The Problem with Free Menstrual Pads

Sanitary pads are expensive. And in some parts of the world, hard to come by. So why not give pads away for free?

It’s an idea that a number of governments have considered this year. Several African countries, including Kenya, Uganda and Zambia, have taken steps toward giving free sanitary pads to girls. In August, Botswana joined the club. And it’s not just happening in low- and middle-income countries. In July, the Scottish government launched a project to distribute tampons and pads to women who can’t afford them.

For some governments, the goal is to boost school attendance for girls. Perhaps free pads would make it easier and more comfortable for girls to manage their periods at school. Others hope that the pads could reduce anxiety about periods — less worry about stains or how to get the next pad, for example.

While menstrual health researchers say it’s encouraging that more countries are talking about periods at the highest levels of power, some question the motivations.

Some critics in Kenya chalk up the plans as campaign promises, and aren’t sure the government will follow through. In June, Kenyan President Uhuru Kenyatta signed an amendment about sanitary pads into law, less than two months before the country’s presidential election. The law said the government would give pads to all girls in public schools who’ve reached puberty and make sure they have a way to dispose of the pads.

Jane Otai, an adolescent health advisor in Kenya for the Johns Hopkins University-affiliated nonprofit Jhpiego, commends the new law. But the timing of its signing tempers her enthusiasm. “Any promises coming from politicians at this time — you take with a pinch of salt,” she says. “My worry is: are they going to follow up on these promises?”

In Uganda, the answer was no. In April, the government backtracked on its plan to give out pads. The reason: a tough economic climate, said President Yoweri Museveni.

Infuriated, Ugandan activist and academic Stella Nyanzi spoke out. On her Facebook wall, she wrote a message directed to the president, his wife and his supporters: “For the children, I refuse your silence, your inertia and your sweet hollow words.” Her sharp criticism landed her in jail, NPR’s Eyder Peralta reported.

And though governments have said that giving pads to girls will improve school attendance, researchers say this step may not be enough to keep them from missing school.

Giving out pads is only part of what needs to be done to help girls manage their periods. It’s not a “silver bullet solution,” says Bethany Caruso, a postdoctoral fellow at Emory University.

“In addition to sanitary pads, we have issues of water and sanitation within the schools,” Otai says. “If the toilets are not habitable, girls will find it difficult to get to school and be able to continue their education if they cannot visit the toilet during her monthly period.”

Toilets — and having a safe, private place for girls to change their pads — get a lot less attention than sanitary pads, says Marni Sommer, a professor at Columbia University’s Mailman School of Public Health.

In schools with latrines, it can be embarrassing for girls to throw their pads into the pit, and other people — like boys — might see the pads and tease girls about them.

To address that issue, some girls use reusable pads so there are no issues with disposal. But this method has its own set of problems. Girls need a little bag to take the pads home to be washed.


That crucial detail was forgotten in an effort to give out reusable pads to girls at a refugee camp in Tanzania, says Sommer. “The [girls are] going to be embarrassed about what to do with their used pad,” she says.

“You think you’ve thought of everything, but they hadn’t thought about the little baggie to go with the reusable pad,” says Sommer. “There’s an essential need to consult girls. What do they need? What do they think?”

Courtney Columbus is a multimedia journalist based in the Washington, D.C. area. She covers science, global health and consumer health. Her past work has appeared in the Arizona Republicand on Arizona PBS. Contact her @cmcolumbus11.

You can make a Difference

Our Haitian seamstresses recently gathered together to share food and learn how to keep their serger sewing machines well oiled and repaired so that they can continue to create quality products. At our next sewing date we will be taking a picture of our MN sewing group sharing food and creating menstrual pad kits for distribution to a local Haitian school in January. Please join us to help make a difference in the lives of Haitian women and girls.
Save the date – October 28, 2017 – 9-4
Days For Girls workday will be at St Mary on the Lake Catholic Church in Plymouth.  It is also National Make A Difference Day so what better way to spend a day doing something good for others.

Hurricane Irma can’t stop our seamstresses

As Hurricane Irma threatened the northern coast of Haiti, many of our seamstresses were busy finishing an order of 158 menstrual pad kits to be delivered in October as well as an order for 20 large tote bags that required an industrial size machine for stitching the canvas type fabric. The sewing center is near completion, which will allow for a central location to collect the finished products as well as store the fabric. Ellen Schroeder was able to connect with the local Haitian Rotary group, who have agreed to be part of our rotary grant application. Unfortunately, due to the weather and flooding in some areas, the seamstresses from the two locations were not able to meet in CapHaitian and see the progress on the sewing center.  

