In 1999, while I lived with my grandmother in Vira Maria in Masaka District, aged 13 and in Primary Six at school, I started my menstruation journey. The only alternative I had for menstruation padding was to use pieces of cotton cloth, which were carefully selected, washed and ironed for me by my grandmother. Yes, eventually my grandmother taught me how to carefully select pieces of cloth, wash, dry and iron them for myself for my use during menstruation.

I was a day-scholar and I remember very well how hard it was for me to maintain my re-usable menstruation pieces of cloth at school. My grandmother taught me when to change and to keep the used pieces of cloth in a polythene bag in my school bag. And when I got home from school, as my grandmother taught me, I would wash my used menstruation pieces of cloth with hot water; put them out to dry; and when dry, iron them. My grandmother impressed upon me that that was the only way to keep my menstruation pieces of cloth clean.

That is why I wonder about reusable pads.

• Is it really possible for re-usable pads to be washed clean, especially with the materials that are put inside of them?
• What materials are inside of them anyway, that enable them to hold the liquid blood for long without sipping out?

I am thinking of girls in the village, such as I was when I started menstruating, who cannot afford to buy ten pieces of re-usable pads. Assuming, as my grandmother taught me, that it is important to change menstruation padding maximum every after six hours, irrespective of if they are soaked or not, it is necessary for a girl or woman who uses re-usable pads to have at least 10 pieces of them. This is so that within a period of 24 hours she uses four pieces and in the next 24 hours she has a fresh set of four to use, while the other set is washed and allowed to dry.

And the two pieces are emergency ones, just in case in cold weather, for example, the washed ones haven’t dried properly; or during days when the blood flow is heavy and there is need to change more than four times in 24 hours. So, am thinking, if a girl or a woman cannot afford to buy 10 pieces, then she may be forced to use re-usable pads for more than six hours, before changing, which is not hygienic. Worse still, such a girl or a woman, may be forced to use re-usable pads that have not dried properly, especially so on the inside where the thick towel like padding is.

I am not against reusable pads but my worry is how to maintain them by the users, especially so when I think if my 13-years old self had been in boarding school. A lady I know, who says she sometimes uses re-usable pads, told me how she maintains hers. She says she uses them on the days when her periods are light and she changes after two hours. When she removes the blood-soaked re-usable pad, she soaks it in water and after about ten minutes, when blood has drained out of the pad, she pours out the water, add fresh water and liquid soap and then lets the used re-usable pad soak for another ten minutes. She then washes it and puts it out to dry under the sun.

• In our Uganda where it is taboo for a woman to dry her knickers outside on the clothes line, how do we expect that school girls will be able to manage to maintain re-usable pads, especially so while they are in boarding school?

Apese (not her name) shared this testimony. She is a 37-years old lady associated with CPAR Uganda, who prefers anonymity, considering the cultural sensitivity of talking about matters menstruation in Uganda. It is important to appreciate, however, that Apese’s concerns are more the norm than the extra ordinary in the context of Uganda.

Case in point, the findings of an empirical study conducted by Bankunda Paula at St. Paul’s Secondary School Kagongi in Mbarara in Western Uganda align with Apese’s testimony. As was the case with Apese, whose grandmother taught her about menstrual hygiene, 94.1 percent of the 102 girls who participate in Bankunda’s study “had a high level of knowledge of menstrual hygiene.”

The majority of the study participants, 74.5 percent, reported using disposal pads and 13.7 percent reported using re-usable pads. Be that as it may, 80.4 percent of the study participants preferred that all “used sanitary towels should be disposed.” There were apparently concerns among study participants that re-usable pads were being used while damp – they are not washed or dried properly, because they are dried under the mattress and or hidden dark corners, because of stigma, girls don’t what other people to know when they are menstruating.

Obviously, Apese is now a professional carrier woman, who can afford to and uses disposal super absorbent pads. While she appreciates the hygiene and environmental challenges that come with her use of disposable pads that are composed of 90 percent plastic, the predominant preposition for her to switch to re-usable pads has not convinced her. Might it be time now to re-think re-usable pads as the best alternative?

The questions raised here in and many others similar, need answers in order to arrive at workable solutions to the current public health and environment destruction concerns associated with disposal pads.

Please consider supporting our “100 women demand to menstruate with dignity campaign” in which we propose to conduct an empirical study on best practice for management of menstrual hygiene products for good public health and environmental protection.

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