LONDON – Scotland could become the first country to ban "period poverty" to help women and girls who can't afford feminine hygiene products such as maxi-pads and tampons.
The issue is rarely spoken about in public, but it affects millions of women and girls around the world, including the United States.
At least 500 million women and girls are estimated to lack the means to manage their monthly periods, according to a 2015 report by UNICEF and the World Health Organization. Many drop out of school or miss days of class as a result.
In Britain, the problem came to the forefront with a 2015 petition calling for the government to ax the "tampon tax" — a 5% sales tax on sanitary products. The government voted the following year to scrap the tariff, but it hasn't been dropped — caught up in Brexit negotiations to separate from the European Union.
In the USA, most states charge sales tax for women's pads and tampons. Nine states have dropped the tampon tax — Minnesota, Illinois, Pennsylvania, New York, Massachusetts, Maryland, New Jersey, Connecticut and Florida, according to NPR. Seven other states have introduced such legislation, most recently Nebraska, Virginia and Arizona.
An attempt in California to eliminate a tax on tampons failed in January.
Women for Independence, a Scottish grass-roots group, published a survey in March that said nearly one in five women in Scotland have been unable to afford sanitary products and improvised with such items as newspapers, toilet paper, socks and old clothes.
One in 10 British girls and women ages 14 to 21 cannot afford sanitary protection, according to the humanitarian charity Plan International U.K.
Monica Lennon, a lawmaker from Scotland's opposition Labour Party, plans to introduce a bill that would allow anyone in need to get free sanitary products at food banks, schools, colleges and universities. A six-month pilot program began in July.
“Women in general don’t talk about their periods and how they manage them," Lennon told USA TODAY. “I’m glad it’s out in the open.”
She noted that condoms and other forms of contraception can be accessed free in Scotland and the rest of Britain, so “why can’t we get that for pads and tampons?”
Lennon said that once the problems were explained to her male colleagues, they were “quite horrified” and then supportive.
Progress has been made in Wales, where the Welsh government announced in March $1.4 million to help address period poverty.
Tina Leslie, a public health worker from Leeds in northern England, started Freedom4Girls to deliver washable, reusable sanitary packs to Kenyan women and girls two years ago.
“Last year, a colleague of mine who knew what I was doing in Kenya said: ‘Do you realize it’s happening in your own city? I’ve got five girls who are missing school because their parents don’t have money to buy sanitary protection.’ I thought, 'Let me do something about it.'"
The charity now collects and delivers environmentally friendly washable pads and menstrual cups to schools, refugee agencies and women's shelters in Leeds and has set up stations so the public can donate products in supermarkets and offices.
"If you can’t afford food, you can’t afford sanitary protection," Leslie said.
Camilla Wirseen set up the Cup Foundation to provide menstrual cups to girls in Kenya. She says the foundation has helped about 15,000 girls with the cups, which last for 10 years.
Wirseen, from Sweden, lives in Kenya's capital, Nairobi. She said she founded the organization in 2015 after learning that up to half of the girls in the Nairobi slums have sex in return for pads.
“Poverty is poverty wherever you are. If you can’t afford it, you can’t afford it," Wirseen said. “The menstrual cup shouldn’t be something you hide."
Men have an important role to help end period poverty. “We try to take away the taboo of menstruation — for me that means including men," Wirseen said.
In India, Arunachalam Muruganantham was shocked to find his wife used rags during her periods. That prompted him to invent a simple pad-making machine so women in rural areas could make their own affordable sanitary protection. His story has been turned into a Bollywood movie, Pad Man.
“Why aren’t we talking about it?" Leslie said. "Half the population in the world menstruates. Boys want to know what their girlfriends are going through, and men want to know what their wives are going through."