A Compendium Menstrual Disposal, Waste Management & Laundering in Emergencies - ReliefWeb
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Menstrual Disposal, Waste Management & Laundering in Emergencies A Compendium
Acronyms
Acknowledgements The resource has been collaboratively produced by
4 CS Coordination, Consultation,
Culture, Communication
This report is made possible by the generous support Margaret Schmitt (Columbia University), David Clatworthy
(International Rescue Committee), Caitlin Gruer (Columbia CU Columbia University
of the American people through the United States
Agency for International Development (USAID). The University) and Dr. Marni Sommer (Columbia University) CXB Cox’s Bazar
contents are the responsibility of Columbia University with inputs from displaced adolescent girls
DIY Do It Yourself
and the International Rescue Committee and do not and women and humanitarian practitioners and
necessarily reflect the views of USAID or the United organizations (see acknowledgements).* FGD Focus Group Discussion
States Government. Please contact Dr. Marni Sommer (marni.sommer@ GBV Gender-Based Violence
columbia.edu) with any concerns or insights you would IDP Internally Displaced Person
like to share with the compendium authors.
IEC Information, Education
Preferred citation: Schmitt, M.L., Clatworthy, D., Gruer, and Communication
C., Sommer, M. (2020). Menstrual Disposal, Waste
IRC International Rescue Committee
Management & Laundering in Emergencies:
A Compendium (First edit). New York: Columbia MHM Menstrual Hygiene Management
University and International Rescue Committee. MSF Médecins Sans Frontières
PVC Polyvinyl Chloride
SWM Solid Waste Management
WASH Water, Sanitation, and Hygiene
© 2020, Columbia University and International Rescue Committee.
All rights reserved. This material is under copyright but may be reproduced by
any method for educational purposes by anyone working to improve the lives
of displaced girls and women in emergency and development contexts, as long
as the source is clearly referenced. It should not be reproduced for sale or
commercial purposes.
First edition, 2020
Contents
1 2 3 4
Introduction Review of Key Consultation Female-Friendly
MHM Concepts Toilets
Page 5 Page 9 Page 11 Page 15
5 6 7 8
Menstrual Material Menstrual Material Washing, Drying Information, Education
Disposal Waste Management & Storage & Communication
Page 21 Page 31 Page 39 Page 49
Preface Menstrual Disposal, Waste Management & Laundering in Emergencies: A Compendium aims to provide strategic We acknowledge that the toolkit utilizes a binary guidance to support organizations and agencies seeking to approach (girls and women), and thus does not rapidly address these critical and often overlooked aspects recognize the diversity of people who menstruate. of an MHM response. The compendium complements There is considerable unexplored scope to broaden the MHM in Emergencies Toolkit, which identified a few these programs to become more inclusive and key gaps in practice, namely: menstrual disposal, waste responsive, and to carefully consider the language management and the laundering of reusable materials. used when equating ‘women and girls’ with ‘people The compendium was informed by a desk review, who menstruate’ for the various contexts in which qualitative assessments with a range of humanitarian humanitarian response efforts occur. actors and organizations, environmental inspections of new approaches and strategies being piloted and direct discussions with displaced girls and women directly experiencing these issues. Published by: Co-published by:
1 Introduction Back to
contents
1 Introduction
Globally, there is increasing attention towards Challenges and Responses to MHM in Emergencies
incorporating menstrual hygiene management 2 Review of key
MHM concepts
(MHM) into humanitarian response. However,
in the majority of emergencies, the distribution
Challenge
3 Consultation
of menstrual materials by response actors Over
tary c
to adolescent girls and women is the most ani ding and rowde
sev
of
s
clu ere d co 4 Female-friendly
common activity. Although materials are
ack ls, in ear ly n
priv dim ditio toilets
essential, their distribution represents only L eria rw ac ini
at de y sh
m un
ns d
one component of a complete MHM response e
5 Menstrual materials
Response
(see Figure 1). Women and girls must also disposal
have appropriate menstrual hygiene and sup M H
health information, in addition to the practical fac por 6 Menstrual materials
M e
ability to use available menstrual materials il i waste management
tiv s
assment around
as intended.
tie
&
& discomfort
7
friendly toilets &
supplies
Washing, drying
materials
bathing spaces
Lack of female
MHM
& storage
More specifically, there has been insufficient
Anxiety and
attention provided to two key areas of an
MHM response: 8 Information,
education &
communication
1) menstrual material disposal and
s
em r
e Re
k
a
ns sp
a
b
waste management; and o on
le
sp se
Re
2) menstrual material washing and drying.
ge Ch
Left unaddressed, existing MHM
ll en M H M i on all
en
ha t
responses are insufficient, and will not C informa ge
be successful in meeting beneficiary
needs. This compendium aims to ac os
L
of k o f tabo
contribute to filling this gap. me kno l s
ura ion
ns w
tru ledge Cult trict H M Compendium
s M
ratio
n & re d to
at e on MHM
rel
Disposal, Waste
Management &
Laundering
5
Although there has been considerable progress
in the openness with which menstruation is This guidance seeks to address key
Back to discussed, along with increased comfort in the gaps with respect to the specific
contents provision of menstrual materials, this progress has
practicalities of managing menstrual
not applied to discussions around the handling of
used, bloody, menstrual materials. These remain, materials. Displaced women and girls
perhaps, one of the most taboo items in the world. using disposable products face clear
1 Introduction challenges figuring out how to get rid
For any woman or girl who changes her pad or
other menstrual material during her period, there is of them in their constrained contexts.
