menopause symptoms and hence did not seek medical advice for the problem.
It was quite evident from the onset of the conversation that she was destined for an admission. We did a quick scan and blood works and“ surprise! Surprise!” she had fibroids. I informed her of my findings and the need for admission. Unfortunately, she was unable to afford my services privately but had the common sense to have an active NHIF card( that time), what is now known as Social Heath Insurance Fund( SHIF). I advised them to go to Kenyatta National Hospital for initial stabilization by way of blood transfusion and consider having a hysterectomy.
I wrote for June a referral letter and she came back about 3 months later to say Thank you! She reported she was received very well and was able to get an initial transfusion and her friends and relatives donated for her blood. She got the surgery- removal of the uterus and has been very well following her management.
As the title is menstrual hygiene so let me stick to that lane. June is very lucky as she is a self-employed business lady with some means and is able to afford to buy pads.
UNICEF’ s water, sanitation and hygiene( WASH) country teams work inclusively with governments, civil society partners and donors, to improve WASH services for children and adolescents, and the families and caregivers who support them. A WASH Fact Sheet written by Agnes Makanyi, WASH Specialist, UNICEF Kenya and Andrew Trevett, Chief of WASH, UNICEF Kenya, cited that“ Small scale studies in Kenya show that users prefer disposable sanitary pads to reusable sanitary pads and homemade alternatives such as pieces of cloth, cotton, pieces of mattress, natural materials( FSG 2016). The same studies showed that 65 % of Kenyan girls across the country use home-made alternatives( FSG 2016). High cost and poverty level emerged as the biggest challenges to accessing menstrual products in Kenya.”
These figures are staggering, sadly telling us that only 35 % of our population are able to access modern menstrual hygiene products.
Types of Menstrual Products
Sanitary Pads: These are made from natural or synthetic absorbent material. Usually kept on for about 2-6 hours. Disposable pads are a common choice, but their cost and environmental impact are of high concerns.
Tampons: Are small absorbent materials that are inserted into the vagina for about 2-4 hours depending on the flow. Environmental impact is still a concern with the other issue being the risk of Toxic Shock Syndrome( TSS) a bacterial infection that may occur from either staying with tampons for a long time or using a wrong size of the tampon.
Menstrual Cups: Reusable, silicone cups offer a more sustainable and cost-effective alternative, as they can also contain a large volume of blood and therefore can be kept for longer.
Reusable Pads: Fabric pads can be made from various materials and are a budgetfriendly option.
Menstrual Discs: A less common option, but can be a good alternative for some women.
Menstrual clothes: Reusable pieces of fabric that are worn externally. In this part of the world, it is quite common to use the proverbial leso. While working in Kilifi in my early days, this was the most common method used by mothers then.
Period Underwear: Another reusable option, though not as absorbent as other products.
Poor menstrual hygiene can result in urogenital infections, school dropout, missed work, social isolation and stigma.
Challenges surrounding menstrual hygiene include access, affordability, sustainability and knowledge gaps to name but a few.
Through policy and regulation, school-based Programs by educating boys and girls on menstrual hygiene and community-based Initiatives such as distributing reusable pads or menstrual cups may address these challenges.
For me thumbs up to Gloria Orwoba, specifically for bringing this issue to the fore and you looked awesome in that white suit! Sorry for the social embarrassment you faced but keep that fire burning …“ a luta continua!” To the rest of us let us do our part to impact on lives of others in our own small individual and unique way.
Dr. Maureen Owiti is a practicing Obstetrician Gynaecologist and fertility consultant based in Nairobi. You can commune with her on this or related matters via email at: Drmaureenowiti @ gmail. com.