© UNFPA/Eric Gauss

Harare, ZIMBABWEThe night before my first period started, I had a vivid dream about how it would happen and I was afraid. The next day, it happened as in my dream and I realized I had nothing to fear. I felt empowered, liberated and confident about my body.

Yet my experience is not the norm for most adolescent girls  especially those who live with a disability.

The connection between a person’s body and their ability to meet its needs is vital.

Today, 15 per cent of the world’s population is living with some form of disability, according to the World Bank. This means that millions of girls globally must tackle the stigma of living with a disability, whilst also properly managing their periods and being confident enough to have autonomy over their body.

Equipping and empowering girls

 

A girl receives sanitary products from
Precious Pearls Trust, which works closely with
Deaf Zimbabwe Trust to bring accurate and critical
menstrual health management information to girls
and young women with hearing impairments.
© Deaf Zimbabwe Trust

 

Precious Pearls Trust is working with adolescent girls and young women in Zimbabwe to do precisely this: “We seek to help girls realize their potential by equipping and empowering them with information on personal development, menstrual health management and life skills training,” said Leone Nezi-Madzinga, 34, Precious Pearls Trust Director.

As a youth activist, Ms. Nezi-Madzinga recognizes that one of the biggest frustrations that adolescent girls and young women with disabilities have is the lack of accurate information on menstrual health management (MHM). Precious Pearls Trust aims to change this.

“Our MHM programme is code-named ‘Girl Talk’. This is a safe space for girls to discuss, share and support each other, and this culminates into clubs that allow the girls to support each other further in matters pertaining to MHM,” she said.

Every girl who attends the club finds an unprejudiced and nurturing environment in which she can ask questions and share her feelings and her dreams. Through the programme, Precious Pearls Trust has directly assisted more than 2,000 girls, and a further 1,200 indirectly.

“The clubs allow peer-to-peer learning and support to be consistent, thereby empowering the girls and the communities to address the stigma that is associated with MHM,” Ms. Nezi-Madzinga explained. “The organization also distributes sanitary products. This is part of the solution to addressing MHM, but information in regards to proper use, storage or disposal of products is also key.”

In the past year, Precious Pearls Trust has made seven sanitary pad distributions and assisted 224 girls and young women.

African Coalition for Menstrual Health Management

The organization is the co-lead for the Humanitarian Settings Taskforce of the African Coalition for Menstrual Health Management (ACMHM), which is tasked with research, standards setting, partnership building, advocacy and knowledge sharing. This gives Ms. Nezi-Madzinga and her network of girls and young women the opportunity to advocate on issues faced by marginalized girls, women and other people who menstruate, including women living with disability.

The ACMHM was formed following the first African Menstrual Health Management Symposium held jointly in Johannesburg, South Africa by UNFPA and the Department of Women of South Africa. The coalition advocates for greater high-level commitment by governments to provide a holistic approach to managing menstrual health issues across the continent.

“Let’s create inclusive spaces for all girls and provide context-specific MHM information,” Ms. Nezi-Madzinga said.

 

 Cleopatra Okumu

CAPE TOWN, South Africa—Imagine, on a day when you had your period, if you had to choose between buying food or pads. What would your priority be? This difficult decision is a reality for homeless women each and every month.

The routine tasks of managing personal hygiene and basic needs present them with a tough choice.

An organization based in Cape Town is tackling this dilemma by providing homeless and underprivileged girls and women with menstrual products. Since 2016, Girls with Wiings has been assisting 250 girls and women in 11 locations with sanitary products every month.

Koinonia Baloyi, founder of Girls With Wiings, with a pack of
menstrual health products that she distributes to homeless and
underprivileged girls and women. © Koinonia Baloyi

“Our most powerful tool when it comes to menstrual health management is action. It’s the power of getting involved, speaking up and taking action,” says Koinonia Baloyi, 28, founder of Girls With Wiings.

Using fitness as a platform to raise resources

True to her words, in 2017 she completed the London Marathon and raised R21,000 (about $1500) for her organization. She uses fitness and well-being as one of her platforms to mobilize funds to provide menstrual health products to girls and women.