2 Review of key
MHM concepts an immediate question about what to do with the And those using reusable materials
used pad or material. If disposable, there needs
must be able to wash, dry and store
3
to be a way to dispose of it. If it is to be reused,
Consultation
it needs to be washed, dried and stored, ready them hygienically between periods,
for re-use. In almost all cultures across the similarly with limited privacy. To
4 Female-friendly
toilets world, there is extreme stigma associated with date, humanitarian responders have
other people (especially, but not limited to, men) provided few innovative solutions
5 seeing or being aware of the existence of this
Menstrual materials
disposal for these challenges.
used material.
This compendium focuses on some specific
6 Menstrual materials
practicalities of managing menstruation in
In discussing these issues, the
waste management
humanitarian contexts. Whereas the MHM in compendium draws on a survey
7 Washing, drying Emergencies Toolkit provides guidance on the of good practices being utilized by
& storage
broader context of providing for menstruation in a organizations around the world, to
humanitarian response, this compendium aims to
8 Information, propose approaches that may be
provide practical guidance on some approaches to
education &
communication menstrual material disposal, waste management adapted to new responses and
and laundering. new contexts.
Compendium
on MHM
Disposal, Waste
Management &
Laundering
6
Four Key Practical Tasks: Disposable & Reusable Materials
Back to
Washing & drying of Waste management contents
reusable materials or final disposal
Reusable materials, including reusable pads and Waste management refers to the final (or secondary)
pieces of cloth, need to be regularly cleaned with 1 Introduction
disposal of menstrual waste (e.g. used menstrual
soap and water and then fully dried to ensure both materials) which may be completed by girls and
their hygienic and comfortable reuse. This can be difficult 2 Review of key
women themselves or, as is usually recommended, by MHM concepts
when there are water shortages (making it difficult to wash), rainy sanitation workers. When girls and women conduct this task,
seasons (making it difficult to dry) or an insufficient amount of soap they may burn this waste informally at home, bury it or combine it with 3 Consultation
is available. An inability to properly wash reusables can result in bad other household waste for dropping into pits or an existing solid waste
odors, discomfort and the premature disposal of the material by users. management system (if operating). When handled by sanitation workers,
4 Female-friendly
final disposal methods can include incineration or dropping waste into toilets
Lack of privacy is also a major problem. People do not want to be seen
larger protected dumping sites such as landfills.
washing their used menstrual materials, nor do they want others in their
5 Menstrual materials
family or community to see the materials that are drying. The need for There may also be recycling efforts and waste sorting after collection. disposal
secrecy often leads to women and girls re-using materials that are still Women and girls often feel discomfort disposing of menstrual waste
damp (as they do not have sufficient time to dry), or that have been dried if they know it may be handled by others, or may be seen by others, 6 Menstrual materials
under mattresses, under clothing, or in other unsanitary locations which especially by men. This may lead them to resort to their own waste management
can be prone to mold. approaches (e.g. burying or burning of used materials).
7 Washing, drying
In some cases, there may also be beliefs around disposal itself. & storage
Disposal of used For instance, some cultures believe that burning menstrual blood
menstrual materials is bad and will cause health problems for the former user. 8 Information,
education &
communication
Disposable materials are intended to be disposed of Storage of
after a single use. As girls and women use several
disposal materials per period, they will need to
menstrual materials
frequently perform this task. In the absence of adequate
Storage of menstrual materials refers to
disposal options, many girls and women drop used materials into 1) the immediate storage of used menstrual materials
pit latrines, forests, rivers or bury them; all in an effort to maintain between washes (e.g. when a girl changes a pad at
their privacy. school) and 2) the storage of menstrual materials
Disposal options should be discreet and aligned with the cultural norms of between monthly periods.
Compendium
the target population. Girls and women are often uncomfortable if others Even after laundering, reusable menstrual materials are often considered on MHM
(men, women and children) can see their menstrual waste. The need embarrassing. Living conditions for displaced populations can make the Disposal, Waste
for disposal systems is particularly urgent in settings where single-use storage of menstrual materials challenging due to a range of factors such Management &
materials (e.g. disposable pads) are commonly used. as limited privacy and the need to keep the reusable materials dry and
Laundering
In addition, the disposal of reusable products is a frequently overlooked clean to prevent mildew or insect infestation. Girls and women may need
aspect of many disposal approaches. Attention should be given to support, in the form of protective and leakproof bags/cases, to safely and
solutions that will incorporate eventual disposal of reusable pads, cloth discreetly store their menstrual materials. Otherwise they may not go to
school or outside the home while menstruating.
and period underwear. 7
Back to
contents
1 Introduction
Aim of Compendium
2 Review of key
MHM concepts The objective of the Menstrual Disposal, Waste
Management & Laundering in Emergencies
3 Consultation
Compendium is to complement the existing
MHM In Emergencies Toolkit published in
2017. During the development of the toolkit, it
4 Female-friendly
toilets was recognized that insufficient learning and
strategies were available around how best to
5 Menstrual materials support displaced girls and women with menstrual
disposal
disposal, waste management and the laundering
of reusable materials. This includes hardware and
6 Menstrual materials software approaches which ensure that girls and
waste management
women are able to utilize and benefit from the
increased provision of menstrual materials and
7 Washing, drying
& storage supplies in many humanitarian contexts.
In order to encourage MHM programming
8 Information,
which is aimed at supporting menstrual material
education &
communication disposal, waste management and laundering,
this compendium highlights a range of new
solutions currently being tested around the
world with the intention of promoting more
localized dialogue and considerations amongst
humanitarian responders working in new and
ongoing displacement contexts around the world.