Sewing in Cramped Quarters

While we are busy building the sewing center in Cap Haitian, our seamstresses and tailor have been busy continuing to sew in cramped facilities. They just completed an order for 65 kits that will be distributed in July and will spend the remainder of the hot Haitian summer constructing 150 kits that are to be delivered in September. We just have the roof to finish on the sewing center but work has slowed while we try to raise the remaining funds. Consider a summertime donation so that we can start sewing in the new center in the fall!


For those of you who have been following this blog over the past few years, you know that I am passionate about all things related to women’s health care. Considering that my job as an Ob/Gyn physician is intimately interwoven with this topic, it is only to be expected that my children are exposed to my opinions during conversations at home. They also hear about my experiences in Haiti and are often recruited to assist with the construction of reusable menstrual pad kits that are distributed to young Haitian girls to encourage them to remain in school after they start menstruation.

May 28th (5-28) is Menstrual Hygiene Day and is dedicated to creating awareness around an often taboo subject. The 5-28 has significance in that most women bleed for 5 days every 28 days. Although Western civilization has made great strides in the past few decades around menstrual health education, the stigma and embarrassment for young girls persists. My daughters and I were finishing a restaurant meal when we noticed that the girl leaving the table next to us had a large blood stain on the back of her dress. We looked at each other with horror while having a hurried discussion about whether it was less embarrassing to run after her and inform her of the stain vs. letting her find out herself. The decision was made as we heard the door of the restaurant close behind her and our chance was lost. Would we have wasted time in discussion if the bleeding had stained her clothes from a large cut on her leg? The blood is the same but the source so much different.

When my daughter informed me that she was combining both of the above experiences into one argumentative essay for her final AP Composition Essay, I had to smile and then pity the male teacher who was to be subjected to her strident opinions. This same teacher (late 30’s) admitted that he has never purchased feminine hygiene products for his wife and had no advice for sources of information to help support her argument that luxury taxes should be abolished on tampons and pads. Because of the work of humanitarian organizations such as WASH in developing world countries and women’s health advocates in this country, resources for information were plentiful.  I have included the first part of her essay below.

Luxurious Taxes

Toothpaste, sunscreen, chapstick, shampoo, condoms, viagra. All daily items, all exempt from taxes. Daily essential items that are categorized as a necessity and aren’t taxed. Items thought to be a luxury, however are taxed. Flowers, cell phones, nail polish, TVs, computers, and jewelry. They add pleasure to your life. Those items are bought by choice and personal interest. What defines whether an object is declared a necessity or a want? Does the gender of a buyer for an object affect the tax, non-tax ruling? Tampons are taxed, but females need them to tend to their monthly periods. Taxes should be removed on tampons in every state. They are looked upon too lightly and assumed to be more of a extravagance and less of need. They are the “pink tax”.

My mom is an OBGYN and she sees female patients on a daily basis that revolve around period defects. Patients are suffering from heavy streaming periods and other dysfunctions that are uncomforting. They have to change tampons more frequently than an average person. Changing tampons every hour is inconvenient and costly.  My mom works with women to try and assist them in feeling more comfortable with the unnatural feeling periods and other dysfunctions of being female and save them time and money from buying so many tampons. However seeing a doctor about menstrual issues becomes even more costly when trying to fix your awkward period malfunctions. Women are feeling embarrassed and uncomfortable.

Tampons. They are declared a luxurious item in thirty-eight states of the United States. On holidays, taxes are removed on some everyday items, however, tampons and pads are still taxed on those special occasions. Tampons are still looked upon as a non-essential item, as if they are used by choice. As if women choose to go out and buy a $7 box of wonderful cotton plugs. As if women choose to have periods every month for an average of thirty-six years of their life. As if women choose to spend close to $2,000 on such a “luxurious” item as a small cylindrical object made of cotton. As if women are being spoiled with an item to protect their blood from leaking out. What a treat.

Tampons aren’t flowers. People wouldn’t buy a box of tampons for their friend’s birthday. Tampons are a common piece of feminine hygiene that keep blood from spilling out uncontrollably and make periods a little less worse. Periods are a naturally occurring part of a female’s life that they can’t prevent, not to mention the berserk side effects of mood swings, cramps and cravings. Tampons and pads have to be used to prevent blood from pouring out and leaking everywhere, time after time after time.  Every second you feel uncomfortable blood shedding; every minute you’re hesitant of leaking; every hour you’re contemplating if you need to change tampons; every day you’re in fear of the current of your flow; every week you wonder when it will be done. Periods aren’t a choice. Tampons aren’t a choice. They are a need. Tampons are calculated to be needed for 456 periods, 38 years, and 2,280 days (2015, Kane) of a female’s life. Tampons are a female necessity.  