“We are giving women a safer and more hygienic alternative to using cloth material and napkins, as well as restoring their dignity,” she says.

We are giving women a safer and more hygienic alternative to using cloth material and napkins, as well as restoring their dignity.

Ms. Baloyi initiated the Fitness for a Cause Campaign, which hosted a public outdoor fitness camp in Cape Town in 2018. She was motivated to do so by commitments made at the first East and Southern African Regional Symposium on Menstrual Health Management, which was organized by UNFPA East and Southern Africa Regional Office and the Department of Women in the Presidency of the Republic of South Africa, in Johannesburg, South Africa, in 2018.

An outdoor fitness day, hosted by Girls With Wiings in 2018 to raise
funds for their ongoing menstrual health drive, raised R50,000 (about
$3650). © Koinonia Baloyi

The #Fit4Wings event, which was conducted by local celebrity fitness instructors, saw Girls With Wings raise R50,000 (about $3650). The money purchased 1000 bags containing reusable sanitary pads, soap, a face cloth and underwear.

“This campaign has contributed significantly towards the advocacy of menstrual health management,” says Ms. Baloyi. “We have seen an increase in both awareness and participation in menstrual heath issues by large corporates, as well as men, through active partnerships, sponsorships and participation in these events.’’

Inspiring continuous action

With their aspirational name, Girls With Wiings is about inspiring continuous action and not allowing homeless and underprivileged girls, women and other people who menstruate to be alienated from society because of their inability to manage their menstrual health.

Menstrual health management is something we need to keep talking about until it is a normal part of our everyday conversation.

“Menstrual health management is something we need to keep talking about until it is a normal part of our everyday conversation, until it is something we don’t shy away from,” she says.

Ms. Baloyi is one of 400 practitioners who have joined the African Coalition for Menstrual Health, the aim of which is to strengthen the voices of its members. She believes her involvement will amplify the voices of practitioners and activists who have come together to address the menstrual health challenges of those who are so often left behind – including girls, women and other people who menstruate, the homeless, and those in prison or fleeing a humanitarian crisis.

– Cleopatra Okumu

ACCRA, Ghana“It is everyone’s responsibility to ensure that wherever you are, you empower girls to speak out.

“Girls have to demand a space for their voices to be heard. Therefore, we urge African governments to support and uplift girls, and make a firm decision to end child marriage.”

We urge African governments to support and uplift girls, and make a firm decision to end child marriage.

There are many ways to describe Natasha Mwansa, but shy and timid are not among them. The 17-year-old youth champion from Zambia is passionate about and relentless in her advocacy for women and girls – particularly against child marriage. And with good reason.

Every year, 12 million girls are married off before their 18th birthday worldwide. This number is unacceptable and keeping silent about it is worse, Natasha believes.

Youth participation must be a priority for Africa, especially in ending
child marriage, as young people account for 60 per cent of the
population in sub-Saharan Africa. No decision about them must be
made without them. © UNFPA/Cleopatra Okumu

“I have been a child rights activist since 2014, when I was 12 years old,” she said. “My interest in women’s and girls’ rights [began] at the first African Union Girls’ Summit in 2015, which I had the privilege to attend.”

Her passionate call to action was made in her opening address at the Second AU Girls’ Summit in Accra, Ghana, in which she emphasized that girls cannot afford to wait for governments to give them a platform to talk about child marriage.

Youth participation was a high priority at this year’s summit, themed ‘Break the silence’, and so girls, boys, young women and young men took centre stage as session leads, panelists and presenters.

Natasha had the opportunity to play a prominent role. Child marriage featured high on her agenda.

Child marriage exacts a high toll in Africa

The cost of child marriage in Africa alone is $68 billion, according to a recent World Bank study. This figure refers to the loss in human capital wealth incurred by countries due to women marrying early.

