Worldwide, periods are a leading cause of absenteeism of girls in school, and not just in developing countries. “Period poverty,” the inability to afford tampons or pads, exists in high-income nations like the United States and United Kingdom, too.

One in 10 girls in the U.K. cannot afford menstrual products. That’s the same percentage of girls missing school due to periods in sub-Saharan Africa.

In India, only 12 percent of an estimated 355 million menstruating women have access to and use sanitary napkins. In the U.S., most states still tax menstrual hygiene products as non-essential “luxury” items.

Here are seven young activists around the world who are taking a stand:

(Save the Children)
(Save the Children)

Saleha Khan broke out of a cycle that most teenage girls who grew up in her Mumbai slum, including her own sister, are forced into: dropping out of school, early marriage and childbirth, and confinement to their homes.

Khan grew up in Govandi slum in eastern Mumbai, next to one of the city’s biggest trash dumping grounds. The tightly packed houses, and lack of clean toilets and privacy means girls struggle a lot when they’re menstruating.

“When a girl gets her period here, she’s scared to even throw away her pads at home,” Khan says. “So, we teach them it’s okay to wrap a pad in paper and throw it in the dustbin,” she says.

In just a few years, Khan has transformed from a quiet, young girl attending local menstrual health sessions to a strong, vocal leader and leader in her community. She started going to these classes at age 12, even though everyone said she was too young. “In the beginning, I used to sit there and just listen,” she says. “Now, I myself conduct those sessions to 30 to 40 girls at a time. I teach them how to manage their periods and what sanitary products to use.”

When her father almost forced her to drop out of school after eighth grade due to financial struggles and worries about her safety going to high school farther away, she stood her ground.

“I decided for myself I want to continue school, I want to become someone great,” she says. So, she reasoned with her family. “I argued with my dad a lot,” Khan says. “My parents were scared about me going out of the area since boys could harass girls on their way to school.”

Not only did she graduate high school, but she’s now a college student focusing on a degree in business and economics. “There’s been a big change in my family, so now, they don’t see me as different from my brothers. My father is now proud of me.”

Khan was shunned in her community for her progressive views, which many deemed inappropriate. Her friends’ parents would even shut the door in her face. “They didn’t want to me to tell their daughters about my experiences, since they thought I would brainwash their daughters,” she says.

Her work has garnered international recognition, and she became the first girl in her community to travel outside India.

(Sophia Spring)
(Sophia Spring)

When British teenager Amika George read that one in 10 girls in the United Kingdom cannot afford tampons or sanitary pads, she knew she had to do something.

“Period poverty’s happening in the least likely places, in prosperous counties,” she says. “Even though this horrified everyone, the government was simply not doing anything about it, and this really infuriated me.”

So, she launched the #FreePeriods campaign to pressure the government to make sanitary products free for girls in the country. Her online petition and campaign grew quickly via social media, and soon, 2,000 young protesters gathered in London to speak their mind about periods. “It demonstrated how we would refuse to accept something we didn’t like if we see injustice,” she says.

Her activism had tangible results: It led the U.K. government to pledge about $2 million in funds collected from the tampon tax toward initiatives to end “period poverty.” George says. “It shows that activism works.”

She says normalizing periods can have a major effect.

“Talking about periods is so necessary,” she says. “Why should we be hiding our pads and tampons? Why should we be whispering about our periods? They are part of who we are as women, and yet we are so apologetic.”

(Photo courtesy of Aditi Sharma)
(Photo courtesy of Aditi Sharma)

When Aditi Sharma took a trip to a remote part of Nepal, it was the first time she saw women and girls banished to outdoor sheds during their periods. The custom, called chhaupadi, is a tradition practiced in parts of rural Nepal, though it was recently made illegal by the Nepalese government.

“I grew up in Kathmandu in a very liberal family, and I was I was completely shocked,” Sharma says. “My rural counterparts were dying of hypothermia, asphyxiation, snake bites and even rape while living in tiny cow sheds, simply because they were menstruating.”

The trip became a turning point in Sharma’s life and led her to start a nonprofit organization called Kalyani, which teaches menstrual hygiene and works to eradicate chhaupadi in Nepal’s Surkhet district.

The deep-rooted tradition stems from the belief that women and girls are impure during their period. “They believe the gods and goddesses will be angry if menstruating girls and women stay at home,” Sharma says. “If you touch a cow during your period, it will stop producing milk. If you touch a tree, it will stop bearing fruit. If you touch a well, the well will dry up.”

Her NGO led education workshops and went door-to-door teaching families about the dangers of exiling women and girls during their periods.

Sharma also teaches girls and women how to make their own reusable cotton sanitary pads that can last two years.

She’s a big advocate about talking openly about periods. “I don’t understand the notion of secrecy around menstruation,” she says. “Half of the world goes through it for a big chunk of their life. There’s nothing dirty about it, nothing shameful about it.”

(Felix Aryee)
(Felix Aryee)

Though Amos (Eli) Katsekpor has never menstruated, he believes men can play an important part in ending the taboo around menstruation.

“Boys and men need to understand menstruation is a normal part of a girl or woman’s life, so there is no need to treat women with discontent,” he says.

The cost of sanitary products is a big concern in Ghana. “There is a 20 percent import tax on sanitary pads, as it is considered a luxury product by the Ghana Revenue Authority,” Katsekpor says. This drives up the costs of sanitary pads, making it impossible for many young girls to access these products.