Although her grade for the entire essay was high, the one critique by her teacher is evidence that we still have some work to do in this country when it comes to education around menstrual health. He penned ” too graphic”.


The work that needs to be done in developing world countries is even greater.  There is a growing awareness that less stigma around menstruation results in better lives for both boys and girls. Girls that stay in school beyond the age of menstruation because they have access to a private bathroom as well as menstrual pads, also have fewer children and are better able to secure a job to support their family because they have obtained a higher level of education. My involvement with the sewing center at Helping Haiti Work has reinforced what I have seen researched. The need for menstrual protection supplies in schools is recognized, but the thirst from teachers and students for education is even greater. Our Haitian seamstresses have been provided with women’s health training and given charts and pelvic models to use in their educational sessions. For $16 a day they will assist in the distribution of the reusable menstrual pad kits and provide 3-4 hours of education to teachers and students.


My hope is that a future granddaughter will pen a similar essay to the one above for her ancient history class and use our current experiences as the beginning of the end when it concerns the menstruation taboo.


Education! Education!

In addition to marketing the Days for Girls reusable menstrual pad kits, our seamstresses have been busy providing education to young women utilizing the Ambassador of Women’s Health teaching that they learned last year. Last week, two of our seamstresses from Ranquite traveled 3 hours to Cap Haitian and then another four hours by motorcycle to Pilette. The program was sponsored by Haiti Marycare and was celebrating young women as part of an empowerment program. The instruction was well received and more events are planned for the future.

Morpheus Concert

We had a fabulous time listening to the Morpheus Band last weekend while also raising money for 2017 microloans and continued funding of the sewing programs. 125 people filled the Hamel Community Center enjoying tunes from Chicago and Blood, Sweat and Tears. Almost $6000 was raised that will help Haitian women expand their businesses.

Haiti – When something can go wrong, it will.

Over the course of the past 10 years visiting and working in Haiti, I have learned that even the most straight forward venture will have stumbling blocks. An hour long trip to the beach can be altered when the van breaks down and you bath in your own sweat, rather than the oceans waves, while waiting for the arrival of a new part.  When you ask a patient to get additional testing before surgery and she disappears for 2 days trying to find enough donated money to afford the cost of testing. Thus, when our recent planned trip to deliver 150 menstrual pad kits to Les Cayes, Haiti on the southern coast of the peninsula started to hit a few bumps in the implementation process, I didn’t worry too much. Haitian ingenuity seems to always overcome these minor obstructions, as it is how the country has functioned for so many years. But as the bumps in the road turned into large potholes, my confidence in our ability to pull off the venture waned.

Two of our seamstresses were to depart Cap Haitian for Port au Prince on Monday, a 6 hour bus ride that left at 3 am. They were to be met at the bus station in Port au Prince  by a representative of International Medical Corps and driven the additional 4 hours to Les Cayes. The seamstresses had the additional responsibility of transporting 150 menstrual pad kits and teaching materials that they would need for the 7 hour teaching session on Tuesday for community health workers and nurses working in the areas affected by Hurricane Matthew. Another 150 kits were to be delivered in March if the teaching went well and the health providers thought that the kits would be helpful to women and girls in remote areas. What could go wrong?

  1. The original chaperone for the women needed to back out 5 days before the trip and we scrambled to find a replacement who we trusted and with whom the women were comfortable traveling.
  2. As snaps were being put on the shield component of the kits, we realized that we didn’t have enough snaps to finish the order. Thank goodness for frequent mission trips from Minnesota, as we were able to send a supply with only a few days notice
  3. Despite counting and re-counting the kits, 39 kits (one large bag) were left behind at the sewing center and the loss not discovered until arrival in Les Cayes.
  4. The seamstresses and chaperone had assumed that lodging and food would be provided once they arrived at their destination. The representatives on the arrival end had not been informed of this and no accommodations were available.

The final outcome? 17 Haitian health providers showed up for the information session today and were highly impressed with the knowledge of Irose, the HHW seamstress. She spoke about puberty, reproduction and how the kits should be used to improve health. Some of the participants were interested in purchasing kits for themselves and family members, asking if they could promote the products beyond the distribution of free kits. Everyone agreed that local production of the product was something they wished to promote.

Once again I am reminded of the resilience of the Haitians. Many of us would have given up when only one of the above roadblocks stood in our way. But our seamstresses only saw it as a temporary detour until we were able to get them back on the road. And those missing 39 kits? They were sent on their own bus ride to Port Au Prince and will be waiting for the driver later today when he deposits the seamstresses back at the bus stop in Port.

