Menstrual hygiene: a ‘silent’ need during disaster recovery
Post-disaster relief and recovery operations seldom focus on women’s priorities regarding menstrual hygiene. There is an increasing awareness to incorporate inclusive, participatory, and gender-sensitive strategies for implementation of response programmes. This article presents empirical findings related to menstrual hygiene management (MHM), demonstrating it is integral to women’s privacy and safety during recovery. Using case studies from India, the 2012 Assam floods and 2013 Cyclone Phailin in Odisha, this article explores menstrual hygiene practices in a post-disaster context. The data were collected through participatory learning and action tools such as focus group discussions, household interviews, priority ranking, and observations. It emerged that menstrual hygiene was overlooked at the household level during recovery; women and adolescent girls faced seclusion and isolation, exacerbating privacy and security concerns post-disasters. Some humanitarian agencies have an ad hoc approach towards MHM, which is limited to distribution of sanitary pads and does not address the socio-cultural practices around MHM. There is a need for strategic planning to address MHM with a gender-sensitive and inclusive approach. This article draws practical and policy inferences from the research for stronger approaches towards initiating behaviour change in MHM, and addressing attitudes and knowledge regarding menstrual hygiene.Atuyambe, L.M., Lynn M., Ediau, M., Orach, C.G., Musenero, M. and Bazeyo, W. (2011) ‘Land slide disaster in eastern Uganda: rapid assessment of water, sanitation and hygiene situation in Bulucheke camp, Bududa district’, Environmental Health 10(38): 1–13 <http://dx.doi.org/10.1186/1476-069X-10-38>.
Bosher, L. and Dainty, A. (2011) ‘Disaster risk reduction and “built-in” resilience: towards overarching principles for construction practice’, Disasters 35(1): 1–18 <http://dx.doi.org/10.1111/j.1467-7717.2010.01189.x>.
Brown, J., Cavill, S., Cumming, O. and Jeandron, A. (2012) ‘Water, sanitation, and hygiene in emergencies: summary review and recommendations for further research’, Waterlines 31(1): 11–29 <http://dx.doi.org/10.3362/1756-3488.2012.004>.
Bryman, A. (2008) Social Research Methods, 3rd edn, Oxford: Oxford University Press.
Connolly, M., Gayer, M., Ryan, M.J., Spiegel, P., Salama, P. and Heymann, D.L. (2004) ‘Communicable diseases in complex emergencies: impact and challenges’, Lancet 364(9449): 1974–83 <http://dx.doi.org/10.1016/S0140-6736(04)17481-3>.
Few, R., McAvoy, D., Tarazona, M. and Walden, V.M. (2013) Contribution to Change: An Approach to Evaluating the Role of Intervention in Disaster Recovery, Rugby, UK: Practical Action Publishing.
IFRC (2012) ‘Disaster relief emergency fund (DREF) India: Assam Floods’, International Federation of Red Cross and Red Crescent Societies.
King, K., Bosher, L.S. and Kayaga, S. (2013) ‘Resilience in the humanitarian sphere: stimulating resilience for recovery’, in R. Shaw (ed.), Proceedings of the 36th WEDC International Conference: Delivering Water, Sanitation and Hygiene Services in an Uncertain Environment, pp. 1–6, Loughborough: Water, Engineering and Development Centre, Loughborough University.
Krishnan, S., Purwar, D. and Borah, B. (2015) ‘Sanitation and disasters: a case study of community and institutional response to Cyclone Phailin, Odisha 2013’, Waterlines 34(4): 412–23 <http://dx.doi.org/10.3362/1756-3488.2015.034>.
Muralidharan, A., Patil, H. and Patnaik, S. (2015) ‘Unpacking the policy landscape for menstrual hygiene management: implications for school WASH programmes in India’, Waterlines 34(1): 79–91 <http://dx.doi.org/10.3362/1756-3488.2015.008>.
Nawaz, J., Lal, S., Raza, S. and House, S. (2010) ‘Oxfam experience of providing screened toilet, bathing and menstruation units in its earthquake response in Pakistan’, Gender & Development 18: 81–9 <http://dx.doi.org/10.1080/13552071003600067>.
O’Reilly, K., 2010. Combining sanitation and women’s participation in water supply: an example from Rajasthan. Development in Practice, 20(1), pp. 45–56. <http://dx.doi.org/10.1080/09614520903436976>
Parker, A.H., Smith, J.A., Verdemato, T., Cooke, J., Webster, J. and Carter, R.C. (2014) ‘Menstrual management: a neglected aspect of hygiene interventions’, Disaster Prevention and Management 23(4): 437–54 <http://dx.doi.org/10.1108/DPM-04-2013-0070>.
