Lifting a Third World Curse

One out of every ten school-age girls in sub-Sarahan Africa routinely skips school about 50 days a year. The reason why is so unbelievable it boggles the mind. It's because they're menstruating.
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One out of every ten school-age girls in today's sub-Sarahan Africa routinely skips school about 50 days a year. Others drop out of school altogether. And the reason why is both so basic and unbelievable in this day and age, it boggles the mind. It's because they're menstruating.

This isn't due to some kind of tribal custom or religious stricture against females bleeding in public (although believe me, the history of menstruation is riddled with superstitions and taboos that would make your hair stand on end). It isn't even due to the lack of private bathrooms (and having to excuse yourself from algebra to go change your tampon is bad enough in an American suburb). The real problem is that the girls don't have access to proper and affordable "femcare", namely pads and tampons, and instead are forced to jerry-rig ineffective alternatives out of whatever they do have lying around.

Trying to use rags, wood, paper, or even dirt and grass to try to staunch one's flow isn't some crazy regional thing; it's what all women and girls around the world did for thousands of years until the first commercial products (pads in the late 19th century, tampons in the late 1920s) were introduced. Some didn't even bother; what do you think all those petticoats and shifts were for? From Harry Finley, founder of the online Museum of Menstruation, comes this translation from a 19th century German health text: "Many women... place nothing in that region [to absorb menses]... some women, even those of the better classes, are often filthy to an almost unbelievable degree."

Like the pad from the early 1970s, the advent of commercial femcare really did represent a "new freedom" for females a hundred years ago. But to girls in today's developing countries, where no more than 3% ever use tampons (compared to 70% in the United States), "that time of the month" is more like a time of house arrest. And this puts the average African schoolgirl (and by extension, her future family and her very community, as well) at a huge financial disadvantage for the rest of her life.

A few years ago, Proctor & Gamble began distributing free Always and Tampax products to a small network of African schools. "There are lots of reasons kids miss school," said the P&G director of the program when the plan was launched. "Being a girl shouldn't be one of them." Whether this was a heartfelt gesture of corporate altruism or an attempt to sneak in the ground floor of a burgeoning global market is almost beside the point. The sad fact remains that for most girls in developing countries, commercial femcare is just too expensive to buy and use regularly.

In the Op Ed page of this week's New York Times, Nicholas Kristof lists several lesser-known but innovative charitable organizations doing good work globally, and one of them is called Sustainable Health Enterprises. S.H.E. is working to kill two birds with one stone: to help women start their own businesses making and distributing their own low-cost pads and to provide affordable, eco-friendly femcare to females. Right now, they're working in Rwanda, but hope to expand their program to other countries, where such goods and opportunities are desperately needed.

Having recently co-written a book in the cultural story of menstruation, I'm constantly struck by the strange relationship this everyday process has had not only with individual women, but with history, the environment, and the social and political movements of the day. Developments and innovations in managing menstrual flow have arisen, as happens with all good design, directly from the needs, beliefs and values of the times. As a result, even the lowly pad can claim to have influenced society itself as a genuine, if unconventional, agent of change.

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