Forced Migration and Period Poverty

By Daffodil

Forced Migration is an involuntary movement of a person, or people,  from their home region due to persecution, conflict, violence, and human rights violations. Period poverty means inaccessibility to safe and hygienic menstrual products, basic sanitation services or facilities for personal hygiene, and menstrual education (how to use menstrual products in a hygienic manner and methods of waste management for menstrual products). How does forced migration lead to period poverty? What are the relations between these two factors? Besides poor living and financial conditions, girls, women and menstruating people in refugee camps _ including internally displaced camps_  have limited access to hygienic menstrual and sanitation facilities. Because refugee camps are usually settled in the areas where women cannot easily access markets and pharmacies. Then again, many of the refugee women cannot afford to buy menstrual products. Moreover, because refugee camps are usually settled in areas where women cannot easily access markets and pharmacies, many refugees are lacking menstrual products. 

Understanding Forced Migration

The latest Global Trends report published by UNHCR in June 2023 indicates that at the end of 2022, 108.4 million people were forcibly displaced. This number hit 110 million within the next six months. This means more than 1 in every 73 people on earth has to leave their place. Of 108.4 million, 62.48% are internally displaced. Surprisingly 76% of the world’s refugees and people in need of international protection are hosted by low and middle-income countries, 20% by least-developed countries. This means almost 9 out of 10 people from forced displacement live in low and middle-income countries. In the first six months of 2023, ongoing and new conflicts and humanitarian situations in these countries, Afghanistan, the Democratic Republic of the Congo, Latin American and Caribbean countries, Myanmar, Somalia, Sudan, and Ukraine, contributed 90% of global new displacement. The Russian invasion of Ukraine in February 2022 caused the forced displacement of 11.6 million Ukrainians (by the end of 2022), which is one of the largest displacements after the Second World War.  In Myanmar, due to the military coup in February 2021, there are over 3 million IDPs (with 155,511 stateless people in Rakhine state) and nearly 4 million people of concern, according to the UN data of May 2024.

Causes of Forced Migration

Why do people leave their homes, friends, and family and start everything from the beginning in a foreign land?

The underlying causes of forced migration are armed conflict, domestic political turmoil (military coup, civil war), persecution based on religion or ethnicity, genocide, statelessness, development megaprojects that destroy homes or livelihoods, extreme poverty, recession, environmental causes (climate change, droughts, earthquakes, and other natural disasters), land degradation and resource scarcity. The Development and Peace – Caritas Canada explains that the triggers of forced migration are complex, numerous, unpredictable, and intertwined, which is why studying migratory patterns based on one single cause should be avoided.

Understanding Period Poverty

Many women across the world are facing period poverty, and this issue has been often overlooked by decision-makers, policymakers, educators, and medical establishments. Nearly 500 million women and girls are affected by period poverty. WaterAid reported that 1.25 billion women do not have access to toilets during their time of the month. According to data presented by ActionAid UK, one out of 10 girls in Africa miss school due to two reasons: they do not have access to menstrual products, or schools do not have safe, private toilets to help girls manage their period with dignity. Again, in Kenya, approximately 50% of school-age girls do not have access to menstrual products, whereas in India, approximately 12 per cent of menstruating women (355 million in total) cannot afford menstrual products. Even in a leading country like the United States, in 2021, nearly 1 out of 4 students were struggling to afford period poverty, and 51% of students have worn menstrual products for longer than recommended (1,010 students who menstruate, ages 13 to 19, were surveyed for this study). The data from this study translates period poverty has impacted lower-income students and students of colour more than it does to white and middle-income students.

Causes of Period Poverty

What are the barriers to women gaining access to hygienic menstrual facilities as well as a clean and safe space to manage their period with dignity? 

Economic burden is the primary reason behind period poverty. For example, inflation and the pandemic cause the rise in the cost of menstrual products, not to mention a pandemic like COVID-19 creates limited access to employment (financial resources) and social services (access to free menstrual products). A woman uses over 9,000 products. So, women facing extreme poverty have financial prioritisation, which makes them think sanitary pads are no longer their basic need, compared to food and shelter for their children.

Cultural stigma and Taboos are also the root cause behind period poverty. In some cultures, menstrual blood is considered to be dirty, so women are taught to keep secrecy and silence regarding menstruation. Public discussion on menstruation is prohibited, and young girls talking about menstruation in front of their fathers or brothers is considered to be lacking courtesy or shameless. Again, men in some cultures consider exposure to menstrual blood to lower their spiritual power. In some corners of the world, there are girls who are afraid to tell their parents that they have started their period due to the cultural belief that girls starting menstruation are considered ready for marriage.

Speaking of cultural stigma, in Nepal, a cultural custom called “chhaupadi”, despite the government’s attempt to eliminate the custom by banning it legally, causes women to be abandoned by their families during their menstruation. So, during their period, women had to live in tiny, unventilated huts made of mud, straw, or rocks. This cultural practice limits women from accessing warm and nutritious food, as well as safe and hygienic shelter. Since women are considered impure during their periods, they are forbidden from participating in normal family activities, touching other people and household items, entering temples, or attending religious activities. This custom also made women victims of health hazards, snake bites, and sexual abuse, not to mention young girls missing their school.

