Acknowledging the female refugee: the availability of period products and education about periods in refugee camps.
In previous papers included on the BizGees website, there is work on antenatal care, PTSD and other issues regarding female refugees and the trauma that they experience. However, there is one experience, universal to all women, refugee or not, which they regularly experience and is such a basic need. That is having your period. Despite this, the service of menstrual care is not provided for all female refugees even though this is a core issue that speaks volumes about the experience of being a female refugee. In a paper conducted by the United Nations Population Fund (UNFPA), it is acknowledged that “menstruation is a critical issue of human dignity, and the protection of dignity is an important principle of human rights.” This demonstrates that by acknowledging a female refugee’s need for menstrual care, you are acknowledging her human rights. If we ignore this issue of menstrual care, we are ignoring the human rights and dignity of female refugees who should be entitled to the right care and sufficient access to period products.
Lack of resources:
From conversations with friends who have worked with refugees and from research, the state of menstrual care amongst refugees is not adequate. After speaking to Brooke Bacigal who has worked with refugees and from my own research, the access to menstrual products is usually quite bad. The United Nations High Commissioner for Refugees (UNHCR) reported in 2019 that 55% of girls in camps had the right products for their menstrual needs and 37% had satisfactory access to underwear. Although there are resources that may be purchased from other refugees within camps, the lack of menstruation products is so rife that, instead of pads or tampons, women are being made to use rags or ripped up old clothes as an alternative. Other research has shown that girls feel that toilets are not female-friendly or safe. In the UNFPA’s paper, it was recorded that 31% of women and 33% of girls responded “no” and that they were not worried about being seen in toilets in refugee camps. 28% of girls and 23% of women said that there was no covered bin in the toilet which would be needed to dispose of used menstrual products. This means that girls and women who are experiencing their periods in refugee camps are not only in need of period products, but they cannot even dispose of them discreetly or hygienically.
Lack of education on menstruation:
By not accommodating girls and women with periods, and not moving to make the correct resources more readily available, those who are menstruating cannot function “normally” and will shut themselves away. They will experience this big change in their lives whilst also having to juggle and navigate the environment of a refugee camp. This starts as a result of miseducation or a lack of education surrounding menstruation. Many children in camps start to menstruate without having been taught about menstruation. In the UNFPA’s study, it was found that less than half of women and girls are informed about their periods before their first menstruation. Part of this is because many children are separated from their families before entering refugee camps and will reach the age of menstruation during the time that they are separated. Learning about menstruation is not just about the process itself, but it is also about how to take care of yourself, how to use period products and how to avoid UTIs and disposing of menstrual products correctly. From my own experience in a school, I often went into bathrooms that were left dirty with menstrual products being left out and not disposed of in the correct bin which only shows that there is not sufficient education in schools let alone in refugee camps where women and girls are not being given sufficient information about their periods. Schmitt and Clatworthy conducted a survey of women in camps in Myanmar and Lebanon. They found that when women and girls learned about how to use disposable pads, they preferred to use them over reusable alternatives. When women and girls use certain alternatives, it is not because they prefer to use them but it is because they are simply inaccessible to them either through pure availability or through education.
Despite this, there is still a stigmatisation of periods among some of those who are teaching their children about menstruation. The aforementioned study by UNFPA gathered responses from girls saying that they were not only told that menstruating was unclean, but also that they had to act and behave in a certain way because they were on their periods. This can be from eating or drinking certain foods to preventing daughters from sports or getting angry with their daughters if they make sudden moves. The UNFPA report also said that “Some girls become victims of child marriage since menstruation is considered as a signal of being ready for marriage and motherhood that can be considered as harmful norms and practices.” When women and girls aren’t educated about how periods are natural, they are left open to harmful information. In fixing this problem, we are not just seeking to provide education within refugee camps as well as resources, it is about making sure that information about menstruation becomes not only universally available but universally enforced.
What does this say about the presence of female refugees?
Not providing resources and not educating refugees on periods leaves them vulnerable to stigma and is also an added weight when they are already in a vulnerable and stressful position. It means not acknowledging their human right to period products and care whilst menstruating and also stops them from integrating with society or being able to live safely and hygienically. If girls also aren’t aware of their periods, it may also suggest that they are not aware of sexual reproduction and contraception. Therefore, in seeking to provide resources and education for these girls and women, it means recognising their human right to menstrual products and it also means enabling them to function within society and taking away this added source of stigma and anxiety.
What are work is being done to fix this?
Despite all of these problems, UNFPA reported that over half of women and girls in these camps are willing to learn about menstruation: 58% of girls and 60% of women. This signifies the importance of ensuring that there are not only sufficient resources but sufficient education for women and girl refugees who are not currently receiving support whilst menstruating. The United Nations High Commissioner for Refugees seeks to source information about refugees and their menstrual care which will help us figure out how women and girl refugees need to be helped. Some friends have signed up with companies such as care4calais or Refugee Community Kitchen to distribute packages with period products. Another company doing this on a wider scale is Anera. They work with Days for Girls (DfG) who make kits with sustainable pads and liners that are sustainable, washable and reusable. Anera distributes these kits to underdeveloped towns and villages in the north of Lebanon. These kits also contain waterproof bags so that they can stow away their liners and underwear discreetly. Another company is Petal. They work towards tackling the United Nations Sustainable Development Goals which include quality education and gender equality. In working towards this, they ensure that girls are educated about menstruation and the use of pads. They also highlight how quality education and education about menstruation as well as the distribution of menstrual products are connected because of the way that girls will miss out on education because of time off taken when they are on their period. They also enable refugees by establishing “community owned micro-enterprises, which make and sell the sanitary towels at 10% the cost of commercial alternatives”. This means that they are also reducing period poverty and poverty in general.
Important factors to consider and what more can be done:
Although these projects are fantastic and a great start in the right direction, there are still many existing problems that we need to consider if we want these projects to be effective. The first, with regards to distribution, is that men are often the ones collecting things from distribution sites so it may be more difficult for women to get these supplies when they need them. Volunteers won’t be able to get them to the women themselves because they need to “respect their tents/sleeping places like you would people’s homes” (Harriet Nokes, volunteer with care4calais and Refugee Community Kitchen). In another BizGees article by Jennifer Kelly on “Maternity Care for Asylum Seekers and Refugees in the UK”, Kelly highlights barriers surrounding giving care to women who are pregnant. This includes communication and understanding barriers, lack of training for HCPs (Health Care Professionals), and practical difficulties - balancing navigating a new country with pregnancy. These will be the same when approaching the issue of giving care to women and girls about menstruation, especially for girls going through puberty and also having to navigate being a refugee. Education on menstrual health should also be continuously provided and monitored when refugee girls move into schools, as seen from my own experiences so that they know how to dispose of menstrual products safely and hygienically in schools. Finally, no education on menstruation may also mean that knowledge of fertility, contraception and sexual health care is not available. This means that there needs to be continuous and enforced education for women of all ages with not only menstrual care but contraceptive care being distributed. In providing all of these services, we are making an active effort to acknowledge the difficulties of the female refugee and therefore acknowledge her human right. It signifies our consideration for their human needs apart from being a refugee, they are refugees that experience periods and have the human right to receive the correct and sufficient care.
Sahar is a second year English student at Oxford University. She researched and wrote this article as part of the Oxford University Micro Internship programme.