we are not numbers
emerging writers from Palestine tell their stories and advocate for their human rights
For many women and girls in Gaza, menstruation has become a daily struggle for health, dignity, privacy, and basic human comfort.
A makeshift bathroom at a displacement camp in Nuseirat, central Gaza. Photo: Muyassar Jamal Rommana
The bathroom stands in the middle of a crowded camp. Its walls are made of torn blankets held together by rope. The floor is sand. A small, dirty water pitcher sits in one corner, while a plastic bag of sanitary pads hangs above the entrance. The makeshift toilet is only a hole in the ground.
“Anyone who wants to look can look,” a teenage girl says with a bitter laugh.
Her words reflect a reality shared by thousands of women across Gaza, where managing menstruation has become a monthly struggle shaped by overcrowding, shortages of hygiene supplies, lack of privacy, and unsanitary conditions.
According to Gaza’s Government Media Office, around 1 million displaced women are currently living across the Strip. The United Nations Population Fund estimates that approximately 700,000 women and girls of menstruating age are facing serious physical and psychological challenges.
For many women, obtaining sanitary pads has become a challenge in itself.
“I cannot afford to buy pads for myself and my daughters,” says 46-year-old Mona Siam, who was displaced from Gaza City’s Al-Zeitoun neighborhood and is the mother of three girls. “I either receive them through aid distributions or my sisters help me buy them because they are employed and financially better off than I am.”
Mona says she has received hygiene assistance only twice during the nine months she has spent in a displacement camp in Nuseirat, central Gaza.
As prices continue to rise and supplies remain limited, many women struggle to manage their periods safely. Humanitarian aid remains the main source of menstrual hygiene products, yet distributions are irregular and often insufficient. As a result, some women are forced to use sanitary pads for longer than recommended, while others rely on cloth scraps or pieces of clothing as substitutes.
Mona recalls that her eldest daughter had to help her younger sister during her first menstrual cycle by using pieces of cloth because no sanitary pads were available in their tent at the time. The experience was deeply distressing for the young girl who broke down crying. When asked why she did not request a sanitary pad from neighbors, the girl replied, “I feel embarrassed asking for something so personal.”
Obstetrician and gynecologist Dr. Basel Fadda explains that using alternatives to sanitary pads increases the risk of infections due to poor hygiene and unsafe materials. Women emphasize that hygiene supplies must be distributed regularly, not sporadically, as many have received aid only once or twice since displacement.
In schools turned into shelters, conditions are as difficult as in the tent camps. At Khaled Bin Al-Walid School, women must climb long flights of stairs to reach bathrooms, adding physical strain during menstruation. Some avoid changing sanitary pads as often as needed to avoid exhaustion or embarrassment.
“If they find a used pad on the ground, all women are blamed and scolded,” says Serena Al-Ashqar, who was displaced from Al-Zeitoun and now lives in the shelter.
Under normal circumstances, women need privacy and time during menstruation. In displacement settings, both have disappeared.
“Come and see the morning line for the bathroom,” says Sanaa Toutah, a displaced mother of four daughters. “More than 20 people — girls, boys, children, and adults — waiting together. It looks like a school line.”
Her family shares a bathroom with four other families. The women are often rushed with phrases like “Hurry up,” “Don’t take too long,” and “Are you done yet?”
Gaza is facing a severe water crisis, which has made menstrual hygiene even more difficult. During a visit to Mona Siam’s tent, she said her family had been without water for two consecutive days. In some cases, they are forced to use drinking water for basic hygiene.
When asked about this, her daughter said, “Let the food wait. What matters is dealing with your period.”
Women wait outside a shared bathroom at Khaled Bin Al-Walid School, now used as a displacement shelter in central Gaza. Photo: Muyassar Jamal Rommana
During field visits, I did not encounter a single fully functioning bathroom. Most consisted of torn fabric walls, sandy floors, dirty containers, and makeshift toilets — sometimes only a bucket or a hole in the ground. Insects and rodents were commonly present. The toilets did not just look unhygienic — they smelled that way too. The air carried the smell of damp sand mixed with urine and human waste. It was so overpowering that standing inside for even a minute was difficult.
Heba Toutah, who lives with her blind husband in a displacement camp, says he struggles to use the makeshift toilets because there is no proper toilet seat or structure to guide him. “He cannot tell where he is supposed to stand or relieve himself,” she says. “The bathroom is simply impossible for him to use.”
Heba also says all of her daughters have suffered from urinary tract and other infections since displacement, which she attributes to the poor sanitation and lack of hygiene in the camp.
Dr. Fadda explains that while women are naturally susceptible to urinary and vaginal infections, displacement conditions have sharply increased the risks of serious infections and disease due to lack of hygiene, water shortages, and inadequate sanitation.
At the same time, war, displacement, and overcrowding have intensified stress among women across Gaza. Many now carry responsibilities that extend far beyond traditional roles, including securing food, water, and shelter for their families. Menstruation is not only a physical challenge but also a psychological burden. Many women avoid using bathrooms at night due to fear and insecurity. If they need to go, they often ask a family member to accompany them.
Heba recalls that one of her daughters once entered the bathroom and suddenly screamed after finding a stray dog inside. Since then, she says, some of her daughters hesitate before entering the makeshift toilets alone.
“You enter the bathroom while you’re afraid,” says Shahd, Mona’s daughter.
In Gaza’s displacement shelters, women are not only struggling to survive — they are struggling to maintain dignity while coping with one of the most personal burdens of life. Some postpone changing their sanitary pads until daylight because reaching the bathroom at night feels too dangerous. Others wear the same pad for longer than they should because they have no alternative.
And for many women, the issue goes far beyond sanitary pads. They call for safe and clean sanitation facilities equipped with running water, sinks, showers, and adequate lighting. Sanaa says women also need separate bathing spaces and better privacy. Dr. Fadda stresses the need for specialized women’s health services, including early screening for infections and access to essential treatment and vitamins. He also warns that severe malnutrition can lead to the cessation of menstruation altogether.
Menstrual health is often treated as a private and personal issue. In Gaza, it has become a public health crisis. Month after month of displacement, unsafe sanitation, limited access to clean water, and untreated infections are leaving lasting physical and psychological consequences for women and girls.
For many young girls, their first experience of menstruation is no longer defined by privacy or care, but by fear, displacement, and the struggle to preserve their dignity. This invisible — and largely preventable — crisis continues to shape their lives every single day.
This article is co-published with Washington Report on Middle East Affairs.
