Hygiene In Emergencies


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

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Hygiene In Emergencies

  1. 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. 2. Why are Unmet Menstrual Hygiene Needs a Problem? <ul><li>Lack of menstrual materials and facilities mean serious constraints to women from developing countries, which worsens in situations of emergency </li></ul><ul><li>80% of displaced are women and children </li></ul><ul><li>Women in camps live with cultural expectations that menstruation remains invisible and secret </li></ul><ul><li>Insufficient data and lack of research hinders a focused and complete intervention </li></ul>WHO (1983), Bharadwaj & Patkar (2004), WHO (2002)
  3. 3. <ul><li>Current emergency responses to menstrual hygiene are: </li></ul><ul><li>Inadequate </li></ul><ul><li>Lack research, qualitative and quantitative data </li></ul><ul><li>Not strategic in design </li></ul><ul><li>Culturally inappropriate </li></ul>Standard Protocol
  4. 4. Gender roles / Status of women Social taboos/practices Lack of political commitment to women’s health needs Lack of mobility Lack of privacy Inadequate 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. 5. Further Research is Needed <ul><li>Magnitude and severity of unmet menstrual hygiene needs and mismanagement of hygiene unknown </li></ul><ul><li>Should occur cross culturally, in emergency and non-emergency settings </li></ul><ul><li>Provide justification for examining and changing emergency response policy and operation </li></ul>Until then….
  6. 6. Sphere (1997), WHO, Harvey et al. (2002) What are Opportunities for Intervention Now? <ul><li>Include menstruation in basic emergency reproductive health services </li></ul><ul><li>Coordinate menstrual supplies provided with water and sanitation facilities to ensure compatibility </li></ul><ul><li>Design water and sanitation facilities around the needs of women (gender mainstreaming) </li></ul><ul><li>Menstrual hygiene promotion and education with affected community </li></ul>
  7. 7. Potential Immediate Low-Cost Solutions <ul><li>Incorporate menstrual hygiene into the Reproductive Health kit – MISP (Minimum Initial Service Package) </li></ul><ul><ul><li>Cloth </li></ul></ul><ul><ul><li>Pads </li></ul></ul><ul><ul><li>Underwear </li></ul></ul><ul><ul><li>Soap </li></ul></ul><ul><ul><li>Basin </li></ul></ul>Dramatically reduce the immediate burden placed upon women
  8. 8. Potential Immediate Low-Cost Solutions <ul><li>Hygiene promotion and education, sensitize entire community to menstruation </li></ul><ul><ul><li>Dispel myths </li></ul></ul><ul><ul><li>Empower women and girls with education on body </li></ul></ul><ul><ul><li>Include men and boys, avoid feelings of inequality </li></ul></ul><ul><ul><li>Assist men with knowledge on how to care for wives/daughters </li></ul></ul>Essential to avoid morbidity, allow for easier management, minimize disruption from school and household chores
  9. 9. Complete Emergency Response to Menstrual Hygiene Needs <ul><li>Provide sufficient quantities of culturally appropriate materials </li></ul><ul><li>Educate women and girls on menstrual hygiene and basic reproductive health </li></ul><ul><li>Ensure access to compatible and appropriate water and sanitation </li></ul>
  10. 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