In 2000, while working for the Aga Khan Foundation in Uganda, Farah Ahamed read about girls who stayed home from school for several days every month. They had no menstrual products, and their schools had little or no sanitation. Some were using leaves, mud, feathers and dirty rags. “What stayed with me was the inequality of it,” she says. “Menstruation itself was not the problem. The circumstances surrounding it were.”

Ahamed is a Kenyan human rights lawyer and writer who moves between London and Nairobi. Eleven years after reading that article, she and her sisters founded Panties with Purpose , a Kenyan campaign on menstrual poverty and education. She later edited Period Matters: Menstruation in South Asia and her first short-story collection is due out in December 2026, titled ‘Queen Victoria in the Basement and Other Stories’.

Her argument is that the world has made periods visible without making them dignified. Call it the Dignity Gap : the distance between what a law, a product or a policy promises and what a menstruator actually experiences.

Kenya moved early. It was among the first countries to remove tax on menstrual products, and in 2017 it amended its Basic Education Act requiring the government to provide free sanitary towels to girls in public schools. For Ahamed, that is where the real test begins. “There is a very important distinction between having a law and experiencing a right,” she says. If funding is unpredictable, products arrive late or in poor quality, or a girl has nowhere private to change, the right exists on paper but not in her life.

Tax cuts have the same limits. A tax-free product can still be unaffordable, missing from rural shops, or of little use without water, a private toilet and somewhere to dispose of it. She also asks whether the saving reaches the buyer or is absorbed along the supply chain. Nor should free products be treated as political gifts. “They are not favours,” she says. “They are part of what a child needs to participate equally in education.”

The product is the door, not the destination

Panties with Purpose began modestly in 2011, aiming to help 1,000 schoolgirls. The sisters asked for new cotton underwear rather than money, partly because they were not a registered charity, and partly because underwear changed the conversation. Pads framed menstruation as a problem girls had to manage. Underwear spoke to health, confidence and dignity.

Within two months, people from more than 60 cities had offered support. Since then, the campaign has distributed 77,716 pairs of underwear to 22,979 girls in 212 locations across Kenya. It has never been only about distribution. Each visit is a full day of workshops on health, hygiene and the reproductive cycle, with drama, lunch and sport. “We want them to feel that they have agency,” she says.

Who controls the conversation

Ahamed’s legal training shapes how she sees the problem. “The law is an octopus; its tentacles reach out to police and colonise even simple conversations about menstruation,” she says.

She saw it in Lahore, while working to install a vending machine for menstrual products in a university women’s hostel. The project stalled because male attendants would need to restock it, and men were barred from the hostel. Getting a pad had become a question of who controls women’s spaces.

The same question now applies to data. Period-tracking apps can help, but cycle data is deeply intimate. Who owns it, who can see it, and what happens when institutions with very different interests can use it? The recent history of reproductive rights in the U.S., she notes, shows how exposed bodily autonomy can be.

Authority over the conversation is still contested , too. After Period Matters was published men sent her articles, explained menstruation on panels and told her what the important issues were. Men have an essential role, she says, “but there is a difference between participating in a conversation and assuming authority over it.”

A rights issue, not a productivity problem

For employers, Ahamed reverses the usual question. Instead of asking whether periods affect productivity, ask what people need to work with dignity.

“It is telling that menstrual leave gets so much attention when we start talking about productivity, but much less when we talk about women’s health and rights.”

Her baseline is practical: free products in workplace bathrooms, just like toilet paper; clean, private toilets and water; somewhere to rest; and flexibility to step away. Period leave should be an option, though she acknowledges the risk that a separate category could medicalise menstruation or become grounds for discrimination. The principle is choice.

At one Pakistani university, she spent three years lobbying a largely male administration before vending machines offering products, pain relief and underwear were installed across campus and in the women’s hostels. Getting a pad without having to ask anyone, she says, is about privacy and autonomy. She also asks who formal policy leaves out. A period-leave policy means little to a woman in the informal economy with no paid leave, no private toilet and no clean water.

Ahamed worries that funders and companies “mistake visibility for progress.” Counting pads distributed or girls reached is easy. It does not show whether a girl had water, privacy, information or a choice.

She points to two shifts funders underestimate. Climate change, through floods, drought and displacement, will make sanitation and privacy harder, yet menstruation is still an afterthought in humanitarian planning. And innovation is broader than technology, for example, Menstrupedia’s comic books, Aakar Innovations’ compostable pads, and artists painting with menstrual blood. Her advice is to fund local organisations, research, education and infrastructure, not just products. “Above all, fund people rather than simply funding solutions.”

From visibility to systems

If she could change one policy across East Africa, Ahamed would make menstrual dignity a properly funded public entitlement, with clear standards and accountability, rather than a charitable project. That means a choice of products, water, private toilets, trained teachers, and boys included in menstrual education.

“A policy that works only for menstruators who already have access to good infrastructure and formal employment isn’t a menstrual-rights policy, it is a policy for the privileged.”

The next stage, she argues, is changing the systems around what we can now see. A girl should be able to ask about her period in class without embarrassment, and find water and privacy in a school toilet.

“We have moved from silence to visibility,” she says. “Now the interesting question is what we do with what we can finally see.”