Around the globe there is growing awareness of, and demand for solutions to, the financial and physical burdens of menstruation. In developing countries the consequence of poor menstrual hygiene can be devastating, even deadly -- linked to skyrocketing rates of reproductive infection and illness. An added dose of stigma and shame often keeps girls from attending school during their periods and otherwise living healthy lives.

Here in the United States, many low-income women and girls share a similar struggle -- especially those who are experiencing homelessness. Inability to afford tampons or pads, or to access hygiene facilities, can severely compromise women's health, productivity and dignity.

And no city knows the price and pain of homelessness quite like San Francisco, where a combination of rapid economic growth and sweeping gentrification has left a trail of collateral devastation.

Standing out among the city's array of essential service providers -- emergency shelters, drop-in centers and meal programs -- is the innovative, resourceful Lava Mae. By transforming retired municipal buses into gleaming mobile restrooms that traverse the city, Lava Mae offers the peace and dignity of clean, safe showers, sinks and toilets.

On a blustery December morning, dozens of women in the Tenderloin wait their turn to take a hot shower at Lava Mae's Polk Street bus stop. The compassion and camaraderie of the Lava Mae team reverberates for blocks on end. The sky blue bus harkens. All are welcome.

Conscious Period, a new Los Angeles-based organic tampon company had just dropped off care packages for more than 50 women: a month's supply of menstrual pads. After gratefully accepting the gift, several women opened up and shared what it is like to experience homelessness while coping with five consecutive days of blood flow each month.

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Anne

A lifelong resident of San Francisco, Anne's landlord announced without warning that he was tripling her rent. Overnight she found herself without a home and, soon enough, without a job. When asked what is hardest about having her period, Anne immediately lamented the lack of private, safe bathrooms in the residence where she sleeps. Constant intrusions make it hard to use the toilet, change a tampon and wash her hands. When offered tampons, she'll take as many as she can carry. "They're so expensive," she added.

Ruth

Ruth let out a hearty laugh and "no thanks" when offered a package of pads. Happily, the hassle of periods is a thing of the past for her. But now, rather than struggling to access tampons, Ruth gravely needs insulin for her diabetes. The Lava Mae team informs her that the bus is strategically parked right next to a building that houses several service providers to which she can go for help with her medical needs (the Shanti Project and Asian & Pacific Islander Wellness Center) and for meals (Project Open Hand).

Dawn

Dawn has lived on and off the streets since she was a teenager. With her husband and her dog, she's now homeless again. A writer, Dawn hopes to one day publish articles on women's health and empowerment. Like Anne, she remarked on the expense of tampons -- impossible for her to afford. A box wouldn't fit in her duffle bag in any event. So she only has a few on hand at any time, and relies on any extras to spare at the shelters and meals programs she attends. Dawn's tip to those who make donations: panty-liners please; they go a long way in helping keep her underwear as clean as possible during her period.

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California broke new ground last week with the announcement by Assemblymembers Cristina Garcia (D) and Ling Ling Chang (R) of new proposed legislation to eliminate the sales tax on menstrual products. This is a welcome development. The "tampon tax" has been making headlines around the world, including a change.org petition that has picked up 40,000 signatures here in the U.S. Every penny counts, including those eight cents on the dollar. But to women without a nickel to spare -- or without a roof overhead -- more relief is necessary than can be achieved with a sales tax break.

In the absence of legislation to mandate shelters and service providers to have menstrual products on hand, donations are a lifeline. Please consider sending a few packages of tampons, pads and panty-liners to your local shelter or meal program. A small gift goes a long way in helping women in the toughest of circumstances maintain their dignity and health.

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Written by Jennifer Weiss-Wolf

All photographs by Laura Epstein-Norris

This post originally appeared in Life Tips on Medium.