They said inadequate provision of sanitary materials, water, sanitation and hygiene (WASH) facilities in schools forced them to stay at home during menstruation.

Isolating themselves

“Boys said they could tell when girls were menstruating by their smell and behaviour, for instance, moving less and isolating themselves from their peers,” the researchers state in study published in 2019, in BMC Public Health.

“Girls complained of friction burns on their inner thighs during their long journey to school due to chaffing of wet non-absorbent material used to make menstrual cloth,” it further reads.

The findings are a reflection of Kenya’s situation. It refers to a previous study in Kenya that established that “Poor WASH facilities deter girls from using the facilities at school, with most girls opting to stay home until they finish menstruating.”

On average, girls begin puberty at 10 or 11 years depending on factors such as nutrition, guides Unesco in its 2014 document Puberty Education & Menstrual Hygiene Management.

In Kenya, Unesco estimates that some 2.6 million girls in school need support to obtain menstrual hygiene products. Further, approximately 300,000 of girls in arid and semi-arid regions would require both sanitary towels and underwear at an estimated cost of Sh2.6 billion.

In 2012/13 financial year, Sh300 million was set aside for the Ministry of Education to provide the sanitary towels. This amount was reduced to Sh30 million in 2013/14 financial year.

Until 2017, the ministry provided an estimated 568,925 underprivileged girls in public primary schools in 82 districts (now sub-counties) within marginalised and slum areas.

The coming into effect of Basic Education (Amendment) Act in June 2017 guaranteed all girls in puberty age enrolled in public primary and secondary schools, free provision of pads. In 2017/18 financial year, the programme was allocated Sh470 million. This catered for 14, 813, 810 packets distributed to 3.7 million girls during the fiscal year.  A sum of Sh420, 618,057 was spent.

Private schools

There are 9.2 million girls enrolled in primary schools and 4.3 million others in secondary schools, confirms data from 2019 Census.

Although data on girls in private schools is elusive, the current data could suggest that 72 per cent of the targeted girls have not benefited from the State sponsored programme.

In May last year, the Ministry of Health launched Menstrual Hygiene Management Policy (2019-2030) with one of the five targets being commitment to ensure WASH facilities are provided in all households, learning institutions, public places, healthcare facilities, workplaces and correctional facilities.

“Without (access to menstrual hygiene materials, latrines and places to change, safe water and sanitation, and good hygiene practices like hand washing with soap), the school environment is unhealthy, gender discriminatory and inadequate,” states Unesco in its aforementioned publication.

Ministry of Education Cabinet Secretary Prof George Magoha announced mid-January the purchase of Sh470 million worth sanitary towels for an unspecified number of girls in public schools across the country.

He said the distribution would begin in the third week of January with each of the benefiting girls receiving a one-off bundle lasting them nine months.

“Each girl will get a collection of (pads for) nine months at once,” he said at Kahundira Primary School in Kiambu County.

It’s, however, unlikely that the girls will receive pads covering the nine-months with the financial allocation.

With the Sh470 million, at least 3.7 million girls will get four packets of the pads out of the 4.2 million needy cases. This will last four months.

In 2019, the then Public Service and Gender Affairs Principal Secretary Ms Safina Kwekwe revealed challenges bedevilling the programme.

“When we started distributing the sanitary pads in the 2017/18 financial year, we gave them out to 3.7 million girls. We spent Sh460 million. We only gave four packs to girls in public primary, secondary and special schools. We had nothing for girls in vocational training and other institutions,” Ms Kwekwe is quoted in a local newspaper article dated September 14, 2019.

She added: “We have been having challenges because the money is not adequate. We need to have more so that girls can remain in school throughout but we have only been able to give them four months’ supply in the past.”

With the new law accompanied with the Menstrual Hygiene Management Policy (2019-2030), it meant, the government sat at the centre of meeting the menstrual hygiene management needs of girls in public facilities.

In 2017/18 financial year, the programme was moved to the Ministry of Public and Gender Affairs only for it to be moved back to the Education ministry, late 2019 following hiccups in tendering and distribution.

From Tana River to Busia, menses remain a taboo topic burying girls in shame

In May last year, we shared a story on the challenges women in Tana River County face during their menses.

