SIERRA LEONE — A typical day for 13-year-old Khadija Marrah begins with chemistry class at her small school in Allentown, Sierra Leone. On a recent morning, Marrah sat hunched over a wooden desk in the front row of a classroom patched together with wooden poles and sheets of corrugated metal. Her shoes were covered in streaks of the red dirt that covers the school grounds. The midday heat pressed in from all sides.
Marrah loves it here at Education For All. But there was a time, after she first got her period, when she thought she’d never be in a classroom again.
“When I was 9 years old, and I was in class four, I feel a warm something,” Marrah recalled.
On her way home from school that day, she realized she had bled through her clothes.
“The neighbors that were outside, everyone was shouting that I had stained my uniform. And there was a woman who said, ‘You are no longer a child, you’re an adult,’” Marrah said.
The neighbors laughed at her, and after that, she said she stopped going to school.
“When I want to wear my uniform… the same woman that said I’m no longer a baby, I’m an adult… they mocked me. And I went inside and take off my uniform. I was not coming to school,” Marrah said.
With support from Mamusu Tarawali, the principal of Education For All, she eventually returned to school. Marrah now lives on school grounds on the outskirts of Freetown five days a week. She is provided meals and menstrual products and doesn’t have to pay school or transportation fees.
But for many girls in Sierra Leone — and around the world — the story ends differently. An estimated 500 million women and girls globally lack access to period products. In low- and middle-income countries, that often means girls drop out of school or miss large portions of the academic year, up to 20%. This is deeply concerning to Dr. Yomba Fasaluku, a district medical officer with Sierra Leone’s Ministry of Health.
In Sierra Leone, the average household earns less than $50 a month. Fasaluku said menstrual products typically cost around $4 to $5 a month — a price many families cannot afford, especially when there are multiple women in the household.
“Menstrual products are not going to be a priority… because you want to eat,” she said.
Some grassroots organizations are working to close that gap. One of them is Uman Tok, which means “woman talk” in Krio. The group distributes reusable menstrual hygiene kits and provides reproductive health education to children in schools across the country.
Mariatu Marley Yateh, Uman Tok’s education director, visits schools to teach about menstruation, ovulation and how to use reusable pads.
Earlier this year, at Education for All, Yateh stood in front of a classroom of 11- to 13-year-old girls. She walked them through the menstrual cycle and answered questions about their changing bodies.
“How many days does the egg stay in the fallopian tubes?” she asked, her voice cutting through the chatter of students. “24 hours!” they shouted in response.
Fasaluku said groups like Uman Tok are making progress — but that progress is fragile.
She points to setbacks from Sierra Leone’s civil war, the Ebola epidemic and the COVID-19 pandemic that have interrupted health and education efforts. Sustained change would require national support: funding, education and legislation that prioritizes menstrual health, she said.
While Uman Tok can’t solve period poverty alone, the resources it provides have made a difference in the lives of students like Khadija Marrah. She recently scored high on her secondary exams and said her success stems from learning about her period.
“It was horrible back then, but now it’s really good,” Marrah said. “I am reaching my goals. Back then, I was having the stress of my period and I was not focused. But now I am focused.”
She no longer feels ashamed. Now, she dreams of becoming a nurse.
“I want to help girls like me,” she said. “They should understand that when they get their periods, it’s nothing to feel ashamed of.”
Reaching these goals is not just about her own future.
“I want to make my fellow girls proud,” Marrah said. “Some men say they are the backbone of Africa. So, we girls want to show them we are also the backbone of Africa, so we are doing everything we can in our power to let them know that we are also a strong woman.”
Still, getting there may be difficult for Marrah. She attends Education For All for free. She is unsure if her parents can pay for more school after she graduates in two years.
Journalism students from the University of Illinois Urbana-Champaign and Fourah Bay College in Freetown, Sierra Leone, contributed reporting for the Illinois Partnership for African Women’s Health Narratives. iPAWHN is an interdisciplinary initiative that empowers early-career African and American journalism and media students to research, produce, and disseminate stories of grassroots innovations addressing women’s health challenges in Africa.