Going With The Flow

06/09/2019

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Every month women between the ages of 11-55 experience their menstrual cycle. In Kenya, menstrual health is swept under the carpet as a woman's thing, with little information given on the subject and periods often treated as something to be ashamed of.

Research from Huru International has shown that 65% of women and girls in Kenya cannot afford menstrual products. The average girl reports missing at least 3 days of school per month because she doesn’t have what she needs to manage her period. This has serious personal and educational consequences, like falling behind in class, dropping out altogether and having to use unsafe substitutes for pads like mattress filling or leaves. For example, a resident of an informal settlement or just a young struggling Kenyan girl with 50ksh will often have to make the difficult choice between buying food and buying a pad; both are basic needs but opportunity cost prevents meeting the later.

Over the last few weeks, we have undertaken research to review the different menstrual products that could provide affordable, safe and hygienic options to girls within Nairobi. We focused on two alternatives, Menstrual Cups and Reusable Pads.

Menstrual Cups

A menstrual cup is a feminine hygiene cup that you insert into the vagina to safely collect menstrual flow. As the name suggests it is in a bell shaped form made from a flexible silicone. There are many ways in which it can be inserted to the preference of the girl/woman. It might sound like a new product, but the menstrual cup was actually invented way back in 1937 by an American actress Leona Chalmers. Awareness of the product, however, generally remains low, although it is starting to increase in both Europe and Africa, interestingly among quite different target audiences. In Europe menstrual cups are making waves among the young and climate conscious in environments such as universities, and are often regarded as a high end product. Contrastingly, in Kenya, and other parts of Africa, menstrual cups are being introduced and promoted by NGOs looking to improve menstrual health options for girls from disadvantaged backgrounds.

With all new products, questions and misconceptions abound. Reading this, you’re probably wondering things like, are they safe? Are they easy to use? Will they save me money?

How about side effects and health issues?

Whilst every woman is unique and they may not be the solution for everyone, from our research users generally give very positive reviews. Menstrual cups can remain inserted up to 12 hours, with users commenting that they are comfortable, and they can get on with their everyday activities without even noticing that it’s there. Light and heavy flows can be managed with cups of different sizes.

Menstrual cups at The Cup Foundation’s shop in Kibera

Menstrual cups at The Cup Foundation’s shop in Kibera

A major attraction is that one menstrual cup can last for as long as ten years, creating potential for savings. Huru’s research found that an average Kenyan girl requires 14.1 pads a month to adequately manage her period (Huru, 2019) with the cheapest pads going for 50ksh to 125 Ksh. In a year, adequately managing her period with disposable products, an average girl could thus have to cover costs beyond 8460 Ksh a year. By contrast, a long lasting menstrual cup costs around 2000Ksh.

Recent research published in the Lancet  (https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(19)30126-4/fulltext) concluded that menstrual cups were as reliable as disposable alternatives, and presented very few complications. They also do not produce an odor and their reusability makes them eco-friendly! However, they may take a while to get used to, meaning the training is key.

At present in Nairobi, the menstrual cups have a slow market as not many know of it and this causes a lot of stigmas and misconceptions towards its use. Much research is needed to help about how best to convey understanding and ensure acceptance of menstrual cups as an option among the girls and women in Kenya. Considerations such as culture and perception, techniques of combating harmful myths and taboos, will be explored as we further our research.

Our research to date has included meeting with The Grace Cup founder, Ebby Weyime, and talking to Sue from Crimson Care about how they raise awareness and use of the cups. They both sell the cup at a price favourable to mostly middle class women but aim to help all females. We also met with Camilla Wirseen who through The Cup Foundation strongly advocates for the education of girls and boys regarding menstrual health and other issues arising from social environment in which the girls and women they support live. Through our research we keenly noted the stress made on training girls on the cup’s use and education of general menstrual hygiene and issues as they are socialized not to discuss the topic of periods.

Meeting with Camilla (left), founder of The Cup Foundation

Meeting with Camilla (left), founder of The Cup Foundation

Meeting with Sue (second from the left) from Crimson Care

Meeting with Sue (second from the left) from Crimson Care

Reusable Pads

Reusable pads look similar to the disposable pads however they can be washed and reused each cycle.  They can last up to 18 months and one is advised to use around 8 pads for her cycle.

Reusable pads produced by Huru International

Reusable pads produced by Huru International

We met with Huru International, an organisation here in Kenya that has specialised in equipping young girls and women with comprehensive health education. Huru pads are quality fabric, leak proof tested and environmentally friendly pads which are Kenyan made by women and men from impoverished informal settlements in Nairobi. To mention some benefits that are highlighted on the reusable pads, they are comfortable and have less infection risk than disposables. They are great for sensitive skin and can be more absorbent than disposable pads as well as being more breathable. There are some downsides, such as handwashing taking time and water, with difficulty getting stains out and also having to carry the soiled towels around before cleaning at home. These are challenges, however reusable pads are adaptable and the similarity to disposable/traditional alternatives makes adoption for girls easier, which is attractive particularly in communities where there might be existing cultural taboos.

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Huru International take a holistic approach which is evidence based, girl centred, community focused and brings in boys as allies. This inclusive approach has helped them reach girls in more inaccessible, isolated communities.

Our hope as we develop a project in this area is to give girls agency to be able to choose their option of management. To pick an option which is appreciated by them and they feel most comfortable using. Rather than preaching the benefits of one option we want to increase awareness and access to many, empowering girls. Furthermore our main aim is to increase education and knowledge about menstrual hygiene management (MHM) and the female body. We understand this is a big task but we are excited to carry on researching this project.

We are beginning research for a new project including training university students in Nairobi to act as MHM ambassadors providing information to young girls about MHM and the options available, as well as acting as role models. This is a very important issue for us and after continuing our research and creating a structure to complement our other projects such as the mentorship program) we will look to roll out a pilot project.

Today and everyday roughly one in seven of the women you see will be on their period. This is an issue that affects half of our population personally, and should be of concern to us all. #menstruationmatters

Patricia and George
(Kite Nairobi committee)