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Womens Menstrual Hygiene Needs in Emergencies

Introduction - womens preferred choice of


Responding appropriately to womens material needs to be matched with
menstrual hygiene needs in emergencies is what is available locally, or what can
an essential component of water, sanitation be procured from outside
and hygiene promotion programmes. It can - questions about choice of material
help to address: should include colour dark colours
gender equality in considering the are generally preferred, and some
different needs of women and men colours have specific meanings in
womens participation in the some cultures and should be
sensitive dialogue that is necessary avoided
to address this issue
womens specific concerns with
In Eritrea, an international NGO
dignity and privacy
approached a womens organisation in
the capital to assist in choosing the most
Unfortunately not enough attention has been
appropriate material to be distributed to
paid to menstrual hygiene in many WASH or IDP women in camps. As the women in
girls education programmes. But whenever the capital mainly used disposable
womens menstrual needs are not met, napkins a recommendation was made to
women are faced with numerous difficulties. distribute one pack of napkins per
Each month they have to cope with several woman. However, the women in the
days of reduced mobility, shame, physical camps tended to use old clothes for
discomfort, disruption of essential daily sanitary protection. After the distribution
activities, as well as health risks. took place, staff noticed the goats in the
camp walking around chewing used
Key considerations napkins, and some women were
observed at nearby river attempting to
Thorough Assessment of Need wash them.
Personal hygiene is one of most womens
priorities, and yet women do not always find Procurement, Targeting, & Distribution
it easy to express their needs. They may Durability if we are only able to distribute
feel too embarrassed to discuss hygiene one piece of cloth per person, durability
with relief workers, and menstruation is seen becomes important
as a taboo subject in some cultures. The Absorbency generally softer materials
subject needs to be approached sensitively, absorb menstrual blood better than hard
by female public health workers, taking the material, but thick material requires more
following factors into consideration: water for washing which may be in limited
- hygiene practices and preferred supply
materials differ, from country to Underwear some materials require the use
country, between urban and rural of underpants or a cord tied round the waist.
areas, and between age ranges You may need to consider if distributions of
within a community these additional items are needed

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Local suppliers should be considered before
bringing in materials from outside, both as
support to the local market and because the
beneficiaries are likely to be familiar with the Distributions need to be handled sensitively,
materials on offer accompanied by basic information (written,
All women of child-bearing age should be pictoral, verbal) about the items provided,
targeted, but womens hormonal balance even if discussions have been had with
can be affected by stress and malnutrition, women.
so care should be taken in making
assumptions about who is of child-bearing Where markets are functioning, it may be
age. A mass distribution of cloth that could preferable to provide women with cash or
have other purposes than simply for vouchers instead of a more traditional
menstrual protection is preferable to narrow distribution.
targeting.
Rather than doing a traditional
distribution, Oxfams team in Banda
In 2007, the Chad programme in Kerfi Aceh after the 2004 Tsunami organised
targeted both IDP and host communities. a market for women to choose their own
The Oxfam team consulted traditional underwear. Women were given vouchers
women leaders from both communities on for sets of underwear, and on the
womens personal hygiene needs, and a arranged day the goods were brought to
dark brown cotton material was chosen. a large tent staffed by a female team.
Women and girls from 11-12 years of age The underwear was supplied by a local
were registered. The Chiefs and their retailer in different colours and sizes, and
secretaries assisted the women with the the women could choose which items
registration process since all the women they wanted.
leaders were illiterate. It was a relief to see
both IDP and host community women who
were generally very hostile to one another
Personal Hygiene and Privacy
sitting together and making jokes as they
Women living in seclusion pose additional
prepared the hygiene kits. The younger
challenges for Public Health staff. If they are
women taught the older women how to use
unable to leave their living areas then
the scissors, while the women leaders
female public health staff will need to
showed the younger girls how to use the
negotiate access to their living areas to find
menstrual cloth. During the distribution
out their menstrual needs and problems. If
Oxfam female staff held discussions with
the provision of communal latrines and
the women on the importance of good
bathing facilities is the only option then the
personal hygiene and health risks
privacy of these facilities is the most
associated with poor hygiene during
important consideration.
menstruation.

Some of the positive feedback was around In Sri Lanka after the 2004 Tsunami,
the involvement of women leaders in the Oxfam constructed communal latrines in
process, the fact that household registration camps. A few latrines in each block were
enabled the distribution to reach target replaced by washing cubicles for the
groups, and that the distribution was not specific use of menstruating women to
rushed, allowing time for questions and wash in. No one consulted the women
discussions. The items, underwear, and though, and they didnt go in them,
material were appropriate and the women because they didnt want everyone to
appreciated the kit. However, women know they were menstruating.
leaders recommended that all women
should be targeted. They explained that it
was difficult to ascertain the ages of older
women, and pointed out that the cloth could
be used for other purposes than just
menstrual protection.
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Following consultation with those living in Washing slab for menstrual cloths inside
camps after the Pakistan earthquake in a screened block and washing lines for
2005, Public Health Engineers worked drying the cloths.
with Public Health Promoters to design
and build womens facilities that provided Disposal of menstrual material
privacy. Womens washing and bathing Distribution of disposable sanitary pads at
facilities were built with additional spaces the beginning of a response can be used as
with plastic sheeting walls that created a temporary solution, provided that
more privacy for washing and drying appropriate disposal solutions are put in
menstrual cloths. place. But in places where refuse systems
are poor or non-existent, disposal of sanitary
In one camp the women appreciated pads is a challenge. If disposable sanitary
having separate units within the latrine pads are to be provided then facilities for
blocks to wash and dry their menstrual effective collection and disposal are
cloths. The separate units were essential.
constructed inside the existing screened
latrines and bathing block structure.
In the 2005 Pakistan earthquake response,
Women were also happy to socialise in
women disposed of used sanitary pads in
these separate units.
the pour-flush toilets. These frequently
Another consideration is whether to blocked, and Oxfam had to hire people to
distribute additional soap for washing unblock the toilets each time. The women
sanitary protection material, and to take into explained that the toilets were the only
account how and where the material will be private place to dispose of used sanitary
dried. Often, menstrual cloths will not be pads. The problem was solved when
hung out to dry in the open but will be Oxfam team provided waste bins and
hidden under other washed clothes. It may advised women to use them instead.
be appropriate to distribute washing lines to
hang up in private spaces where cloths can
be dried.
In Haiti during the hurricane response in
2008, the pre-packed household/
personal hygiene kit contained six
packets of sanitary pads. However, the
Public Health Promotion team discussed
disposal of used sanitary pads
beforehand. Women were advised not to
throw used pads out in the mud or with
other garbage but to bury them.
Communal pits were dug for this
purpose; this worked well with no signs
of used pads visible around the shelters.
This was a useful temporary measure
3 until field staff had time to consult
affected women and source materials
appropriate to their culture.
Monitoring
Monitoring mechanisms should be put in
place from initial logistics ordering of
materials for menstruation through to post-
distribution and the feedback used as much
as possible to improve support during
menstruation for women.

i
Jeanette Cooke, Practical Intervention to
meet the menstrual Hygiene needs of
Schoolgirls A case study from Katakwi,

Uganda Msc. Thesis, Cranfield University,


UK, 2006.
Tania Verdemato, Responding to Womens

Menstrual Hygiene Needs in Emergencies


Suzanne Ferron 2004

A case Study from Katakwi, Uganda Msc.


Thesis, Cranfield University, UK, 2005.

Vulnerability and socio-cultural


considerations for PHE in emergencies
Technical Brief