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Dr. Emily Wilson-Smith
Dr. Emily Wilson-Smith

Written by Dr. Emily Wilson-Smith – Chair of Irise International 

Before I even set foot in Uganda as a teenager I had anticipated period horror. I took myself to my general practitioner and explained that the combination of a pit latrine and a period just wasn’t going to work out for me. There was nothing for it but for him to give me the pill. It took me another five years to work out that women and girls in Uganda had to endure the pit latrine-period combo every month and that it didn’t really work for them either.

It is fair to say I was a bit slow in coming to this conclusion. A group of girls had to spell it out for me during some research in their school. Menstruation wasn’t even on my radar. They explained that they could not afford pads and were using rags, leaves and even corn husks. Menstruation was taboo and they were confused by myths and a general lack of knowledge about their own bodies. I spent the rest of the day wondering how they managed to get to school at all during their periods, then sent an angry email to Always asking them what they were going to do about all these girls who were having definitively unhappy periods.

Always never answered but later that year I co-founded Irise International, a charity and research group working to develop a replicable and sustainable solution to menstrual hygiene management in East Africa. We were young and foolish and cheerfully blundered our way through our first baby steps as a charity. But our redeeming feature was that we always listened. We listened hard to what East African women and girls were telling us because we knew that without them we were clueless.

At the time there was relatively little happening to improve menstrual hygiene for these girls. It was such a neglected issue most people looked at you like you’d gone a bit mad if you mentioned it. Not just my parents’ friends in rural Shropshire (who had probably never said the word menstruation out loud before) but people running NGOs in Sub Saharan Africa. Things are changing now. We are celebrating the first International Menstrual Hygiene Day this week (wow!) but I can’t help but think that if the world just listened a bit more to girls we would have got here much sooner.

And this is just the starting point. Talking about menstruation starts conversations about how we structure our society and the impact menstruation has on girls’ opportunities, both at home and abroad. I worked as a doctor for a year and the thought of facing a medical on call without my trustee tampons and ibuprofen was daunting. You were lucky if you got to pee let alone change your sanitary wear at appropriate intervals! It often occurs to me that even a medical career in the UK has not been designed for a menstruating woman let alone a pregnant one! Women who do it have to adapt to fit a mould that was developed by men a long time ago.

The reality is that despite all the progress that has been made in advancing gender equity, the world is still not a girl friendly place. It is less unfriendly, but is that really enough? Talking about menstruation highlights the need for a paradigm shift towards a world designed to enable women and girls rather than just to allow them. After all, we all want to live in a place where both men and women are able to work together to reach their full potential don’t we? So ultimately Menstruation Matters because Girls matter. Period. If we care about the health and empowerment of women and girls, we need to talk periods and everyone needs to listen.

About the Author:

Emily has a BSc in International Health from the University of Bristol and a medical degree from the University of Sheffield. She worked as a doctor for a year and is now moving to Uganda to coordinate Irise’s work full time.  She has nearly ten years of experience in women’s health and development. Previous research includes an evaluation in Kenya for the Kenyan Orphan Project and research into women’s health in Madagascar with the Access Madagascar Initiative. Emily led the Irise pilot work in Kenya, Zimbabwe and Uganda in 2011 to 2014. You can check out the paper on Irise’s pilot work here. She is now working to develop Irise’s Freedom Franchise Model, conduct our large scale study into the impact of menstrual hygiene on school girls’ absenteeism and is soon to take up a post as Research and Teaching Associate at Kampala International University . Follow her @emswsmith.

For more information on Irise’s work please visit their website at or follow them on Facebook and Twitter.

Cover image c/o Irise International

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