Menstrual health is overlooked during disasters in South Asia. Women face severe challenges accessing hygiene products, clean water, and privacy. Experts urge integrating dignified menstruation into disaster planning to ensure safety, dignity, and health for all.
During natural disasters, women and girls urgently need support with menstrual hygiene products. Yet, this issue remains largely ignored in disaster response planning.
Rita Saha from Aadityanath Tole in Lalitpur Metropolitan City-11 was menstruating on September 29, 2024 — the night floods from the Nakkhu River devastated the area.
“I was asleep when I woke up and found myself surrounded by water,” she recalled. “Our house was submerged. We couldn’t save food, clothes, or anything — we just ran for our lives. That day was more harrowing for me than for others,” Rita said. “I was menstruating and had neither panties nor a sanitary pad. The flood destroyed everything. Shops were underwater, and everyone was just trying to survive.”
According to locals, this was the worst flooding they had ever seen. A Weather Attribution Report confirmed record-breaking rainfall in central and eastern Nepal. On September 28, more than 320mm of rain fell in at least 25 weather stations across 14 districts — half of London’s annual rainfall — the highest recorded in Nepal in 54 years.
The deluge caused the Bagmati, Sapakoshi, and Nakkhu rivers to overflow. According to the Lalitpur District Administration Office, 51 people died between September 26 and 28. Another 608 houses were destroyed and 1,679 partially damaged.
Amid the chaos, menstruating people like Rita faced unique difficulties. In disasters, access to basic menstrual products is often overlooked.
Bimala Shrestha, a neighbor in the same community, recalled how Rita came to her house asking for underwear. “I felt uncomfortable giving away my used panties, but I gave her what I had,” she said.
Shanta Parajuli, a local social worker, said menstrual pads, clean water, and hygiene supplies are more crucial for women during disasters than even food. “No one thought about dignified menstruation until that flood. It must now be recognized as a critical part of disaster relief,” she said. Shanta, whose daughter was also menstruating at the time, experienced similar challenges. “There was no safe space to manage used pads. Water and mud flooded the first two floors of our home. We had to shelter on the top floor. Many women must have suffered silently during that time,” she said.
She urged the local government to develop a disaster response plan that specifically addresses menstrual needs.
What preparation looks like?
Flood- and landslide-affected areas often lack private spaces, sanitary pads, disposal facilities, clean toilets, or water. Yet, menstruating women and girls still need these essentials — along with safety and education.
Gender specialist and sociologist Samjhana Wagle said that all three tiers of government, as well as non-governmental organizations, have ignored this issue. “The gender dimensions of climate change are severely underestimated,” she said. “Disaster plans focus only on rescue and overlook reproductive and menstrual health.”
Asia was the region most affected by climate- and water-related disasters in 2023, according to the World Meteorological Organization (WMO). The region, home to 60% of the world’s population, is heating faster than the global average — with the warming rate nearly doubling since the 1961–1990 period.
In Nepal, hundreds of women are affected by floods and landslides each year. According to the National Disaster Risk Reduction and Management Council, 180 women died and 136 were injured in flood and landslide incidents last year. “These statistics don’t even capture other consequences like health problems and psychological trauma,” Samjhana added. “The government must take responsibility for addressing these overlooked impacts.”
Meeta Sainju Pradhan, a Gender Equality and Social Inclusion expert, emphasized that emergency assistance must comprehensively address women’s sexual and reproductive health. “Women need safe and dignified menstrual care, access to family planning, and health services during disasters,” she said.
When floods or landslides force displacement, menstruating women need safe pads, water, and private places to change and wash. Without these, they may resort to unsafe materials that cause infections. Overcrowded shelters with few toilets make it difficult to manage menstruation safely.
Neglecting their needs can lead to stress, shame, and even sexual harassment while accessing toilets. Pregnant women, elderly women, and those with disabilities also need special attention. Providing menstrual kits, clean toilets, and safe spaces is essential for their safety, dignity, and health.
In South Asia, including Nepal, menstruation during emergencies is rarely prioritized in disaster planning. Many women and girls face enormous challenges due to lack of menstrual products, clean water, toilets, and privacy — resulting in stress, health issues, and embarrassment, especially for adolescent girls.
Bimala recalled that no targeted help was provided during last year’s floods. “Seven months later, the ward office distributed menstrual pads based on the voter list,” she said. “By then, it wasn’t needed anymore. Shops were open again. Worse, women living in rental homes were excluded from the distribution.”
Suresh Sunar, spokesperson for the National Disaster Risk Reduction and Management Authority (NDRRMA), stated that the authority had developed new guidelines in 2025 with a focus on women’s needs. “We have made specific guidelines this year addressing women’s concerns,” he said.
During the 2022 Pakistan floods — one of South Asia’s worst climate disasters — over 33 million people were affected, including 8 million women of reproductive age. Many had to use tree leaves or dirty cloths to manage their periods. A survey in Sindh province found that 40% of 25,000 women used reused cloths instead of sanitary pads, which they considered unaffordable.
A 2015 study conducted in Nepal’s Sindhupalchok district after the earthquake revealed that 18.8% of women identified menstrual management as an urgent need. Within the first week, 42.8% were menstruating, yet none had received menstrual hygiene products. The use of reusable cloth increased from 66.7% to 76.1%. Though 78% of women preferred disposable pads, they were not made available.
Shanta said the government must take responsibility for ensuring dignified menstruation during disasters — including climate-induced ones. “During normal times, we can manage. But disasters like floods, landslides, and earthquakes make it nearly impossible,” she said.
Dr. Radha Paudel — rights activist, Madan Prize laureate, and the proponent of the dignified menstruation concept — emphasized the need to restore dignity for menstruators. She advocates for a holistic, feminist, human rights-based approach that includes access to safe, eco-friendly menstrual materials in both normal and crisis situations. She stressed the importance of building infrastructure that supports dignified menstruation, calling on authorities to prioritize it.