Compendium
on MHM
Disposal, Waste
Management &
Laundering
8
2 Review of Key MHM Concepts Back to
contents
1 Introduction
MHM in Emergencies Basics: laundering, including storage between cycles 1. MHM Materials
or directly after use. 2 Review of key
A Quick Overview & Supplies MHM concepts
For each emergency context, the types of
When integrating MHM into an emergency, it menstrual materials, types of facilities and Prior to selecting a menstrual material for 3 Consultation
is important to consider three key components: types of information provided are inter-connected. distribution in a new emergency, consider cultural
Materials & Supplies, Facilities and Information. This necessitates a coherent approach starting implications, what types of supplies are needed 4 Female-friendly
More detailed information can be found in the from material selection, through to final waste to support management requirements, how toilets
MHM in Emergencies toolkit. Within each of these management, for an effective MHM response. facilities should be designed and any educational
components, there are the relevant aspects for The practicalities around the handling of used instructions that may be required. 5 Menstrual materials
disposal
designing approaches for menstrual materials materials, such as laundering of reusables, also
disposal, waste management and/or need to be incorporated into the planning. Optimizing the usage of menstrual materials:
Different menstrual materials require different 6 Menstrual materials
waste management
tasks associated with their proper usage. Both
3 Components to an MHM response software and hardware solutions can enhance 7 Washing, drying
the usage and acceptability of these products. & storage
Software solutions include ensuring girls and
women have sufficient information on how to 8 Information,
education &
use the materials, such as how to wash, dry communication
sup M H and dispose of them. It can also include tips
fac por for minimizing the likelihood of stains and
M e
il i reducing odors in reusable materials. Hardware
tiv s
solutions include providing supplies that improve
tie
&
supplies
materials
usage such as laundry detergent (as opposed to
MHM
just basic soap) for removing blood in reusable
pads and on underwear, providing leakproof
bags to enable convenient and discreet storage
and transport after changing pads, and/or ropes Compendium
for home-based drying of reusables materials on MHM
(see Chapter 7 for more information). Disposal, Waste
Management &
M H M i on
t Laundering
informa
9
2. MHM Supportive 3. MHM Information
Facilities Girls and women need to know how
Back to Reminder: Menstrual
contents to properly use any new menstrual
Girls and women need WASH facilities or
other private locations for managing menstruation
materials or facilities provided to them. Materials vs Menstrual
Aspects of the menstrual materials, supplies Supplies
and its related tasks. This includes spaces for
and facilities being introduced may be different
changing menstrual materials during the day
1 Introduction than what girls and women used prior to Menstrual Materials: Materials used to catch
and night as needed, disposing of menstrual
displacement, so it is essential to provide clear blood such as a pad, piece of cloth, tampon,
waste, bathing or cleaning themselves, washing
2 Review of key information, often in the form of demonstrations, menstrual cup, period underwear or any other
MHM concepts and drying their used menstrual materials and
on how to properly use these new materials preferred method.
underwear and private storage for re-use
or resources. MHM information should also
3 Consultation
during the next menstrual cycle.
include basic menstrual health education Menstrual Supplies: Any supplementary
Existing taboos and secrecy around menstruation (especially for pubescent girls), and address items needed to support the management
4 Female-friendly
in many societies mean that WASH actors should harmful cultural or social norms related to
toilets of menstruation such as supplies for
consider the following illustrative examples menstruation. See Chapter 11 from the toolkit washing/drying of reusables, storage bags
when consulting with girls and women around for more information on the delivery of education or instructions on how to properly use or
5 Menstrual materials
disposal design and implementation: for girls, as they may need different information maintain the product.1
than women.
6 Menstrual materials
•G
irls and women often prefer not to take
waste management used menstrual waste out of a toilet.
Effective Usage of Menstrual Materials: What do girls & women need to know?
They are concerned that others may see them
7 Washing, drying carrying it. Thus, optimal disposal options should
& storage
be directly inside toilet stalls where girls and Reusable Materials: Disposable Materials:
women have some privacy.
8 Information, •H
ow do I insert or attach the reusable material? •H
ow do I insert or attach the
education &
communication • Girls and women may have blood on their disposable material?
hands or clothing after changing menstrual •W
hat is the ideal duration of wear for the reusable
materials; water inside or nearby the toilet stall material (as to avoid leaks, irritation or health risks)? •W
hat is the ideal duration of
enables them to discreetly wash their hands or wear for the disposable material
•H
ow do I properly clean (wash and dry) the reusable (as to avoid leaks, irritation or
clothing without others seeing this blood.
material for continued usage over time? What other health risks)?
• Blood in water after bathing or laundering supplies do I need to properly clean it?
can be embarrassing for girls and women, •H
ow and where do I properly
•H
ow do I safely store the reusable material between dispose of the material
so drains in bathing spaces may need to be
Compendium each usage or menstrual period? following single usage?
covered to mitigate this exposure.
on MHM
•H
ow and where do I eventually dispose of a reusable
Disposal, Waste material after their prescribed lifespan?
Management &
Laundering
103 Consultation Back to
contents
1 Introduction
Introduction Consulting girls and women Engaging Men and Boys 2 Review of key
Consultation should be the first step when MHM concepts
designing or improving any MHM-supportive There are a variety of methods that can be used When designing or constructing new WASH
facilities or programming. When consultation to ensure girls and women are involved with facilities or resources for girls and women, it is 3 Consultation
is utilized from the onset, there is often the design of MHM supportive facilities and often necessary or useful to include men and
higher acceptability and utilization of facilities programming. Focus Group Discussions (FGD) boys in the process. Some reasons include: 4 Female-friendly
toilets
and resources by girls and women. Careful with age-segmented groups of adolescent girls
•C
hallenges may arise when larger or more
consultation is especially important when and women can be a useful tool for soliciting
conveniently located WASH facilities are 5
trying to address solutions for taboo-laden inputs. It is important not to overlook vulnerable Menstrual materials
girls and women, such as those experiencing provided to only the female population. Male disposal
topics like menstrual disposal or the handling
physical or mental disabilities. Additional beneficiaries may decide to use new female
of menstrual blood while washing and drying
facilities, regardless of gender signage, which 6 Menstrual materials
menstrual materials. consultation methods can strengthen the waste management
consultations, such as: can make female users uncomfortable and
All consultation activities should be led by females less likely to use the facility.
