What you need to know:
- On top of the harsh struggles of living on the streets after fleeing abusive marriages, these women can barely afford sanitary towels.
- This, to them, is a fairy-tale luxury. They resorted to using pieces of cloth and carrier bags for menstrual health and hygiene interventions.
A strip of mattress, an old blanket and a local cobbler’s tools of work huddled against an electricity post. These are the only possessions that make up Leah’s* and Alice’s* home.
A few metres ahead of the little set-up lies a heap of pungent-smelling waste. Noisy squabbles can be heard from a bar behind them. None of these seems to bother the pair much. After all, when you live on the streets of Nairobi, there are far greater concerns.
On a normal day, their meal would be a cup of githeri (boiled mixture of maize and beans) and a little drinking water. They also need a few coins to access public toilets. But this is not an ordinary day, at least not for these two young women. It is the first day of their menstruation and Leah says nothing is more daunting.
“Sometimes I pray to God to delay my menstruation. When it is here, it is a troublesome thing that disrupts my day. I even ask God why is it necessary to menstruate!” a dispirited Alice adds.
She and Leah have been homeless for more than three years, having escaped abusive marriages. On top of the harsh struggles of living on the streets, they can barely afford sanitary towels. This, to them, is a fairy-tale luxury. The duo has resorted to using pieces of cloth and ‘Uhuru bags’.
The ‘Uhuru bag’ is a nonwoven carrier that became popular in Kenya after former President Uhuru Kenyatta issued a directive banning single-use plastic bags in 2020.
The young women explain how they use a razor to cut small vertical pieces of the ‘Uhuru’ bag, which they then roll into a tampon-like form. The makeshift tampon would then be inserted up the vagina.
“I cannot layer the pieces of the bag horizontally on my underwear because the blood would easily leak. That would be very shameful. The method we use absorbs the blood for many hours,” Leah narrates.
The carrier-bag tampon, she explains, has to be removed every time she wants to urinate. It is re-inserted after urinating, an extremely painful process.
“The ‘tampon’ can absorb blood for as many as two days. This is good because pieces of clothes and bags cannot be wasted, both are very hard to come by,” Alice says.
“The tampon is very uncomfortable and makes my vagina feel tight and constrained. I also get itchy down there if I wear it for too long. I think everyone around me knows what is inside me.”
The longest both women have worn a carrier-bag tampon is three days. They say they had to do so because they couldn’t find other carrier bags to fashion into tampons.
“Sometimes when I have worn the carrier-bag tampon for too long, it starts to smell and people jeer at me for smelling bad,” Alice recounts, amid tears.
Though effective, gynaecologist Francis Odawa says poor menstrual hygiene practices, such as the ‘Uhuru’ bag tampon, pose serious health risks.
“When a woman inserts a product picked from the streets, she is bound to introduce bacteria and micro-organisms from the environment into the delicate female genital tract. This causes localised infections inside and outside the vagina,” says Dr Odawa.
“Some of the infections include those in the vagina (vaginitis), along the lining of the uterus (endometritis), the fallopian tubes (salpingitis) and the pelvic cavity (pelvic inflammatory disease).
“These localised infections cause a lot of pain and, without surgical intervention, can lead to infertility. This is because when reproductive structures become infected, they get blocked and cannot function properly.”
Dr Odawa adds that using the ‘tampons’ for too long may expose them to toxic shock syndrome. “It is an unfortunate practice that these women are using such things to manage their menstruation. Society needs to come in and address this group of vulnerable people. I would recommend reusable sanitary towels as opposed to measures such as tampons and menstrual caps that need to be inserted in the genitalia.”
Both Alice and Leah survive on menial jobs such as washing clothes in the nearby informal settlement for meagre pay of as low as Sh100. Nonetheless, empty stomachs cannot prioritise sanitary towels.
Also read: Make sanitary towels widely affordable
“At times when on my periods, I cannot get laundry jobs because the women say that I smell so much that I cannot wash their family clothes,” Leah says. “But there are some kind-hearted ones who would help me with water to take a shower.”
