“We suffer from hunger, thirst, bombs. We suffer from being refugees. And now even because there are no menstrual products. This is just a new suffering,” says Bisan Owda, a woman from Gaza.
Heba Usrof, a different woman from Gaza, is running out of options to deal with her menstrual cycle. Pads have disappeared from pharmacies and stores. This has been the case since the war that began on October 7, and the situation reflects how nearly every basic need has become difficult to meet in Gaza in recent months, be it be food or medical aid.
The acute shortage of menstrual products is a result of Israel’s total siege and bombing of Gaza, which began after the October 7, 2023, attack on Israel by Hamas.
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State of Women in War Conditions
Women are forced to use scraps of tent cloth, old clothes and any other fabric as menstrual products. First aid workers working in Gaza confirm this information.
“This is the current reality for hundreds of thousands of women and girls in Gaza. Some women cut a part of towels to use for menstruation. They also use tent parts and fiber — some of it is cut to be used as pads, and some women cut extra clothing for diapers,” says Tess Ingram, communications specialist at UNICEF.
In wartime, the use of these materials as menstrual products is unhygienic, as they can be extremely harmful to women and menstruating people — unsanitary conditions and the usage of raw materials as pads, which may carry a large number of bacteria and viruses, greatly increase the risk of infection and possibly lethality. It can also cause toxic shock syndrome.
“The problem is that we have to move a lot. We don’t have the luxury of sitting down and resting, so it’s really hard,” Usrof describes the menstrual period.
Pregnant women who undergo caesarean section without anesthesia are in a harsh situation. According to Tess Ingram, babies are “born in hell” without anesthesia for their mothers.
“Watching newborn babies suffer as their mothers bleed to death is what should be keeping us up at night,” Ingram says.
Currently, 50,000 women in Gaza are pregnant. Being on the verge of starvation is especially damaging to both pregnant and nursing mothers, who lack access to nutritious food and their and their babies’ bodies are exhausting every day. Of the pregnant women, 5,522 are expected to give birth in February, but the dysfunctional state of maternity hospitals makes it difficult to predict how women will manage to protect themselves and their children.
“Many of us elderly have been left to fate. I am scared and tired, I expect the worst,” says a 72-year-old woman from Gaza.
Since October 7, more than 1.9 million people have been forced to leave their homes. According to the United Nations, more than 1.4 million of them ended up in Rafah, a nearly two-square-mile tent “city” near the Egyptian border, where the number of displaced people outnumbers Rafah’s residents by four times, causing extreme overcrowding.
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According to UN Women, both of Gaza’s two women’s shelters are currently closed, and communication and power outages severely limit the ability to provide services remotely. The number of widowed women who bear full household responsibilities, which means they have to feed and protect their families, has increased to about 3,000. As a result of the same mass slaughter, about 10,000 children lost their fathers.
The only functional maternity hospital in northern Gaza is running out of fuel, and further fuel supply is a serious problem.
“I put my life in danger during childbirth and I hope that I did not bring my child into this world for them to be killed for no reason,” says the Palestinian woman.
Food and medical supplies are not allowed to be brought into Rafah, because entry into the area is prohibited. It is forbidden to include sanitary napkins, tampons and birth control pills, which can stop or postpone menstruation. Pills like these are not safe to use for this purpose, however, as drug supplies run out, even this less helpful practice cannot help women delay their periods.
Heba Usrof says her menstruating friends take these pills so they can skip their periods and not have to deal with the consequences — physical pain and increased need for body care or worsening mental health — in the moment. Usrof plans to do the same because, she says, it’s the only way out.
Imagine having to manage your period without menstrual products, toilet paper or soap, and not being able to wash yourself. Many women go weeks without showering. Standing in line at the hospital for up to 30 hours to be cleared, — Riham Jafari, ActionAid worker in Bethlehem.
“No one talks about these issues,” says Akila, a gender protection expert, explaining that during the war, talking openly about menstruation and the obstacles it causes remains a taboo. In her opinion, this partly reflects the face of traditional and conservative society in Gaza, although she adds that the subject is sensitive and hidden in the rest of the world too.
Water and Hygienic Conditions
According to UN women, only one of the three water pipes between Israel and Gaza is functional and only one toilet per 486 people works.
Adara, who was forced to leave her home with her four children, says they “suffer a lot when they need to use the toilet” and that they “have to wait in line for a very long time”.
Currently, in Rafah, which has become a shelter for most of the displaced, access to clean and running water is extremely limited, given that only one water pipe is functioning. In particular, according to ActionAid’s data, each inhabitant needs at least 15 liters of water for one day to meet hygienic needs, although only 1.5-2 liters of water is available for each person from the minimum 15 liters necessary to meet basic needs. Without water it is impossible to maintain basic cleanliness, but these conditions are especially difficult to deal with for people who are menstruating.
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Adara says these conditions are excruciating for people.
“We suffer a lot when we want to go to the bathroom. We stand in line for a long time. The bathrooms are far away,” she says.
