Managing Menstruation Among Refugee Women in Uganda
Managing Menstruation Among Refugee Women in Uganda

Managing Menstruation Among Refugee Women in Uganda

For more than a decade, the subject of menstruation in humanitarian settings has captured the attention of the international community and humanitarian actors. Now a globally recognized public health challenge, the negative impact of menstruation-associated social stigma and cultural practices on healthy living and educational attainment — as well as the negative effect of improperly … Continued

For more than a decade, the subject of menstruation in humanitarian settings has captured the attention of the international community and humanitarian actors. Now a globally recognized public health challenge, the negative impact of menstruation-associated social stigma and cultural practices on healthy living and educational attainment — as well as the negative effect of improperly disposed menstrual waste products on health and the environment — have been highlighted in recent studies. If appropriate interventions are not put in place in multi-cultural emergency settings, unhygienic practices will not only affect girls’ and women’s ability to fully engage in activities of daily living, but they will also remain vulnerable to several diseases, such as pelvic inflammatory diseases.  In addition, due to the lack of appropriate disposal facilities, some people in refugee camps burn, bury or throw away the menstrual waste products, which negatively affects the environment. For example, it has been an estimated that more than 250 million menstrual pads will clog up European water bodies by 2030. All these mean that women often cannot manage their periods safely and are prevented from leading healthy and dignified lives.

Even with successful interventions, such as the provision of dignity kits for refugee women, a lot more remains to be done. Uganda provides an interesting case study for a better understanding of the challenges and identifying of solutions for girls’ and women’s access to menstrual hygiene management among refugee communities. Improving women’s ability to adequately manage their periods generally falls into three categories: providing appropriate menstrual materials and supplies (such as sanitary pads, clothes, soap, underwear, and clean water); supportive infrastructure (such as private and safe changing rooms, toilets, and disposal facilities); and appropriate menstrual health education.

The provision of appropriate menstrual materials and supplies is probably the most discussed and emphasized component of the above three categories. Despite the attention given to it, a study conducted in more than ten refugee settlements across Uganda showed that most women and girls used old, worn-out clothes to manage their periods. In one particular region of Uganda (Southwestern), more than seven in ten women do not have enough materials for absorbing blood, while almost six in ten girls do not have underwear. A United Nations High Commission for Refugees (UNHCR) needs assessment report found that four in ten refugees in Uganda are in need of clean water, soap, and toilets. Women who need extra assistance in order to utilize the toilets and those who are too weak to collect water by themselves face a greater challenge during menstruation.

Equally important is improving the availability of and accessibility to supportive infrastructure for adequately managing menstruation needs. Refugee women in Uganda face a big challenge getting access to changing rooms for menstrual hygiene management purposes as more than half of the refugees in Uganda are in need of shelter and other requirements. Because of this, many refugees (especially women and children) end up sharing houses with other families — meaning that they would not have adequate privacy during menstruation. The situation isn’t any better for the refugees that settled near the capital city of Kampala, as more than ten households reportedly share a single toilet facility daily. This means that the female refugees living in rural settlements and those in the urban areas all continue to face challenges accessing hygienic toilets and private changing shelters during menstruation.

The third key component of menstrual hygiene management in humanitarian setting is having access to information. Even outside of emergency settings, many adolescent girls and other community members in developing countries lack knowledge on menstruation and the girls are often not prepared for their periods. In Uganda, more than four in ten refugees report that they do not have enough knowledge on menstrual hygiene management. Because of this, some women wash and dry the re-usable pads near the river while others re-use damp sanitary pads. However, menstrual health education programs in the refugee settlements in Uganda are mainly provided at school, which means that only those in schools would have access to health education on menstruation.

It is evident that refugees in Uganda have not been able to adequately manage their menstruation in privacy and with dignity. They face a wide range of barriers during menstruation which affects their dignity, health and wellbeing. But through interventions that fulfill the need for menstrual supplies, adequate infrastructure, and health education, periods can be managed in ways that safeguard the health and dignity of every adolescent girl and woman, even in humanitarian emergencies.