to enhance the comfort and ease of participants. •C
onduct one-on-one interviews to complement 7 Washing, drying
& storage
FGD, and allow for more in-depth exploration •N
egative reactions from male community
In some cases, it might be useful to collaborate
of taboo topics that girls and women may not members may arise from providing new
with Protection actors or Community Volunteers 8 Information,
be comfortable discussing in front of peers; female facilities. Discussions with community
who have pre-existing relationships with female education &
•D
evelop physical models or drawings to depict leaders can be a useful place to assess communication
beneficiaries and may be able to more easily
WASH facilities, their layout and potential the possibility of this challenge arising and
foster their participation or solicit feedback
solutions and improvements to address girls’ address it early.
on specific topics.
and women’s needs; • T he location of the facility may determine
• Invite girls and women to inspect the facilities not only a female user’s comfort level in
during construction to ensure they feel using the facility, but also if the males in their
confident about their recommendations for families are accepting of it, especially at night.
improvements and determine if any further Assessing male perspectives on the location
refinements may be needed; of a new facility can be useful prior Compendium
• Invite girls and women to view newly to construction. on MHM
constructed or renovated facilities in nearby •S
ometimes boys and men may not have Disposal, Waste
communities in order to assess reactions and considered some of the distinct sanitation Management &
perceptions on acceptability prior to scaling up. needs of females in their community. Laundering
•C
onduct walk-throughs of existing facilities By reviewing these various issues with
where girls and women can convey their them proactively, they may be more likely
opinions and recommendations on specific to support and champion the development
aspects; of new or improved facilities. 11Examples from the Field: Consultation Practices
Back to Utilizing an inclusive girl-centered consultation process
contents
Location
Dzaleka Refugee Camp, Malawi
1 Introduction Organization
Plan International
2 Review of key
Basic Information
MHM concepts
Plan International utilized a Human Centered Design (HCD) approach
to generate insights from girls and women in Dzaleka Camp exploring
3 Consultation
challenges and solutions related to MHM. This included engaging with
a diverse group of girls and women across a range of ages, ethnicities,
4 Female-friendly
toilets religions and levels of education. In addition, Plan also engaged families/
foster caregivers, local gatekeepers and institutions within Dzaleka
5 Menstrual materials
Camp. The 2-week HCD process included an initial phase comprised of
disposal observation of community spaces, FGDs and discussions with girls and
various actors involved in MHM programming. The focus was on exploring
6 Menstrual materials the MHM experiences and challenges experienced by girls and young
waste management
women. Following this phase, a co-creation process was introduced
with girls, women, boys and men aimed at identifying solutions to the
7 Washing, drying
& storage identified challenges. This included the use of drawing, modeling and
other participatory approaches aimed at soliciting input and feedback.
8 Information, This included exploring issues related to menstrual disposal, washing
education & and drying of reusable products in a context where worries about
communication
witchcraft were very prevalent.
Benefits
Segmenting the groups by age (including separating early adolescents
from older adolescents) enabled girls to be more confident sharing their
insights and thoughts. Important insights were generated regarding the
specific challenges associated with witchcraft beliefs and their implications
for identifying solutions related to disposal or washing of menstrual
materials. These insights are now being used to inform the development of
Compendium
potential solutions aimed at addressing these issues.
on MHM
Disposal, Waste
Management &
Laundering
12Examples from the Field: Consultation Practices
Interactive surveys and co-creation sessions for informing WASH design Back to
contents
Location
Somali Region, Ethiopia
Organization 1 Introduction
Save the Children UK (STC UK) and Eclipse Experience Ltd.
Basic Information 2 Review of key
MHM concepts
DA consultation strategy was introduced by STC UK and Eclipse which
utilized a user-centered community engagement methodology comprised of
3 Consultation
two core components: interactive digital surveys and co-creation sessions.
These two interconnected components were used to inform how to design
4 Female-friendly
improvements to child-friendly sanitation spaces. The interactive surveys, toilets
which used visual components to help overcome literacy barriers, also
involved the production of visual outputs that could quickly inform design 5 Menstrual materials
decisions. The surveys included questions based on scales of “smileys” disposal
and interactive questions which enabled participants to respond by tapping
on the digital illustrations on the tablet. The co-creation sessions with 6 Menstrual materials
waste management
community members were then utilized to dig deeper into issues and
enable for a collaborative process for creating solutions for addressing the
7 Washing, drying
issues identified. Although specific to child-friendly sanitation, such methods & storage
could prove useful for soliciting girls’ and women’s feedback on sensitive
topics related to menstruation and female-friendly sanitation solutions. 8 Information,
education &
Benefits communication
Digital tools can help overcome literacy barriers and be highly adaptable
based on the context. In addition, such tablet surveys may be cost effective
and useful for the rapid data collection, analysis and creation of visual
outputs to inform decision making during an acute emergency response.
Challenges
Data collectors and co-creation facilitators will require training and may
be unfamiliar with the new technologies and interactive survey methods.
There is the potential for equipment malfunction or breakage, especially in Compendium
challenging environments. on MHM
Additional Resources Disposal, Waste
Ethiopia Pilot Outcomes Report Management &
Interactive Digital Survey Findings - Ethiopia Laundering
User Centered Community Engagement Collective Case Study Reports
13Examples from the Field: Consultation Practices
Back to A Social Architecture Approach for Developing Female Friendly Toilets
contents
Location
Cox’s Bazar, Bangladesh
1 Introduction Organization
Oxfam with support from UNICEF and UNHCR
2 Review of key
Basic Information
MHM concepts
During the development and construction of female friendly
WASH spaces, WASH staff in Cox’s Bazar, Bangladesh implemented
3 Consultation
an iterative social architecture approach to better involve girls and
women across the entire process. The social architecture approach
4 Female-friendly
toilets consisted of multiple consultations with women and girls in the
community over the course of 9 months, from the initial consultation
5 Menstrual materials
to assess their needs and decide on the design, the creation of 3-D
disposal models so that they could visualize and discuss the layout, inspections
of the facility as it was being constructed and follow-up consultations.
