In Cameroon, cuts to US international aid are leaving gaps in services for girls. In conflict-affected regions in particular, education, menstrual hygiene products and safe support services are increasingly lacking.
Every morning, mist drifts over the tea plantations of Tole, on the slopes of West Africa’s highest mountain, Mount Cameroon. Here, in Fako Division in southwestern Cameroon, thirteen-year-old Eposi lives. The separatist conflict that has simmered for years over the country’s English-speaking region has displaced the girl, her siblings and their mother from the village of Ebonji, about 100 kilometres away.
As the eldest child, Eposi shoulders adult responsibilities before and after school. She fetches water, cooks meals and looks after her younger siblings while her mother works on the tea plantation in Tole. Her wages barely cover food, rent and school fees.
When Eposi gets her period, she tears strips from worn-out pieces of cloth that her mother no longer uses, carefully folds them into her underwear and prays that they will get her through the day. They rarely do.
Every month brings the same fear: blood seeping through her school uniform, classmates noticing, laughter that cuts deeper than the fabric she relies on. “I don’t like going to school when I have my period,” she says. “I’m afraid the other children will laugh at me.” She sits stiffly in class, avoiding getting up or drawing attention to herself. Sometimes she simply stays at home.
According to a 2024 survey by UNICEF, the UN Children’s Fund, 70 percent of menstruating women and girls do not have access to basic hygiene products. Seventeen percent of girls miss school because of inadequate menstrual hygiene.
Around one million internally displaced people live in Cameroon, about half of them children, and roughly a quarter of those are thought to be girls. For girls who have already been uprooted by conflict, menstruation has become an additional obstacle to their education.
In addition, according to UN figures, almost 2,500 schools have been closed as a result of the conflict, affecting around 850,000 children. For adolescent girls, this often also means a lack of education about menstrual health.
By 2026, the Cameroonian government had sought to address the problem through its menstrual hygiene management programme by partnering with NGOs. One of them is Vision in Action Cameroon (VIAC). The non-profit organisation sent educators to schools and villages. They taught girls about their bodies and distributed hygiene kits, while training peers and community leaders as multipliers.
Cuts to US foreign aid by the temporary initiative known as DOGE, led by Elon Musk as part of the US government, hit VIAC hard. “We had to cut salaries by almost 50 percent and lay off staff,” says VIAC director Peter Fongeh. “Programmes for people with disabilities, for sexual and gender minorities, and even for safe abortions – all of this was stopped overnight.”
The effects were immediate. Girls once again resorted to unsafe practices: using foam, cotton or rags to manage their periods. “One girl told us she used a sponge to absorb the blood; another said she stuffed cotton inside herself to stop it,” says Fongeh. “That is the reality when education and supplies disappear. Menstruation does not wait.”
Because of the cuts, VIAC had to shut down one of the few hotlines providing information on safe abortions. “We know what negative effects this will have,” says Fongeh. Maternal mortality will rise because women will once again resort to traditional, less effective methods of contraception. Communities are asking for help, but VIAC can no longer respond to their requests. “Cutting funding means cutting lives short.”
The collapse of aid programmes has also destroyed jobs. Sakwe Theophilus works for Cosmo, a faith-based organisation that was funded in part by USAID until 2025 and supports children living with HIV and their families. Theophilus organised events and coordinated volunteers. “I’m struggling to survive now,” he says. “The little I earned fed my family. I thought the work would continue because the need was endless.”
Tallah Thierry worked for a USAID-funded HIV prevention programme. He describes its termination as a “heavy blow”. Formally unemployed, he continues to visit communities as a volunteer to check on young people who had depended on the programme’s support. “I had to start over on the job market without any hope,” he says.
Local NGOs are now scrambling for donations to keep some of the educational work alive. They cannot come close to replacing the cuts. Volunteers and supportive individuals step in wherever they can, but their resources are limited.
“We are keeping afloat with the help of volunteers,” says VIAC director Fongeh. The NGO offers training in the production of reusable sanitary pads. But without funding, even this is difficult.
The United Nations Office for the Coordination of Humanitarian Affairs (OCHA) in Cameroon puts the funding shortfall for hygiene-related assistance this year at US$11.76 million. Without investment, education about menstrual hygiene will continue to decline – particularly in conflict-affected areas where government services are scarce.
Menstrual health rarely makes headlines. It lacks the urgency associated with war or famine. Yet its absence changes lives – through missed schooling, increased shame and rising health risks. The silence surrounding menstruation is itself part of the crisis. Teachers who are often inadequately trained avoid the subject. And girls like Eposi grow up without understanding their bodies, internalising the stigma that isolates them even further.