Women in rural Rwanda find affordable sanitary solutions.

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Before it clocks six in the morning, Alice Bazizane Twisenge is up to start preparing for her day
at school. Among her many early chores before she leaves is to fetch water and in the dry season
she has to walk at least three kilometers away from home.
The 18-year old is the second born in a family of five girls and two boys living in Nyagitabire
village in Kayonza district, Eastern Rwanda.
For the teenage Twisenge, carrying a jerrycan for the three kilometers or any other cleaning
chores at home is not a problem, but her biggest worry is what to do if her menstrual period starts
while she’s at school, hence skipping studies is an option.
In rural sectors of the Kayonza district, period poverty is making it hard for many girls as well as
women from low-income families to access menstrual health products. Many use materials such
as leaves, pieces of mattress, unhygienic rags, or toilet paper that can potentially bring them
serious health issues.
“I used to feel shy and uncomfortable telling my dad to buy me pads, I could make up stories to
skip school,” Twisenge says, “Lack of affordable sanitary products is a very common challenge
for girls in rural areas whose families are too poor to afford sanitary products.”


According to the World Bank report, in 2020 at least 20 percent of Rwanda’s schoolgirls,
particularly in rural areas, miss up to 50 days of school per year because of no affordable pads.
In an attempt to tackle the challenge, girls and women in Kayonza have taken steps to counter
this issue by making reusable cloth pads that are relatively cheaper.
Elena Uwizeyimana, a tailor from Nyagitabire cell in Gahini sector is one the residents who
started the initiative in 2021 to address the challenge in her community.
The 30- year old, trains vulnerable girls and women how to make their personal reusable pads.
Some, she makes to sell to those who can’t make themselves.
These cloth pads can be used a dozen of times, they also absorb menstrual blood and, they stay
put for about four to more hours, depending one’s menstrual flow. After use, the pads have to be
washed really well, dried before it can be reused.
Uwizeyimana explains how they are made from a simple process of only having materials like a
piece of flexible light absorbent cotton fabric, a button, a needle, and thread.
“You cut the piece of cotton into a long shape with rounded ends, and then cut the plastic piece
slightly larger than the cotton piece. Thread your needle and sew the cotton piece to the plastic
piece,” she explains.

“After that you need to stitch the piece of fabric to the soft piece, the cotton side facing outward
and the flexible side between the fabric and cotton. These reusable pads are also required to have
a smaller narrow hole for the button to fit through.”
To wear them, one needs to place it in the underwear, wrap the wings under it, and use the button
to secure it in place.
Made from breathable cotton, the reusable towels are said to cause less sweating and odor, and
don’t have side effects if kept clean.
Uwizeyimana has trained at least 18 girls and women, mostly school dropouts the necessary
skills of tailoring pads as well as cloth cutting and sewing, so they can learn the skills that could
support themselves through producing useful products for themselves and the communities.
So far, she has trained at least 18 trainees, with sessions undertaken from Monday through
Thursday every week from 8:00am -1:00pm. Many of those who want to learn the skills come to
her from the neighboring villages and are not charged for the lessons in hope will train others.
Grace Ingabire, a sewing machine novice aged 23 years from Karubamba village in Rukara
Sector says that after three weeks of training from Uwizeyimana, it took her a few tries to get the
sewing technique, but after two months she got the hang of it now!
“I made five washable cloth pads for myself that I rotate along with a few others. I now help
friends to make their clothing pads,” Ingabire points out. “You put the pad on your underwear, it
absorbs your menstrual flow for about 7-8 hours, and when it’s saturated I put it in a bucket of
water and let it soak for some minutes.”
Another tailor Joseph Rwamugambo who makes and sells pads with his wife says they make the
cloths pads not only to generate income, but to spread an ecological awareness of the value of
reusable cloth pads.
Rwamugambo explains that they purchase the materials from wholesalers in Kigali at a cost of
roughly Rwf12,000 (US$ 12) while the plastic costs around Rwf6,000 to Rwf7000 (US$6-7) and
they are all imported.
The two-meter piece of cotton produces 20 – 25 reusable pads depending on sizes cut out.
Rwamugambo notes that they make different types and the cost also range between Rwf500 to
Rwf 700 (US$0.5 – 0.7).
Since Twisenge started using the reusable pads skipping school is no longer an option and
attends all other school as well as social activities promptly.
Josiane Mukandayisenga a mother of two who lives in Murundi sector says that before, she
needed to use three disposable pads per day which is 5/28 days. She needed at least 180
disposable pads per year.

It became easier for Mukandayisenga after switching to reusable pads because she now spends
less than half of what she used to and doesn’t miss any of her engagements due to lack of money
to purchase a menstrual pad.
Alice Mutesi, a single mother from the Mwibiza Sector notes, “I wish I was a boy. I opted for
reusable because they don’t irritate, smell or itch. “They’re comfortable to use, not only
economical and environmentally friendly, but can be used for around 3-4months if they’re rinsed
well.”
The reusable pads can be won for more than four hours, but you may have to change it more
frequently if you have heavy flow and gets filled up sooner than that. It is advisable to have an
extra pad in case you’re on journey.
The problem with these pads as many observes, it is difficult to wash the reusable cloth pads
right away, you need to soak them first and it requires a lot of clean water to rinse them well.
For Climatina Keza, a resident of the Mwiri Sector, disposable sanitary pads are a luxury she
often couldn’t afford and wonders why it took longer to have this option.
“I prefer to use reusable pads, they have changed life both socially and economically. They feel
dry and comfortable, and sometimes I forget that I am even wearing them because they’re light
and absorbency is good,” Keza says, adding that she always has at least five pieces ready to use.
“I had to choose between buying food and sanitary pads since a pack of single-use disposable
pads costs Rwf1000 ($1), a day’s wage that puts food on the table for the entire family,” the 25-
year old mother adds.
“In most cases, I could not allow my children to go hungry, so I would buy food and then cut
pieces from old clothes and masteries to use as pads, today I use hygienic reusable pads, and find
no problem using them.”
In 2019, the government of Rwanda added sanitary pads to a list of goods that are Value Added
Tax (18%) exempted in a bid to ease their affordability.
Alex Mupenzi, a shopkeeper at Kayonza market who sells several brands of sanitary pads, says
that tax exemptions didn’t change prices.
Dr. Fils Jean Claude Kwizera at Rwinkwavu Hospital however warns that reusables are not safe
if they’re kept unhygienic. They have to be washed with clean water to remove soap, detergent,
dirt, or impurities and should be stored in hygienic conditions.
“Doing so will remove most of the menstrual blood or urine making them less likely to stain or
smell. They should have a fresh sanitary towel, to make the switch then rinse the used pad,” he
cautions.

Although making these sanitary towels is easy, getting enough materials to make them is
difficult because they are imported from either Uganda or Tanzania. Their accessibility is also a
challenge because there are few tailors who make them and are not available to a lot of people
who wants them
“Due to increase in the global prices, each wholesaler is charging different prices for materials
which leads to price discrimination,” observes Uwizeyimana.