Uplifting the Girl Child (Burundi)
PROFILE of YALI Mandela Scholar, Grace Ningejeje, and Uplifting the Girl Child
Written by Deborah Jordan Brooks, Ph.D.
Edited by Andrew C. (IMHER Research Assistant)
SUMMARY: Grace Ningejeje came to Dartmouth in 2017 through the YALI Mandela Program to further develop a project on menstrual hygiene in her home country of Burundi, which faces a tremendous degree of menstrual stigma combined with unusually high degrees of poverty and school dropout rates by girls. IMHER was developed to help Grace – and by extension, other innovators like her — to gather the foundational information typically needed to launch menstrual health programs, and help an organization to grow after the startup phase has ended. In the meantime, Grace has been making considerable progress at home, with a new organization focused on education, disposable pad donations, and a newly published book for girls in her country about menstrual hygiene. She is still trying to figure out how to produce commercially viable pads in a place where little disposable income exists for most families and where the almost-never discussed challenges faced by girls tend to be overshadowed by other pressing family needs.
As the entrepreneur who inspired the creation of IMHER, it seems appropriate to profile Uplifting the Girl Child, and its founder, Grace Ningejeje, in one of IMHER’s inaugural blog posts.
Coming to Dartmouth
At Dartmouth, we came to know Grace Ningejeje when she came to campus as a YALI Mandela Scholar from Burundi in the summer of 2017. Her goal was to improve menstrual hygiene education and product access in her country, and she taught those of us at Dartmouth a great deal about her country and her work there.
Along with other young African innovators from a range of different sectors, Grace received intensive training in entrepreneurship, business development, design thinking, and digital story telling while at Dartmouth. She and the other scholars took classes, made presentations, created videos of their work, and networked across issues and industries. After about three weeks at Dartmouth, the YALI fellows went to Washington, D.C. where they networked with hundreds of other YALI scholars who had been studying at other universities across the United States.
MHM in Burundi
Most of the challenges in Burundi will be familiar to anyone working in the global menstrual hygiene space. Lack of formal education around sexual and reproductive health issues reduces information among both children and their parents. That is compounded by widespread menstrual stigma, which reduces discussions of such matters at home. Commercial products tend to be too expensive for many girls, when available at all in rural villages. And the limited availability of comfortable bathrooms (i.e., private, safe, waste cans for pads, warm water, running water, and/or soap) tends to compound menstrual care options.
However, Burundi does face a few extra challenges with respect to menstrual hygiene, even as compared to many other countries in the same region:
- Burundi is one of the highest-poverty countries in the world (with close to three-quarters of its population estimated to be living in poverty in 2017).
- Burundi is a predominantly rural landscape, so village life – rather than urban life (with its greater store and product availability) – is the norm there.
- The requirements for the operation of NGOs (especially, international organizations) have been changing within Burundi in recent months. As new rules and norms for NGOs settle out, the effects of those changes on how even local non-profit organizations and businesses for the social good will need to operate in the future are still somewhat unclear.
While other organizations may have done short-term pad distributions in Burundi, we currently know of only one other organization (SaCoDe, with its Agateka Dignity Project) that has a permanent presence there. While it represents an opportunity in some respects, it also may reflect the challenge of doing this type of work there. Moreover, the lack of an existing MHM network within the country also presents some extra challenges to those trying to do this kind of work.
Grace had a clear vision of the most immediate issues to address in her country:
- More girls in Burundi need to learn about menstruation and the best options for self care in school, ideally before they start menstruating.
- Provide more affordable access to commercial sanitary pads, especially in villages, where commercial products are too rarely available at all.
- Donate sanitary pads to girls who will not be able to buy commercial sanitary products at any price.
- Where need cannot be met with disposable pads, teach girls how to make their own comfortable reusable pads.
Grace recognizes that there are related, bigger issues in play, too — i.e., eliminating menstrual stigma, educating not just girls but their mothers, fathers, and brothers, opening up dialogue between mothers and girls in homes, whether reusable products might be viable there, and reducing poverty in Burundi. However, she recognizes that she will likely have to focus first on the most actionable parts of the issue (the “lower hanging fruit”) in order to be able to achieve much progress at all.
The First Challenge – Information
The very first challenge seemed like a relatively manageable one, compared to those other, bigger issues: specifically, Grace needed to figure out what information and resources already existed about menstrual health education, product production, and product delivery options.
For example, what has been done in Burundi and in neighboring countries on menstrual hygiene already? Have any educational materials been produced in the most prevalent language (Kirundi)? What are any low-cost alternatives to standard disposable pads? How inexpensive can a low-cost pad be, while still being comfortable, effective, and financially viable for its producer? Are there any other scholarship or awards programs that could help her do her work?
While Grace was doing the challenging work of her YALI program, I offered to start that information gathering process while she was here in New Hampshire. Due to my academic work on female empowerment, I found it to be an interesting topic, and given that my job as a professor involves finding, assessing, and synthesizing reams of information for others to learn efficiently, I assumed that this should be a relatively easy task.
It was not an easy task. It was difficult, frustrating, and wildly inefficient work. It was perhaps best characterized by the phrase “finding a needle in a haystack.”
