Amika George started campaigning for the government to provide free period products after learning girls were using newspapers, toilet roll and socks to cope with their periods and missing school each month.

The 20-year-old, who launched the Free Periods campaign in 2017, initially found the government ignored her efforts to fund the free provision of menstrual products in all schools and sixth form colleges.

“I was really disgusted to hear there were girls in the UK who were missing up to a week of school every month,” Ms George, who was 17 when she began the campaign, told The Independent. “I was horrified and really angry that even though it was being publicised, the government did not respond.”

The campaigner resorted to working with a law firm to build a “robust legal case” which argued the government had a legal obligation to provide period products under the Equality Act.

Period poverty is a widespread issue in the UK — with 49 per cent of girls having missed a day of school due to periods and one in 10 women aged 14 to 21 not able to afford period products.

How women around the world manage their periods Show all 26 1 /26 How women around the world manage their periods How women around the world manage their periods From menstrual cup to cloth, menstruation skirt or homemade sanitary pad, WaterAid highlights the many and varied ways in which women around the world manage their periods. Within the communities that WaterAid works, they talked to women about their periods. The result is a revealing snapshot of traditions passed on from mother to daughter, as well as women’s own, often innovative, solutions.. WaterAid How women around the world manage their periods Nowana from Zambia, 45, fills a pouch with powdered cow patties that she uses during her period 'I mainly use cow patties to manage my periods, occasionally I use a piece cut from an old blanket. I only use a blanket if am home and not intending to go anywhere. But the cow patties I use at any time whether I am just home or I am travelling to different places. Our parents taught us about the use of cow patties a long time ago before we even heard about pads. I was shown this method by my grandmother and I have been using it since that time. Money is scarce and I cannot afford to buy pads, they are expensive and that’s why I use this method. I have children who are of age who also need pads and if you put all of us together, you will agree that it’s a lot of money that will be required and we cannot afford that.' WaterAid/ Chileshe Chanda How women around the world manage their periods Powdered cow patties and the pouch Nowana would use during menstruation 'I would prefer pads to cow patties if I had a choice. They are easy and already made, they are disposable and don’t require a lengthy process like the one I go through when using cow patties.' WaterAid/ Chileshe Chanda How women around the world manage their periods Hilary from London, 27, uses reusable sanitary pads to manage her period 'The environment is a big factor for why I use reusable sanitary pads. It’s about reducing waste. I use a combination of different reusable sanitary pads, cotton or bamboo, when I am on my period. A group of women in India makes some of them as a means of sustainable income. It is important to me that they are made of natural materials because I find it most comfortable and eco friendly. Fortunately, I am in the privileged position to think of comfort when it comes to sanitary towels.' WaterAid/ Billy Barraclough How women around the world manage their periods A reusable sanitary pad Hilary would use during menstruation 'I buy these pads mainly from independent stores, most of them are online only, that focus on sustainable products. Most regular stores don’t sell them. They are about 9 pounds for one towel, though the price differs depending on size and absorbency. They do stain and since they are made of cotton or bamboo, they usually last about as long as a regular piece of clothing. Some of the ones I have are now 2 years old.' WaterAid/ Billy Barraclough How women around the world manage their periods Lepera Joyce frpm Uganda, 23, showing her goatskin skirt which she uses when she is on her period 'Our village is a pastoralist community; we have many cattle, goats and sheep. After slaughtering them, we keep the skins for use as bedding, clothing and also for managing periods. I have this special skirt made out of goat’s skin that I wear during my period. The skirt is made in such a way that it has a thick folded bottom ending, which we locally call “ Abwo” – the tail of the skirt. When I have my period I wear this skirt, I find a comfortable place to sit, I fold the tail of the skirt “Abwo” in between my thighs and wait for blood to drain in the tail of the skirt.' WaterAid/ James Kiyimba How women around the world manage their periods The goatskin skirt which Lepera Joyce uses to manage bleeding when she is on her period 'I use this goatskin skirt because it’s always available; it’s our traditional sanitary pad.' WaterAid/ James Kiyimba How women around the world manage their periods Steph