Hygiene In Emergencies

Report on menstrual hygiene needs (health and sanitation) of women and girls in complex humanitarian emergencies and armed conflict

1. Menstrual Hygiene Needs: The
Overlooked Necessity for Women and
Girls Displaced by Conflict and
Natural Disaster
Maggie Shergill MPH, LSW
Johns Hopkins University,
Bloomberg School of Public Health

2. Why are Unmet Menstrual Hygiene Needs a
Problem?
Lack of menstrual materials and facilities mean serious
constraints to women from developing countries, which
worsens in situations of emergency
•80% of displaced are women and children
•Women in camps live with cultural expectations that
menstruation remains invisible and secret
•Insufficient data and lack of research hinders a focused
and complete intervention
WHO (1983), Bharadwaj & Patkar (2004), WHO (2002)

3. Current emergency responses to menstrual hygiene are:
• Inadequate
• Lack research, qualitative and quantitative data
• Not strategic in design
• Culturally inappropriate
Standard Protocol

4. Gender roles / Status of women
Social taboos/practices
Lack of political commitment
to women’s health needs
Lack of mobility
Lack of privacyInadequate facilities for women
Poverty
Cannot afford
materials
Low education
level
Lack of knowledge of menstruation
and basic reproductive system
Unknown cultural practices
and women’s needs in non-
emergency settings
Disaster or
Armed Conflict
WOMEN & GIRLS
-No materials
-Few facilities
-Social constraints/low status
-Not consulted in relief efforts
Sanitation Sector
Insensitive design for women
Lack of gender research
Lacking practical solutions to
specifically meet hygiene needs
Reproductive Health
Excludes menstruation in RH
services
Relief protocols and manuals
No strategic outline to address menstrual
hygiene needs
No standards or requirements to to meet need or
evaluate services
Lack of data / research
Hygiene Promotion
Basics of menstrual hygiene
Focused on women/girls only
Relief staff can be insensitive
in approach
WOMEN & GIRLS
-Manage menstruation
with limited resources
-Rashes, infections
-Unknown magnitude/
severity of morbidities
and related impact
Coordination?
Understanding
Determinants

5. Further Research is Needed
•Magnitude and severity of unmet
menstrual hygiene needs and
mismanagement of hygiene unknown
•Should occur cross culturally, in
emergency and non-emergency settings
•Provide justification for examining and
changing emergency response policy and
operation
Until then….

6. What are Opportunities for Intervention Now?
•Include menstruation in basic emergency reproductive
health services
•Coordinate menstrual supplies provided with water and
sanitation facilities to ensure compatibility
•Design water and sanitation facilities around the needs of
women (gender mainstreaming)
•Menstrual hygiene promotion and education with affected
community
Sphere (1997), WHO, Harvey et al. (2002)

7. Potential Immediate Low-Cost Solutions
•Incorporate menstrual hygiene into the Reproductive
Health kit – MISP (Minimum Initial Service Package)
»Cloth
»Pads
»Underwear
»Soap
»Basin
Dramatically reduce the immediate burden
placed upon women

8. Potential Immediate Low-Cost Solutions
•Hygiene promotion and education, sensitize entire
community to menstruation
»Dispel myths
»Empower women and girls with education on body
»Include men and boys, avoid feelings of inequality
»Assist men with knowledge on how to care for
wives/daughters
Essential to avoid morbidity, allow for easier
management, minimize disruption from school and
household chores

9. Complete Emergency Response to Menstrual
Hygiene Needs
•Provide sufficient quantities of culturally appropriate
materials
•Educate women and girls on menstrual hygiene and basic
reproductive health
•Ensure access to compatible and appropriate water and
sanitation

10. Thank you!
Any Questions?
Bharadwaj, S., Patkar, A. (2004). Menstrual Hygiene and Management in Developing
Countries: Taking Stock. http://www.mum.org/menhydev.htm
Harvey, P., Bagri, S., Reed, B. (2002). Emergency Sanitation: Assessment and Programme
Design. Water, Engineering and Development Centre. Loughborough University, UK.
Snowden, R., Christian B. (1983). Patterns and Perceptions of Menstruation. WHO. New York,
St. Martin’s Press.
Sphere Project: Humanitarian Charter and Minimum Standards in Disaster Response (1997).
http://www.sphereproject.org/handbook/html/4_ch2.htm
WHO. Water, Sanitation and Health, Environmental Health in Emergencies and Disasters.
http://www.who.int/water_sanitation_health/hygiene/emergencies/sanitation/en/

WHO (2002). Gender and Health in Disasters.
http://www.who.int/gender/other_health/en/genderdisasters.pdf