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Safepad: Battling lack of menstrual health and hygiene

“Women, men, everybody should recognize that menstruation is very natural and none of us would be here if it weren’t for menstruators. We must live with it and talk about it, and make sure that menstruators get information and access to products.”

Menstruation is a regular occurrence for two billion women and girls around the world, yet at least 500 million women and girls lack adequate facilities for menstrual hygiene management (MHM), resulting in poor menstrual hygiene. This is often caused by lack of access to proper menstrual products and information. Trine Angeline Sig (she/her/hers), Co-founder and Managing Director of Real Relief, states: “Consequences do not only affect individuals but can alter entire societies.” The consequences are, for example, vaginal infections, which can cause infertility and other serious health problems when relevant treatment is not available; further increase of the gender gap as adolescent girls and young women miss out on education. Studies show that girls without the opportunity of managing their menstruation simply stay away from school when they are menstruating. 

Real Relief, a Danish private company established in 2013, found a way to address this challenging issue. With their innovation Safepad, they won the Danish Design Award 2018 in the “Daily Life” category. Safepad is a reusable sanitary pad which offers a safe and infection-free experience for women on their periods. Real Relief collaborates with local and international partners, striving to make a real difference in this global challenge.

We recently caught up with Trine to reflect on her organisation’s goals and growth over the years.

Can you tell me a little more about yourself and Real Relief?

Yes, of course. We are headquartered in Denmark, with a subsidiary in India, where we develop many of our innovations. We also make kits for UNICEF – we do their hygiene and dignity kits. And now one of the innovations, the Safepad. Safepad is a reusable sanitary pad. The reason for developing a product like Safepad is that we have primarily been working in Sub-Saharan Africa, combating Malaria by distributing insecticide treated mosquito nets for almost 20 years. During those many visits to Africa, we often came across girls that were not attending school because they did not have access to sanitary wear. So, being a textile company and used to working with textiles, plus our company being based in a textile area, we thought: “why don’t we bring a solution to the market that helps girls not miss out on school because they don’t have access to sanitary wear?” Hence, we developed Safepad.

When did you start developing Safepad?

We started in 2016. I’ll share with you the reasoning behind developing what we call an intelligent reusable pad, which we believe Safepad is, because of its antimicrobial treatment that kills bacteria. I went to Tanzania with a standard reusable pad – I believed I had the solution to all girls’ problems. I went to the ministry of health and presented the product. I was almost thrown out of the office because they raised the issue of girls not having access to water, and not having access to clean water. 
The health minister was saying there was absolutely no way they were distributing a product like this, because it has the potential to carry bacteria and they are not distributing bacteria bombs between the legs of girls in Tanzania. I thought maybe the guy had a point, so, I went back to my team which had been working on developing long-lasting insecticide incorporated into mosquito nets, and we had textile engineers within the company. My partner, who is a chemist, and I started looking into which technologies are available, and what we could combine to have a solution where we are certain about not distributing bacteria bombs between the legs of girls in need of menstrual products. So, we innovated Safepad.

 A local production site in India.

Now the core of the technology is the antimicrobial treatment. When bacteria hits the surface of the positively charged fabric, it gets killed. It disappears from the fabric. So, we are certain that a Safepad is safe and is hygienic to use at all times. Even if the girl does not have access to clean water.  Even if she washes her pads in contaminated water, even if she does not dry the pad outside in the sun. We are confident and certain, and it’s proven and tested and documented that the product is safe and hygienic to use. And we treat all the layers: Safepad has a leak proof back side, an upper layer which is soft and nice to touch so it doesn’t give you any itches and annoys you when using it, and the absorbency layers inside. All three layers are treated with this antimicrobial treatment, ensuring that bacteria cannot grow even inside the pad. That’s the core of the technology, and quite unique as there aren’t many other antimicrobial treated reusable pads on the market. So, we believe it is an innovative solution. We also received recognition from the Danish design award back in 2018 for having developed a simple solution to a huge problem, in a very intelligent way.

What is your goal with the distribution of Safepad?