from Australia, 27, uses an IUD as well as tampons and pads to manage her period 'I have an IUD to help manage my endometriosis and polycystic ovary syndrome, which in turn helps manage my menstrual cycle as well.' WaterAid/ David Freeman How women around the world manage their periods IUD Steph would use during menstruation 'The Mirena means that I don't get a regular period, which is exactly what I was hoping for. Instead I have maybe 2 days of very light bleeding a month, it is quite random at the moment, but I don't find this difficult to deal with. I almost always experience pain before the bleeding starts, so I can predict my needs quite well. For any bleeding I do have, I use pads and tampons as needed. I also have some prescribed pain medication to help ease any symptoms that my cycle may cause.' WaterAid/ David Freeman How women around the world manage their periods Munyes, 44, from Uganda 'During my period I find it easy and very normal to make a hole in the ground and sit on top of it for blood to drain in it. Whilst growing up, the mature women including my mum taught us the different methods of managing our periods, but I preferred this method of making a hole in the ground. No man, not even your husband should see your blood. Even me, I have taught all my daughters how to use this method. I am happy and confident when using this method because I always find a private place where no man will see me. This gives me confidence that I am safe.' WaterAid/ James Kiyimba How women around the world manage their periods Sangita from Nepal, 32, holds up a finished reusable sanitary pad 'Ready made pads are costly and if you do not dispose of them properly it will pollute the environment.' WaterAid/ Mani Karmacharya How women around the world manage their periods A reusable sanitary pad made by Sangita 'When I got to know about the menstrual pad making training, I was curious. I never knew that there are ways to make homemade cotton pads in a well-managed way. The training was two days. The first day was mainly theory where we were told about menstrual hygiene management behaviour, measurement for the pad making, preparing paper cutting drafts. The next day was the practical where I made two cotton pads. Besides pad making, the training was useful because I gained knowledge on menstrual hygiene management. Before this training, I used to be very shy while talking about menstruation. But now I am not shy anymore because menstruation is a natural process,' says Sangita WaterAid/ Mani Karmacharya How women around the world manage their periods Limpo from Zambia, 22, cuts cow patties to size for use during menstruation 'I was born here and I have been living here all my life. My (extended) family lives in Kembi and we have all grown up here. I use cow patties to manage my period. I started using them along time ago just from the time I started having my period. I collect cow patties from the grazing areas for cattle in the plain and they are readily available. Sometimes I collect dry ones and other times I collect semi dry ones depending on the season. If it is wet season, I collect cow patties and stock them somewhere to make sure they are completely dry before use. In a dry and hot season like now, I find them already dry and all I do is pick and use.' WaterAid/ Chileshe Chanda How women around the world manage their periods A cow patty on top of the cloth Limpo would use Limpo, 22, 'I do not put the cow patties directly on my skin, I wrap it in a cloth and place it nicely to capture the flow without staining other clothes. I like this method because cow patties soak up a lot of blood before they are completely soaked. I go about doing all sorts of things without any trouble.' Mongu District, Zambia, August 2018. WaterAid/ Chileshe Chanda WaterAid/ Chileshe Chanda How women around the world manage their periods Claire from Manchester, 40, uses a menstrual cup during her period to reduce waste 'The one thing with the Mooncup is that it is more hassle. It needs boiling to clean it properly. We have a ‘Mooncup pan’ in which I boil it and sometimes I have to rush into the kitchen to stop someone from boiling an egg in it.' WaterAid/ David Severn How women around the world manage their periods Claire holding a menstrual cup 'I don’t find the moon cup as convenient to empty when I am out and about. I’d only be able to do that if adequate facilities are available, since you do end up with blood on your hands.' WaterAid/ David Severn How women around the world manage their periods Elizerbeth Chisale from Malawi, 54, teaching her grand-daughter, Mary how to make a sanitary cloth locally known as nyanda 'During our menstruation period, we use nyanda, which is a rag or a piece of cloth cut off from an old chitenge wrap [sarong]. We place it in a piece the underwear. However, some among us cannot afford underwear, so in that case, we secure the nyanda in place by tearing a long and thin piece of the rag and tie it around the waist to hold the fabric tight in place. We also know of women who are very poor that they can’t even afford the chitenge wrap, so they