Social construction of menstruation as a disgusting process rather than a biological one, silences public advocacy on menstrual health. Insufficient menstrual and reproductive health education not only fuels misinformation, stigma, and discrimination toward women but also stops women from being able to manage their periods in an effective, safe, and hygienic manner. 

Intersection of Forced Migration and Period Poverty

As a consequence of forced migration, many women have to leave the comfort of their homes and live in poor conditions in refugee camps. A survey by UNHCR in 2019 revealed that only 55% of women can access menstrual products, and only 37% are supplied with proper underwear. There could be humanitarian aid for food, clothes, and medicines, yet dignity tool kits are often overlooked. Women in refugee camps do not have a space to change their clothes, what is worse is they do not usually have access to clean bathrooms where they can change their menstrual pads or wash their reusable pads. For refugee women (including those internally displaced), menstrual aids such as chocolate, pain relief balm, painkillers, iron supplements, or evening primrose oil capsules are such a luxury. Taking a warm bath during menstruation was never an option for them.

Moreover, toilets in refugee camps are not always separated by gender or not lit well at night, leading to sexual assault and harassment in shared toilet spaces. Overpopulation in refugee camps is the main factor which makes it difficult for women to access menstruation and sanitation facilities. In Moria refugee camp, which is the largest refugee camp in Europe and settled on the Greek island of Lesbos, each woman receives only four pads per month. This situation is even worse during the lockdown period in COVID. Because refugees cannot leave the camp without permission, NGOs had to prioritise their humanitarian support to tackle COVID-19. Initially, the camp was supposed to host 3,000 people, but the number hit nearly 20,000 people in 2020, meaning up to 160 people sharing one toilet and over 500 people using the same shower. In some parts of the Moria camp, 325 people share one tap (with no soap). 

Again, gender-based violence has surged in these crowded camps across the world. Women dare not risk their safety by making a trip to the toilet in the dark at night, which is usually far from their place.

As much as forced migration is standing behind period poverty, political unrest is also the major factor that women suffer from shortage of sanitary products.

“The import of sanitary pads and baby products like diapers into Rakhine State were banned during the military coup period. Likewise, Baby Stores are prohibited from selling these products. Because the resistance forces may use these products as a replacement for bandages during battles” — Su Su Hlaing (alias), Age 27, Rakhine State, Myanmar.

“Transportation charges to the internally displaced camps is more expensive than the cost of the menstrual pads. There are often limitations by the military to transport menstrual pads and other medical aids. It is also difficult to hygienically keep these menstrual pads in the camps because the living conditions are poor there. I have heard of two incidents in which two girls from Rakhine State and Kachin State, staying in IDP camps, passed away because they  had to use cloth during menstruation. There is a serious need of raising awareness on how to use menstrual pads. However, because of the poor living conditions in camps, there is hardly clean water in the rainy seasons. Sometimes, pads are no longer clean and hygienic due to poor storage.”  — Tun Tun, Rakhine State,  Myanmar

Shortage of sanitary products in refugee camps also brings consequential health problems. Women in refugee camps have been using newspapers, leaves, and old clothes as the replacement of sanitary pads. Using unhygienic materials, followed by limited access to sanitation facilities causes urinary tract infections, which are not treated properly in most cases.

In addition, period poverty in Refugee camps may vary on the socioeconomic status and educational background of refugees. Scholars conducted a study on the menstrual hygiene management challenges that displaced girls and women in Myanmar and Lebanon. The study found that Myanmar women have more restricted access to financial resources and the market compared to Syrian refugees in Lebanon with higher socio-economic status. Likewise, more Syrian refugees (adolescent girls and young women) have more basic knowledge on menstrual health prior to their menstruation causing less distress and embarrassment. 

In addition to restricted access to menstrual products, sanitation facilities, and knowledge on menstrual health, disposal of menstrual products is also another big issue in refugee camps. Many refugee camps do not have adequate waste disposal systems such as bins, collection services, and incineration facilities. In some cases, women do not have knowledge on proper disposal of these products, and latrines end up clogging. Some of the women may prefer to bury the used products. Again most of the camps are crowded, do not have privacy, sometimes settled on flood-prone sites,  which made this option almost impossible.

Suggestions to Governments, Policy Makers, NGOs, and Civil Society Organisations

In conclusion, governments and NGOs (like UN entities) should take the menstrual health management and privacy of women into consideration before settling in refugee camps. At the same time, sufficient guidance on Menstrual Health Management ought to be given to humanitarian relief staff supervising camps and beneficiaries. Meanwhile, policymakers and civil society organisations should advocate for the public to eliminate cultural stigma and taboos regarding menstrual health. Access to menstrual and reproductive health products such as pads, tampons, cups, and condoms are not only human rights but also a basic human need. Thus, governments and humanitarian response organisations should consider spending more budget to adequately distribute such products in refugee camps and to adopt female-friendly WASH (Water, Sanitation, and Hygiene) facilities.

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