In rural Ethiopia, menstruation is a taboo subject, rarely discussed publicly or privately. Many schools don’t have adequate toilets, and girls often can’t afford sanitary pads. They make do with strips of cloth, dry grass and pieces of old mattresses.
Not having adequate bathrooms and sanitary supplies leads to embarrassing situations at school. As a result, girls often stay home three to five days a month and fall behind in their studies. Some eventually drop out.
When Washington University obstetrician-gynecologist L. Lewis Wall, MD, DPhil, and his wife, Helen, lived in Ethiopia last year while he was a Fulbright scholar, the couple met an Ethiopian woman who is trying to change the experience of adolescent girls in rural Ethiopia by providing them with reusable sanitary pads and education about menstruation.
After getting to know the woman, Frewini Mabrahtu, the Walls decided they had to do something to support her mission.
“Menstrual hygiene management is a human right for women,” said Wall, professor of obstetrics and gynecology. “It makes such an impact on girls. How could we not help?”
So last year, the Walls established a St. Louis-based organization called Dignity Period to raise awareness about the lack of sanitary pads for girls in Ethiopia and to help distribute them to girls in secondary schools.
“Lewis and Helen Wall made me a promise that they would support this project, and that promise became a reality,” Mabrahtu said. “I will be always grateful to the Walls for their involvement. They helped me see the light at the end of the tunnel.”
Making a difference
Mabrahtu earned a bachelor’s degree in chemical engineering in 1992 in Texas and worked for 10 years in the United States. On a visit home to Tigray, a region in northern Ethiopia, she was disheartened to learn that not much had changed for adolescent girls when they begin menstruating. She remembered all too well not having access to sanitary pads, missing school and feeling isolated during her adolescence and young adulthood.
Mabrahtu moved back to Tigray in 2005 determined to make a difference. With a $150,000 loan, she hired 42 local women and started a factory that makes reusable, washable sanitary pads at a cost significantly less than that of commercially available, disposable pads. Today, the factory produces more than 100,000 pads each year.
Mabrahtu’s biggest challenges are lack of financial support and limited ways to distribute pads to girls in secondary schools.
To help with these hurdles, Dignity Period, the organization started by the Walls, is partnering with the factory and the College of Health Sciences at Mekelle University in Tigray, where Wall was a Fulbright Scholar. The aim is to distribute 50,000 kits in 2015 to secondary-school girls in Tigray. Each kit will include four reusable pads, two pairs of underwear, two bars of soap and information about menstruation.
Wall and his colleagues at Mekelle University plan to conduct cultural studies about attitudes toward menstruation in Tigray and develop culturally appropriate educational materials for the local school system.
While at Mekelle, Wall also met with Robin Shepard, DSc, the faculty adviser of the Washington University chapter of Engineers Without Borders USA, who is working with the civil engineering department at Mekelle University to design toilets for schools.
“We, along with other international groups, want to increase the number of toilets in schools,” said Shepard, adjunct instructor in the Washington University School of Engineering & Applied Science. “We want to make sure the toilets that are installed meet the special needs of girls, giving them privacy and a place to wash. The goal of our project is to make sure they attend school every day.”
Wall’s Fulbright scholarship helped establish a residency training program in obstetrics and gynecology at Mekelle University. For the past 20 years, he has worked doggedly to help women in Africa with obstetric fistulas — injuries during childbirth that cause bladder and fecal incontinence.
But he was struck personally by the struggles of girls in rural Ethiopia.
He hopes Dignity Period and other efforts one day will expand to all of Ethiopia and other African countries. “These are problems throughout the world,” he said. “We all need to work to make it easier for adolescent girls to stay in school.”