Beyond this, girls who are married off as children are more likely to drop out of school and to encounter gender-based violence. They also typically lose their sense of self-worth and are not always given proper access to sexual and reproductive health services, including menstrual health and hygiene.

Inability to access menstrual health products may not be the only contributor to a family’s decision to give their girl child away in marriage, but it has far-reaching implications for girls and women. For instance, when a family suffers economic hardships, menstrual products are not a priority. Girls must do without them, resulting in ‘period poverty’.

Periods in many African countries are shrouded in silence and secrecy, a matter that concerns Natasha. “Menstrual health and hygiene are often overlooked in Africa. They are looked at as taboo and people are quite uncomfortable talking about them,” she said.

However, early marriage is not a solution for period poverty. It only aggravates a girl’s situation if she does not have correct information on puberty and menstruation, leaving her unable to articulate her needs to her husband.

In [some] traditions, girls are not allowed to talk about it or even say that they are [having] their periods to the men they are married off to.

“In [some] traditions, girls are not allowed to talk about it or even say that they are [having] their periods to the men they are married off to,” she said.

Break the silence to ensure reproductive well-being

Yet silence is the perfect breeding ground for taboos and stigmas in families, communities and countries. It also allows key decision-makers to continue sidelining the reproductive well-being of girls and women.

Often it is believed that by providing pads, tampons and menstrual cups, girls will have autonomy over their bodies and their health. But having access to menstrual products is only half the battle – the silence behind sexual and reproductive health must be overcome too.

How can this be done? By being bold, visible and vocal about these issues. And most importantly, by creating systems that are supportive, informative and action-oriented.

UNFPA-UNICEF programme to end child marriage empowers girls

One such system is the UNFPA-UNICEF Global Programme to Accelerate Action to End Child Marriage. Through the programme, girls and young women are given opportunities to discuss the challenges they face and how to access the right information and services on sexual and reproductive health, education, life skills and child marriage in an environment that is safe and confidential.

To date, the programme has given 74,000 girls in Mozambique access to safe spaces in their communities and referrals to adolescent-friendly health services. In Uganda, 27,000 adolescent girls have been equipped with life skills and financial training through school clubs and ‘Go back to School’ campaigns.

When a girl is empowered and given the right tools to make decisions about her body, her education and her finances, she is able to change the trajectory of her life – and the lives of her children. This is why ending child marriage for the African girl is a powerful action for the woman she will be tomorrow.

– Cleopatra Okumu

JUBA, South Sudan—“My periods are a nightmare as they are very painful, and I can’t get [access to] any sanitary products.”

For millions of women and girls displaced by conflict and natural disasters in Africa, adequate hygiene facilities and privacy during menstruation are rare. Nyanjuma Gatloth, 20, is one of them.

As she describes her monthly ordeal with menstruation, she recalls how her life, and that of her family of seven, has changed since they fled Bentiu, the capital of Northern Liech state. They have taken shelter in one of the United Nations Protection of Civilian sites (PoC) in Juba. PoC sites are settlements within the United Nations premises in which civilians seek protection and refuge when fighting breaks out in surrounding communities.

Living in a PoC is difficult, as we depend on food handouts from humanitarian actors.

“Living in a PoC is difficult, as we depend on food handouts from humanitarian actors,” says Ms. Gatloth.

She had her first period in 2013, at the age of 15. This was also the year the current conflict began in South Sudan between the government and opposition forces, just two years after the country gained independence from Sudan in 2011.

Nyanjuma had her first period in 2013, at the age of 15, the same year
the current conflict began in South Sudan between the government
and opposition forces. © UNFPA South Sudan/Juma Delu

The conflict has had a devastating impact on the human population. Thousands have been killed or wounded, a large part of the country’s infrastructure has been destroyed, livelihoods have been lost, and basic health services have been disrupted.

As many as four million people have been displaced and seven million are in need of humanitarian assistance.

The situation has been compounded by a severe economic crisis and continued depletion of resources; affected families in the country are reported to be surviving on yam and wild fruit.[1]

Ms. Gatloth believes that without the support of her mother, who helped her through the process of managing her first menstruation, she would have found it impossible to continue attending school.

