Women and girls in flood-stricken Pakistan need menstrual products. These women are trying to help
'Periods do not stop during floods,' says university student collecting sanitary products
The calamitous floods that have washed over one-third of Pakistan have left millions of people displaced and vulnerable to hunger, waterborne illnesses and other health concerns — women and girls, in particular.
The United Nations Population Fund estimates more than eight million women and girls of reproductive age have been affected by the deluge, with 1.6 million in need of humanitarian assistance. "Access to family planning and menstrual hygiene products can also be disrupted," the agency warned.
University students Anum Khalid and Bushra Mahnoor felt compelled to help.
"Periods do not stop during floods," said Khalid, a 23-year-old architecture student who spoke to CBC News from the city of Multan.
The pair launched an online movement to distribute sanitary products, along with soap and underwear, so women, girls and people who menstruate are not denied vital needs — or their dignity. Their efforts have also spurred a debate about the need for menstrual hygiene to be a primary component of disaster relief in the country, where there are stigmas surrounding menstruation.
Women's needs 'neglected'
Khalid and Mahnoor, who met over Facebook two years ago but haven't ever met in person, started the Mahwari Justice campaign. "Mahwari" is the word for menstruation in Urdu, Pakistan's national language.
The idea stemmed from Khalid receiving a call in June from a woman in a flood-stricken area of Balochistan, Pakistan's largest province. The woman, in tears, told Khalid she and others were unable to manage their periods. Some had even resorted to using leaves.
Manhoor had her own experience going through a flood at the age of 10, when her family wound up to a relief camp in the village of Khairabad in 2010. She recalled seeing a girl around her own age with blood-stained clothing and having to be covered up by her mother — an image that has stuck with her.
"When the floods hit Pakistan in 2022 … I knew once again women are going to be neglected, women's needs are going to be neglected," the 22-year-old psychology student said in an interview from her university hostel in Lahore.
Even before this disaster, access to hygiene products was limited for many: a poll conducted for UNICEF In 2017 found 44 per cent of girls in Pakistan did not have sufficient access to sanitary products.
The World Health Organization has called for menstrual health to be recognized as a human rights issue.
A grassroots effort
Using social media, Mahwari Justice is channelling the goodwill from everyday citizens who contribute small amounts of money, donate packages of sanitary napkins, sew pads and volunteer to travel to flood-affected areas and deliver the kits, which cost about $2 Cdn each.
But it's been a challenge.
The initiative has gained public attention, but not necessarily the support of the companies that manufacture menstrual products.
Manhoor said one major manufacturer donated 150 packages of sanitary napkins, but that's a fraction of what's needed. The Mahwari Justice campaign has already helped 12,000 women and girls since June and they're expecting to distribute kids to up to 50,000 in the coming weeks and months, Manhoor said.
Other companies, Khalid said, offered miniscule discounts rather than actual goods.
The pair approached textile companies for donations of cloth and cotton to make reusable pads, but only received waste material that wasn't always fit for that use.
Manhoor said they also reached out to multiple non-government organizations working on reproductive health issues in Pakistan, but didn't get any response.
As far as international humanitarian aid agencies are concerned, Canadian Red Cross spokesperson MairiAnna Bachynsky told CBC News the organization has issued a flood relief appeal to Canadians. Donations will be provided directly to its partner, the Pakistan Red Crescent Society, to best decide how to allocate them.
Global Medic, another aid agency based in Canada, said it does not send items such as sanitary products as those are best procured in the affected country.
Stigma about menstruation
Khalid and Mahnoor are inspired by the support they've received so far, but they said menstruation is a taboo subject in Pakistan — even within their own families.
"People like to totally dismiss menstrual relief [and] menstrual hygiene, as a genuine need," said Mahnoor.
One critic on social media remarked sanitary products were "luxury goods," but Khalid said she can't be bothered to engage in such discourse.
"It's not a luxury," she said, and providing sanitary products to disaster victims should be considered no different than handing out bottles of water.
But online debates over whether period products are an important aspect of flood relief may not be a bad thing, at least when it comes to breaking through taboos, according to Sana Lokhandawala, the co-founder of HER Pakistan, an organization promoting access to menstrual health education and products.
"Whenever there is hatred or backlash coming, when it is about menstrual health, it's a huge opportunity because that's the only time we're talking about menstruation in Pakistan," she said in a discussion with the Pakistani English-language news outlet Dawn.
Khalid is happy to see discussion open up about menstruation. She recounted how one man recently reached out to her to say reading about Mahwari Justice online prompted him to begin having an open conversation with his daughter about menstrual health.
Disasters disproportionately affect women, girls
Women and girls are "often more affected" by natural disasters and that's why their needs should be prioritized, said Dr. Lynda Redwood-Campbell, director of the Global Health Department of Family Medicine at McMaster University in Hamilton, Ont.
When it comes to menstrual hygiene, Redwood-Campbell said a girl who can't go to school because she doesn't have access to sanitary products can miss up to a week of classes a month while menstruating — about 25 per cent of her class time. That limits her education and possibly her ability to later find a job, she said.
In the aftermath of a disaster, not being able to properly care for oneself while having a period can even mean foregoing the most basic needs.
"Imagine a young woman who doesn't have sanitary products and she doesn't have food either," said Redwood-Campbell, who is also a senior medical officer with the emergency response unit of the Canadian and International Red Cross.
"If there's stigma around it, she can't go stand in line for three hours or longer … to get food or water, the necessities of life, so she stays back by herself and often probably misses meals."
Though Redwood-Campbell said has seen improvement in the humanitarian sector over her more than 25 years of disaster scenarios, she said many well-intentioned aid organizations still don't recognize the importance of prioritizing menstrual hygiene.
"I actually think the majority of Canadians would absolutely have no idea that this is even an issue, even women too," said Redwood-Campbell.
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With files from CBC's Philip Lee-Shanok