Much of the basic information was mostly out there in some form. However, it was usually buried under enormous piles of less-useful information gathered for other purposes (often public relations and donor management), often with some over-claiming as a result. Statistics cited were sketchy and often without “sources” so that it was rarely clear what was known versus not.
The process seemed far too labor intensive and error prone for newer and smaller entrepreneurial efforts and NGOs. Mechanisms for information sharing once work was underway were also unclear. It seemed inefficient and ineffective to have everyone who works in this domain “reinventing the wheel” by having to locate the same information on their own.
University students, however, have the time and incentive to learn how to gather such information as part of their learning. Dartmouth works hard to support professor/student collaborations, and I have found that my students at Dartmouth have been enthusiastic to be able to help further the likely success of the (mostly-female) innovators who devote their lives to this important issue – who can then better help girls and women in considerable need. Putting this information together seemed like a “win win” situation all around. Thus, IMHER was born.
It took our team over a year to compile the information I promised Grace when she participated in the YALI program, and even more time to figure out how to present it in user-friendly form. But now it is compiled and available for her, and others, to use as needed.
An Organization & Book
Shortly upon returning home in the fall of 2018, Grace started an organization on the topic called Uplifting the Girl Child.
Recognizing that a core issue in her country was a lack of educational materials in Kirundi, combined with the need for a way to open up dialogue between girls and their elders about menstruation, Grace also began writing an educational book, which was published in 2019.
As published authors of children’s books know, they consist of far more than a compelling story. Grace had to find and hire an illustrator to create culturally relevant, engaging visual storytelling for readers in her target age group. She needed to draft and redraft the language and seek feedback from experts and focus groups of teachers and children. And then she had to find a publisher and negotiate a low-enough sales price so that it would be viable for her to use as part of her educational work.
But within a year of having the idea, Grace published what is, to her knowledge, the first book on menstrual hygiene written in the language of Kirundi, and specifically for Burundian readers. Its title is, “Break the Taboo on Menstrual Health.”
Some challenges still remain: the book is not free for distribution (publishing rights do not typically work like that), so she has to find donations to cover the costs of distribution. It is also unlikely to reach its intended audience without her delivering it; Grace therefore needs to have the time and the organizational structure to distribute the book, conduct school visits, and arrange public readings of it.
Grace has also been grappling with the array of challenges reported by many MHM educators. One has been how to address the wide array of issues that are not directly MHM related that inevitably tend to come up in student Q&A sessions. For example, Grace and her brother (a medical doctor, who accompanies the team on school visits) have found that girls often become most interested in learning about their menstrual cycles when it is places in the context of pregnancy, and how to predict fertility. Yet how much of the emphasis in a short classroom visit about menstrual health should be devoted to helping girls – sometimes girls who are quite young – learn about pregnancy and how to avoid it when sexually active? There are not easy answers to such questions.
Regardless of the fact that challenges still remain, small-scale educational outreach around menstruation is now in place in at least a small and growing group of rural schools that did not have it before. At least some girls in Burundi are being reached with a culturally relevant, engaging treatment of the book. And not only will the message of the book help them understand what is going on with their bodies and to feel more positive about it, but it may help – bit by bit – to break down menstrual stigma in the families of the girls reached by these educational efforts.
Grace is still trying to figure out whether it will be possible to create a financially-viable disposable pad-making business in Burundi.
- Can she produce pads that can be less expensive than others on the market, while still being desirable in terms of quality?
- Can she get her pads to a price that will be cost-viable in rural areas, such that rural small-store owners will be willing to stock the product, knowing that it will sell well?
- Should they be manufactured locally or in Asia, where trade-offs may exist between cost, quality, and job creation?
- Can she sell low-priced products with a profit margin that will allow her to achieve her other goals? That is, without deterring too many potential buyers, can she charge enough for each pack of pads to be able support herself and any needed staff in doing this work full time, while still having the resources to donate education and products to the girls with the highest-need?
- Is it possible to do so in the context of the changing government restrictions on NGOs that are being newly established?
Moreover, like many small-scale entrepreneurs, Grace needs to figure out how to do all this while also working a full-time job in a different industry to support herself as these other efforts get off the ground. And she cannot afford to hire paid staff without a revenue stream. In the meantime, she faces the standard challenges associated with running any small, all-volunteer organization.
At IMHER, we can’t directly resolve those substantial challenges. We cannot fund organizations, and we do not have the essential expertise that local experts like Grace can use to address such issues. What IMHER can do is provide information about what others have done in their own countries, provide a database searchable by country which can facilitate networking with others in the field, compile resources used elsewhere, and write stories about what other innovators have done with their work that might provide applicable ideas for innovators like Grace to combine with their local expertise. We can also provide events calendars, scholarship deadlines, and other resources that might facilitate her work in other ways.
In practice, it will not be possible for Grace alone – or even a much larger number of entrepreneurs – to fully resolve menstrual hygiene education and access issues for girls in Burundi on a national basis in the short term. The challenges there are significant, while government resources and local funding options to support such efforts are limited.
However, the fact that a young innovator is able to find ways to make progress on this issue in the meantime – and has been able to empower individual girls (and potentially indirectly, their sisters, aunties, and mothers) with information and product access – is to be celebrated.
TO LEARN MORE: Want to learn more about the work of Uplifting the Girl Child? Check its organization listing in our database of organizations, and go the organization website and/or Facebook site directly.