Fortunately, period poverty is fast becoming a thing of the past after we covered the story on menstrual hygiene challenges where women dug holes to sit on for hours during their menses.

The story that shocked the world, saw donors from as far as Turkey, Britain and the US march into the county to triumph over the shame of the 21st Century, marking the genesis of a revolution that is fast reinstating comfort to lives of the women and girls in the region.

Menstrual hygiene ambassadors and menstrual cops moved into villages donating countless sanitary towels.

“In the past, we could not even talk about our private parts, sanitary pads were not a language we spoke. We only did what our mothers taught us," says Salima Waqo, a mother of three.

Ms Waqo is one of the women who taught her children the traditional way of menstrual hygiene since that is what she knew.

According to her, she learnt about sanitary towels in June after activists started making door to door visits to teach on menstrual hygiene.

"Even my children knew about sanitary towels, but they never shared with me, they were embarrassed to do so," she says.

Leila Nuru, an activist and a menstrual cop notes that most women from pastoral communities are not schooled on sanitary towels, and rely on traditional methods, where rags are used or holes are dug in the worst circumstances.

A woman watches as her daughter digs a hole for her menses in the bush in Makutano village, Tana River County.

Photo credit: Stephen Oduor | Nation Media Group

The activist notes that even shops in the remote areas never stock sanitary towels.

"Women in our community are very shy, if they have to buy sanitary towels from a shop, the attendant has to be a woman, or they will send a child," she says.

Ms Nuru has started training men from pastoralists’ communities on understanding menstrual hygiene and how to support their children and women through the process.

According to her, in the community where men are the providers, only knowledge is required to sustain the solutions currently being implemented.

However, poverty remains the community's biggest challenge. As a result, the women have appealed to the national government and relative organisations to equip them with re-usable sanitary towels.

They say that unlike the disposable ones, re-usable towels are sustainable, cost, and environmental-friendly.

According to Muslima Godana, an activist, a lot of the disposable sanitary towels have ended up in water reservoirs and the streets, hence detrimental to both the environment and human health.

"The disposable towels need to be done away with as we adopt an alternative solution," she says.

Efforts to eradicate menstrual disparity in the county are encouraging, with the county government allocating Sh2 million to support menstrual hygiene.

Kenya Works Organisation among other organisations, distributes re-usable sanitary towels targeting 5,000 girls and women in pastoral communities for free.

In Busia County, many adolescent girls faced with challenges of accessing menstrual hygiene management products admit to having transactional sex for pads.

Ms Mary Makokha, the Director of Rural Education and Economic Enhancement Programme (Reep) says some parents only provide food for their families and ask the girls to look for other basic needs on their own.

“This is happening because of poverty – girls and some women don’t have the financial means to buy sanitary products,” says Ms Makokha, noting that men also take advantage of desperate students, sexually exploiting them before offering money for their basic needs.

The girls accept as low as Sh50 to buy sanitary towels.

“Girls are exposed to boda boda riders, truck drivers, shamba boys and even weird grown up men in the villages,” Ms Makokha adds.

The poverty rate pushes some of the girls to either engage in prostitution or marry young to ease the financial burden on their families.

Ms Florence Opetu* (not her real name), a Form Three student at Murende Mixed Secondary School says she engaged in the business when she could not afford pads.

“One day, I was having my periods but did not have pads; when I stood up, my clothes were stained. The whole class started laughing,” she says.

 This really embarrassed her.

“One day while heading home from school, a boda boda rider offered me a lift. I resisted hesitantly but after he persuaded me and assured that it was a mere lift, I accepted,” she adds.

The school girl says she ended up getting into a relationship with the man in his mid-30s.

Period poverty is a widespread problem in the country – and those who cannot afford sanitary pads use old cloths, pieces of blankets and newspapers.

During the Covid-19 pandemic, girls who got free sanitary products at school were pushed to desperate measures and scores became pregnant as they looked for money for pads.

The government failed to extend the services to their homes when schools closed on March 15, 2020, leaving the girls at the mercy of the society.

Meanwhile in Kilifi County, stakeholders and organisations have been in the frontline to boost the National government’s initiative, through the Woman Representative’s office, to provide sanitary towels to school girls.

