Shima Younes, 35, reluctantly takes the pills that delay her menstruation. The woman, already a mother of four, lives in a tent in Rafah, at the southern end of the Gaza Strip, and feels she has no choice, lacking running water, hygiene products and minimal privacy. “I find it difficult to take these pills, but it is the only solution, even though they give me back pain and some very big episodes of sadness,” he explains.
Since October, the simplest gestures of daily care, such as going to the toilet and washing, with a minimum of privacy, especially during menstruation, have become essential for the displaced people in Gaza who live in the vast improvised camps in the south of the territory Stopping dozens of people has become a real masterpiece. Thousands of people are woefully overcrowded. These women in many cases have to choose alternative and sometimes risky solutions for their health, such as taking these medications.
“The lack of sanitary pads and tampons worsens this situation and many women resort to Norethisterone tablets, as in the case of Shima,” explains Walid Abu Hatab, a medical consultant in Gaza specializing in obstetrics and gynecology. This medication is a hormonal treatment that helps increase progesterone levels, thereby delaying menstruation. But it's a double-edged sword: It offers temporary relief in this emergency situation, but can cause several unwanted side effects such as irregular vaginal bleeding, nausea, dizziness and mood disorders. “They pose an additional risk to the health of those who are already suffering from the incessant bombing,” the expert added.
According to the UN, 1.7 million Gazans have been displaced out of a population of 2.2 million and the kidnapping of more since October 7, when the Islamist movement Hamas carried out bloody attacks in Israel that, according to official figures, left 1,200 people dead than 200 people. The Israeli military response, which continues to this day, has caused the deaths of at least 30,000 Palestinians and injured around 70,000 people in Gaza, according to the Hamas-controlled Ministry of Health.
The lack of accessible toilets, washing facilities and laundry services significantly affects women's psychological balance.
Nivín Adnan, Palestinian psychologist
“We know that births, even by cesarean section, are carried out without anesthesia. The education system has almost completely collapsed and there is a serious risk of surviving girls missing out on the entire school year, leading to increased risks such as child marriage, family separation or human trafficking. “There are also reports of gender-based violence, including sexual abuse and rape threats against detained women by Israeli forces, in both the Gaza Strip and the West Bank,” said Dorothy Estrada Tanck, president of the UN Working Group on Discrimination against Women and Girls.
The flutter of life
“The cost of the conflict over women's well-being has a thousand faces,” confirms Nivin Adnan, a fellow displaced psychologist and social worker from Gaza, adding that the physical discomfort and psychological changes that come with menstruation are in this context Death will make things worse, fear, misery and displacement.
“The lack of accessible toilets, washing facilities and laundry services significantly affects the psychological balance of women. “In addition, the accommodations are small and there are neither amenities nor the slightest privacy,” he explains. The expert also warns: “For girls experiencing their first menstruation under such circumstances, the use of medications that delay periods poses enormous health risks.”
Displaced Gazan women cook at a UN school in the southern Gaza Strip on February 24, 2024. MOHAMMED SABER (EFE)
And for expectant mothers, the path to motherhood is fraught with danger. In makeshift and overcrowded shelters, in destroyed schools and in half-destroyed houses, these women fight to defend their lives in the midst of chaos. Some don't make it. “I no longer feel the flutter of life within me. “My unborn son, already robbed of his innocence and condemned to ruin,” sobs Aya Ahmad, who believes she has lost the child she was expecting but has not yet been able to confirm it because she does not have access to a hospital Ultrasonic.
Marina Pomares, coordinator of the Doctors Without Borders (MSF) project in Gaza, has just returned from a month-long mission in the Gaza Strip and confirms to this newspaper that there are many women who have not been able to attend pregnancy checks and they do not know how their baby is doing goes.
The head of MSF also explains that there are “complications with pregnancies, abortions and births in shelters and tents” because Gazans do not have access to the few hospitals that are still functioning or are afraid to go there , without being looked after there. What do you need? “And once they have their baby, they have to live with him in a tent in precarious conditions. They worry that breastfeeding won't work because of stress and that they won't be able to find formula or that he'll get sick and they won't be able to take him to the doctor,” he summarizes.
