Dear all,

Please see attached press release to a newly launched campaign which is a collaboration between Monki (H&M family), The Cup Foundation and Lunette (menstrual cup producer in Finland).

Monki has produced three beautiful videos. All aim to break the taboo and inform women there are other options to pads and tampons that are more environmentally friendly, pose less risk for infections, very cost effective and super comfortable.

See also newly published article in Newsweek: "Men fighting menstruation shaming in the developing world" where cups are again mentioned.

www.newsweek.com/2017/07/21/men-fighting...ng-world-634902.html


Best
Camilla
CEO and founder The Cup
www.thecup.org

Hello Camilla,
i have read through the thread in your project menstrual cup in educating girls especially those girl in rural and urban poor communities who vulnerable to this , in my country Sierra Leone it hardly see girls with age gap of 9-14 years talk about this is a challenge or may I say a taboo to even the parent to talk about menstrual circle to their girl child. I'm a running a small voluntary organization called Water and sanitation for the Urban and Rural Poor (WASURP) .Is a new organization which was lunch few months. Our first project will be or hygiene and sanitation. Can we have your input in our project in Sierra Leone . Or to even partner with you so girls from this part of Africa can also benefit from your project. you can mail me directly if there is a need for any personal discussion This email address is being protected from spambots. You need JavaScript enabled to view it. .
cheers
Matico

Dear Diane,

I agree, sanitation and menstrual hygiene management go hand in hand as well as sex ed etc.

Buy in...well, good training is key as all.

The girls who are hesistant to start using are encouraged by their peers in our follow up session where the girls who are using share why they like it and how it changed their life (they can play soccer etc).

We also add in that a girl who is using is appointed as a mentor/trainer to a girl who is afraid so she helps her to use it.

If you want we can skype and I can share more in detail.

Many warm regards

Camilla

Dear Elisabeth,

Yes, the Annual Report was brief.

The boys were added to have bigger impact. We teach the boys the same things as the girls; reproductive health, signs of puberty etc but also touch on subjects that effect boys like crime and drugs. The trainers are again role models and Joshua who is now performing the trainings has a background in crime and according to interviews he has been able to change the mind of some youths already.

The boys act differently during the trainings. Not shy like the girls but shout out their problems and questions.

The age span is the same 9-16 but mostly 11-16. The girl team does half the class (the girls) and the boys are trained at the same time in the schools. Boys only recieve two trainings compared to the girls who get four trainings. The subjects of pregnancy, prostitution, abortions, menstruation etc are more complex.

The boys are also trained as the girls in human rights (I call women rights human rights) and are taught what love is all about and how to treat a women. According to studies 60 % of underpriviliged women in Kenya think that men have the right to beat their wifes.

The parents information meetings are also important. Right now we are reaching about 1500 person a month counting boys, girls and parents/teachers/elders. Our goal is 4000 girls a month + 4000 boys + parents + teachers + elders.

Thank you

Camilla

Thanks for this post, and for your great work. The photos are inspiring. We need to figure out a way to make cup education a routine part of any and all handwashing programs. Women of Sanitation......unite! This deserves all the attention we can give it. I'm going to take this on in two urban poor Districts in Accra, ideas? Experiences in how to get buy in?

Hi Camilla,

I would like to know how more about how you involve and reach the boys? This wasn't explained in your annual report.

What age range are the boys, what messages do you give them and how have they been reacting?
I would assume quite positively, because maybe they're also happy about taboos being lifted and them getting better information about menstruation and women's reproductive cycles?

Regards,
Elisabeth

Dear all,

Happy New Year!

Attaching The Cup Kenyas annual report which is describing the problems we fight with underprivliged girls in puberty are going through in Kenya and how our program is trying to help.

During 2015 we succeded in helping 2000 girls, 300 boys and inform 3200 parents.

We are now planning a scale up and writing a proposel with Umande Trust to reach 4000 girls + 4000 boys + parents + teachers + elders a month while schools are open with a team of only 30 girl trainers and 10 boy trainers. The program is very scaleable and effective.

For more info see attached Annual report.

Camilla

Dear Penny,

Thank you for your input and sharing of information.

The cup has many advantages not only in these situations but for all women.

We focus a lot on hygiene in our trainings and girls do bring a bottle of clean water for rinsing the cup to schools, a bit like bringing water for washing when going to the toilet.

Camilla

Hi John
Thanks for your response.

