By Sneha Gupta
Menstruation, as natural a process as any other, has strangely enough always been a topic cloaked by an overwhelming and irrational culture of silence that has directly led to a continuous increase in the vulnerability of people who menstruate. Treating menstruation as a taboo topic creates an ecosystem of fear and vulnerability that unfortunately forms the quotidian reality of people who menstruate. Placing this culture in contexts of armed conflict exacerbates their vulnerability. The shame associated with menstruation has been used as a means of control over the bodies of people who menstruate in contexts of armed conflict, as well.
People who menstruate are among the worst affected across the continuum:before, during and after armed conflicts. In peacetime, these taboos bring about socio-cultural restrictions in the everyday life of people who menstruate. For instance, in Nepal, it is common for girls to be isolated during menstruation, in a practice known as chaupadi. Similarly in Sierra Leone, it is commonly believed that used sanitary napkins can be used to make someone sterile (House, Mahon, Cavill., 2012). Pre-conflict conditions bring about significant changes in structural adjustment programs such as an increase in expenditures for arms, at the expense of health care, education and public services (Jansen, 2006). Consequently, there is a diversion of resources from these domains - meaning that sexual and reproductive health (SRHR) does not receive as much, if any at all, support.
Gender based violence including sexual violence, trafficking, sexual slavery and the intentional spread of STDs have steadily been used as weapons of warfare. For example, women in Rwanda were frequently gang raped and deliberately infected with HIV/AIDS (Jansen, 2006). There is not much difference between wartime and post-conflict contexts, as these years are mostly interim periods before the fighting restarts, unless the war ends entirely. The already abysmal health facilities and medical services continually worsen as the majority of physicians and nurses do not return once the conflict subsides, as was witnessed in Bosnia and Herzegovina (Clark, 2001). The overcrowding in refugee camps along with the inadequate WASH infrastructure (Water, Sanitation and hygiene) exacerbates the risks of diarrhoea, cholera and other dangerous infections (Als D, Meteke S, Stefopoulos M, et al., 2020). Qualitative assessments conducted with displaced girls and women in Lebanon and Myanmar showed that the main problems experienced on the ground in these differing emergency contexts were fairly similar. There was a lack of menstrual supplies along with a complete lack of access to appropriate menstrual hygiene information (Schmitt, 2017).
As of 2017, over 26 million people who menstruate were displaced due to conflict and disasters (UNICEF, 2019). The majority of them lack access to basic facilities like sanitary pads, underwear and water. Essential privacy is completely lacking in war zones. Further, in these contexts, people who menstruate usually do not have access to functional toilets and those lucky enough to have access to toilets find themselves in toilets that do not have adequate security, lighting and water. A study conducted by Global One in displacement camps in Syria and Lebanon observed unanimous complaints from refugee girls about the unhygienic condition of their toilets. They expressed that the toilets were so dirty that they preferred changing their menstrual materials in their shelters, despite these areas not having any form of privacy (Pujol-Mazzini, 2017). Their traditional lack of control over family finances leads to them having minimal funds for sanitary products, as they find it acutely awkward to ask for sanitary products from their male relatives. Assessment missions, first response teams and distribution teams mostly consist of male members, making it difficult for people who menstruate to avail access to sanitary products and informed guidance about menstrual health management (UNICEF, 2019., Schmitt, 2017).
Menstruation impacts the lives of all people who menstruate. It is not limited to cis-gender females. Non-binary people who menstruate face alarming levels of marginalisation and exclusion. This results in restriction of their freedom, choices, mobility and negatively impacts their participation in school and societal life. Such a culture also prevents non binary people from accessing essential health and education services. These challenges are magnified for people who menstruate in armed conflicts. Thus, leaving them out of any conversation related to menstruation is unjustifiably oppressive.
The silence and stigma associated with menstruation are apparent in peacetime and wartime and is seldom addressed across the continuum. The Women Peace and Security Agenda has promising potential to systematically address the problems faced by all people who menstruate in armed conflicts, instead of identifying menstruation as a cis gender women’s problem alone. However, with the Women, Peace, and Security Agenda excluding the mention of SRHR in the last two resolutions at the behest of the US, it seems clear that addressing SRHR in conflict contexts is not a priority. While some may argue that the Biden Administration may not continue the Trump Administration’s hardliner views around SRHR, the gap endures.
Pujol-Mazzini, Anna. (March 8, 2017). "For refugee women, periods a dangerous, shameful time." https://www.reuters.com/article/us-womens-day-refugees-periods-feature-idUSKBN16F1UU
Schmitt, M.L., Clatworthy, D., Ratnayake, R. et al. Understanding the menstrual hygiene management challenges facing displaced girls and women: findings from qualitative assessments in Myanmar and Lebanon. Confl Health 11, 19 (2017). https://doi.org/10.1186/s13031-017-0121-1
Caroline O. N. Moser, Professor Caroline Moser, Doctor Fiona Clark Palgrave Macmillan (2001).
Jansen GG. Gender and War: The Effects of Armed Conflict on Women’s Health and Mental Health (2006) doi:10.1177/0886109905285760
Sara Sethia, ‘War and Menstruation’, One Future Collective (2018). Available at: http://onefuturecollective.org/war-and-menstruation/
UNICEF, ‘Guidance on Menstrual Health and Hygiene’ (2018). Available at: https://www.unicef.org/wash/files/UNICEF-Guidance-menstrual-health-hygiene-2019.pdf
House Sara, Mahone Therese, Caville Sue, ‘Menstrual Hygiene Matters’ (2012). Available at: https://washmatters.wateraid.org/sites/g/files/jkxoof256/files/Menstrual%20hygiene%20matters%20low%20resolution.pdf
Als D, Meteke S, Stefopulos M, et al. Delivering water, sanitation and hygiene interventions to women and children in conflict settings: a systematic review. BMJ Global Health (2020). Available at: https://gh.bmj.com/content/bmjgh/5/Suppl_1/e002064.full.pdf
O'Keefe, Theresa. (2006). Menstrual Blood as a Weapon of Resistance. International Feminist Journal of Politics. 8. 535-556. 10.1080/14616740600945123
Christina Binder, Karin Lukas, Romana Schweiger; Empty Words or Real Achievement? The Impact of Security Council Resolution 1325 on Women in Armed Conflicts. Radical History Review 1 January 2008; 2008 (101): 22–41. doi: https://doi.org/10.1215/01636545-2007-036
Un women, In Focus: Women Peace and power. (https://www.unwomen.org/en/news/in-focus/women-peace-security)
UN: Women’s International league for Peace and Freedom (https://www.peacewomen.org/why-WPS/solutions)