This is the case of Noor Zakari, 24, who gave birth to her second child while living in a refugee camp in Rafah. “I am surrounded by many displaced people. In the harsh winter, being in the tent is unbearable and I worry about my baby's health as it is too cold at night and there are not enough clothes or blankets,” she explains.
Survive no matter what happens
“For example, women need sanitary pads and we can’t even find them in stores. They also do not have a decent and safe place to shower or a proper latrine in which to relieve themselves. Going to the toilet is a feat because either they are practically in the middle of the street or they have to walk away and then be accompanied,” says Pomares.
These women's fears are completely justified. It is women who don't eat, don't sleep, who have to look after other children. They are exhausted, but their priority is to survive no matter what.
Marina Pomares, Doctors Without Borders
The MSF coordinator also explains that there are women who suffer from severe vaginal and urinary tract infections due to poor hygiene and the inability to change clothes. “They've never had them in their lives, they come to us because they're feeling bad and they don't know what's happening to them,” he explains.
In its regular report on the situation in Gaza on February 23, the United Nations warned of the urgency of providing more hygiene materials for women in the Gaza Strip. So far, around 9,000 menstrual hygiene kits and around 3,500 dignity kits have been distributed, including soap, sanitary napkins and underwear, a ridiculous number compared to the need. The UN also reports that information on self-protection and reporting sexual assaults is being distributed, and efforts are being made to create safe spaces for women and girls.
“The fears of these women are completely justified. It is women who don't eat, don't sleep, who have to look after other children. They are exhausted, but their priority is to survive at all costs,” says Pomares. “It is clear that if a mother has to take her child to the neonatal intensive care unit because of a problem, there is a risk that he or she will die, because in a room designed for 12 children there are 60 babies. “We work to give them some confidence and security, but the support we can give women in these circumstances is very limited,” she adds.
Asmaa Sendawi is nine months pregnant and also lives with her husband in a tent in Rafah. This 27-year-old first-time mother doesn't hide her grief. “The truth is that I don't know how I'm going to give birth. I'm ready, but there's nothing there for this newborn. “My daughter could die, she definitely will,” he sobs.
Currently, the only maternity hospital in Gaza is the Emirati hospital in Rafah, where Médecins Sans Frontières operates. There are 26 beds in this maternity hospital, but all of them are permanently occupied and 80 births are attended to every day, in addition to the beds registered in other partially functioning medical centers or clinics or in emergency shelters. Accordingly Unicef dataFrom October to the end of January, around 20,000 babies were born in Gaza.
Gaza journalist Eman Alhaj Ali poses with her brother Yusef in Rafah, next to the refugee camp where they had to seek refuge in January 2024. Courted by Eman Alhaj Ali
My name is Eman
My name is Eman, I am a journalist and 22 years old. I am the author of this report and I suffer from the same difficulties as some of its protagonists. I live in a tent in Rafah with my parents and seven siblings. We arrived a month ago, but it feels like years. I've lost track of time. I miss my former life, my independent and warm bedroom. All of this is very far away. We don't have a mattress for everyone and I slept on the floor for many days. My whole body hurts, I can't rest and I'm constantly cold, especially at night when I'm shaking for hours.
The arrival of the tanker is a respite in the midst of this despair, but the often polluted and dirty water it contains reminds us of our extreme situation. My father leaves the house every day to look for food, but despite his best efforts, we eat the same thing every day: some preserves, peas and, best of all, some cheese. Over time the tent seems smaller and smaller and I get a claustrophobic feeling. The sometimes heavy rain threatened to fall several times. Because of these living conditions, we were all sick and had difficulty breathing.
These days I hear talk of a long ceasefire before the arrival of the holy month of Ramadan. I have no trust. Normally we would already be shopping, preparing food and living in the house for this date that is so dear to us. But this Ramadan will undoubtedly be terrible for Gaza.
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