Trevor Mundel, MD, is President of Global Health at the Bill & Melinda Gates Foundation. He leads the foundation’s efforts in research and development of health solutions, including vaccines, drugs, and diagnostics.
NASA recently announced the discovery of liquid water on Mars, raising hopes that within a decade we might know whether or not we're alone in the universe. The proof came from chemical analysis of Martian salts, conducted by spectrometer, from the Mars Reconaissance Orbiter.
The invention of a spaceship that can make sophisticated discoveries 140 million miles away is an extraordinary feat on the part of the human race. But there are other extraordinary innovations that don't require a billion-dollar piece of equipment. Sometimes, all they require is stuff that's just lying around.
Two people who know this well are Megan Mukuria and Dr. Lawino Kagumba, whose Kenyan organization ZanaAfrica, supported by Grand Challenges Canada and the Bill & Melinda Gates Foundation, is using free agricultural byproducts to manufacture sanitary pads that poor people can afford. Inexpensive pads like these might not only solve the problem of low school attendance by adolescent girls in Africa but ultimately be a key to empowering millions of women across the developing world.
Mukuria discovered the problem of expensive pads almost by accident when she was working for Homeless Children International - Kenya. She was going through the organization's budget and realized that, after bread, the most expensive line item was sanitary pads, even though there were relatively few adolescent girls in the program. So she started asking questions.
What she found out was that modern sanitary pads are made using expensive pine fiber from Norway or North America, which puts them out of the reach of millions of Africans. In Kenya, which actually has good pad coverage compared to other African markets, 65 percent of women and girls still lack access to pads. Instead, they make do with unhygienic alternatives - unsterilized cloth, newspaper, bark, banana leaves, and even dung - all of which can cause serious health problems.
But the unavailability of sanitary pads isn't just a health issue; it's also an education issue. Since these alternatives are not only unhygienic but also ineffective, girls using them often choose to stay home when they're menstruating - which means that they can miss more than a month of school every year. As a result, many drop out altogether. This only adds to the shame menstruating girls are made to feel and further damages their self-esteem.
A number of people have attempted to develop alternatives to pine-fiber pads, but it's proven difficult to make an inexpensive, high-quality product that can be manufactured on a large scale. So Mukuria and Kagumba, a materials scientist, began experimenting with different formulations to address those challenges. They started by tossing things in the blender - literally in Kagumba's kitchen blender - and ultimately, with the help of a Grand Challenges Explorations grant, developed an effective pulp blend. (The patent is pending for the formula they finally settled on, so they haven't yet revealed just what that pulp is made of.)
But it's not just the way the pads are made that is innovative; it's also the way they're being delivered to women. Here again, Mukuria and Kagumba found a solution that was hiding in plain sight.
At first, ZanaAfrica tried training health workers to sell the pads, but it turns out that what makes a good health worker doesn't necessarily make a good saleswoman. So they turned to a path with a time-honored history in Kenya: roadside kiosks, where women buy many of their daily necessities. Even when the pad was widely available, though, Mukuria and Kagumba realized that they needed to make it popular. After doing market research, they landed on the name Nia, which means “purpose” in Swahili. Now they're raising brand awareness by working with grocery stores and supermarkets - the same strategy commercial products use to boost their sales - and kiosk business is starting to take off. In other words: When ZanaAfrica tried to create a new way to distribute Nia, they were less successful. Now that they're piggy-backing off detergent and Coke, though, they're reaching many more women.
In the long run, Mukuria and Kagumba see their work sweeping across Africa, reaching past education and health into the heart of how tens of millions of women and girls see possibility. It's all part of what Mukuria calls a revolution of the obvious. Innovation isn't limited to big discoveries that advance interplanetary research. Simply finding new ways to look at what's in the backyard can change lives here on earth.