And you think you've got problems...

LUCKY ONES: Students from Great Horizon secondary school in Uganda's rural Kyakayege village including Resty Nakawoza (far left) proudly pose with their AFRIPads after a reproductive health presentation.
LUCKY ONES: Students from Great Horizon secondary school in Uganda's rural Kyakayege village including Resty Nakawoza (far left) proudly pose with their AFRIPads after a reproductive health presentation.

Western ads commonly depict the millions of women who use tampons and pads as being so enamoured with the product they're practically having a relationship with them. In fact I recently saw a magazine ad that urged women to "break up" with their current tampon and replace it with "one that's easier to hold."

But in rural parts of Uganda many girls and women have never even heard of tampons or pads. This hit home during some interesting email correspondence with a Ugandan school headmaster Anthony Jjuuko, who organises reproductive health lessons for schoolgirls.

"Sorry for not replying sooner" he wrote, "but I was finding out what tampons are and whether girls use them."

"This was a new term for me and all the girls and women I asked did not know what tampons are and (had) to check in a dictionary where we found the meaning."

In Sembabule town, more than 200km away from the Ugandan capital of Kampala, most of the dusty roadside dukkas (small shops) are unlikely to carry pads, forcing Ugandan girls and women to find their own substitutes. "I was scared and I used papers and leaves because I had nobody who could counsel me," said orphan Resty Nakawoza, recalling the horror of menarche. "I had no solution for that."

Living with her older brothers, Resty, 16, didn't learn about menstruation. It's unlikely her siblings would have been able to fork out the monthly 3,500 UGX ($1.50) for pads, (generally only available in larger supermarkets in city centres) anyway. Resty used paper and the local ebikokooma leaves for her first three periods, before switching to old rags. "But I was scared to come to school and go near the students when I had the periods," she admits.

Alarmingly, one in 10 school African schoolgirls cut class during menstruation or drop out entirely because they lack access to effective sanitary products, says UNICEF. In Uganda, poor menstrual hygiene management among schoolgirls causes them to miss four days of school a month - 20 per cent of their academic year.

Anthony still recalls the horror of seeing blood "leaking" from a menstruating student as boys shouted at her. She never came back to school after the incident and became pregnant at age 15.

Sophia Klumpp couldn't forget being called by a concerned headmistress into a boarding school in remote Kitengesa district, southwestern Uganda, in 2008, months after coming to Africa as a community development volunteer. The headmistress had noticed some surprising behaviour amongst her schoolgirls.

"They were pulling pieces of foam out of their mattresses and essentially using that as a sponge in order to absorb their monthly menstrual flow," remembers Klumpp, a 30-year-old American.  When Sophia experienced her own Ugandan emergency and had a hard time finding pads, the lack of sanitary wear issue "became personal".

Around that time, Sophia was introduced to Lunapads, a reusable cloth pad invented by a Canadian "women-owned and operated social mission-based business". While some eco-conscious Western women were instant fans of the product for others the idea of a reusable pad came with a 'yuck factor'.

Inspired, Sophia and some local women began ripping up a doona and drawing pad shapes on to it. Drawing inspiration from Lunapads and having identified a gap in the Ugandan market for reusable sanitary napkins, she and her partner Paul Grinvalds embarked on a six-month pilot modelled on the Lunapad to see if its use could keep girls in school during their menstrual period.

Three years later their social business AFRIPads makes affordable washable cloth pads lasting up to a year. They're sold directly to Marie Stopes who stock them at health centres across Uganda. World Vision, UNICEF and Plan are among the 120 NGO customers AFRIPads also has.

"I've sold pads to girls before in really remote areas and they come up with their money and then once they give it to you they feel proud," describes Paul. AFRIPads, who have received two international accolades this year for empowering women, provide jobs to nearly 60 Ugandans, most of them at their factory.

Today Anthony and his co-worker Barbra Nabitula hand out the pads for free to girls to try after their talks and speak to parents.

"I will tell them my parents about them," said Goretti Nasolo, who had been using exercise book pages as replacements, after a recent lesson at Kyanjovu Primary School in Lwengo district.

In Kenya pads are reportedly used as a form of currency by older men luring younger women into having sex with them in exchange for the products.

The Ruby Cup, a reusable silicone menstrual cup and the brainchild of Danish and German entrepreneurs, is now being sold to women in Kibera, the country's largest slum, at an affordable price.

"As with the mobile revolution in Africa, where it skipped the European path of traditional landlines, the continent's heading towards superior and more sustainable sanitary products, leaving out the entire conventional and disposable menstrual hygiene era," says managing director Maxie Matthiessen.

- Daily Life