cut off a piece of their blanket and use that; it is less sanitary than the chitenge but then, they have no other option. Sometimes, a piece of cloth from our husband’s old shirt comes in handy, if a chitenge wrap is not available,' explained Elizabeth WaterAid/ Dennis Lupenga How women around the world manage their periods Tamala from Malawi, 23, also uses a piece of cloth called nyanda during her period 'Cleaning the nyanda can be problematic for us and our families, particularly with issues of hygiene and sanitation.' WaterAid/ Dennis Lupenga How women around the world manage their periods Nyanda, a small piece of cloth used as a sanitary pad in Kapyanga, Kasungu, Malawi “To clean a used nyanda, we use our feet first, continuously rubbing it against the ground, so we don’t have to touch it with hands. We then wash it in the mbiya [a clay pot used to store water] which means no-one else in the family can use it, because it becomes unsanitary, so we usually need two clay pots or even plastic basins, although the reality is that most families can only afford one. This sanitary constraint also demands that we should have two bathrooms, one for when we are on our periods and one for the rest of the family to prevent infections, but most of us cannot afford two bathrooms, so we have to cope with what is available,” said Tamala WaterAid/ Dennis Lupenga How women around the world manage their periods Women from Kapyanga sharing menstrual hygiene experiences, Malawi ‘If married, our husband is not supposed to see any piece of cloth that we are using, so the rags are carefully secured in a small plastic bag which we hang on a top corner close to the ceiling in the bedroom; this we do to ensure that our men do not have any close contact with that bag, even when we are not on our period. Depending on the menstruation flow, we can change the rags between three to five times a day. At night, we need to be extra careful not to stain the beddings, so sometimes we need to go out and change up to every three hours. Travelling long distances when we are on our period is a challenge. The flow during menstruation is intensified as opposed to when you are at home. As we are required to change and clean the nyanda once it is soaked, we have to stop and use a nearby river or shallow well to clean ourselves. This is not easy as most rivers have children playing around the banks. We make sure we have packed at least three to five pieces,’ said Mercy, 44 WaterAid/ Dennis Lupenga How women around the world manage their periods Doris from Zambia, 19, holds lint cotton she uses during menstruation 'When am on my period, I stop playing soccer or any other sporting activities. I can’t run or play games with my friends. I use pieces of chitenge material and cotton wool to manage my periods. [A chitenge is a wrap originally designed for women to cover themselves from the waist downwards.] I get my pieces of cloth from my mother’s old and worn out chitenge. As for the cotton wool, I pick it from the cotton fields and stock it up for use when need arises.' WaterAid/ Chileshe Chanda How women around the world manage their periods Saba from Islamabad, Pakistan, 18, cutting a cloth to use during her period 'I use cotton cloth to manage my periods. I get the cloth from home, from the clothes that we used to wear earlier and are now old and rough.' WaterAid/ Sibtain Haider How women around the world manage their periods A piece of cloth to be used as sanitary pad by Saba 'My mom told me to use cloth during my periods. I cannot afford to use sanitary pads.' WaterAid/ Sibtain Haider How women around the world manage their periods Lydia from Tanzania, 26, uses cotton sanitary pads when she is on her period 'I use non-reusable pads from a brand called HC. I find them very comfortable because they are naturally cold and I experience very serious menstrual cramps. When I put them on, the cold helps to take away the pain and I feel comfortable and more relaxed. I just buy them from a shop at a price that I can afford. Even if it gives you pain the fact that you have periods means that you are healthy and you are able to conceive in the future. It is something to be proud of and something that makes me feel feminine.' WaterAid/ Priya Sippy How women around the world manage their periods Burkina Faso Pieces of old or worn loincloth, used by the majority of girls and women to manage their periods, especially those in rural areas or of modest means. 'During my periods, I use pieces of traditional loincloths to protect myself and prevent infections. I tried the cottons [sanitary pads] but they cause slight wounds on your body. So I prefer to use the pieces of loincloths.' Brigitte, 23, Ouagadougou, Burkina Faso WaterAid/ Basile Ouedraogo How women around the world manage their periods A sample of sanitary pads, known as cottons, sold in the shops and used by some women or girls, who are wealthier, mainly in urban areas of Burkina Faso 'With cotton, I feel more comfortable. Cotton is good but the only issue is that it can run out and that you can’t afford to buy more.' WaterAid/ Basile Ouedraogo