This is an indication that the sanitary pads being distributed by National Government Affirmative Action Fund (NGAAF) do not meet the demands in schools. 

The Filipino winning souls while ensuring they enjoy every moment of life

As you drive towards South Kinangop, off the Naivasha-Nairobi highway, there is an imposing house on the hill overlooking Lake Naivasha.

The house owner is a Filipino woman who came to Kenya in 1998. Ms Minalyn Nicklin, 56, is a missionary with a big vision and mission; to help poor girls and women in Naivasha and its environs enjoy safe menstrual hygiene management (MHM).

Ms Minalyn Nicklin displays some of the reusable sanitary pads she makes at her house in Naivasha town. 

Photo credit: Francis Mureithi | Nation Media Group

She makes reusable sanitary pads that are environmentally friendly, accessible and affordable, in a section of her house, which she has converted into a workshop.

Disposable sanitary pads are prohibitively expensive for girls and women in Naivasha rural villages. This means that during menstruation, they use old clothes which often leak, staining their dresses and are uncomfortable.

Ms Nicklin wants this to change. "I believe every journey in a positive direction starts with a single step. Making sanitary pads that are easy to use, inexpensive, and recyclable could be a big help for women."

Her husband, Mr Peter Nicklin who is a medical doctor and her step son Alistair support her venture.

She says limited access to clean water, proper sanitation facilities and sanitary pads make it difficult for girls and women to manage their menstruation hygienically.

As a result, many young women face considerable physical and social challenges during menstruation, including missing school and missing out on important economic activities.

Ms Nicklin’s venture has support from local partners and individual volunteers from the US.

Her pads are made of cotton with the inside layer made from a nylon-type fabric. They are washable after use enabling users to save money because of a longer utility.

Women and girls who use them say they are comfortable and leak-free.

"I have no fears moving and doing my house chores," says Ms Jemimah Musimbi, a beneficiary.

Ms Nicklin says the objective of her missionary work in the country is not just to win souls alone but also make sure the souls enjoy every moment of their lives.

“I have discovered that many poor women and girls in the surrounding villages use old rags, and other unhygienic substances like leaves as pad during menstruation," says the mother of two.

This, she says, could lead to reproductive diseases and affect maternal mortality.

"My mission is not just to increase the accessibility and use of clean sanitary pads, but also create job opportunities for rural women," she explains.

She has invested in five sewing machines and employed three workers.

‘Period man’ seeking to change men’s mindsets towards menses

He calls himself Period Man! A year ago, 28-year-old Mr James Atito was teaching girls at Kakuma village in Turkana County how to use pads, maintain cleanliness during the menses and manage pain among other things.

He had been contracted to undertake the sensitisation. Then one of the girls stood up and asked him: "Why do you talk about periods? Are you period man?" That passed as one of those curious queries. The session ended. Evening came.

As he took a walk around the village in the evening, he noticed a group of seven girls sitting along the paths on the rills. Some sat on the bare soil. Some on animal skins.

"I wondered why the girls were sitting there late in the evening when they should be at home," he starts off the conversation.

Mr James Atito is a male advocate in the fight towards ending period poverty.

Photo credit: Kevin Odit | Nation Media Group

"I was shocked to be told that they were on periods and that they were forbidden from their homesteads until their periods were over. That was an unimaginable stigma. I felt so sad for them and it got me thinking. I said I must do something to end the stigma."

His journey back to Mombasa, where he is based, was filled with thought of what he can do different to emancipate women and girls from period shame and discrimination.

After two months of researching through reading publications on periods and web scraping, Mr Atito found a missing voice in ending period poverty – that of men.

"Often men are barriers to women's access and use of family planning. And we tell men to be engaged in family planning but we don't tell them how. It's the case with how girls access and use sanitary towels," he says.

To reach men and use himself as an example of a male advocate in the fight towards ending period poverty, he settled for Period Man, an identity that equally identifies with the girl who sought to find out whether he has the monthly experiences of menses.

So who is the Period Man? This is the brand name behind Mr Atito that he copyrighted through formal registration with Kenya Copyright Board.

For the past one year, Mr Atito has run two campaigns on Facebook and Twitter,

#Men4Periods365 and #Men4PeriodsMovement, meant to raise men's consciousness on their role in ending period poverty.