6 Menstrual materials The female friendly WASH space developed was comprised of toilets,
waste management
a shower room and a laundry area.
7 Washing, drying Benefits
& storage
The social architecture approach was able to capture girls’ and women’s
voices during the design and construction phases. For example, girls
8 Information, and women indicated they would prefer for the toilets to be combined
education &
communication with the shower and laundry area, as this would reduce stigma they felt
when entering standalone toilet blocks. The inclusion of girls and women
throughout the entire process also generated buy-in to facilities, with
women and girls indicating they were more likely to take ownership of the
facility and ensure for its proper maintenance and cleaning.
Challenges
This approach involves many consultation sessions with community
members, which may take months and delay an organization’s ability to
Compendium construct facilities quickly. Future iterations of this approach may need to Every male person was saying that
be conducted at a faster pace. Additionally, because it is dependent on
on MHM
community opinion, female friendly toilet units in each community may if the facility is nearby my house, I will
Disposal, Waste
Management &
have different designs based on different needs (2). let my woman or girl go use that one. If
Laundering
it is just a bit far, then maybe I will not
let my ladies go use the washroom.
14 WASH officer, Cox’s Bazar, Bangladesh34 Female-Friendly Toilets Back to
contents
1 Introduction
Introduction
2 Review of key
In overcrowded and privacy scarce Water availability inside the toilet stall is particularly Besides the features inside the toilet stall, the MHM concepts
displacement contexts, toilets are often the relevant to menstruation. Girls and women may entire design of toilet/washroom facilities provided
only space available for girls and women for have blood on their hands or clothing after for women and girls should be thought through 3 Consultation
changing or disposing of their menstruation changing menstrual materials. Thus, water inside carefully, especially in terms of their placement or
materials. Toilet stalls, which may be the or nearby the toilet stall enables them to discreetly location within the built environment. 4 Female-friendly
most private and secure spaces available wash their hands, clothing and/or reusable pad •A
ccess: Depending on the culture, it may be
toilets
in displacement contexts, oftentimes fall without others seeing this blood. In other cases, shameful or embarrassing to be seen entering
short in actually addressing the full they may want to rinse or wash a reusable pad on 5 Menstrual materials
toilet blocks. The more visible that toilets are disposal
sanitation needs of women and girls. the spot, prior to taking it home for more thorough to other members of the community, the more
washing and drying. challenging it may be for women and girls to
The diagram on the next page depicts the 6 Menstrual materials
key components of a ‘Female-friendly Toilet.’ With respect to disposable materials, girls and access them. Sometimes, it may be helpful to waste management
This concept was developed through direct women often prefer not having to take used combine female toilets with other ‘women-only’
menstrual waste outside of the toilet given facilities, such as showers and laundry areas, so 7 Washing, drying
discussions with displaced women and girls living & storage
in a range of humanitarian settings. Despite there concerns that others may see them carrying it. that it is less apparent why a person is entering
being significant differences in cultures and When possible, disposal options should be located a facility. In addition, accessing toilets during the
8 Information,
contexts, strong agreement emerged around the directly inside the toilet stall to promote privacy nighttime can be problematic for many girls and education &
communication
essential components for making toilets safer, more and ease of use for girls and women. If toilets are women given safety concerns, poor lighting and
appropriate for meeting girls’ and women’s needs, pit latrines, girls and women may be likely to drop fears of vermin or dogs.
and thus, increasing the likelihood of their use. used materials directly into the pit if alternative, •H
igh Demand: Where there are long queues for
culturally appropriate disposal options are not toilets, there is oftentimes pressure to use the
provided, thus potentially increasing the fill rate toilet quickly, with others banging on the door
of the latrines. and asking you to hurry. This pressure can make
girls and women especially uncomfortable when
needing to change or clean menstrual materials
or clothing. Compendium
on MHM
The houses are too small and don’t allow for Disposal, Waste
Management &
privacy. It is one room for the entire family. The size Laundering
of the house and the lack of separation from the
men and boys is a problem.
15
Rohingya Woman, Rakhine State, Myanmar4An example of a
female-friendly toilet
Adequate numbers of safely located toilets separated A shelf and hook for hygienically storing Easily accessible water (ideally inside the cubicle)
(with clear signage) from male facilities. belongings during usage for girls and women to wash themselves and
menstrual materials
Some units should be accessible to people
with disabilities
Clear signs instructing girls and women to dispose Night time light source both inside and outside of
Safe and private toilets with inside door latch
of menstrual waste in the trash bin or chute the toilets
Walls, door and roof are made of non-transparent A chute for discreet disposal of menstrual Grab bars to assist pregnant, elderly or disabled
materials with no gaps or spaces. Entrances should materials persons – format can vary and is to be discussed
be screened so that people cannot be seen entering OR with users
and leaving the cubicle itself Trash bins (with lids) to dispose of used
menstrual materials
Back to
16 contents•P
rivacy: Many toilets have gaps around the door, •M
aintenance: Toilets, especially those shared
holes or gaps in their structure, low walls or wide with multiple families or open to the public,
gaps under doors. These design flaws result often become dirty, and may deteriorate or be Back to
in anxiety by women and girls that they can be vandalized, unless suitable community structures contents
seen from outside while using the toilet and are in place. The provision of appropriate
changing their menstrual materials. disposal options that are regularly serviced can
•S
ecurity: Many toilets lack latches, as they are also improve perceptions of cleanliness by users.