Last spring, the government announced girls at primary and secondary schools in England and Wales would be provided with free sanitary products from early 2020.

The government backtracked and rolled out the scheme to a wider age range — also including those in sixth form colleges — after it came under fierce criticism from campaigners for initially only choosing to distribute period products in secondary schools.

Ms George applauded the government scheme but raised concerns schools might not take up the offer of providing sanitary products due to not being aware they are accessible.

“I am really, really excited they will be freely available from next week,” she added. “The really important thing is the schools take up the government on it. We are pushing for all schools to get involved. Access to period products should be categorised as a basic necessity in the same way that toilet paper and soap are, and tampons and pads should not be classed as a luxury item.”

Sanitary products in the UK are classed as a “luxury, non-essential item” and taxed at 5 per cent — with the average lifetime cost of sanitary products estimated at £4,800.

Ms George said lots of friends and strangers had contacted her to recount their own experiences of period poverty.

She added: “Some would say they had got really behind on work and missed huge chunks of the curriculum because of not being able to afford sanitary items. One girl searched in nooks and crannies to find spare change. A lot of the time the girls are too embarrassed, because of stigma and shame, to ask their parents. They do not want to put their parents in the situation of saying: ‘It is food or stuff for your period and we have to prioritise food’.”

The campaigner said teachers had told her they had been forced to spend their own money on buying period products for pupils after noticing the same girls were missing school each month.

She said she had heard from girls who had resorted to using rags and sleeves of old T-shirts for their periods due to not being able to afford proper menstrual products. Women and girls who are faced with period poverty are at risk of a potentially fatal bacterial infection called toxic shock syndrome, Ms George added.

She argued a significant reason why period poverty remains unaddressed is due to the stigma and taboo that surrounds periods.

“Women stick tampons up their sleeves from a young age,” Ms George added. “It is culturally ingrained for us to stay quiet about them. We have been consciously taught periods are shameful and embarrassing and should be a silent topic. Seeing products in schools will encourage children to immediately start conversations about products and around periods.”

The activist said she had encountered backlash from trolls since starting her campaign — explaining men sometimes get angry she is talking about periods publicly and insist period poverty is not a real issue.

She added: “They say ‘periods are disgusting, you are a typical teenager who wants the government to pay for everything’. They sometimes also wrongly make the assumption parents can’t afford products because they are spending money on alcohol and cigarettes.”

Ms George said she hoped to launch a Europe-wide campaign to make schools across the continent follow suit and offer free sanitary products.

Women who have experienced period poverty are more likely to experience anxiety or depression and find it difficult to afford their bills, studies have found.

Lucy Cannon, a PE teacher at John Cabot Academy in Bristol, said girls were missing whole days of education until the school started offering free products in conjunction with a scheme called the Red Box Project.

She said: “They weren’t prepared so would leak in a lesson, go home and rarely come back. Or, they were simply too scared to come into school without any products. Since introducing the red box, one girl said to me: ‘I can be a child again, I can run around at lunchtime without worrying; before, I only had one pad to last all day so was always worried about leaking.’