Don’t forget about our upcoming fundraising event with the band Morpheus playing at the Hamel Community Center on March 4th from 7-9 pm. All proceeds will be used to support our sewing program and the microfinance loans. Ticket information available on our homepage.

Combining Forces to Get the Job Done

Helping Haiti Work delivered 75 Minnesota made menstrual pad kits to SOIL, a Haitian organization that produces fertilizer from human waste. SOIL is working in the area of Haiti that was affected by Hurricane Matthew and was able to distribute the kits to those women in need.
Don’t forget our concert fundraiser on March 4th, featuring the band Morpheus. More info can be found on our homepage


All around the world, women and girls face a monthly reality: menstruation. Periods are often taboo, something shameful, to be hidden away and never mentioned. Certainly menstruation is often considered a women-only topic – we ask each other for help if we’re in a tight spot and have forgotten a pad or tampon, we talk in coded language about cramps, irritation, and other inconveniences we tend to bear in silence each month.

It is truly unfortunate that menstruation is still considered a shameful and unacceptable topic in most places. And for many women silence is just one of many challenges they face each month. In countries where access to clean sanitation facilities is already a struggle, having a steady supply of sanitary products can prove difficult, whether for availability or cost reasons. For those of us who have access to supplies it can be easy to overlook the importance of pads, tampons, Diva Cups, whatever we use for menstrual management. But consider what you would do if you couldn’t access those supplies during your monthly period. Would you be able to go to work or school? Leave the house to socialize? Likely not – or you would have to improvise a pad from something around your home, like a rag or old shirt, increasing your risk of infection and likely leaving you feeling vulnerable and insecure about leaving the house.

Luckily, periods are starting to gain attention around the world – whether women in the US and other countries are protesting the “pink tax” or women like Leslee Jaeger are working to develop local and sustainable solutions to provide women with safe, reusable menstrual management supplies. Recently, Leslee co-funded Helping Haiti Work to do just that: provide locally made and affordable menstruation kits and create an economic opportunity along the way. Helping Haiti Work now has two sewing centers around Cap Haitian where woman work to craft reusable sanitary pads and prepare “kits”, which contain a pair of underwear, washable and reusable sanitary pads made from cotton fabric, soap and a sealable bag to store used pads before washing. The kits are designed to look like a cute clutch bag, making them subtle enough to carry around.


SOIL and partners distribute Haitian-made menstruation kits after Hurricane Matthew.

After Hurricane Matthew devastated southern Haiti, Leslee and her partners at Helping Haiti Work decided they wanted to contribute to emergency response drives, and donated a large number of their menstrual kits to SOIL’s hurricane relief effort.

In December a friend of SOIL’s, local activist and community leader Rea Doll, distributed the kits in Darbouze, a community in southern Haiti that relies heavily on the tourism industry. The impact of Hurricane Matthew in this community will likely be long-lived, as the decrease in tourism means that many families are having to pull children from school to save money and also work to bring in additional income. In the face of these challenges, menstruation presents an even bigger issue for women.

Rea, in collaboration with a local organization called OJED, distributed kits to women throughout Darbouze. Additionally, Rea realized that the kits could provide an opportunity to create jobs in Port-au-Prince and southern Haiti by replicating the work Helping Haiti Work has done in northern Haiti. Rea will be working with Leslee and her partners to further explore the possibility of opening a sewing center in Port-au-Prince (where Rea has space in the school she runs), and distributing kits throughout southern Haiti.

At SOIL, we were honored to be of assistance in connecting Helping Haiti Work’s generous donation to Rea and OJED, and we are so excited to see sustainable and entrepreneurial solutions like Leslee’s growing through new connections and opportunities to serve an ever increasing number of women.

Morpheus Concert 3/4/2017

Saturday, March 4, 2017 at 7:00 PM – 9:00 PM
Hamel Community Center, 3200 Mill St, Medina, MN 55340

You are invited to a concert featuring the band, Morpheus! Rock to music by Blood, Sweat & Tears, Steppenwolf, Santana, Chicago, The Eagles, The Doors and others as the 12-member group performs hits from some of music’s greatest bands.

Admission: $15 in advance. Use this ticket link to make your tax-deductible donation through GiveMN. Refreshments will be available; wine/beer for a $5 cash donation at the event. Bring your friends!

Hamel/Medina Community Center just off Hamel Rd, a half mile west of Hwy MN-55 and Old Rockford Rd. (NOT Medina Ballroom but the Community Center at 3200 Mill Street, Hamel, MN 55340).