1 Introduction
often stolen or broken. The lack of a secure latch •S
pecial Needs: Many girls and women may
creates a constant risk that someone might open experience physical and intellectual disabilities
2 Review of key
the door while the toilet is in use. that necessitate the support of a caretaker MHM concepts
•G
ender: In some humanitarian responses, when accessing toilets and managing their
toilets are designated to be ‘shared’ by two or menstruation. Additional room may be needed 3 Consultation
more families, without gender segregation. In inside the stall for the caretaker or design
other cases, even if toilet blocks are marked as measures (ramps, bars) to enhance ease of use
4 Female-friendly
male or female, people do not necessarily follow (see toolkit for more information). toilets
the rules. For women and girls especially, the
presence of men (or possibility of their presence 5 Menstrual materials
disposal
in the future) in the toilet can make management
of menstruation more stressful.
6 Menstrual materials
•S
tigma: When developing a block of female waste management
toilets for communal or institutional use, it is not
advised to just design one or two of the stalls as 7 Washing, drying
& storage
“menstruation” supportive (e.g. disposal option,
water inside). This can lead to stigma and reduce 8 Information,
the likelihood that women and girls will use those education &
communication
stalls for fear of inducing shame when others
see them enter.
Compendium
The informal settlements are not secure, so we on MHM
can’t go outside [to the toilets] at night…. Disposal, Waste
Management &
Syrian Woman, Beqaa Valley, Lebanon2 Laundering
17Examples from the Field: Female Friendly Toilets
Back to
contents Modifying existing toilets to be more Female Friendly
Location
Nyaragusu Camp, Northwest Tanzania
1 Introduction
Organization
Oxfam-Tanzania in collaboration with the IRC
2 Review of key
MHM concepts
Basic Information
Existing toilet blocks constructed for adolescent girls attending school were
3 Consultation
modified after the initial construction to become more female friendly. This
included the introduction of a few inexpensive modifications to enhance
4 Female-friendly
toilets girls’ comfort while using the toilets. Hooks and a shelf were added inside
each stall so girls could hang their bags or clothing while using the toilet or
5 Menstrual materials changing their menstrual materials. A mirror inside the stall was introduced
disposal
so that girls could check for blood stains on their clothing. Lastly, buckets
of water were provided directly in each stall to ensure girls could wash any
6 Menstrual materials
waste management blood off their hands and the toilet slab.
Benefits
7 Washing, drying
& storage Even though the toilets had already been constructed, simple “add-on”
improvements can be introduced at a later point in time. These basic
8 Information, measures can enhance girls’ confidence in using the toilets and changing
education &
communication their materials during the school day. These measures were provided in all
of the toilet stalls, not just one, to reduce the potential for stigma.
Challenges
The water buckets in each stall need to be routinely filled throughout the
day. There is potential for theft of the mirrors or hooks.
Compendium
on MHM
Disposal, Waste
Management &
Laundering
18Examples from the Field: Female Friendly Toilets
Back to
Combination toilet, shower and laundering spaces for females contents
Location
Rohingya Camps outside Cox’s Bazar, Bangladesh
1 Introduction
Organization
Oxfam with support from UNICEF and UNHCR
2 Review of key
MHM concepts
Basic Information
Consultation with girls and women during the design phase identified
3 Consultation
a dislike of standalone toilet blocks as female users felt uncomfortable
when others could see them entering the toilets. Instead, girls and women
4 Female-friendly
preferred a combined unit, where the showers, toilets and a laundry toilets
area were all located in one entirely fenced in space. In addition, women
recommended adding a variety of other female-supportive measures, 5 Menstrual materials
disposal
including a bamboo pole in the toilet stall to assist older and pregnant
women when they squatted, and a bench in the shower space.
6 Menstrual materials
waste management
Benefits
Girls and women liked the design as no one knew the reason they were
7 Washing, drying
inside the female WASH unit, as the combined space provided them with & storage
enhanced privacy.
8 Information,
Challenges education &
communication
As this unit was larger than normal toilet blocks, it required more land for
construction. The size made it challenging to find adequate locations in the
already space limited camps. In addition, Rohingya girls and women had
limited mobility. Thus, identifying a location that was close enough to their
homes so that they would be permitted to freely use the facilities required
dialogue and compromise with male household heads.
Additional Resources:
1. Women’s Social Architecture Project - Phase 1 Final Report Compendium
2. Social and Feminist Design in Emergency Contexts Article on MHM
Disposal, Waste
Management &
Laundering
19Examples from the Field: Female Friendly Toilets
Back to
contents Modifying existing toilets to be more Female Friendly
Location
Rohingya Camps outside Cox’s Bazar, Bangladesh
1 Introduction
Organization
Red Crescent Society of Bangladesh with the support of the
2 Review of key
MHM concepts Danish Red Cross
Basic Information
3 Consultation
Conversations with women and girls revealed that many feared
getting stuck in a latrine at night and during monsoons, along with
4 Female-friendly
toilets concerns about being followed into a latrine. In response, male
Rohingya volunteers who were supporting the construction of new
5 Menstrual materials latrines brainstormed about a solution. Their proposed solution was to
disposal
create an emergency alarm device to address this issue. The volunteers
designed a bamboo pole and stick device that can be used to make
6 Menstrual materials
waste management an alarm noise to alert neighbors if needed. After testing, women and
girls recommended that the height of the pole needed to be easily
7 Washing, drying reached while a user is sitting or using the latrine.
& storage
Benefits
8 Information, While the needs of women and girls vary by context, and WASH
education &
communication solutions will depend on locally identified preferences, this is an
example of a simple solution to a widespread problem that was
designed by the beneficiaries themselves and implemented at
low cost.
