Menstruation, conversation, innovation

Teams in the Democratic Republic of the Congo are working with local communities to understand more about the challenges displaced women face in managing menstrual hygiene. Could a simple idea lead to a potential solution? Deputy medical coordinator Dr Alain Kikwaya-Vangi shares an update …

Illustration showing women in a discussion group

“I’m surprised,” said the woman. “Surprised that MSF would want to help with something like this. It’s so personal.”

The woman was talking during a discussion group for a new project our team has been piloting in South Kivu, in the Democratic Republic of the Congo.

The project aims to assess the feasibility of distributing menstrual underwear to displaced women in the region. Menstrual underwear is made with special fabric so it’s absorbent, washable and re-usable.

The idea came from a colleague who found it the best option for herself in the challenging contexts where Médecins Sans Frontières / Doctors Without Borders (MSF) operates. If menstrual underwear worked for her, could it work for women living in these contexts full time?

South Kivu has seen repeated cycles of armed violence between communities, forcing thousands to flee for their lives. In their search for safety, people in this remote area often find themselves with no access to essentials like water, food or healthcare.

In December, I met a woman who told us that she’d woken in the middle of the night to find her house on fire around her: her village was being attacked. She managed to get out, but there was no time to grab anything. When we met her, she was living in a 10m square schoolhouse with forty other people, and had no bedding, no spare clothes, nothing.

In the groups we’ve been running with women who have been through this terrifying experience, they have told us how, in the aftermath of a crisis, they are completely dependent on materials they can find around them to help manage menstruation. Often these materials are not safe or hygienic, and this can impact both women’s physical health and their mental wellbeing. But menstrual hygiene isn’t always considered in an emergency response.

The women in the groups have shared their views and helped us understand the needs and cultural perceptions around this sensitive topic, which has helped us feel confident to move to the next phase of the pilot. After several delays because of violence and insecurity in the area, we’re now distributing menstrual underwear to 150 women who have agreed to test it out and share their feedback.

Whatever the final conclusions of the trial, I hope this project has shown how vital it is that menstrual hygiene is a component in every emergency response, especially with displaced people. Consulting the community from the start has given us the opportunity to learn, to get closer to them, and to optimise our approach, and this is something we’ll be using in future initiatives too.

For now, our team is focused on the distribution, and looking forward to hearing what the women have to say. They have already given us ideas for the next phase of the project!


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