There are 30 million women who menstruate in Ethiopia, and close to 75% of them experience period poverty — the lack of access to adequate resources and education to manage menstruation.
It’s an issue that inspired Sara Eklund to start working to make an eco-friendly and affordable period product available to all women both in Ethiopia and across Africa.
Eklund launched Ethiopia’s first menstrual cup brand, the Noble Cup, in 2018. Now, the brand cup is already stocked by between 10 and 13 stores and pharmacies in the country and hopes to grow its reach.
“It’s driven by the vision of being able to offer African women an alternative method of menstrual management and wanting to raise awareness,” Eklund told Global Citizen. “Wanting to be able to provide them a product that is available at a price point that would work for them.”
Menstrual cups are bell-shaped suction receptacles that collect blood and can be kept in for up to 12 hours. They are the safest and most economical option for women living in poverty, last up to 10 years, and can be used with limited access to water and sanitation.
“African women in general, women of the Global South, deal with lots of issues with menstruation, it’s across the board,” Eklund said. “It’s like, is your dad gonna give you money for you to buy pads?”
Lack of panties makes using makeshift or disposable pads difficult for menstruating Ethiopians to use. Put the cup between your cervix and save a pair of undies today!
— EVERY QUEEN BLEEDS (@noble_cup) January 8, 2020
.
Affordable undies is an important factor in positive #MHM🩲#EveryQueenBleeds#mutanta#underwear#Periodspic.twitter.com/raHBWAlmEo
The majority of schoolgirls in Ethiopia do not have access to clean water or safe toilets. One 2016 study by UNICEF found that over a quarter of girls in Ethiopia missed school because of their period.
Most women in the country only wear skirts, and might only own enough underwear to keep a pad or makeshift barrier made out of unsafe materials in place when they’re on their period, Eklund explained.
Like many countries around the world, period products are taxed as luxury goods in Ethiopia, at 15%.
Young girls sit and listen to discussions during the Noble Cup Menstruation Education Workshop.
Young girls sit and listen to discussions during the Noble Cup Menstruation Education Workshop.
But while menstrual cups are cheaper in the long run, stigma and taboos around periods can make it difficult for people in any culture to try them.
Families and neighbors are responsible for disposing of their garbage in Ethiopia, and communal trash management can perpetuate even more shame around period products and menstruation.
“Most people in Ethiopia, they're living in housing compounds with 10 to 15 people,” Eklund said. “You're sharing the same toilet and garbage facilities and throwing away [a] soiled pad, even if your family gives you pads, becomes a point of anxiety.”
Young girls might carry used pads in their backpacks and dispose of them on the way to school to avoid the embarrassment, she said.
Eklund, who is American and Ethiopian, lived in East Africa until the age of 18. Tampons aren’t sold in stores in the country, she added, highlighting that the lack of access to tampons is rooted in the idea that “women should not be putting anything in their vaginas.”
On trips to the United States, Eklund had the privilege of stocking up on tampons. It wasn’t until she was in her 20s attending graduate school at New York University, however, that she heard about menstrual cups from friends and tried one.
“You have to learn how to use it [a menstrual cup], there is a learning curve, you have to be comfortable with yourself,” Eklund said.
Menstrual cups need to be inserted into the vagina, and many people think that the product will take their virginity, or is not safe. Eklund believed similar misconceptions before she received more information about menstrual cups.
What's more, for the nearly 75% of girls and women aged 15 to 49 years old in Ethiopia who have undergone female genital mutilation (FGM), menstrual cups can be especially intimidating. FGM can cause survivors to experience infections during menstruation and feel more isolated and stigmatized during their period.
"The period is still a non-recognized experience, the elephant in the room,” Eklund said, which is why education is at Noble Cup’s core.
Pictured here is Sara Eklund, founder of the Noble Cup.
Pictured here is Sara Eklund, founder of the Noble Cup.
The organization holds “Every Queen Bleeds” workshops in communities and at universities to distribute cups and teach people how to use them properly. Once people who menstruate are empowered with information about how to use menstrual cups, they are more open to giving them a chance.
Women in Ethiopian culture usually don’t talk about menstruation amongst themselves, but the workshops allow girls and women the opportunity to share menstruation experiences, learn about the global period movement, and discuss taboos.
Eklund has found that older women in positions of power are often the hardest people to convince to switch to menstrual cups.
“They don't want to recognize their own menstrual stigma, and they don't want to recognize the fact that methodology to period management can shift,” Eklund said.
Since Ethiopia elected its first female president Sahle-Work Zewde in 2018, the government has started making an effort to change the way people in the country view menstruation. Eklund is on President Zewde’s tactical team for menstrual health to find solutions.
Visionary @DrSenait, thanks for taking the time to meet and consider the was of managing menstrual fluid in it's objective and abstract thinking. Looking forward to a future of more methods and more awareness to the sacred and secret. Period. #EveryQueenBleedspic.twitter.com/5ZHEKq3w91
— EVERY QUEEN BLEEDS (@noble_cup) October 7, 2019
Noble Cup has also teamed up with the Center for International Reproductive Health Training (CIRHT) to provide reproductive health care to low-income women in Ethiopia in 2020. The organization has had to pull back the initiative to distribute Noble Cups to CIRHT clinics due to the COVID-19 coronavirus pandemic, Eklund said.
She has, however, tweeted Ethiopia’s government urging it to allow Noble Cup to import period products and make them available during the crisis.
“Periods don't stop just because of this,” Eklund said.
Noble Cup has big plans to manufacture locally and expand to sell Noble Cups in more African countries by the end of 2020. Through workshops and marketing, Noble Cups wants to continue building awareness on menstrual cups and help normalize periods.
Signs are pictured in Addis Ababa, Ethiopia.
Signs are pictured in Addis Ababa, Ethiopia.
For every Noble Cup purchased, one is donated to support workshops in schools, juvenile facilities, and job training sites for women and at local NGOs.
“It's important to still keep the conversation of options [going],” Eklund said. “I feel often despite being probably a larger population of consumers, they [African women] are left out of the conversation when we're talking about periods.”