According to the United Nations Refugee Agency, women comprise 49% of refugees worldwide. The number increases further if we consider those who are affected but not displaced. Menstrual hygiene management (MHM), which is already under the pressure of a culture of silence and taboos, further becomes an issue of concern for people trapped in conflict situations.
Here are 10 reasons why the conversation on menstrual hygiene and health, and communication becomes critical for menstruating people in conflict areas:
1. Conflict areas often lack adequate facilities for menstrual health management. Lack of WASH (water, sanitation, and hygiene) facilities at public places, schools, and health centers sharing toilets by multiple families, or the possibility of injuries amongst women, or the overall lack of safety in being able to regularly change menstrual products poses limits on a person’s privacy. This primarily affects menstrual health management by not allowing access to a private, clean and dignified experience.
2. Even with healthy habits, the absence of means of disposing of sanitary pads, or no separate toilets,lack of water for hygiene purposes can degrade existing hygiene habits.
3. Menstruation is a topic of taboo in many cultures. Already, there is little-to-no communication among families about menstruation, and also a lack of inclusion of menstruation hygiene habits in school curriculums. Above that, the inherent restrictions on dialogue and expressing voices in conflict areas further hamper the possibilities of dialogue on menstruation.
4. Material aid for survivors in conflict areas is important because routinely-needed items like sanitary cloth or pads, underwear, soap are left behind. But, often the focus of resource teams and rescue operations is only on providing aid rather than providing menstruation-related education and skills. The integration of menstrual hygiene management in existing programs and responses are lacking, and it is crucial for different sectors involved in operations to coordinate.
5. We know little about menstrual health management in conflict-ridden areas. What are the real struggles in conflict areas? What are the context or country-specific struggles? In what ways do menstrual hygiene habits get restricted? There is an urgent need for the generation of evidence through contextual qualitative research that can help us understand the problem in-depth and then taking appropriate action.
6. Even if menstrual hygiene habits are demonstrated as part of education in conflict areas, the lack of resources can demotivate people in bringing those habits into their daily routine. So along with sustained dialogue, problem-solving along with people in existing situations and teaching them life skills is much needed. For example, women might have lost control over their finances while being displaced in a conflict zone and simply talking about money needed to purchase sanitary pads can be a matter of embarrassment. In such cases, problem-solving through overcoming shame and teach ways to communicate can be helpful.
7. The proportion of men in rescue-missions is generally more. This can bring in gender biases in communication and aid methodology. Breaking the gender binaries is hard but teaching men to communicate effectively when it comes to menstrual health discourse is important.
8. The stress and mental health trauma due to living in conflict zones can hamper a person’s free expression of menstrual issues. The rescue staff also needs to learn to create enough safe spaces and empathetically listen, apart from solving problems or simply giving suggestions.
There have been attempts where organisations have developed communication material that is especially sensitive to the needs of menstruating people in conflict areas, for example, the toolkit developed by Columbia University. More such attempts in research, training, disaster preparedness, and communication need to be promoted in order to holistically execute an inclusive period paath (lesson).
Note: The author is part of the current batch of the Writer’s Training Program.