The ultimate goal is that no girl is left behind because of her period. We look at it from a Safepad angle. The more overarching goal is to live in a more developed and equal world, where girls and women have exactly the same rights and opportunities as boys and men. Of course, being a woman, I cannot accept that girls are not getting the same opportunities as boys. I guess there is an ambition, and a wish, to create a more equal and developed world. And there is a more narrow focus and goal to bring more Safepads, more information, more education, out there. 
So Safepad is at least one solution that is already proven and available, can assist in getting girls through their education, if their period is preventing them from attending. And it’s tough, because we have this funding gap, and menstruation is not our priority. Maybe that is not our priority, because many decision-makers are men, and they don’t see this as a problem or a concern, or an area that needs attention, programs, money. I don’t know but what I know is that menstruation is not prioritized. More women need to stand up for making this a priority and we need more girls educated so that they can become the leaders of tomorrow and the politicians and presidents of the world. That’s where the decisions are made. That is where the funding is being allocated, where the budgets are made. And if we are not part of that, menstruation will never get the attention it needs. And it will never get the funding that is needed to get everybody on board. It’s a huge task. And we can try to put it higher on the agenda by talking more about it and educating more people.

Is your target group only in the global south?

Well, as we have primarily been working in developing countries by distributing mosquito nets, that is where we have our expertise. We are used to working with international and national organisations. The UN, government programs, etc. That is our core business. That being said, we are selling Safepads in Denmark. But as we all have access to clean water, washing machines, we don’t need antimicrobial treated pads to kill bacteria. It doesn’t offer the same advantages here that it does in third world countries, where access to clean water is not a given. There are so many other alternatives like the menstrual cup, which is a fantastic product as well here and which is sold in larger quantities here than what we see in 3rd world countries.  Why are we not selling menstrual cups in third world countries? Well, to you use a menstrual cup you need access to a toilets, with privacy – you need to close the door, be in a calm sitting position, and have access to clean water. In many settings in third world countries, this is not possible, you don’t have access to that… but if you do, the menstrual cup is a great alternative. 

Has the Covid-19 pandemic presented any new challenges?

Yes, the pandemic has a major impact on the programs in third world countries. Basically, programs have come to a standstill. That has an impact. Another thing is distribution: in Kenya for example, nobody has been in school for 12 months, and normally, school distributions, which pads were part of, are now  on a standstill. In general, supply chains have not been fully up and running throughout the period, so even in markets where Safepad or other products have been commercially available, we have seen that they have simply not been on the shelves. This has a really big impact on girls.

"The ultimate goal is that no girl is left behind because of her period."

Where do you see your organization going in the next few years?

One of the things that we have done to strengthen the supply chain to get closer to the girls and women in need, is to set up local production. This is also because I have a personal ambition to help the empowerment of girls and women in the countries. When we first started, the first production was set up in India. Since then, we also set up production in Nepal and in Bangladesh, where we have two production sites. We also have a project in the refugee camps, where refugees from Myanmar are involved in making pads. Other women are involved in marketing and sales by going back with the pads made within the refugee communities and selling them in the different camps. That is quite an amazing project that is headed by UNHCR.We also started two small projects in Kenya and Nigeria, and I hope they can be scaled in 2021. 

And we also started in Afghanistan, however I have never been to Afghanistan, and feel it’s a bit complicated to handle things from here. This leads me to another point: there is so much stigma and taboo surrounding menstruation in general in the world, even in “developed” countries, but if you go to Afghanistan, it’s another level. I am really worried about how we are going to manage it. Having a product produced is one thing, but marketing and selling something we are not supposed to talk about is a whole other thing. This is going to be the first time we are setting up a production where we haven’t been. And given current circumstances, we cannot travel there either. So, we have developed video sequences to show how to manufacture a Safepad. All the way from starting manufacture to producing the finished product. We’re going to have video training to train them how to do it. So fingers crossed we have something that looks like a Safepad in Afghanistan without our presence, so that we can finally launch the set-up and make Safepad available for all girls and women in the country. 

How many people are you currently reaching?

That is really hard to say. Right now, not that many. Before Covid-19 hit us all, we were reaching many more. UNICEF, probably our largest distribution partner, was distributing menstrual kits through their hygiene and dignity kits, but also as a stand-alone product. And they have hardly been distributing any in 2020, which has a major impact on the overall numbers distributed in 2020. And I unfortunately foresee a continued decrease in 2021.