Riham Jafari, ActionAid Palestine’s Advocacy and Communications Coordinator, also talks about the challenges faced by women and people who are menstruating. According to Jafari, managing menstruation in the conditions in which people are in Rafah is very difficult, because people have to manage their periods very closely with others, without any of privacy, as well as using the bathroom, which is not only an insult to their dignity, but a real threat to their health.
“One of our colleagues told me that she has not washed for several weeks. Women like my colleague are showing incredible resilience and find creative ways to manage their menstrual needs, even though they shouldn’t have to,” says Riham Jafari.
The ability to manage menstruation safely and with dignity is a fundamental right of women, — Riham Jafari
Jumana Shahin, a women’s rights activist in Gaza, says that due to the scale of the humanitarian crisis in Gaza, women’s needs are being completely neglected.
“This situation is not easy. And there is no way out of this situation, because it is more difficult than you imagine,” adds Shahin.
Effects of War According to Gender
According to the Palestinian Ministry of Health, as of February 2024, more than 28,000 people have died in Gaza as a result of Israel’s attack, including more than 12,000 children. The death number is three times more than the total number of deaths in the previous 15 years of the Israeli-Palestinian war. As of the data of February 5, 100,000 people are considered dead, injured or missing. According to the data of UN Women in January, there are about 16 thousand women or children among the dead, which completely changes the gender distribution of the dead as a result of the war. In particular, approximately 70% of the dead today are women and children.
In addition, more than 1.9 million people are internally displaced, including nearly 1 million women and girls. The entire population of Gaza, about 2.2 million people, is on the verge of starvation.
These and other indicators are based on the data of the document “Gender Alert: The Gender Impact of the Crisis in Gaza“, which was published by UN Women. It describes the situation in Palestine as part of a six-month multi-sectoral response and focuses on the disparities that make it clear that men and women are affected differently by the ongoing genocide in Palestine.
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“Now everything is lost and the future is very uncertain. And what worries me the most is, will I ever go back home?” – says a Palestinian woman.
According to UN Women, 2 mothers are killed every hour in Gaza.
According to the same data, the current situation in Gaza has acute impact on women and girls.
The World Health Organization (WHO) also speaks about the fact that the issue is gender sensitive. The organization issued a statement in November 2023, almost a month after the beginning of the war, stating that women, children and infants bear the disproportionate burden of the escalation of hostilities in the Palestinian territories, as access to health services is virtually completely limited.
According to the statement, shelling, damaged and dysfunctional medical facilities, massive levels of displacement, collapse of water and electricity supplies, and limited access to food and medicine make access to essential maternal, newborn and child health services impossible.
WHO focuses on pregnant women, of whom more than 180 give birth every day. It is expected that 15% of them will have complications related to pregnancy or childbirth, which will require additional medical intervention and assistance, however, under current conditions, women cannot access emergency obstetric services. According to the organization, 14 hospitals and 45 primary health care centers are closed. Therefore, women have to give birth in shelters, on the streets, in ruins, or in overcrowded medical facilities, where the sanitary conditions are getting worse and the risk of infection and medical complications is increasing.
WHO suggests that due to the lack of appropriate conditions, mortality of mothers is expected to increase. The statement also mentions that the psychological burden caused by hostilities is extremely damaging to reproductive health, which may lead to stress-induced abortions, as well as stillbirths and an increase in premature births.
How Can We Help?
As Riham Jafar states, donating menstrual products to charities is not helpful because the charities have no guarantee that they will be allowed to cross the border with Rafah.
Riham says the most important weapon people have now is to spread messages to stop the fire. This will facilitate the delivery of humanitarian aid to its destination.
“Finding safe routes and opening the borders for humanitarian aid will also ensure the delivery of the necessary products for women,” says Jafar.
ActionAid, together with local partners such as the Association for Women and Child Care (WEFAQ), is distributing hygiene kits that include tissues, toilet paper, soap, sanitary pads and wet wipes.
The same group also organized 60 toilets and shower blocks in the shelter area in Rafah. This gives women and girls more opportunities to have their own private space.
A donation of £15 will ensure the delivery of a hygiene kit containing a month’s worth of menstrual products, along with other hygiene products. To purchase one hygiene kit and give it to a person in Gaza who needs it, you can make a donation at the following link.
On October 7, 2023, Hamas, an organization designated as a terrorist organization by the European Union and the United States, attacked and massacred Israeli civilians. About 1,400 people were killed and 240 people were kidnapped during the attacks by Hamas. More than 100 of them are still believed to be in captivity. Israel responded to the mentioned actions by invading Gaza and starting a military operation.
Despite the termination of attacks by Hamas on Israel, Israel has not stopped bombing the Gaza Strip since October. Gaza is a Palestinian territory surrounded by Israel on almost all sides. It should be noted that mostly civilians, including women and children, are victims of Israeli attacks in Gaza.
On February 12, Rafah, where displaced civilians are taking refuge, was shelled by the Israel Defense Forces, killing 67 people and injuring dozens, according to the Gaza Ministry of Health.
Deir al Balah, central Gaza, was also bombed, resulting in the killing of 15 people.
Humanitarian and human rights organizations working on the ground call the situation in Gaza catastrophic, given that the civilian population is starving and has been completely cut off from access to basic needs, including medical services.