When they can’t find any jobs, sleeping on an empty stomach is the only option. They have made friends with the local tailors, who sometimes give them cloths that they use to make tampons, instead of using Uhuru bags.
“When I ask for the strips of cloth, I don't tell them what I am planning to use them for. I don’t think they would give them to me if they knew my intentions,” Leah says.
Even so, the tailors can only give them only so much as they also use the cloths to mend holes in their clients’ clothes.
If Alice and Leah had access to safe and affordable sanitary towels, the Uhuru bag tampon would not be an option. Alice confesses: “If you're not strong-hearted, you can actually die by suicide because of the constant ridicule.”
Apart from physical health risks, Nairobi-based psychologist Claire Omolo says women who experience period poverty also face stigma associated with menstruation. She told the Voice that the stigma could also lead to mental health issues such as anxiety and depression.
“Moreover, an individual may develop low self-esteem that affects their lives greatly. Such individuals avoid interacting with others, and may not believe in themselves enough to do things that propel them towards becoming the best version of themselves,” she adds.
The Uhuru bag tampon is a menstrual health reality for thousands of women who live on the streets of Nairobi.
According to the 2019 census data, over 20,000 Kenyans are homeless, with 2,348 being women and girls. Most homeless women are found in urban centres. Only 841 women are homeless in rural areas. Nairobi City leads with the highest number of homeless women (679).
These statistics have significantly increased since the onset of Covid-19. According to the Kenya Institute for Public Policy Research Analysis Economic Report 2021, 37.5 per cent of Kenyans could not afford to pay rent during the pandemic.
The issue of homelessness among women is compounded by period poverty. According to the Ministry of Gender, over 65 per cent of women and girls in Kenya are unable to afford period products, even though the government has over the years adopted measures to address the period poverty.
In 2004, the state lifted import duties and value-added sales tax on menstrual hygiene products and solutions. And in 2017, it passed a law to give schoolgirls free sanitary pads. Despite these measures, local community and gender-equality champions say the price of menstrual pads is still too prohibitive for women living on the streets.
Abdul Ali Hussein, who has earned the moniker Mr Pads for his work in championing menstrual hygiene in informal settlements and for women living on the streets, says that though the government’s Sanitary Towels Programme is noble, it excludes vulnerable girls and women who are not part of public institutions.
“Most homeless women can barely afford sanitary towels because their main sources of income were heavily disrupted by the pandemic. Some well-wishers like myself donate sanitary towels to them, but that hardly helps because menstruation is a monthly affair,” Mr Hussein told Nation.Africa.
The Menstrual Hygiene Policy 2019-30 advocates that county governments should provide menstrual health management products in learning institutions, workplaces and public spaces.
However, Nancy Githutha, a community health volunteer who works closely with street families such as Alice and Leah, said the women have never benefited from any government-led sanitary towels programme.
“The Nairobi county government usually disburses sanitary towels to public schools but has never reached out to homeless women. I hope Nairobi’s new governor has prioritised street families in his agenda,” she says.
Margaret Sunguti, the county head of Public Health, says City Hall only has a budget for sanitary towels programme for public schools, but not for homeless women.
“We cannot spend money on projects that the county has not budgeted for. However, the county is planning to include the provision of sanitary towels for women who live on the streets in the next county integrated development plan,” Ms Sunguti said in an interview with Nation.Africa.
Despite a comprehensive menstrual health management policy, county governments seem to have excluded vulnerable groups that exist outside public institutions.
Policy analyst Scheafffer Okore opines that the counties should adopt and localise the menstrual health policy. This, she says, would make menstrual health management a priority and make menstrual products interventions a reality.
“The idea that menstrual health management sits squarely within primary schools is already government failure. The existing policy should also be expanded to include homeless families. County governments must prioritise menstrual health and dignity because these women are the same people who make part of the electorate,” Ms Okore says.
Meantime, the Uhuru bag tampon remains the reality for Alice and Leah.