Parkinson, J. (2009) A Review of the Evidence Base for WASH Interventions in Emergency Responses, Atkins/UNICEF WASH Steering Group.
Sommer, M. (2012) ‘Menstrual hygiene management in humanitarian emergencies: gaps and recommendations’, Waterlines 31(1–2): 83–104 <http://dx.doi.org/10.3362/1756-3488.2012.008>.
Sommer, M., Caruso, B.A., Sahin, M., Calderon, T., Cavill, S., Mahon, T. and Phillips-Howard, P.A. (2016) ‘A time for global action: addressing girls’ menstrual hygiene management needs in schools’, PLOS Medicine 13(2): p. e1001962 <http://dx.doi.org/10.1371/journal.pmed.1001962>.
World Bank (2013) Cyclone Phailin in Odisha: Rapid Damage and Needs Assessment Report, Washington, DC: World Bank Group.
Atuyambe, L.M., Lynn M., Ediau, M., Orach, C.G., Musenero, M. and Bazeyo, W. (2011) ‘Land slide disaster in eastern Uganda: rapid assessment of water, sanitation and hygiene situation in Bulucheke camp, Bududa district’, Environmental Health 10(38): 1–13 <http://dx.doi.org/10.1186/1476-069X-10-38>.
Bosher, L. and Dainty, A. (2011) ‘Disaster risk reduction and “built-in” resilience: towards overarching principles for construction practice’, Disasters 35(1): 1–18 <http://dx.doi.org/10.1111/j.1467-7717.2010.01189.x>.
Brown, J., Cavill, S., Cumming, O. and Jeandron, A. (2012) ‘Water, sanitation, and hygiene in emergencies: summary review and recommendations for further research’, Waterlines 31(1): 11–29 <http://dx.doi.org/10.3362/1756-3488.2012.004>.
Bryman, A. (2008) Social Research Methods, 3rd edn, Oxford: Oxford University Press.
Connolly, M., Gayer, M., Ryan, M.J., Spiegel, P., Salama, P. and Heymann, D.L. (2004) ‘Communicable diseases in complex emergencies: impact and challenges’, Lancet 364(9449): 1974–83 <http://dx.doi.org/10.1016/S0140-6736(04)17481-3>.
Few, R., McAvoy, D., Tarazona, M. and Walden, V.M. (2013) Contribution to Change: An Approach to Evaluating the Role of Intervention in Disaster Recovery, Rugby, UK: Practical Action Publishing.
IFRC (2012) ‘Disaster relief emergency fund (DREF) India: Assam Floods’, International Federation of Red Cross and Red Crescent Societies.
King, K., Bosher, L.S. and Kayaga, S. (2013) ‘Resilience in the humanitarian sphere: stimulating resilience for recovery’, in R. Shaw (ed.), Proceedings of the 36th WEDC International Conference: Delivering Water, Sanitation and Hygiene Services in an Uncertain Environment, pp. 1–6, Loughborough: Water, Engineering and Development Centre, Loughborough University.
Krishnan, S., Purwar, D. and Borah, B. (2015) ‘Sanitation and disasters: a case study of community and institutional response to Cyclone Phailin, Odisha 2013’, Waterlines 34(4): 412–23 <http://dx.doi.org/10.3362/1756-3488.2015.034>.
Muralidharan, A., Patil, H. and Patnaik, S. (2015) ‘Unpacking the policy landscape for menstrual hygiene management: implications for school WASH programmes in India’, Waterlines 34(1): 79–91 <http://dx.doi.org/10.3362/1756-3488.2015.008>.
Nawaz, J., Lal, S., Raza, S. and House, S. (2010) ‘Oxfam experience of providing screened toilet, bathing and menstruation units in its earthquake response in Pakistan’, Gender & Development 18: 81–9 <http://dx.doi.org/10.1080/13552071003600067>.
O’Reilly, K., 2010. Combining sanitation and women’s participation in water supply: an example from Rajasthan. Development in Practice, 20(1), pp. 45–56. <http://dx.doi.org/10.1080/09614520903436976>
Parker, A.H., Smith, J.A., Verdemato, T., Cooke, J., Webster, J. and Carter, R.C. (2014) ‘Menstrual management: a neglected aspect of hygiene interventions’, Disaster Prevention and Management 23(4): 437–54 <http://dx.doi.org/10.1108/DPM-04-2013-0070>.
Parkinson, J. (2009) A Review of the Evidence Base for WASH Interventions in Emergency Responses, Atkins/UNICEF WASH Steering Group.
Sommer, M. (2012) ‘Menstrual hygiene management in humanitarian emergencies: gaps and recommendations’, Waterlines 31(1–2): 83–104 <http://dx.doi.org/10.3362/1756-3488.2012.008>.
