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Freweini Mebrahtu said that when Dr. Lewis Wall met her in Ethiopia and learned of her struggling project to save girls from dropping out of school by giving them reusable sanitary pads, Wall’s first question was: “How can we give more pads?”

Wall, a Washington University obstetrician and professor, and his wife, Helen Wall, were inspired upon their return from Africa in the fall to create the St. Louis-based charity Dignity Period with an aim to help distribute pads to 50,000 school-aged girls in its first year.

“We want dignity for girls and women of Ethiopia — period,” Wall said.

Menstrual supplies and even underwear to attach them to are unaffordable for impoverished families in Ethiopia. Some try to make due with strips of old cloth and even dry grass. Because menstruation is considered an embarrassing and taboo subject — many believe menstruating girls are impure — girls miss as many as five days a month from school to avoid accidents.

They fall behind in their studies and even drop out of school altogether, ruining their chances for careers and escaping poverty.

Mebrahtu says as many as 18 million girls and women in Ethiopia lack access to sanitary pads.

According to UNICEF, about one in 10 African girls either skip school during menstruation or have to drop out of school because they don’t have sanitary pads.

It’s not surprising that Wall, 64, responded in full force. The doctor and anthropologist has long worked to improve the social and medical conditions of women in sub-Sahara Africa — providing medical care, conducting research and educating health care providers. Twenty years ago, he founded the Worldwide Fistula Fund, to help the 3 million women who suffer with an obstetric fistula — a childbirth injury that can lead to a heartbreaking life of isolation and shame. Nearly three years ago, he opened a 42-bed hospital in Niger to care for women with fistulas, which can be easily repaired with surgery.

Wall spent eight months in Ethiopia last year as a Fulbright Scholar at Mekelle University, working to improve residency education in obstetrics and gynecology. That’s when he and his wife learned of Mebrahtu’s factory, where the pads are made, and her passion to make a difference in girls’ lives. The Walls knew others would be as eager to help as they were, if they could just make them aware.

“Here in the land of plenty, it’s stunning to hear that girls have to drop out of school because they don’t have any menstrual protection,” Lewis Wall said. “To hear that you can’t get a tampon or pad or underwear, and therefore your life goes out the window, is unbelievable.”

For just $4, each girl can get a kit that consists of four pads that last 12 to 18 months, two pairs of underwear and two bars of soap. “You can do huge things for someone at a trivial cost,” Wall said.

Mebrahtu’s own story shows how pervasive shame and fear is about menstruation. Mebrahtu, 50, grew up in a small town in the Tigray region of Ethiopia. Her father lacked schooling, but he worked hard to become a motel owner and make sure his children were educated. Yet, Mebrahtu was shocked and confused when she first got her period.

“What girls overhear from grownups was that girls have their periods because they are being bad, and therefore are ready to be married,” she said.

Mebrahtu wanted to hide so no one knew, but she learned her friends were experiencing the same thing. They would use old pieces of clothing as pads and brought large scarves to cover themselves if their clothes became stained. She never dared to ask questions about things she didn’t understand like irregular periods and cramps.

Mebrahtu had the opportunity to come to the U.S. and study at Prairie View A&M University in Texas. She remembers her first visit to a drugstore, with its overwhelming choices of sanitary pads. From that moment on, she would wonder about girls back home.

She earned her chemical engineering degree and worked in the U.S. for 10 years. After the communist regime fell in Ethiopia, she returned home and was sad to learn nothing had changed for adolescent girls. “The stories I heard were shocking — digging a hole and squatting over it for three to five days, or wrapping themselves in strips of cloth,” Mebrahtu said. “I needed to figure out a solution.”

She developed and earned approval to sell a simple and effective cotton pad with a waterproof lining. The pads are environmentally friendly, easy to wash and cost far less than single-use disposable pads. In 2009, Mebrahtu received a loan and built Mariam Seba Sanitary Products Factory, named for her daughter. The factory in Mekelle employs more than 40 local women and produces more than 100,000 pads a year for girls across Ethiopia. The unmet need, however, is enormous.

“The challenge we still face is that we are not able to reach the girls who need our product most because they cannot afford to buy it even though the price is reasonable,” Mebrahtu said. “That is why we need help from an organization such as Dignity Period to reach these poor girls as fast as we can.”

Dignity Period has a website and mailing address to accept donations. Its inaugural fund-raising gala well be held April 24 at the Missouri Botanical Garden. Mebrahtu will attend, along with the president of Mekelle University, which will distribute the pads to girls in secondary schools, provide education and conduct research to assess misguided beliefs and better target interventions.

“We need our debutante ball, our coming-out party as an organization,” Wall said. “We want to show the community what we’ve got and what we hope to do.”