Challenges
Implementation of this alarm system required consultations with
user groups to ensure all women and girls would be able to benefit
from the system.
Compendium
on MHM
Disposal, Waste
Management &
Laundering
205 Menstrual Disposal Back to
contents
1 Introduction
Introduction
2 Review of key
Disposing menstrual materials, meaning used MHM concepts
Key Things to Remember:
materials with or without blood stains still
on them, is a highly sensitive and frequently 3 Consultation
stigmatized experience for most girls and
women. Used menstrual materials are Girls & women use on average 7-10 disposable pads per month; 4 Female-friendly
toilets
considered distasteful and associated •D
isposal challenges can lead to unhygienic coping strategies, like wearing a menstrual material for
with strong negative cultural taboos. longer than 4-6 hours;
5 Menstrual materials
Girls and women in most humanitarian contexts do •E
xtended usage of materials can result in discomfort, irritation and higher likelihood for stains; disposal
not want anyone, including females, cleaning staff,
children and especially males to see this waste. •E
ven when using reusable materials, girls and women will have to throw them away eventually; 6 Menstrual materials
Sensitivities around menstrual waste can make Disposal options are still needed, although less frequently. waste management
it challenging to find good ways to support girls
7 Washing, drying
and women. Disposal solutions must be discreet & storage
and culturally acceptable, requiring sustained
consultation with girls and women, and clear Key Questions to ask:
8 Information,
education promoting proper use. education &
communication
1. What type of menstrual material did girls and women use prior to displacement?
Current Practices
2. What type of menstrual material are they currently using in this context?
Before designing and introducing a new
3. How and where did girls and women dispose of menstrual waste back home (prior to
menstrual disposal solution, it is essential
displacement)?
to know girls’ and women’s:
4. How and where are girls and women currently disposing of menstrual waste in this context?
• previous (pre-displacement) practices
5. What types of challenges do girls and women experience throwing away menstrual waste
• current menstrual disposal practices Compendium
in this context?
• c ultural beliefs and stigmas surrounding on MHM
6. What are girls’ and women’s beliefs and/or worries about disposing of menstrual materials
menstruation Disposal, Waste
in this context?
This learning will enable design of a disposal Management &
7. How would girls and women prefer to dispose of menstrual materials? Laundering
solution that meets girls’ and women’s needs.
21Methods for Disposal
Girls and women generally adopt one of the following methods when disposing of menstrual waste. Disposal
Back to
behaviors may be influenced by environment limitations, materials used, facility design, facility location, and
contents
cultural practices and beliefs around menstruation or used materials.
Method Practice Considerations
1 Introduction
Household solid Menstrual waste is often combined with other types This method tends to work fine if there is a functional solid waste
2 Review of key waste streams of household waste. It is then either picked up or management system in place. In some cases, waste may pile up in
MHM concepts
dropped off at designated disposal points. communities, posing environmental hazards. Girls and women may not
be comfortable with this method if they think their menstrual waste will
3 Consultation
be left in the open and/or seen by others.
4 Female-friendly
toilets Disposal containers or Menstrual waste is sometimes directly put into A cleaning system, which includes routine emptying of the containers/
bins inside toilets or disposal bins or other containers. This method bins, is essential to promote confidence by users and thus usage. Most
5 Menstrual materials
bathing spaces is most commonly found in communal or girls and women prefer for the containers to be discreet and covered
disposal institutional toilets. to minimize others ability to see inside. This system is likely only
feasible in gender-segregated toilets given sensitivities about males
6 Menstrual materials seeing this type of waste.
waste management
7 Washing, drying
Immediate burning (at Some girls and women may prefer to immediately Burning is usually more challenging in camp contexts given space
& storage the household level) burn used menstrual waste, either separately or limitations and safety regulations about household-level fires. Burning,
alongside other household waste. especially of plastics often found in disposable and reusable materials,
8 Information, can also emit particulates, dioxins and furans, which are unhealthy for
education &
communication the nearby community.
Ad hoc disposal or Ad hoc disposal refers to the disposal of menstrual These practices can create environmental hazards and unsanitary
burial of waste waste by discarding it outdoors, often in alleys, living conditions. They are especially problematic in densely populated,
fields or rivers. Burial of menstrual waste outside, flood-prone or loose soiled environments. Stray animals and children
a common practice for many girls and women, may also uncover this waste.
may be how they managed menstrual disposal Ad hoc disposal or burial practices are often performed at night
prior to displacement. or before dawn to enhance privacy, which can also pose security
Compendium challenges for girls and women.
on MHM
Disposal directly Throwing used menstrual materials directly into Any water seal (flush) toilet is prone to blockage, in the P-trap itself,
Disposal, Waste
into toilets toilets/latrine holes is often the most convenient or in the drain line or sewer beyond.
Management &
and private option. This is especially the case in Direct disposal can also increase the rate at which pits, cesspits
Laundering
the absence of any other disposal solution being and septic tanks fill and also make de-sludging more difficult as
available inside the toilet facilities. the equipment may become clogged. Cloth, including reusable pads,
is generally more problematic than disposable pads with respect to
22 de-sludging.MENSTRUAL DISPOSAL: FOUR KEY ELEMENTS
How will the disposal strategy (e.g.
bin, chute) minimize opportunities
for others to view this waste? How
DISCREET will the design promote confidence
DESIGN among girls & women?
How will the disposal and
waste management systems be
communicated to girls & women?
How will feedback be solicited?
COMMUNICATION MAINTENANCE
WASTE How will the disposal strategy be
MANAGEMENT maintained over time (e.g. emptied,
cleaned, frequency of service)?
