In this 21st century, some girls and women are finding solace in plant leaves and banana sheaths which they use as sanitary pads, writes ALBERT SHARRA.
It is Tuesday, the clock is ticking to around 10:30am and a class is in session at Ntanila Primary School in Dowa. One Standard Eight pupil walks slowly towards and kneels before her teacher. She requests to go out.
The teacher, looking concerned that the pupil will miss part of the lesson, hesitantly agrees to the request.
To classmates, she is visiting the toilet. Yes, but there is more.
Aged 14, the pupil—whose identity we have withheld for ethical reasons—walks behind the classroom to the nearby bushes. She is in her menstruation and wants to hide in the shrubs to clean up.
Menstruation is a normal biological process and a key sign of reproductive health. It is the natural monthly occurrence in healthy adolescent girls and pre-menopausal adult women. Its onset occurs anytime between the ages of eight and 16 and lasts between at least four and seven days every month.
Like a thief, she looks this direction then that, before plucking leaves from a Gmelina tree. She squats behind the tree and replaces the leaves she had worn in the morning. It is the plant leaves that she calls sanitary pads.
“I cannot afford sanitary pads in the shops. Sometimes I use a piece of cloth, but still I feel uncomfortable because it gets wet easily. Leaves are easy to change and dispose of,” says the girl.
She reveals that in addition to Gmelina leaves, the bananas tree—particularly its fresh stalks that form the upright layers of the leaf sheath—also forms a better sanitary pad.
“When partially dried, banana sheaths absorb liquids better. However, it is itchy,” says the pupil.
Mercy Njati, a teacher at Ntanila, confirms the practice.
“Some might not believe this, but we need to act. It is sad that our girls walk with leaves in their underwear during menstruation periods. Many can hardly access rags because rags form part of their clothing. Shops are not a priority either due to poverty,” she says.
Njati, however, reveals that since some leaves cause itching and cuts, most girls choose to stay away from school during their menses.
“Imagine walking with itchy and sharp-edged leaves between your thighs. With long distances, it is risky. And missing classes every month is a big loss,” she says.
Girls at Ntanila Primary School are just an example. Our investigations show that such is a national crisis and with poverty being its major cause many cannot afford.
A spot check with some shops reveals that the minimum cost of a pack of 10 disposable modern sanitary pads is K600.
The 2015 World Bank poverty line report says an ordinary Malawian lives on $1.9 (about K1 300) a day and this can only buy two packs. Prioritising pads amidst several necessities is a gamble.
However, depending on menstrual flow, one can use a pack or more per month. This is what calls for the need for reusable sanitary pads.
Some entrepreneurs have taken advantage of the need. They are producing and selling a pack of 10 reusable sanitary pads at an average cost of K4 000 and can be used in two years.
Of 10 girls sampled in Blantyre rural and Thyolo to establish what they use during their menses, none mentioned pads. They all said they use rags and banana sheaths.
This corroborates findings of the Girls with a Vision Association (Gwava) research.
“We sampled populations in two districts of Blantyre and Dowa and found that 56 percent of the population uses unsafe materials,” reveals Tadala Thembakako, Gwava executive director.
This reveals how this natural situation has become. However, whether the improvised sanitary pads are successful or not, of concern is the health implications they bring to female reproductive system.
Cynthia Kanyika, a nurse, says improvised pads just put the girls at risk.
“I have not treated any girl with cuts or sores between the thighs, but I have interacted with many in the district and they revealed the suffering that is in using leaves as pads. We should find a solution,” she says.
In a telephone interview from Kasungu District Hospital, Dr Ireen Kamwaza confirmed the practice, but said being a sensitive issue, girls keep it under wraps.
“Even if they sustain cuts or develop sores between the legs due to friction, they do not report to the hospital. I am informed that many use Vaseline to cure the bruises,” she says.
Fanuel Lampiao, College of Medicine reproductive health physiologist is shocked and describes the practice as a crisis.
“This is dangerous. Plants carry microbes which include germs and bacteria that can cause infections. Furthermore, sexual organs are soft and delicate to cuts and infections,” he says.
He adds that there is no protection on sexual organs that can stop infections.
Lampiao says although it cannot be automatically concluded, such practices put women at risk of cervical cancer infections in addition to increasing the risk of them contracting sexually transmitted infections (STIs), including HIV, due to cuts caused by the leaves.
“Let us encourage them to use soft cloth they can wash and reuse,” he says.
Kamwaza corroborates: “Leaves are moist and are a breeding ground for microorganisms. So too are the rags. They hold dust, which is also a breeding ground for microbes.”
Thembakako says this is why her organisation is promoting reusable sanitary pads made from locally available materials.
“We just train girls on how to make them and manage their menses,” she says.
Gwava is not alone in the project as demand is high. But most organisations work in selected districts with a small capacity just as Gwava itself.
“We really need to increase our outreach area and government should join us because it is a health issue,” says Thembakako, adding that, in some countries, sanitary pads are free and are placed in toilets, hotels, clinics and schools just like condoms.