Women in areas of Pakistan hit hardest by devastating floods are struggling to gain access to sanitary products — while some feel they cannot talk about periods with those delivering aid.
Monsoon rains and record flooding have badly hit the country's north-west provinces, killing more than 1,400 people and affecting more than 33 million.
Now women in the areas are finding that government aid does not always contain sanitary products.
Some are hesitant to talk about periods in a country where the subject is often considered taboo, volunteers say.
Ayesha, 37, from Gohar Abad village in the Charsadda district of Khyber Pakhtunkhwa province, said some women at camps set up to help those affected by the flooding did not know how to use sanitary products.
“When the flood alerts were issued and the water approached our village, my brother-in-law called me to say that he was sending a vehicle to evacuate us and for us to take some belongings with ourselves," she told The National, as she removed mud and stones from her flood-hit home.
She said she and her relatives rushed to the Abdul Wali Khan Sports Complex in Charsadda at night, along with other people from flood-hit areas.
“Having no facilities at the camp, we spent the night under the open sky,” Ayesha said.
The next morning, the district administration provided shelters to people at the camp. Meanwhile, many volunteers and welfare organisations brought food and other essentials.
Ayesha said she had met a woman in distress, who had started her period and had no sanitary products.
She said she had also spoken to other women at the camp who were menstruating and told them to tell authorities about the problem. She said many said they felt they could not talk about the issue.
“At that time, I reached out to the doctors who were in the medical camp for those affected by the floods and informed them about the women having a menstruation cycle. The doctors said they had no sanitary products," Ayesha said.
She said doctors later provided distributed sanitary products for those affected, but some women did not know how to use them. She therefore tried to educate the women about how to use sanitary pads.
Non-profit organisation Da Hawwa Lur has also come to the aid of women facing such issues by distributing sanitary products. It is also helping to educate women on their use.
Shawana Shah, who has run the organisation since 2012, told The National it had decided to help women in flood-hit villages in Nowshera, Charsadda and some parts of Peshawar village by distributing sanitary products, napkins and hygiene kits "on a large scale".
She said she decided to help when a Da Hawwa Lur volunteer told her about a teenage girl who had started her period in Nowshera.
The teenager asked for help but her parents and male volunteers did not know where to take her.
“Talking about periods and menstrual health is taboo in the region," Shawana said. "After visiting different villages, we realised that the most of the women were not aware of taking care of their health and did not have any idea of how to use sanitary pads.
"The women were hesitant to take the sanitary products from us in the beginning. We tried to convince them as much as we could.”
One volunteer, Umar Khan Utmanzai, said he had faced problems while distributing sanitary products among women.
Mr Utmanzai said that it was easy to distribute food, but people were "shy" about accepting sanitary products.
"They don’t talk about this problem," he said.
He and Shawana have attempted to educate people about the hygiene kits.
"The issue of periods or menstruation cycle is normal for women," Shawana said. "This should be accepted by society and we need to talk on this problem openly.”