Sommer, M., Caruso, B.A., Sahin, M., Calderon, T., Cavill, S., Mahon, T. and Phillips-Howard, P.A. (2016) ‘A time for global action: addressing girls’ menstrual hygiene management needs in schools’, PLOS Medicine 13(2): p. e1001962 <http://dx.doi.org/10.1371/journal.pmed.1001962>.
World Bank (2013) Cyclone Phailin in Odisha: Rapid Damage and Needs Assessment Report, Washington, DC: World Bank Group.
Atuyambe, L.M., Lynn M., Ediau, M., Orach, C.G., Musenero, M. and Bazeyo, W. (2011) ‘Land slide disaster in eastern Uganda: rapid assessment of water, sanitation and hygiene situation in Bulucheke camp, Bududa district’, Environmental Health 10(38): 1–13 <http://dx.doi.org/10.1186/1476-069X-10-38>.
Bosher, L. and Dainty, A. (2011) ‘Disaster risk reduction and “built-in” resilience: towards overarching principles for construction practice’, Disasters 35(1): 1–18 <http://dx.doi.org/10.1111/j.1467-7717.2010.01189.x>.
Brown, J., Cavill, S., Cumming, O. and Jeandron, A. (2012) ‘Water, sanitation, and hygiene in emergencies: summary review and recommendations for further research’, Waterlines 31(1): 11–29 <http://dx.doi.org/10.3362/1756-3488.2012.004>.
Bryman, A. (2008) Social Research Methods, 3rd edn, Oxford: Oxford University Press.
Connolly, M., Gayer, M., Ryan, M.J., Spiegel, P., Salama, P. and Heymann, D.L. (2004) ‘Communicable diseases in complex emergencies: impact and challenges’, Lancet 364(9449): 1974–83 <http://dx.doi.org/10.1016/S0140-6736(04)17481-3>.
Few, R., McAvoy, D., Tarazona, M. and Walden, V.M. (2013) Contribution to Change: An Approach to Evaluating the Role of Intervention in Disaster Recovery, Rugby, UK: Practical Action Publishing.
IFRC (2012) ‘Disaster relief emergency fund (DREF) India: Assam Floods’, International Federation of Red Cross and Red Crescent Societies.
King, K., Bosher, L.S. and Kayaga, S. (2013) ‘Resilience in the humanitarian sphere: stimulating resilience for recovery’, in R. Shaw (ed.), Proceedings of the 36th WEDC International Conference: Delivering Water, Sanitation and Hygiene Services in an Uncertain Environment, pp. 1–6, Loughborough: Water, Engineering and Development Centre, Loughborough University.
Krishnan, S., Purwar, D. and Borah, B. (2015) ‘Sanitation and disasters: a case study of community and institutional response to Cyclone Phailin, Odisha 2013’, Waterlines 34(4): 412–23 <http://dx.doi.org/10.3362/1756-3488.2015.034>.
Muralidharan, A., Patil, H. and Patnaik, S. (2015) ‘Unpacking the policy landscape for menstrual hygiene management: implications for school WASH programmes in India’, Waterlines 34(1): 79–91 <http://dx.doi.org/10.3362/1756-3488.2015.008>.
Nawaz, J., Lal, S., Raza, S. and House, S. (2010) ‘Oxfam experience of providing screened toilet, bathing and menstruation units in its earthquake response in Pakistan’, Gender & Development 18: 81–9 <http://dx.doi.org/10.1080/13552071003600067>.
O’Reilly, K., 2010. Combining sanitation and women’s participation in water supply: an example from Rajasthan. Development in Practice, 20(1), pp. 45–56. <http://dx.doi.org/10.1080/09614520903436976>
Parker, A.H., Smith, J.A., Verdemato, T., Cooke, J., Webster, J. and Carter, R.C. (2014) ‘Menstrual management: a neglected aspect of hygiene interventions’, Disaster Prevention and Management 23(4): 437–54 <http://dx.doi.org/10.1108/DPM-04-2013-0070>.
Parkinson, J. (2009) A Review of the Evidence Base for WASH Interventions in Emergency Responses, Atkins/UNICEF WASH Steering Group.
Sommer, M. (2012) ‘Menstrual hygiene management in humanitarian emergencies: gaps and recommendations’, Waterlines 31(1–2): 83–104 <http://dx.doi.org/10.3362/1756-3488.2012.008>.
Sommer, M., Caruso, B.A., Sahin, M., Calderon, T., Cavill, S., Mahon, T. and Phillips-Howard, P.A. (2016) ‘A time for global action: addressing girls’ menstrual hygiene management needs in schools’, PLOS Medicine 13(2): p. e1001962 <http://dx.doi.org/10.1371/journal.pmed.1001962>.
