Health experts says that women in Libya are ‘invisible’ and have little access to reproductive healthcare.
Experts are warning that women who survived flooding caused by Storm Daniel in Libya have been left without proper care and are “almost invisible” despite aid efforts.
Weeks after the disaster, which killed more than 4,000 people and left over 10,000 missing, women are still struggling to get access to hygiene, sanitation and menstrual products.
With an estimated 16,000 people displaced in and around Derna, many survivors have been forced to set up tents in front of the remains of their homes.
With much of eastern Libya’s medical infrastructure severely damaged by the storm, already overstretched medical facilities are under even more stress, making healthcare and meeting women’s needs particularly difficult.
According to Alex Gray, the head of international funds at the Centre for Disaster Philanthropy, women are among the worst affected during natural disasters.
“Pre-existing, structural gender inequalities mean that disasters affect women and girls in different ways than they affect boys and men. The vulnerability of females increases when they are in a lower socioeconomic group, particularly in the Global South,” he told Middle East Eye.
Gray said that women were vulnerable in terms of disaster preparedness, evacuation, response, number of deaths, health needs and recovery.
He clarified further that women in Libya will now need continued access to quality antenatal and postnatal care, and sexual and reproductive health services.
“After a disaster like the devastating floods in Libya, women typically have reduced access to appropriate healthcare facilities and services because of damaged health infrastructure and higher healthcare needs among survivors,” he said.
“A lot of times aid organisations are staffed by men and you can tell the decisions are made by men,” explained Hajar Darwish, a Libyan women’s sexual health specialist living in the UK.
“The first thing they think about is food, clothes and medication, and after that if someone thinks about women’s needs it’s half hearted, or you can tell it’s from someone who doesn’t experience periods,” she added.
One aspect that is rarely considered in the aftermath of a disaster, such as the flooding in Libya, is how to dispose of products in a way that limits the risk of further spread of disease.
“Organisations don’t really think about how things are getting disposed of afterwards. So if people are taking medication or are diabetic, can they dispose of their needles correctly and safely?” Darwish asked.
Another issue with aid provided for women in Libya is often a lack of education about what the products do, she added.
“Many organisations provide ‘Dignity Kits’ for women but people don’t know what’s in them and what they’re donating towards, so it also means that people can’t scrutinise what’s in them.
“I have also noticed that organisations don’t consider appropriate clothing when it comes to women, for example women need specific underwear such as bras especially if they’re pregnant and there’s no point in giving out menstrual pads if they have no underwear to stick it to,” she explained.
“These disasters are going to continue to happen and they’re going to get worse, we really need to do better. I feel like more organisations need to put a policy in place or work alongside specialists to create a policy that could be streamlined and then later adapted to different populations.”
Darwish warns that if standards in helping women following disasters do not improve, it could have serious consequences.
“For women who are already pregnant, if they don’t have clean hygiene facilities, any infections can spread to the foetus which could cause severe health complications for the woman and the unborn child,” she says.
Heba Shaheed, a women’s pelvic health and wellbeing expert, also believes that women are often an “afterthought” in natural disaster crises.
“Women are affected in their own individual ways in natural disasters, especially when it comes to being a mother, being pregnant or giving birth. They not only have limited access to things for their baby, such as formula and clothing, but they are also faced with issues such as not having access to nurses, doctors and midwives,” she told Middle East Eye.
Shaheed says that women’s needs are only considered after food, blankets and shelter, meaning that when it comes to delivering aid to women, it is often forgotten that they have additional needs.
“There are a lot of organisations that now do consider women’s needs but it’s still not the first thing on their minds, it’s thought of later. This is something that needs to be improved, especially as it is something that women won’t speak out about, especially in a natural disaster,” she says.
“My advice to aid organisations is to consider that at least half of women affected in emergencies are women who have menstrual hygiene needs, so it’s important for us to provide access to personal hygiene products and also items that can help them clean and purify themselves after their cycle,” she added.
Feelings of shame
Darwish says that often in the aftermath of a natural disaster, women often experience shame as a result of not being able to address their basic needs.
“Accessing period products in Libya is already quite hard and inconvenient, the products are not great and it can be very awkward to purchase them,” she said.
While emergency aid efforts are typically carried out very quickly and can often be uncoordinated in the first few hours or days following a disaster, Darwish maintains that aid organisations and charities should be including women in their discussions about how to help from the get go.
“Accessing period products in some countries in North Africa is one of the most scrutinising things you will ever have to do, it’s so humiliating. The products are never on display, buying them is like you’re doing something illegal and their quality is shambolic,’ she said.
Darwish also says that there is the risk that women will face increased urinary tract infections (UTI), lack of pain management for their menstrual cycle and difficulty accessing contraception, which could result in increased unplanned pregnancies.
“Shame and embarrassment will be some of the biggest issues as women are not able to clean up after themselves and things are being disposed of in the street which could cause infections.
“This could result in anxiety and incite depression. Women’s mental health will deteriorate as they are having to worry about when their period will come, and when it does come, not being prepared for it,” she added.
With many parts of Derna destroyed by the floods, basic sanitation, such as hand washing facilities and toilets, are not available, which contributes to the risk of disease spreading.
According to Gray, the amount of loss and destruction in Libya will trigger a significant need for mental health and psychological support, due to emotional trauma and grief.
“Interventions that provide access to female counsellors and psychosocial support in safe spaces are a good investment in post-disaster situations like the one in Libya and are needed now,” he said.
In order to provide female survivors with proper care, Gray believes that funding is needed for programmes specifically for women and girls.
Gray believes that these gender-specific programmes should address the unique needs of women and girls, and be culturally sensitive in order to help women recover.
He also said that more funding needs to be put towards research that seeks to understand the needs of women and girls in the aftermath of disaster.
According to Gray, teams composed of women from the same cultural background as those affected would help ensure assessments on needs were done quickly and effectively.
“We need to ensure that the voices of women inform programming and the provision of aid and assistance that affects them,” he said.