I have managed to go through primary and secondary [school] because she supported me and taught me that I should never be ashamed about having my periods.

“I have managed to go through primary and secondary [school] because she supported me and taught me that I should never be ashamed about having my periods,” she says.

Managing menstrual hygiene

Menstruation is a biological process that about half of the world’s population experiences for a significant proportion of their lifetime. To manage their menstrual hygiene adequately, women and adolescent girls need clean menstrual material to absorb or collect the menstrual blood.

They need to be able to change the absorbent material in private and as often as necessary for the duration of the menstrual cycle, using soap and water for washing the body as required. They should also have access to facilities to dispose of used menstrual management materials.

When she was at school, Ms. Gatloth and her friends received free sanitary pads from a non-governmental organization (NGO) working in the area.

The South Sudanese NGO Health Support Organization-THESO supplies schoolgirls with reusable sanitary pads twice a year, as part of their emergency reproductive health services.

“I would wash my pads and put them to dry for reuse,” says Ms. Gatloth. But once she had completed her primary and secondary school education, the situation changed for the worse.

“Besides the pain that I have to try and manage, I can’t get any sanitary products to use,” she says. As a result, her period has become like “a terrible sickness”.

[On] the days that I am lucky, I get a few sanitary pads from my friends, while other days I end up using rags to absorb the blood flow.

“[On] the days that I am lucky, I get a few sanitary pads from my friends, while other days I end up using rags to absorb the blood flow.”

She washes herself inside her small hut made of tarpaulin, and disposes of the used pads or cloths by wrapping them in a polythene bag and dumping them in a pit latrine.

“I was dreaming of becoming a pilot”

Today, Ms. Gatloth feels far removed from the future she hoped for. Her parents cannot afford to send her to university in another country to achieve her dream career.

“It bothers me a lot as the future looks bleak. I was dreaming of becoming a pilot but the crisis killed it,” she says.

With the signing of the recent peace agreement in South Sudan, she hopes to return one day to her home in Bentiu – but for now, she remains sceptical: “For us, even going back home and settling is very difficult as we lost everything. Everything was taken [from us],” she says.

For now, she feels safe and secure in the PoC, a place she calls home – but a home far from home, nonetheless.

– Juma Delu with additional input from Aimee Manimani Nsimire

 

[1] https://radiotamazuj.org/en/news/article/over-7-000-people-urgently-need…

Comedian Margret Cho once joked: “Over half the world menstruates at one time or another, but you’d never know it. Isn’t that strange?”

Yet there is nothing funny about the silence behind menstruation for millions of adolescent girls and young women, who are often uninformed and ill-equipped to handle their period because no one wants to talk to them about it.

Take Ninsiima Jovat, 17, a student at Bishop McAllister College Kyogyera, Uganda: “Our school has a teacher assigned to career guidance, and other teachers assigned to other academic-related responsibilities. The school also has a female teacher in charge of conducting monthly check-ups among girls for pregnancies. However, no teacher is assigned to give menstrual health management (MHM) support or advice to girls in all three schools I have studied [at].”

She was speaking to Lydia Asiimwe, who was conducting research on menstrual health management (MHM) in Uganda.

Ms. Asiimwe, 36, is co-founder of EcoSmart, an environmentally sustainable start-up enterprise by girls for girls. It involves the production of low-cost sanitary towels made from sugarcane for girls in rural communities.

Since she participated in the First East and Southern African Regional Symposium on Menstrual Health Management, organized by UNFPA, the United Nations Population Fund and the South African Department of Women in Johannesburg, South Africa in May 2018, she has been speaking about and advocating for improved menstrual health management for girls and women in Uganda through her maiden initiative, Break the Silence Uganda.

In addition to  developing sanitary pads, we are going to tackle issues around access to information and improving existing infrastructure, especially in public schools, to support MHM.

