Dear Dr. Balachandra,

I think you can access the attachment in my reply to Susannah, but just in case I am attaching it here again.

Best regards
Torben

Dear Siri and Susannah,

My reply is to both of you - trying not to spam the forum.

Siri, I shared the study we made with Safepad in cooperation with Solidarities International in Myanmar with you, you probably haven't read it yet. In this study the drying time of Safepad was evaluated. The result was that the users estimated the drying time to be between 1 and 1,5 hours in the dry season and up to 3 hours in the wet season. You are completely right about your comment that this is due to the fabric of the pad. Safepad is also made out of Polyester - 3 different sorts of materials, upper layer is a soft material that lets fluid pass, middle layer is highly absorbent microfiber and the back layer is water proof thin material - all are however 100% Polyester.

Susannah, the thin cotton sheets that are often used are reclaimed materials taken from any available source, be it old shirt, towels or other cloths, matress filing seems to be popular as well, even cow dung are reported being used. Obviously the user in many cases has little control over how clean these materials are before they start using them as menstruation material. Because of this and because of the risk of build up of bacteria and fungi from multiple use of regular reusable pads, we added the antimicrobial feature on Safepad - making it definitely more hygienic.

We are using Polyester because it is far more durable than cotton. A Safepad can be reused at least 100 times if care instructions are followed. Polyester is, from that perspective alone, significantly more environmentally friendly than cotton, but also the manufacturing process of Polyester gives it an environmental advantage over cotton. Cotton is probably the most poluting material around. 1 kg of cotton uses 10,000 liters of water and 16% of all insecticides used in agriculture worldwide goes into cotton growing.

This is an interesting one, how long can it be reused, I mean the of times: menstrual waste disposal, management and laundry in emerging situation.

Hi Torben,

Apologies for my delay in responding! Thanks so much for your insights. I really appreciate it. I would be curious to learn more about what type of guidance you provide to safe pads users on the following:

1. Like all products, Safe pads will eventually need to be disposed of, even after several months or a year, depending on factors like maintenance practices, water availability, etc. What type of advice do you give users for the final disposal of Safe Pads?

2. Do you provide Safe Pads users with any advice on how to dry the pads in privacy scarce settings? Or how to dry them during monsoon or rainy season when outdoor drying options are not viable?

Thank you again for your thoughts!

Best,
Maggie

Hello Susannah,

My apologies for the delay in responding! We have come across some interesting learning in our search although much of it comes from more anecdotal conversations and field-based research which remains on-going. We will be writing up those findings in a compendium though in coming months.

In the meantime, you may find the following items of interest:
1) A literature review of menstrual disposal practices globally by Elledge et. al 2018: Menstrual Hygiene Management and Waste Disposal in Low and Middle Income Countries-A Review of the Literature

2) Preliminary learning from a social architecture project exploring new drying approaches by Oxfam in Cox's Bazar: Oxfam Rohingya Response: Women's Social Architecture Project - Phase 1 Final Report

3) A low-cost hardware pilot of disposal options in communal toilets in Dhaka, Bangladesh by Johns Hopkins and icddr, b researchers: Piloting a low-cost hardware intervention to reduce improper disposal of solid waste in communal toilets in low-income settlements in Dhaka, Bangladesh

Best,
Maggie

I think the issue is often that drying out in the sun is not a viable option in many contexts due to privacy and overcrowding concerns by girls and women. However, one benefit of cloth in terms of drying, as opposed to reusable pads, is that you can't always tell what you are drying on the line. We have found many cases where women and girls just put a piece of cloth on top of reusable pads drying outside so that you cannot tell what is beneath it. Although it might take a bit longer, it does enable for an increased sense of privacy.

The majority of girls and women we have talked with though prefer pads to cloth though because it is less likely to shift or cause leaks and thus enhances their mobility throughout the day. Some findings on that from camps in Tanzania can be found here: link.springer.com/article/10.1186/s41018-018-0034-7

I think the issue is often that drying out in the sun is not a viable option in many contexts due to privacy and overcrowding concerns by girls and women. However, one benefit of cloth in terms of drying, as opposed to reusable pads, is that you can't always tell what you are drying on the line. We have found many cases where women and girls just put a piece of cloth on top of reusable pads drying outside so that you cannot tell what is beneath it. Although it might take a bit longer, it does enable for an increased sense of privacy.

The majority of girls and women we have talked with though prefer pads to cloth though because it is less likely to shift or cause leaks and thus enhances their mobility throughout the day. Some findings on that from camps in Tanzania can be found here: link.springer.com/article/10.1186/s41018-018-0034-7

Apologies for my slow reply, Elisabeth! Many thanks for sharing these tips and the compendium on sanitation technologies link. There are actually several references on menstrual disposal considerations scattered across the compendium, which is great to see!

The document however largely promotes the use of disposal bins with lids which may be a challenge in some settings. For example, we found that in the displacement camps in the Rakhine State of Myanmar, girls and women would often refuse to use the waste bins provided due to fears that others would see it, including cleaning staff. More on those issues can be found here .

I am not sure if these challenges could be overcome, even with sensitization, or if new types of disposal options that are more discreet in nature are warranted. For example in post-earthquake Nepal, Oxfam built latrines with disposal chutes connected to the latrine stall, thus offering a discreet disposal option, as highlighted in this blog entry: www.oxfam.org/en/nepal-nepal-earthquake/...ter-nepal-earthquake

Thanks for your help!

Hi Regina,

I am terribly sorry, I never saw your question until today, when Maggie replied to my post.

Safepad can be reused up to 100 times, maybe more if care instructions are followed. Depending on how many pads the individual woman has at her disposal, this translates into between 1 and 4 years of use.

The antimicrobial treatment does not wear out - it becomes slightly weaker - but the Safepad will stay antimicrobial enough to prevent growth of bacteria and fungie throughout its lifetime.

I hope this answers your question.

Best
Torben

Dear Maggie,

Thank you for your feedback.

1. We recommend that women dispose of Safepad in the same way as they dispose of any used clothes. After all Safepad is just a textile and at the end of its lifetime it can be treated like any other textile that is worn out.

2. Safepad has two advantages in terms of drying: 1. It is drying very fast. As I mentioned in my original post, our field study from Myanmar shows that Safepad dries within 1 - 1.5 hours in the dry season and 3 hours in the wet season. 2. Safepad does not need to be dried outside, the reason why it is recommended to dry normal reusable pads in the sun, is that the UV rays from the sun has an antimicrobial effect and therefore reducing the bacterial load on the pads. Safepad has this effect build in and therefore does not need sun drying.

I hope this answers your questions?

Best
Torben

Dear Maggie,

May I also draw your attention to some reports ( womena.dk/resources/ ) on practical experience from 100+ sites in Uganda, as well as soon to come from South Sudan, Kenya, Denmark). Water use, drying time, and disposal patterns for example vary greatly by product (and brand).

Siri

Dear Siri,

This is a very helpful, thanks so much! For the scope of this current project, we're mostly focusing on disposable and reusable pads/cloths although I do realize that being able to successfully use a menstrual cup also requires access to enabling spaces for changing and washing. I will explore this literature to see if there is anything about the environmental aspects needed for the usage and maintenance of cups as it might be helpful. Thanks!

Best,
Maggie