“There is sort of this hope for a magic bullet, like the perfect pad, that will solve this,” said Marni Sommer, a conference organiser and associate professor at Columbia University who has studied menstruation-health management for more than a decade.
But even a never-ending supply of the perfect pad wouldn’t address broader issues, she said, such as the fact that girls and teachers don’t have adequate private restroom and sanitation facilities, and that they lack enough information about what’s happening inside their bodies. Advocates working on the issue agree.
“A holistic approach is definitely what’s needed,” Walker said. “You need to have the pads, you need to have the proper facilities around it, you need to have the education. It’s all linked.”
Basic infrastructure issues continue to be a hurdle to increasing access to education. A 2009 UNICEF survey of schools in Tanzania
found that just 11% of schools had enough toilets. Roughly half of those facilities had working water.
A striking two-thirds had no place for disposing of sanitary products. Even subtle design changes, such as providing separate bathrooms for boys and girls, and installing sinks in locations where girls can wash blood off their hands in private, can make a big difference, Sommer said.
Another major barrier is making menstruation less taboo — and better understood. Periods have long been treated as something to be kept secret in many cultures
"What we see often is just such a wide range of information being passed to girls and women," Grinvalds said. "You have girls who are very well informed, may come from households where their mums tell them what to expect…but then you also have girls who get their period and they think there’s something wrong with them because they are bleeding."
Some communities are rife with rumours that tampons and disposable pads are bewitched and will cause infertility, Walker said. In Tanzania, Sommer learned the story of a girl who thought she was deathly ill when she experienced her first period. The father of one girl in Ethiopia wanted to beat her when he learned what was happening.
“It’s traumatic enough to see blood for the first time, let alone think you’re dying or be afraid you’re going to get beat up,” said Sommer, who has created a book on puberty
to share with girls, boys, parents and teachers in the developing world. Hundreds of thousands of copies, tailored to match the language and cultural norms in the target country, have been distributed so far.