World Bank (2013) Cyclone Phailin in Odisha: Rapid Damage and Needs Assessment Report, Washington, DC: World Bank Group.
Atuyambe, L.M., Lynn M., Ediau, M., Orach, C.G., Musenero, M. and Bazeyo, W. (2011) ‘Land slide disaster in eastern Uganda: rapid assessment of water, sanitation and hygiene situation in Bulucheke camp, Bududa district’, Environmental Health 10(38): 1–13 <http://dx.doi.org/10.1186/1476-069X-10-38>.
Bosher, L. and Dainty, A. (2011) ‘Disaster risk reduction and “built-in” resilience: towards overarching principles for construction practice’, Disasters 35(1): 1–18 <http://dx.doi.org/10.1111/j.1467-7717.2010.01189.x>.
Brown, J., Cavill, S., Cumming, O. and Jeandron, A. (2012) ‘Water, sanitation, and hygiene in emergencies: summary review and recommendations for further research’, Waterlines 31(1): 11–29 <http://dx.doi.org/10.3362/1756-3488.2012.004>.
Bryman, A. (2008) Social Research Methods, 3rd edn, Oxford: Oxford University Press.
Connolly, M., Gayer, M., Ryan, M.J., Spiegel, P., Salama, P. and Heymann, D.L. (2004) ‘Communicable diseases in complex emergencies: impact and challenges’, Lancet 364(9449): 1974–83 <http://dx.doi.org/10.1016/S0140-6736(04)17481-3>.
Few, R., McAvoy, D., Tarazona, M. and Walden, V.M. (2013) Contribution to Change: An Approach to Evaluating the Role of Intervention in Disaster Recovery, Rugby, UK: Practical Action Publishing.
IFRC (2012) ‘Disaster relief emergency fund (DREF) India: Assam Floods’, International Federation of Red Cross and Red Crescent Societies.
King, K., Bosher, L.S. and Kayaga, S. (2013) ‘Resilience in the humanitarian sphere: stimulating resilience for recovery’, in R. Shaw (ed.), Proceedings of the 36th WEDC International Conference: Delivering Water, Sanitation and Hygiene Services in an Uncertain Environment, pp. 1–6, Loughborough: Water, Engineering and Development Centre, Loughborough University.
Krishnan, S., Purwar, D. and Borah, B. (2015) ‘Sanitation and disasters: a case study of community and institutional response to Cyclone Phailin, Odisha 2013’, Waterlines 34(4): 412–23 <http://dx.doi.org/10.3362/1756-3488.2015.034>.
Muralidharan, A., Patil, H. and Patnaik, S. (2015) ‘Unpacking the policy landscape for menstrual hygiene management: implications for school WASH programmes in India’, Waterlines 34(1): 79–91 <http://dx.doi.org/10.3362/1756-3488.2015.008>.
Nawaz, J., Lal, S., Raza, S. and House, S. (2010) ‘Oxfam experience of providing screened toilet, bathing and menstruation units in its earthquake response in Pakistan’, Gender & Development 18: 81–9 <http://dx.doi.org/10.1080/13552071003600067>.
O’Reilly, K., 2010. Combining sanitation and women’s participation in water supply: an example from Rajasthan. Development in Practice, 20(1), pp. 45–56. <http://dx.doi.org/10.1080/09614520903436976>
Parker, A.H., Smith, J.A., Verdemato, T., Cooke, J., Webster, J. and Carter, R.C. (2014) ‘Menstrual management: a neglected aspect of hygiene interventions’, Disaster Prevention and Management 23(4): 437–54 <http://dx.doi.org/10.1108/DPM-04-2013-0070>.
Parkinson, J. (2009) A Review of the Evidence Base for WASH Interventions in Emergency Responses, Atkins/UNICEF WASH Steering Group.
Sommer, M. (2012) ‘Menstrual hygiene management in humanitarian emergencies: gaps and recommendations’, Waterlines 31(1–2): 83–104 <http://dx.doi.org/10.3362/1756-3488.2012.008>.
Sommer, M., Caruso, B.A., Sahin, M., Calderon, T., Cavill, S., Mahon, T. and Phillips-Howard, P.A. (2016) ‘A time for global action: addressing girls’ menstrual hygiene management needs in schools’, PLOS Medicine 13(2): p. e1001962 <http://dx.doi.org/10.1371/journal.pmed.1001962>.
World Bank (2013) Cyclone Phailin in Odisha: Rapid Damage and Needs Assessment Report, Washington, DC: World Bank Group.
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