You are asking million dollar questions - first for (some) countries of Asia, indeed there are differing cultural dimensions. There are a number of colleagues working in development, NGO, government, and academic sectors who have accumulated much knowledge around this topic over many years (can pass on some contacts if needed). There are a few hundred published papers also. The general view when talking to professionals here is that menstrual cups would not be used by girls [saying they can only be used by 'married' women], but there is no evidence to show this either way. maybe they are right, but it would be good to validate. One paper in Nepalese schoolgirls (Oster and Thornton) suggests girls will use, I attach the file. We and some other colleagues would be keen to do an acceptability feasibility study should any funding be available.

Water and sanitation in schools and at home was not at a particularly high level in our Kenya study. We had a minimum threshold (see one of attached papers). Because of concerns of infection, we also provided hand wash detergent to schools and bar soap individually to all study girls to support hand-washing - we have WASH follow up data observations we are analyzing to see if soap etc was actually available at unannounced school spot-checks, and longitudinally measuring the level of WASH in school on the termly spot-check days.

Logistically we could not provide water but girls first, don't need to wash the cups every time they empty (just reinsert), and second girls themselves were (are) incredibly resourceful - they would bring their own bottle water in if the school was dry, or water was far from reach, to ensure they stayed clean and were not embarrassed.

Our experience in Kenya was that girls initially had concerns about using cups, and uptake took a little time, but they have so little resources that an opportunity to have something that helped them overcame these barriers - along with repeated study nurse training and also older aged girls peer support (a secondary school in same region had cups donated by charity over many years, so girls were our 'champions'). A second paper is attached on the qualitative findings describing this (Mason et al), and also one on the WASH conditions of the schools (we do have home WASH also, but will take a while to complete analysis).

Hope this helps
Anyone want to fund a menstrual cup acceptability study among girls - happy to hear from you!
best, Penny

Dear Penelope,

Thanks for sharing news of your study and future research! We are seeing how to consider menstrual cups in the Asia context and I was wondering if you area aware of similar initiatives /points of contact in Asia?

Specifically:
In the homes and schools for your trial, is there enough clean water for girls to wash themselves and the cups?

According to my colleagues, in Asia menstruating women are considered "unclean", products used are used are hidden and not discussed. The topic itself is still very taboo. Did you have resistance on this front? (The colleagues find it difficult to imagine it being acceptable in Asian countries.)

What was the perception of the girls themselves towards this new product? Did they report preference over the previous products they used?

Very best regards,
John Brogan
Terre des hommes
This email address is being protected from spambots. You need JavaScript enabled to view it.

Hi John

Our collaborative partnership (Liverpool School of Tropical Medicine; Kenya Medical Research Institute, the US Centers for Disease Control and Prevention; and Safe Water and AIDS Project) in western Kenya, recently completed a feasibility study following up girls provided menstrual cups, sanitary pads, or usual practice (control) in 30 rural primary schools for over a year. We had routine nurse screening, lab-confirmation studies,community and facility monitoring to check if girls could potentially acquire TSS (Toxic Shock Syndrome); plus checking a swatch of used cups among staph aureus positive girls, for TSS-toxin 1. Within this pilot number (~200 girls) there was no adverse harms.

It is our understanding no TSS has been associated with cups because vaginal insertion does not dry the mucosal lining and thus does not cause micro-trauma (but do check with cup companies that have ongoing safety monitoring schemes that there are no cases). These safety results (not yet published) are sufficient for our UK funders to support now a much larger scale trial (~2000 girls), where we will also continue vigilance to contribute toward global safety data.
Hope this helps. You may also contact me directly if more questions, or just put them in this thread.

Penelope Phillips-Howard
Liverpool School of Tropical Medicine, Pembroke Place, L3 5QA, Liverpool, UK
Kenya Medical Research Institute (KEMRI) Centre for Global Health Research, P.O.Box 1578, 40100 Kisumu, Kenya
E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Dear Colleagues,

Thank you for this post promoting the use of menstrual cups. Our team is interested to learn more, especially as an alternative to (improper) incineration of MHM materials. Could you provide references and views on the following:

In Asia where Sanitary pads/ cloths are the norm, tampons are not culturally acceptable and definitely not for unmarried girls even among the most educated of women. Is there any experience with use of menstrual cups in Asia?

Besides cultural acceptability, in situations where clean water and hygiene are major constraints- we assume that use of the devices comes with major risks. Has "Toxic Shock Syndrome" (documented with tampons and considered for any product inserted vaginally) been studied in the context of developing countries?


Best regards,

John Brogan
Terre des hommes