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The Unequal Effects of Conflict on Women

When we think about war and conflict, a lot of horrible images come to mind. What it might not immediately make us think about though is how this might affect people who menstruate or those who are pregnant.

Conflict and instability have an unequal effect on women. From a lack of access to menstrual products to giving birth in very unsafe situations, it is important to highlight how war can disproportionately impact women.

Here at Kari, disproportionate inequalities are something we speak about a lot. We have already established that women are disproportionately impacted by conflict, but not from the angle of periods or pregnancy.

In this article, we take a deeper look at these issues and hope to shed light on these impacts of conflict, something all too often brushed to the side during these conversations.

How does conflict affect people who are menstruating?

Periods and hormonal cycles are very susceptible to external influences. Situations of high stress and uncertainty can change a regular cycle. Quite commonly, stress can cause a delay in the onset of your period. However, it can also exacerbate the painful side effects of menstruation too.

A study comparing menstrual cycle data of women in war zones with a control group found that up to 35% of women reported changes to their menstrual cycle up to three months after the war, compared to less than 3% of the control group.

Furthermore, another study conducted in Ukraine found that almost two-thirds of adolescents experienced changes to their period during the war. Changes included increased pain and heavier bleeding.

In January 2024, the UN estimated that 700,000 women and girls in Gaza are having menstrual cycles, but they are managing them without access to the most basic hygiene products. Pads do sometimes sporadically appear on the shelves, but at five or six times their usual price.

How are people managing their periods in Gaza right now?

Without access to private bathrooms, water shortages, and very limited privacy, people who are menstruating are facing a lot of barriers to managing their periods.

To deal with this, some have been taking norethisterone tablets (period-delaying pills). These are usually only prescribed to help those with severe menstruation-related problems such as endometriosis. But the reality is that in Gaza right now, these are more accessible than pads and tampons. According to Marie-Aure Perreaut Revial, of Doctors Without Borders, requests for contraceptive pills have quadrupled since the outbreak of the attack.

Others have reported using strips of tents to stand in for period products. Materials that should be being used for shelter. Some are even reporting using old clothing; either their own or even their children’s.

What are the health risks of these strategies?

It’s probably not too surprising that taking period-delaying pills is not the best for your body, if you don’t have health conditions that make it impossible not to. Norethisterone in particular comes with side effects such as high blood pressure, stomach problems, and nausea. Indeed, it is recommended to talk to a doctor before taking the drug. However, this is not a luxury that women in Gaza are currently privy to.

For those using scrap tent materials and old clothes, there is a risk of overusing supplies, due to their shortage. Toxic shock syndrome is not just caused by tampons. Wearing any period product for too long could lead to a buildup of bacteria in the body, and associated illness, or even death.

These risks are compounded when women in vulnerable situations do not have access to sanitary bathing conditions, or even sanitary water. This happened to Maram, who contracted a genital bacterial infection that had her hospitalised for several days. In fact, the hygiene is so bad in Gaza, that even just using the bathroom may cause a bacterial infection, especially among women, according to Samia Abu Draz, a gynaecologist in Gaza City interviewed for the New Arab.

Speaking with ITV news, one woman says that her only wish right now “is to go back to my home, sleep in my bed and use my bathroom”. Everyone deserves the decency of hygiene.

What about those who are pregnant?

According to the World Health Organisation, as of November 2023, there are an estimated 50,000 pregnant women in Gaza.

That’s more than 180 births every day.

On November 1st 2023, a big maternity hospital, Al Hilo Hospital, was shelled.

Now, it is expected that maternal deaths and child morbidity and mortality are expected to increase. This can be due to stress-related still-births and miscarriages, premature babies who would rely on neonatal care which is now unavailable, and pregnant people facing unforeseen pregnancy-related complications due to a lack of medical capacity.

According to the Guardian, 40% of the estimated 50,000 pregnant women in Gaza are classed as high-risk. That is 27 women experiencing pregnancy or birth related complications every day, in an area with only 3 undamaged hospitals remaining.

From giving birth without anaesthesia, to month-old children who have never been washed. From C-sections performed by surgeons without water, pain medication, or anything to sterilise tools, to umbilical cords being cut with the sharpest object within reach… These are all factors reported of the harsh reality of what it means to be expecting a baby in Gaza currently.

Furthermore, if a newborn can survive such a birth, many are not being vaccinated, nor documented. They are treated as though they do not exist.

For something that is supposed to bring so much joy, the experience of childbirth is now only a traumatic one.

How can I help?

ActionAid says that sending or donating period products to Gaza is not useful. This is because they may not get across the border.

However, what they do recommend is donating to aid charities working on the ground. Donating to organisations such as WEFAQ which distributes hygiene kits to women and children in Gaza could be a good starting point.

Here at Kari we are loud and proud with the opinion that periods and women’s health are nothing to be ashamed of… on the contrary. However, the harsh and lived reality for so many in the world in 2024 is that this does not always, if ever, feel like something that should be celebrated.

As a community we have the power to spread awareness about these issues. There is a lot of action to take. But little by little, we can all help to make a difference.  

If you feel affected by what you’ve just read, read our article here on compassion fatigue. It’s important to look after yourself, amidst the horrors that are ongoing globally.

This article has been reviewed by our Kari Health Experts and Editorial Board to ensure accuracy and reliability of the information presented. However, please note that the content provided is for informational purposes only and should not replace advice from your medical professional.

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