Additionally, “women and girls usually shy away from accessing menstrual supplies because of the way they will be treated,” he says.

One menstrual health initiative, “Save the Red Days,” — founded by female activist Binta Alhassan Kimba — encourages women and girls to openly share their period stories online with others.

“Gradually, we are making menstruation part of normal, everyday conversations,” Katsekpor says. He joined this project to help bring discussions to high schools, where boys are included in the mix. These programs also include basic menstrual health education, such as how to calculate the timing between periods.

Katsekpor also developed radio programs and public service announcements to spread the message on Ghana Community Radio Network.

Katsekpor is hopeful that men can become better supporters of women and girls.

“I hope for a future where men will proudly go to the pharmacy or supermarket to pick menstrual supplies for their daughters or wives and not be ashamed,” he says. “I hope for a future where men will not stay away from their spouse or refrain from eating the meals they prepare because they are on their periods.”

(Photo courtesy of Mashiyat Rahman)
(Photo courtesy of Mashiyat Rahman)

When Mashiyat Rahman got her first period, she had no idea what was going on. “I firmly believed that I was about to die — and this was despite growing up in an urban middle-class household,” Rahman says.

“When my younger sister was growing up, I went out of my way to explain the basics of menstrual and reproductive health to her,” she says. This served as a catalyst for Rahman’s interest in researching how women and girls in Bangladesh experienced menstruation. “I was shocked to find out how disastrous the situation was,” she says.

After conducting surveys, Rahman discovered that a staggering 52 percent of female students did not know about menstruation before their first periods. “Some did not know what exactly menstruation was despite having regular periods,” she says. In some low-income areas, she found women believed it to be a disease or a curse.

Rahman knew she had to do something to change this. She launched training programs in communities to teach girls and women about menstrual and reproductive health and created open spaces where they could seek advice.

She and three university classmates founded the social enterprise Resurgence, which pioneered a low-cost method to create biodegradable sanitary pads out of the water hyacinth plant. Rahman’s project tackled two big problems at once: the lack of affordable sanitary products and the overgrowth of water hyacinth in Bangladesh.

Resurgence distributes these pads to women and girls in slums, rural areas and women working in garment factories. “We also employ women from these communities in our production and distribution processes,” Rahman says.

Through her work, Rahman is trying to create open conversations around menstruation, but it isn’t always easy. “Many of our advocacy efforts were often termed as ‘extremist’ or ‘radical’ ideas at first,” she says. “But these viewpoints have greatly changed over the past year in the communities in which we have worked and trained women.”

(Heather Hazzan)
(Heather Hazzan)

Between her freshman and sophomore years of high school, Nadya Okamoto first came across “period poverty.” She had just moved to Portland with her mother, and they didn’t have their own home at the time. While transferring buses on her long commute to school, she began talking to homeless women at shelters near the bus stop.

“They were in much worse living situations than I was,” Okamoto says. “I was hearing their stories of using pillowcases, brown paper grocery bags, toilet paper, cardboard and cotton balls to take care of their periods.”

A 16 year old with a big vision, Okamoto founded her nonprofit organization, Period, to distribute tampons, pads and menstrual cups to women and girls in need, and educate people about menstruation. In the past four years, her organization says it has donated 400,000 period packs to women and girls in need.

Another major goal of Okamoto’s: To help repeal the “tampon tax,” a sales tax that’s assessed on feminine hygiene products in most states across the U.S.

During her first year at Harvard, she wrote her recently-published book, “Period Power: A Manifesto for the Menstrual Movement.” She hopes young readers will also pick up the book. “I want to change the way people think and talk about their own period from the very first one,” Okamoto says.

(Photo courtesy of Ruth Nassiwa)
(Photo courtesy of Ruth Nassiwa)

As a teacher, Ruth Nassiwa saw girls as young as 11 years old missing school during their periods. They couldn’t afford sanitary pads, and were embarrassed to talk about menstruation.

“There was a situation where a girl in class had her period and a male teacher ordered this girl to stand, which she couldn’t do due to her situation,” Nassiwa says. Since it’s taboo to speak openly about periods, the student was afraid to tell the teacher. “She was forced to stand, which made all the students laugh at her, and she hated school,” Nassiwa says. “Then I realized the girls needed my help, so I started working on menstrual health.”

In an effort to shatter the stigma around menstruation and discourage dropout rates, Nassiwa helped implement the Sanitary Pad Project at Johnson Nkosi Memorial Primary School in Uganda. In addition to teaching students to make low-cost sanitary pads with available materials, she also trains students and teachers about menstruation. Since some of the girls are HIV-positive, they also learn how to properly wash the pads in their own water basins and hang them to dry.

She says normalizing menstruation is the first step toward no longer feeling ashamed about it. “I realized these girls need to know that having periods is normal,” she says. She includes boys, teachers and parents in her training, so that they fully understand it’s just a part of girls’ lives.

Next up, Nassiwa will bring the Sanitary Pad Project to another local school, as part of her work with the Mpoma Community HIV/AIDS Initiative.

Though it can be a challenge to fit pad-making into the school curriculum, girls have become much more comfortable discussing their periods.

“Now, the girls know who to talk to when they have their periods,” Nassiwa says.

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