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.
Role of local actors in WASH (water, sanitation and hygiene) during disaster recovery: policy implications from evidence in Odisha, India
Krishnan, Sneha
Twigg, John
Environmental Hazards, Vol. 19 (2020), Iss. 4 P.341
https://doi.org/10.1080/17477891.2019.1667290 [Citations: 4]Reproductive health in the recent disasters of Iran: a management perspective
Sohrabizadeh, Sanaz
Jahangiri, Katayoun
Khani Jazani, Reza
BMC Public Health, Vol. 18 (2018), Iss. 1
https://doi.org/10.1186/s12889-018-5311-2 [Citations: 13]Water, sanitation and hygiene (WASH) and disaster recovery for community resilience: A mixed methods study from Odisha, India
Krishnan, Sneha
International Journal of Disaster Risk Reduction, Vol. 35 (2019), Iss. P.101061
https://doi.org/10.1016/j.ijdrr.2018.12.023 [Citations: 14]Menstrual hygiene management among women and adolescent girls in the aftermath of the earthquake in Nepal
Budhathoki, Shyam Sundar
Bhattachan, Meika
Castro-Sánchez, Enrique
Sagtani, Reshu Agrawal
Rayamajhi, Rajan Bikram
Rai, Pramila
Sharma, Gaurav
BMC Women's Health, Vol. 18 (2018), Iss. 1
https://doi.org/10.1186/s12905-018-0527-y [Citations: 34]Women’s Support Shaken: A Study of Women’s Political Trust after Natural Disasters
Kreutzer, Willow
(2022) P.1
https://doi.org/10.1017/S1743923X22000289 [Citations: 0]A systematic review of menstrual hygiene management (MHM) during humanitarian crises and/or emergencies in low- and middle-income countries
Patel, Kripalini
Panda, Nishisipa
Sahoo, Krushna Chandra
Saxena, Shipra
Chouhan, Narendra Singh
Singh, Pratibha
Ghosh, Upasona
Panda, Bhuputra
Frontiers in Public Health, Vol. 10 (2022), Iss.
https://doi.org/10.3389/fpubh.2022.1018092 [Citations: 1]Public Health and Disasters
Health-EDRM in International Policy Agenda III: 2030 Sustainable Development Goals and New Urban Agenda (Habitat III)
Chan, Emily Ying Yang
Ho, Janice Y.
Wong, Chi Shing
Shaw, Rajib
2020
https://doi.org/10.1007/978-981-15-0924-7_7 [Citations: 2]Social Morphology, Human Welfare, and Sustainability
Menstrual Hygiene Management During Times of Complex Humanitarian Crisis: Listening to the Voices of Rural Adolescent Girls of Assam
Kerketta, Saraswati
Baruah, Suchibrota
Baruah, Pratyasri
2022
https://doi.org/10.1007/978-3-030-96760-4_13 [Citations: 0]Public Health Disasters: A Global Ethical Framework
Public Health Disasters
Afolabi, Michael Olusegun
2018
https://doi.org/10.1007/978-3-319-92765-7_1 [Citations: 0]GENDERED BoP HYGIENE MARKETS IN RURAL INDIA: A CASE STUDY OF SOCIAL ENTREPRENEURSHIP AND SOCIAL INNOVATION
SINGH, SUKHPAL
The Hong Kong Journal of Social Work, Vol. 51 (2017), Iss. 01n02 P.51
https://doi.org/10.1142/S0219246217000055 [Citations: 2]Adaptive capacities for women’s mobility during displacement after floods and riverbank erosion in Assam, India
Krishnan, Sneha
(2022) P.1
https://doi.org/10.1080/17565529.2022.2092052 [Citations: 2]Menstrual Hygiene Management During Emergencies: A Study of Challenges Faced by Women and Adolescent Girls Living in Flood-prone Districts in Assam
Bhattacharjee, Mayuri
Indian Journal of Gender Studies, Vol. 26 (2019), Iss. 1-2 P.96
https://doi.org/10.1177/0971521518811172 [Citations: 11]Women’s and girls’ experiences of menstruation in low- and middle-income countries: A systematic review and qualitative metasynthesis
Hennegan, Julie
Shannon, Alexandra K.
Rubli, Jennifer
Schwab, Kellogg J.
Melendez-Torres, G. J.
Myers, Jenny E
PLOS Medicine, Vol. 16 (2019), Iss. 5 P.e1002803
https://doi.org/10.1371/journal.pmed.1002803 [Citations: 142]Systematic review of menstrual health and hygiene in Nepal employing a social ecological model
Sharma, Aditi
McCall-Hosenfeld, Jennifer S.
Cuffee, Yendelela
Reproductive Health, Vol. 19 (2022), Iss. 1
https://doi.org/10.1186/s12978-022-01456-0 [Citations: 2]Socio-cultural implications for women’s menstrual health in the Pacific Island Countries and Territories (PICTs): a scoping review
Maulingin-Gumbaketi, Elizabeth
Larkins, Sarah
Whittaker, Maxine
Rembeck, Gun
Gunnarsson, Ronny
Redman-MacLaren, Michelle
Reproductive Health, Vol. 19 (2022), Iss. 1
https://doi.org/10.1186/s12978-022-01398-7 [Citations: 0]Effects and resilience to climate crisis among adolescents: a narrative review on South Asian countries
Patel, Sangram Kishor
Rajak, Rahul
(2022) P.1
https://doi.org/10.1080/17565529.2022.2149255 [Citations: 0]- A call to action: organizational, professional, and personal change for gender transformative WASH programming
- Transgender-inclusive sanitation: insights from South Asia
- Providing municipal faecal sludge management services: lessons from Bangladesh
- Adolescent schoolgirls' experiences of menstrual cups and pads in rural western Kenya: a qualitative study
- Global assessment of grant-funded, market-based sanitation development projects