But on a positive note, we are increasing the local output. I would say we are probably distributing in total, 10,000 packs a month right now. We are reaching approximately 10,000 girls and women a month. But even though we are increasing our output, it is really just a drop in the ocean.. It’s nothing, compared to what is needed.

"...there is so much stigma and taboo surrounding menstruation in general in the world..."

What are the main challenges that you are facing with Safepad?

The problem is still that many of the girls don’t have access to the product even though we have a solution. It is not a problem for us to deliver. We can make two million pads a month if that was needed. But the problem is that the girls do not have the means to buy the products themselves. So, there is a funding gap between the demand and supply.

And that is of course something that we had to look into. How can we ensure that we don’t leave any women or girls behind? Because if they don’t get education, they are not going to get a job. Hence, they will not be able to buy the product. If they get education, they are more likely or in a better place to get a job, earn their own money, have their own income, andbe able to buy products for themselves and their daughters. Essentially, if they get an education,  they will have the income-generating activity that will enable them to  handle their own menstruation. I’m not trying to pretend that Safepad solves all girl/woman issues. But it’s at least part of the solution in some countries where girls actually miss out of school, or maybe even drop out, because they simply get too far behind when starting their menstruation.

So lack of funding and attention is currently the main challenge that you are facing. What are tools to face them?

Yes. I would say, the biggest concern is lack of funding, which is combined with lack of attention. This is simply not prioritized… I’m about to say that girls are not prioritized. But that might be taking it a little too far. But, between us, I can say that that is the feeling we are getting when talking to decision-makers within countries. Because they simply do not prioritise these products. And the product alone is not enough; we also need information and education. We go to countries or communities or schools where girls don’t even know what menstruation is, and they don’t have anybody to ask about it. 

Thus, we have also developed a booklet called My First Period. When we go to a project, we normally hand out a few of these booklets. And we often see it is the teachers or the headmasters that take the booklets themselves instead of giving them to the students, because they themselves lack the information. They actually seek the information they don’t have, and they don’t know where to find it. Often when girls ask their mothers or teachers, they don’t get adequate answers or enough information, or any information at all. This is problematic. We still don’t really talk about it. And there is still too much stigma surrounding menstruation. There are barriers to be disrupted here and we really need to work hard to make this a natural thing, which it is. But to many it is not, and I think the only way to normalize it is by talking about it. By spreading information, by educating more people – not only the girls, also the boys. The women, the men, everybody should recognize that menstruation is very natural and none of us would be here if it weren’t be for menstruators. We must live with it and talk about it, and make sure that menstruators get information and access to products.

What we have also investigated, because there is a lack of funding, a lack of attention, is reaching out to others. Which is why I’m reaching out to you at Stories to Action, for example. You can help us to place this higher up on the agenda. We need politicians, decision-makers, to recognize that this is something important – Important not only to girls and women, but to development in general. Now, in 2021, I don’t think we can justify leaving any woman or girl behind. We need to get everybody on board.

Just one last question. What do you think about countries having new policies regarding menstrual products for all?

I think it is fantastic. I was talking to my teenage boy. He is not very shy about it, maybe because this is something we have been talking about over the years when developing Safepad. But even in a Danish school setting, pads are locked into a special locker in a special room and if the girl does not have the product she gets her period, she has to ask the teacher to leave the room, go to a special locker, get it unlocked… and we were only talking about having free access. There is nothing to lock or hide away, nothing to be embarrassed about. And setting up a mechanism like this, makes it something unnatural. Converts it into something that is forbidden. We need to change that – as part of normalizing menstruation. 


For more information on Real Relief and Safe Pad, check out:

About the author: Lara Paulus, originating from the Netherlands, is currently residing in Glasgow, UK. She volunteered in multiple settings to assist in long term sustainability of aid programs. In 2018, she finished her Master of Science in Global Health at Maastricht University, the Netherlands. After her Master’s, she devoted her career to working with asylum seekers and refugees. She worked for a Dutch refugee organization and completed an internship with the International Rescue Committee in Los Angeles. She is now assisting in research, and supports asylum seekers in Glasgow.

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