10 September 2024 by Limpho Sello

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Sentebale Mothibeli, 22, stands among dozens of girls and women in Mphaki, Quthing, receiving their annual supply of sanitary pads, underwear, and essential hygiene items such as bath soap.

As Mothibeli collects her package, a weight is lifted off her shoulders, knowing she won’t have to resort to using cloth scraps in place of sanitary pads.

“I come from a family that struggles to make ends meet. Sometimes, we can’t even afford necessities like food, and when we don’t have food, buying pads is nearly impossible.

There are times when we don’t have soap and have to wash the cloths I use for padding with just water,” Mothibeli told Uncensored News on September 9, 2024.

Her story highlights a struggle faced by many in rural areas of Lesotho, where access to menstrual hygiene products remains a challenge.

Addressing this issue, Mathato Nkuatsana, the Ministry of Health’s Adolescent Health Manager, pointed out that while cloths were traditionally used for menstrual hygiene, there were strict guidelines on how to clean, dry, and store them.

“Nowadays, due to poverty, women might use any cloth they can find, even baby clothes. These makeshift solutions are often reused without proper cleaning, creating a breeding ground for fungus and bacteria,” Nkuatsana explained.

She explained that sanitary pads are designed to be breathable and are typically kept in clean environments. However, despite their benefits, Nkuatsana warned that improper use of even safe menstrual products can still pose health risks for girls and women.

“When sanitary products are used improperly, they can cause fungal infections. Prolonged use of a single sanitary pad or cloth can lead to vaginal infections, which may escalate into more severe conditions like cervical cancer,” she says.

Nkuatsana describes how these infections develop: “Imagine using a pad for an extended period. The friction can cause tiny pimples, leading to itchiness, redness, and swelling.”

She explained that over time, these symptoms can progress to blisters, rashes, or even open wounds.

Abnormal vaginal discharge

The result, according to Nkuatsana, is an abnormal vaginal discharge, often accompanied by a foul smell, which is distinct from normal discharge and indicative of an infection.

Mothibeli remembers very well how prolonged use of sanitary towels made her uncomfortable. 

“When I have enough pads, I change them three times a day, and I feel fresh and confident. But when I don’t, I have to stretch their use, which leads to leaks, odour, and discomfort,” Mothibeli explained.

She added: “When I don’t have enough sanitary pads, I use a cloth. It bruises me, causes a bad odour, and makes me feel very self-conscious.”

Mothibeli’s struggles are echoed by many women and girls in rural areas, including Mantoaleng Bulane, a Village Health Worker in Mphaki. Bulane faces similar challenges while managing menstrual health for the nine grandchildren under her care.

“Sometimes, there are not enough pads for everyone, so I have to alternate between cloths and pads. The girls use cloths at home and save the pads for school to avoid embarrassment,” she said.

However, Bulane acknowledged that the cloths are far from ideal. “They often do not wash them properly, and sometimes I find them discarded around the house, stiff with dried blood. It’s not healthy, but we have no other options,” she lamented.

Mathato Nkuatsana, the Ministry of Health’s Adolescent Health Manager, explained that situations like those Mothibeli and Bulane described can lead to infections. She said these infections may spread to the urinary tract, causing additional pain and discomfort during urination.

“Despite these symptoms, many women are hesitant to seek medical attention, often confusing these infections with sexually transmitted infections (STIs).

“Unfortunately, the stigma surrounding STIs prevents many from getting the help they need,” Nkuatsana adds.

Meanwhile, Nkuatsana added that the use of unconventional materials like toilet paper, newspapers, or even mohair during menstruation is not uncommon in impoverished areas.

Nkuatsana warned that these materials can disintegrate and introduce harmful particles into the body, increasing the risk of infections that can damage the cervix and other reproductive organs.

To prevent vaginal diseases associated with improper use of sanitary towels, Nkuatsana argues that pads should be changed at least every four hours or sooner if they are full.

“This helps prevent infections by reducing the time that menstrual blood is in contact with the skin,” advised Nkuatsana.

Nkuatsana stressed that maintaining cleanliness during menstruation is crucial to preventing infections.

Lack of infrastructure

Nkuatsana further added that Mphaki’s menstrual health crisis is compounded by a lack of basic infrastructure.

“There are scarce shops to buy sanitary products, water is scarce, and many homes don’t have toilets,” Nkuatsana explains.

“In households where there’s no money to buy pads, girls are forced to improvise with whatever materials they can find.”

Nkuatsana highlighted the need for menstrual health products to be as accessible as condoms and family planning commodities.

“Our goal is to ensure that every girl has access to safe and affordable menstrual products. The government has already taken steps to lower the prices of sanitary pads by removing taxes, but for many, even a reduced price is still unaffordable,” she said.

The Ministry of Health, along with various partners such as the United Nations Population Fund (UNFPA), is working on strategies to distribute sanitary pads across the country, starting with the most vulnerable areas like Mphaki.

“We hope that with continued support, we can reach every girl and woman in need,” said Nkuatsana.

Meanwhile, the UNFPA Lesotho Country Representative, Innocent Modisaotsile, emphasised that collaboration between institutions is key to eliminating menstrual poverty in Lesotho.

“By working together, we can create a world where menstruation is no longer a barrier to education, dignity, or equality,” Modisaotsile said during Lesotho’s belated commemoration of Menstrual Health Day on August 16, 2024.

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Education and awareness

While providing sanitary products is essential, Nkuatsana stressed the importance of menstrual education.

 “We held a two-day community dialogue in Mphaki on 14 and 15 August 2024, involving parents, men, women, boys, and girls. The discussions covered everything from menstruation basics to how to properly use and dispose of sanitary products,” she said.

She explained that the goal of these sessions was to remove the stigma surrounding menstruation and to ensure that everyone understands the importance of proper menstrual hygiene.

“We want girls to feel confident and know when to seek medical help if they notice something wrong with their menstrual cycle.”

Nkuatsana said that combining accessible menstrual products, education, and community support offers hope for a future where every girl and woman can manage their menstrual health with dignity. She emphasised that this approach will help eliminate fear of infection and stigma.