The aim is to move towards more integrated MHM services, and to this end she is working with the University of Makerere to roll out Break the Silence Uganda at 25 public schools in Western Uganda. Although each school hosts 300 girls, the programme is intended to reach 45 to 50 students at each school due to limited staffing capacity.

Ms. Asiimwe anticipates that Break the Silence Uganda will help dispel unhealthy traditional beliefs about MHM, and supply factual MHM resources to girls in schools on how to manage their periods. She also seeks to provide transitional information to women who are ending their menstrual journey, and to inspire boldness in girls and women to share their MHM experiences.

Watch her interview on NTV Uganda.

“You should not feel ashamed or skip school”

Also inspired by the MHM Symposium is Okeri Ngutjinazo, 21, a journalist from Namibia and an MHM advocate. Through Power Pad Girls (PPG), she is using her writing and speaking skills to contribute to improvements in menstrual health for girls and young women in Namibia. Power Pad is an entity that advocates and raises funds for reusable menstrual pads for Namibian schoolgirls.

A speaker at the symposium, the event has had a profound effect on her outlook on MHM.

Speaking about menstruation has always been a no-go topic in communities. When you [start] your period, you are told that you are now a woman but there is no real explanation of what that actually means.

“Speaking about menstruation has always been a no-go topic in communities. When you [start] your period, you are told that you are now a woman but there is no real explanation of what that actually means,” she said.

Through PPG, Ms. Ngutjinazo aims to dismantle stigmas and taboos around MHM, and promote the production of reusable pads in Namibia.

“Historically, when a woman was menstruating, she was deemed to be unclean during her period, and anyone who touched her or any of her objects would also be unclean until the evening. That should not be what young girls think of and they should be comfortable speaking openly about menstrual health,” she said.

Okeri Ngutjinazo advocates and raises funds for reusable menstrual
pads for Namibian schoolgirls. © UNFPA ESARO

“[Having] your period does not make you dirty or [a lesser person]; you are beautiful, no matter what. You should not feel ashamed or skip a day of school because you can’t afford a pad or tampon.

“Through PPG, we hope to reach more schoolgirls and teach them about menstrual health and different reusable products that are available to them.”

Read her thoughts on MHM in Namibia here: Let’s talk about periods.

Reaching visually impaired adolescents with learning resources

Hyasintha Ntuyeko, 33, a social entrepreneur and MHM advocate from Tanzania, believes that inclusion and collaboration are important drivers of change for MHM in Tanzania, a country where sanitary pads are VAT-free thanks to the government’s progressive policies.

Through the symposium, I managed to secure learning resources for our programme with adolescents. Recently, those learning resources were made available to visually impaired adolescents.

“Through the symposium, I managed to connect with key people such as Dr. Marni Sommer and through her organization, Grow and Know, I managed to secure learning resources for our programme with adolescents. Recently, those learning resources were made available to visually impaired adolescents,” Ms. Ntuyeko said.

As a result of her partnership with Dr. Sommer, the MHM advocate has received funding to develop resources in braille for Menstrual and Puberty Programmes.

“Our approach was to read stories together with adolescents during the story-telling session, analyzing the lesson learned but also trying to reflect together if there are any real-life experiences that a student has experienced which relate to the story we read,” Ms. Ntuyeko explained.

To date, they have translated 25 books on each of the topics ‘Growth and Changes’, ‘To become a Young Man’ and ‘Healthy Adolescence’.

Ms. Ntuyeko will continue to work with the Head of Department for Women and Children at Tanzania League of the Blind, to mobilize funds to produce more books, which will be placed in school libraries across the country.

Watch this video about her initiative.

The Menstrual Health Management Symposium set in motion an action-for-change movement across the continent, and the newly formed Africa Coalition for MHM is leading the charge. The coalition consists of individuals, agencies, governments and organizations working in or interested in MHM from Africa and across the globe. It promotes greater participation by young people as a means to secure a future in which every girl and woman is able to access MHM and sexual and reproductive health services, through entrepreneurship, advocacy, skills development, knowledge management, South-South collaboration, research and policy making.

By Cleopatra Okumu