The issue of period poverty in refugee camps is a complex one and, as confirmed by the United Nations High Commissioner for Refugees; “menstrual health is NOT just about sanitary pads or cash to buy sanitary pads”.
Long lines to the toilet, little to no lighting throughout the camps, no locks on toilet doors, peeping Toms, sexual and gender-based violence, unhygienic toilets, and irregular access to period products are just some of the realities faced by many women living in refugee camps across the globe.
There are at least 79.5 million forcibly displaced people around the world. Of those, 2.6 million live in official refugee camps, whilst millions more are living in informal camps or urban areas. Women make up half of these populations, yet access to period products in these environments is woefully lacking.
INCONSISTENT ACCESS TO PERIOD PRODUCTS
A 2019 survey conducted by the United Nations High Commissioner for Refugees (UNHCR) found that, on average, only 55% of women’s needs were met with regard to period products, and only 37% for underwear.
When women do not have access to the products needed to manage their periods, they are forced to go without, preventing them from carrying out daily activities such as waiting in line at food distributions, getting water, or attending language lessons or psychosocial support services offered by NGOs. Alternatively, women will use makeshift pads made of old rags and other objects found in the camps, adding another potentially dangerous health risk to their already high-risk situation. NGOs on the ground fill in the gaps where they can, but a lack of period products is only one of many issues caused by period poverty in refugee camps.
It is not uncommon for adolescent girls who attend school whilst living in a camp to miss class if they are unable to manage their periods. A survey of girls living in the Nakivale refugee settlement in Uganda found that 43% of girls miss school during their periods. This is in large part due fears of accidents, teasing from peers, and the staining of clothes.
Reusable products - often touted as a solution - are not always an option, given the fact many women and girls in camps do not have access to washing facilities to keep their reusable pads clean. “Even in camps where residents have regular access to toilets and washing machines, women will not use reusable pads if there is not a private place to dry them,” says Hayley Smith, Founder and Director of Lifting Hands International.
This highlights the importance of considering camp conditions and engaging with the women set to receive period products in order to assess their needs. A survey of women in camps in Myanmar and Lebanon found that once women had learned how to use disposable pads, they were preferred to reusable ones. The main reason cited for this was increased confidence when it came to leakage protection during daily activities.
TOILETS ARE NOT FEMALE-FRIENDLY OR SAFE
Whether or not women have the period products they need, problems of toilet access and physical safety remain widespread. Limited numbers of toilets in overcrowded camps result in lengthy waits in the queue – an added stress when trying to prevent leakage whilst bleeding. Additionally, toilets are not separated by gender, which results in lack of privacy, vulnerability to sexual harassment, and assault. This occurs both in the queue and in the stalls.
Women living in camps are often up against the requirement to maintain modesty. This prevents women from relieving themselves in whatever place, unlike their male counterparts. Ironically, these demands for women’s modesty restrict them to using toilet facilities where that modesty is regularly violated. It is important to note that camps are typically equipped with squatting toilets, resulting in greater lower-half exposure than the Western counterpart.
STIGMAS SURROUNDING MENSTRUATION - AN ADDED STRESS
Stigmas and embarrassment surrounding menstruation run high, making the lack of privacy in toilets and tent dwellings a major issue. “Women do not want men seeing the pads at all,” says Giuliana Colella, Director of Operations for Lifting Hands International’s refugee community centre in Serres, Greece. Instead, “female residents regularly ask for dark plastic bags or paper towels to hide them on distribution days”.
Furthermore, cultural beliefs surrounding fears of others seeing used pads are also held. This fear extends to the staff tasked with maintaining the toilets then seeing the used products. Women often go to great lengths to dispose of used pads, for instance, getting up early to bury them in a secluded location, or putting the pads directly into the toilet. The former drives women to venture out alone, rendering them potential targets of sexual violence, whilst the latter adds to toilet backups and desludging problems.
A MULTIFACETED SOLUTION
This is a multifaceted problem, requiring a multifaceted solution.
First, period products must be part of consistent aid and distributions. Most importantly, the women receiving the pads must be surveyed or consulted, so that they are provided with period products that they are likely to use. This must be carried out regardless of whether camp conditions warrant a cheaper option, like reusable pads.
Second, education about and combating the stigmas of menstruation must be provided to both female and male camp residents, staff, and volunteers alike. Educational initiatives must include how to use and properly dispose of period products.
Third, toilets in camps need to be constructed in a female- and period-friendly manner: locks on the doors, fully enclosed and well-lit, with bins for proper waste disposal, and enforcement of female-only toilet facilities.
The final aspect of a multifaceted solution would be to expand the understanding of these needs into wider society in order to create a more enlightened culture around menstruation and period management. These solutions are already being offered by women living in refugee camps, humanitarians, and scholars, with the hope that such awareness will lead to person-centered and women-focused solutions to improve the less-than-ideal living situations of female residents of refugee camps.
Melissa Robel holds an LLM in International Human Rights from Northwestern Pritzker School of Law. She currently manages a nonprofit, Pads 4 Refugees, which helps NGOs on the ground deliver pads to women living in refugee camps. She also works as an artist and teaches English Language Arts at a middle school in the Bronx, New York.