Ljungberg, J94, emptied her suitcase on a table, and out tumbled cotton-candy-colored packages of disposable pads and tampons, as well as reusable cotton pads and other supplies. The girls marveled at the softness of the pads. They glanced suspiciously at the tampons. “They had never seen some of this stuff, and they had a ton of questions,” Ljungberg said. And they wanted to know about more than just the products themselves. How does menstruation work? they asked. Can you have sex during your period? In time, the visitors asked the girls about their own first period, and about how they dealt with menstruation.
The team had come to Nepal as part of Giving Wings, the Swedish foundation that Ljungberg launched in 2010 to address the problems that women in many parts of the world experience when they lack the resources to care for themselves during menstruation. Through grant funding, Giving Wings supports efforts to distribute menstrual health products and educate women in developing nations, and invests in new products and technologies in the hopes of improving the lives of women across the world.
Ljungberg sometimes goes into the field to conduct research, as with her recent work in Nepal. That trip was part of a three-year pilot project that Giving Wings is undertaking in partnership with a new philanthropic organization called the Maverick Collective that works to fight poverty among women and girls. Over the course of their stay in the country, the Giving Wings team put questions about menstrual health to one hundred Nepali women and girls. Almost everyone, from every socioeconomic slice of life—urban, rural, Christian, Muslim, Hindu, different ethnicities, different castes within those ethnicities—said they had never discussed menstruation before. They said that before they’d gotten their first period, they hadn’t even known what one was.
Unfortunately, these revelations were not unexpected. Especially in low-income countries, but even here in the United States, menstrual health is often a neglected and poorly understood topic. A 2015 report by UNICEF and the World Health Organization estimated that at least five hundred million women lack sufficient resources to manage their periods. Those resources include basic biology education but also clean water and soap, a regular ration of absorbent materials, a means for either laundering used supplies or disposing of them, and enough privacy to handle everything with dignity.
In the absence of all that, many women resort to practices that range from the ineffective to the unhygienic. A study in India, for example, found that 88 percent of women simply use sand, ash, wood shavings, newspapers, leaves, or other alternatives. Such improvisations can lead to infections, shame, and a spiral of medical consequences. The practical challenges of menstruation can affect a woman’s life in other ways as well. In many developing nations, for instance, girls often stop attending school when their period starts, either because they don’t have reliable means to manage menstruation or because they can’t count on finding a private bathroom during the day. And a survey in Kenya found that one in four fourteen-year-old girls had engaged in transactional sex to acquire money to buy pads.
There’s also the fact that many cultures still stigmatize menstruation. During her time in Nepal, for example, Ljungberg traveled into a remote western region to learn more about chaupadi, a set of restrictions imposed on women while they menstruate and for ten days after giving birth. Out of fear that they will contaminate anything they touch, women are exiled to sleep in unheated huts, usually too small to stand in. It’s not uncommon for women and their infants to die from exposure, smoke inhalation, or even wild animal attacks during chaupadi.
Taken together, the hardships that plague women because of their periods amount to a health crisis that most of us don’t even know exists. “We’ll never have gender equality without talking about menstruation,” Ljungberg said.
Ljungberg launched giving Wings with her husband, Johan Ljungberg, E95, when they were still in their thirties. They were in the thick of raising a family in Stockholm and building their careers. She had started designing medical devices in the United States, with a biology degree from Tufts and a master’s in biotechnology. She went on to work in management consulting for McKinsey and got an M.B.A. at Tuck, and is now a partner at Influence Film, which supports documentary filmmaking. Johan studied civil engineering at Tufts and also worked in consulting before returning to the family business in Sweden. He is chair of the board of the investment company Tagehus Holding. What they both really longed to do, though, was to work for change in the world.
So Cristina spent a year exploring ideas with the Philanthropy Workshop, an organization that serves budding philanthropists who want to figure out how they can help. “The question I was asking was: What are some of the most significant challenges facing the world today, and, of those, which are actually ripe for change?” Cristina said. “Menstrual health came up as the most overlooked, underfunded issue that’s closely linked to so many others—water, sanitation, women’s rights, fertility, education, child marriage. But nobody was really talking about menstrual health.”
Seeing their opportunity, the Ljungbergs founded Giving Wings. With funds from a family business, the nonprofit foundation works to improve women’s lives generally, but its special focus is on menstrual health. It gives grants to groups that provide menstrual health resources to women, and that educate women about their own bodies. The foundation also invests in companies and organizations that promote menstrual health. Giving Wings has current grants and investments in Kenya, Uganda, Pakistan, and Nepal.
Progress on an issue as complex and long neglected as menstrual health does not come quickly, of course, and the way forward varies from one community to another. For that reason, the foundation directs support to local leaders. “As funders of these projects, we’re super sensitive to the fact that we don’t have the solutions,” said Gerda Larsson, the managing director of Giving Wings. “We have to trust their solutions.”
One Giving Wings success story is its work with AFRIpads, a company founded in a rural village in Uganda. Giving Wings invested early in the company—which now employs one hundred fifty Ugandans, about 90 percent of them women—to manufacture reusable cloth pads. More than a million pads have been produced so far. A two-pack sells for about $2.50, which, because the pads can be used for twelve menstrual cycles, is far less than the cost of disposable pads on the market. The kits are sold in Uganda, Kenya, and Malawi and are also distributed worldwide by nonprofit organizations and relief agencies.
AFRIpads was “a small investment,” said Ljungberg, who sits on the company’s board, “but for me it’s been a huge learning journey. You’re not competing with other menstrual health products, you’re asking someone to buy a product for the very first time.” The challenge helped her understand that to do the kind of philanthropy she wanted, to make the kind of change she’s after, she couldn’t limit herself to traditional philanthropic practices. “I think that small funders like me who want to engage with an issue should be willing to have a higher risk threshold, to support things that others aren’t ready to fund,” she said.
One such initiative is the Cup Foundation, a Kenyan organization that Giving Wings helps fund. The group provides girls with a silicone menstrual cup, a bell-shaped device that is inserted into the vagina to collect menstrual blood. Each cup can last up to ten years, saving women thousands of dollars over the product’s life. According to CEO Camilla Wirseen, the Cup Foundation distributed five thousand cups in its first year, and it’s aiming to reach a million girls eventually. “Cristina was the first person to support us, and without it, we would probably be a year behind or more,” Wirseen said.
In addition to providing women with menstrual health products, Giving Wings is helping to develop technologies that can improve lives. For instance, the organization is backing a smartphone app called Clue, which helps women track their menstrual cycles and discern previously overlooked patterns, such as when premenstrual symptoms tend to start, and when between-periods spotting tends to occur. The app, which is the work of a Berlin-based company, has been downloaded in one hundred eighty countries. It allows women to manage their fertility more effectively, and gives them a convenient way to share information about their cycles with their partners and health providers. Researchers at Columbia University are crunching data from the app’s users to suss out connections between women’s menstrual cycles and chronic diseases. Giving Wings is also investing in Menstrual Health Hub, a new website, scheduled to launch late this year, that will serve as an information clearinghouse for menstrual health field workers, including researchers, policy specialists, and grassroots organizations.
For all these early successes, Ljungberg remains focused on the work ahead. She recalled a recent conversation with a midwife, who said that because her own menstrual cup was uncomfortable, she used a diaphragm in its place. “And then my head exploded,” Ljungberg said. “I want to invent a menstrual cup that’s also a diaphragm, a tool that women and girls can use to manage their menstruation and their fertility. And I want to find a way to manufacture it for ten cents.” That might be a crazy idea, she acknowledged, “but maybe it’s just worth asking the question.”