He for instance shares information on period pain and its management, how to make reusable pads - a skill he learnt through apprentice - and maintain menstrual hygiene.

"Men perpetrate period shame and discrimination. My mission is to reach them at the household level and find sustainable solutions. Once we have solutions, we will no longer need to push the government or partners to provide girls with the pads," he reckons.

Mr Atito studied finance and accounting.

Period of shame that birthed Janet’s book My First Time

“It was a shocking, frustrating and sad. How is it that we are in 2013 and the girls are using chicken feathers and goats hides?” This is Ms Janet Mbugua’s reflection of a feature on period poverty titled “Period of Shame.”

Ms Janet Mbugua is the founder of Inua Dada Foundation, launched in 2014, to call the government to action to prioritise the menstrual hygiene needs of girls. 

Photo credit: Dennis Onsongo | Nation Media Group

It was aired on a local TV station in 2013. It featured girls from Marigat in Baringo County who demonstrated how they fitted the non-absorbent goat hides or stuffed chicken feathers in their underwear. They pluck the feathers from a live or slaughtered chicken. While unmarried girls are allowed to borrow the goat hides from their married peers, a harmful practice that exposes them to infections.

One of the girls interviewed said: “It is very uncomfortable. It pricks you. During examination, I write while standing,” added the girl then in Class Seven.

At the time, 90 per cent of the allocation to the sanitary towels programme had been slashed.

Ms Mbugua is the founder of Inua Dada Foundation, born out of the pain and shock she felt when she watched the feature. Since its launch in 2014, Ms Mbugua has used it as the voice to call the government to action to prioritise the menstrual hygiene needs of girls.

‘Period of Shame’ was the topic of discussion in her subsequent talk shows. For days, the discussion trended on Twitter.

“People were outraged to the point they were leaving pads for those girls outside our gates of the TV station,” she shares. “And it triggered me, so I asked my boss ‘Can we do something? I don’t feel okay with this just dying as it is. She agreed and I came up with Inua Dada Initiative.”

The initiative, she says, was aimed at pushing the government to allocate the programme more money alongside mobilising resources to buy pads for the girls.

Later, they delivered pads and underwear to about 10,000 girls in Baringo County. Nevertheless, she was not happy about the one-off donation.

The need for a sustainable means to end girls’ inaccessibility to the menstrual products, proper sanitation facilities and information, nagged her. And this is how she ended up registering her foundation in 2014. And later in 2017, opting out of the media.

In 2018, she started compiling content for her book My First Time. The book that launched in February last year, profiles menstruation experiences of 50 girls including those with disability and HIV.

With the book, she purposes, breaking the silence on period poverty and ending the stigma, attached to it. She also features men’s voices.

“Men cannot be ignored in the conversation. They are our biggest allies,” she says.

Her book is bringing changes to how men perceive the subject.

“I’d go to places and fathers could come up to me and say ‘Your book helped me figure out, how to break down this conversation at home with my sons and daughters,” she says.

Ms Mbugua is extending the book to add an addendum on the Pan-African perspective on emerging period poverty issues during the Covid-19 period. The new version will be out in two months.

She says: “Period poverty was blown wide open during Covid-19. Suddenly, schools that were giving pads were closed. Suddenly, the women who were washing clothes to earn a keep had lost their jobs. A lot of girls turned to sex for pads, more than we know.”

She is happy her relentless efforts on social media have resulted in more people engaging in the subject, wrapped as a taboo.

“I posted a picture of my stained pyjamas…there were 10,000 likes and about 1,000 comments. It tells you people want to talk,” she says.

“A few people in the comment section are saying ‘Thank you for just opening this door for us to comment on an issue that is so often a taboo.’…and for me that is a win.”

In the midst of the pandemic, Ms Mbugua has maintained the momentum through virtual activities.

Last year, she held a virtual period party where women highlighted the prevailing challenges and advocated for action from the government. She has earned herself a special friend for her consistent campaign against period poverty; public criticism.

Late last year, her foundation embarked on a sustainable approach of ending period poverty. It entered into partnership with The Pad Project to run a two-pronged pad project in Nairobi County.

Report by Moraa Obiria, Francis Mureithi, Stephen Oduor, Shaban Makokha and Maureen Ongala.