Period poverty worsens with inflation crisis, as girls trade sex for pads or risk infection by using rags, leaves and cow dung
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Inflation pushes up prices of period products across Africa
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More girls miss school and use dangerous alternatives
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Campaigners call for end to taxes, more menstrual cups
By Kent Mensah
ACCRA, Aug 16 (Thomson Reuters Foundation) - After being shamed over bloodstains on her uniform, Ghanaian student Juliet Opoku misses about a week of school each month because her parents, who are farmers, can no longer afford pads.
The cost of period pads has more than doubled to 12 Ghanaian cedi ($1.43) from 5 cedi last year in the west African nation, where inflation is about 32%, forcing poorer families like Opoku's to focus on buying food over sanitary products.
"I skip school because once I stained my uniform and the boys teased me. It has affected my confidence," Opoku, 15, told the Thomson Reuters Foundation by phone from Ghana's southern Ashanti Region.
"Sanitary pads are very expensive ... I sometimes use toilet roll, baby diapers or a cloth during my menses," added Opoku, who wants to become a nurse.
The global problem of spiralling inflation has pushed up the cost of period pads in many African nations, driving more girls out of school or to unhygienic alternatives that can cause infections and infertility, say health experts and charities.
The price of a packet of period pads had increased by 117% in Zimbabwe and by 50% in the Democratic Republic of Congo by April compared to January, found ActionAid International, which campaigns on women and girls' rights.
Charities say this could have dire consequences for millions of African girls - impacting their education, health and dignity, driving them to have transactional sex with older men - and ultimately worsening gender inequality.
"As prices continue to rise, our main concern is that women will forgo spending on health, such as on medicines and sanitary products, to prioritise food and other things to support their families," said Suganya Kimbrough of Catholic Relief Services.
"This could have a tremendous impact on girls attending school and women earning their livelihoods," said Kimbrough, deputy director for program quality in East Africa, adding that families were also skipping meals and selling livestock to cope.
EDUCATION, HEALTH RISKS
Period poverty, often defined as the inadequate access to menstrual hygiene information, products and toilets is common across much of Sub-Saharan Africa. In the face of stigma, girls often miss classes and can even drop out altogether.
In Kenya, a study sponsored by the Bill and Melinda Gates Foundation found 65% of women and girls were unable to afford pads, and only 32% of rural schools had a private place such as toilets for girls to change their period pads.
The United Nations estimates that one in 10 girls in Sub-Saharan Africa misses school during their period, which can add up to as much as 20% of a school year.
Even if these girls complete their schooling, they are likely to fall behind boys of their age, exacerbating existing inequalities in educational attainment, say campaigners.
When girls use makeshift alternatives, such as paper, old rags, leaves and even dried cow dung, they risk falling ill with reproductive and urinary tract infections, say health experts.
"Girls can contract general bacterial infections from using pieces of cloth," said Anita Asamoah, an independent public health advocate.
"If proper care is not taken, these infections will later on lead to Pelvic Inflammatory Disease or infertility."
Pelvic Inflammatory Disease is an infection of the womb, fallopian tubes and ovaries, which can make it difficult to become pregnant and increases the chances of an ectopic pregnancy in the fallopian tubes.
Without money for pads, some girls have sex with older men, perpetuating a cycle of reliance and exploitation, which can lead to unwanted pregnancies and early motherhood.
"Men have lured them into transactional sexual relationships in exchange for sanitary towels," said Adjoa Nyanteng Yenyi, who works on adolescent sexual health with the United Nations Population Fund (UNFPA) in Ghana.
"Many girls have fallen victim to adolescent and unplanned pregnancy."
Research by the Kenya Medical Research Institute and U.S. Centers for Disease Control and Prevention in rural Western Kenya found that 10% of 15-year-old girls surveyed had sex with men to get menstrual products.
TAMPON TAXES, MENSTRUAL CUPS
Campaigners are urging African countries to remove taxes on period products - often dubbed tampon taxes in the West - to make them more affordable. Only a handful of countries, such as Kenya, Rwanda and South Africa, have done so.
Ghana imposes an import tax of 20% and an additional 12.5% VAT on menstrual pads, which the Ghanaian Revenue Authority categorises as luxury items.
In addition, campaigners say more countries should provide free pads to schoolgirls, following the example set by Kenya, South Africa, Botswana and Zambia, as well as cheaper, reusable products like pants with washable liners and menstrual cups.
Kofi Kyeremateng Nyanteng is Ghana country director for CouldYou?, which distributes silicone menstrual cups to marginalised girls globally.
"We need to explore efficient and sustainable ways to address menstrual poverty," he said.
"One sure strategy is to put reusable products like the menstrual cup on the desks of policymakers," he said, adding that the cups can last for up to 10 years.
($1 = 8.4000 Ghanian cedi)
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(Reporting by Kent Mensah @kentmensah. Additional reporting by Nita Bhalla @nitabhalla. Writing by Nita Bhalla. Editing by Katy Migiro. Please credit the Thomson Reuters Foundation, the charitable arm of Thomson Reuters, that covers the lives of people around the world who struggle to live freely or fairly. Visit http://news.trust.org)
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