What type of final disposal method will
be used for collected menstrual waste
(e.g. burning, waste pits)? Is this method
acceptable to girls and women? Back to
contents 23Communal Facility Examples of Menstrual Disposal Strategies for Communal Toilet Facilities
Disposal Hardware
Back to
contents Communal or shared toilets, which Piped Disposal Chutes in Communal Toilets
often serve multiple households in
displacement contexts, may be the only Location
location where girls and women are able Rohingya Camps outside Cox’s Bazar, Bangladesh
1 Introduction
to change menstrual materials. Toilets Organization
are also often the preferred space for
Red Crescent Society of Bangladesh with the support of
2 Review of key girls and women to dispose of menstrual
MHM concepts the Danish Red Cross
waste, given preferences to not have to
take menstrual waste outside of toilet Basic Information
3 Consultation
stalls for risk of others viewing it. Pipes made of 75mm (3”) Polyvinyl chloride (PVC) are
inserted into the back of the toilet stalls to form chutes,
4 Female-friendly Important Note: If toilets are not gender
toilets leading to vaults lined with concrete rings (1.8m or
segregated, many girls and women may
6’ deep). Users can dispose of their menstrual waste
not be willing to use any disposal solution
5 Menstrual materials through the chute, and it is deposited into the vault.
disposal that is provided inside of them, such as
a dustbin. The waste in the vault is collected for incineration every
3 months. To ensure girls and women know what the
6 Menstrual materials
waste management A range of different examples of disposal disposal was and how to properly use it, clear signage
strategies have been identified from both with pictures was placed directly over the chute.
7 Washing, drying emergency and non-emergency contexts
& storage Benefits
around the world.
Women can directly dispose of pads without being seen
8 Information, and without fear that others will see the menstrual waste
education &
communication and associate it with them.
Challenges
Girls and women indicated sometimes also using water
to ensure waste made it successfully down the pipe. In
some events, pads did get stuck. In some locations, a
bamboo stick was kept inside the stall, to clear the pipe
as needed. Water was also sometimes used to move
materials through the pipes, but could result in higher
Compendium filling rates of the vaults.
on MHM
Disposal, Waste Additional Resources
Management & A webinar presentation describing the design and
Laundering implementation proces
24Examples of Menstrual Disposal Strategies for Communal Toilet Facilities
Back to
Basic Waste Bins with Lids contents
Location
Internal Displacement Camps located in the Rakhine State, Myanmar
1 Introduction
Organization
Oxfam Myanmar
2 Review of key
MHM concepts
Basic Information
Rohingya refugees living in camps were found to be either burying
3 Consultation
menstrual waste or putting it directly into the toilets, which resulted in
the clogging of toilets. In response, WASH workers introduced basic
4 Female-friendly
covered waste bins in gender segregated communal latrines. Such waste toilets
bins were designed to allow women to dispose of materials without having
to leave the stall. Environmental cleaners were responsible for the routine 5 Menstrual materials
disposal
collection of the waste from the bins for disposal in communal incinerators
located in the camps.
6 Menstrual materials
waste management
Benefits
This method allowed women privacy in that they do not need to leave
7 Washing, drying
the toilets with used menstrual waste for burying or other disposal & storage
methods. It also protects the integrity of the toilet hardware and
reduces the clogging of pipes. 8 Information,
education &
communication
Challenges
In many contexts, girls and women are uncomfortable using any type
of open waste bin as they fear others may see that waste, including
cleaners, and know it is theirs. This is especially a challenge when there
is not gender segregation of toilets. Hygiene concerns, such as exposure
to germs, that are associated with touching lids, can also be an issue. In
addition, smaller bins, such as this model require more frequent servicing
by cleaners as they have limited capacity. Cleaners, when from the same
culture as the community, have also been found to scold or shame girls
Compendium
and women when putting their menstrual materials in these waste bins.
on MHM
Disposal, Waste
Management &
Laundering
25Examples of Menstrual Disposal Strategies for Communal Toilet Facilities
Back to
contents Waste bins with pedal-operated lids
Location Challenges
Dhaka, Bangladesh This system requires frequent emptying of disposed materials and
1 Introduction
potential for theft of bins. Toilet users and cleaners indicated discomfort
Organization
icddr,b and Johns Hopkins University when viewing menstrual waste in bins which could lead to discomfort
2 Review of key
MHM concepts by users. Some women would wrap the menstrual waste in paper or
Basic Information
polythene prior to disposal to reduce detection. Researchers suggested
A new waste bin with pedal-operated lids was piloted in communal toilets
3 Consultation exploring a bin with a flap rather than a lid to better conceal the waste
in urban slums in Dhaka. The reason for introducing these bins was that
inside the bin.
the toilets were filling very quickly due to the dropping of all types of waste,
4 Female-friendly
toilets including menstrual cloth and pads, into the pits. Desludgers indicated
that the waste was creating challenges for them, especially pieces of
5 Menstrual materials cloth. Discarded trash was also found to make the toilet environment
disposal
uncomfortable for users. In response, a new disposal system was
introduced into the communal toilets aimed at diverting menstrual waste
6 Menstrual materials
waste management (in addition to diapers and other bathroom waste) from direct drops into
the latrines. To promote usage, both signage and demonstrations were
7 Washing, drying conducted with the community. Both paid cleaners and volunteers were
& storage
used for emptying the bins in the pilot activities (2).
8 Information, Benefits
education &
communication Women found the pedaled waste bins with lids to be an acceptable option
and liked that the pedal enabled them to open and close the receptacle
without touching it. The liners in the toilets can make it easier for paid
cleaners and volunteers to conduct emptying duties as needed. Users also
indicated reduced toilet blockages since the bins were provided.
Additional Resources
1. An article by Yeasmin et al. 2018 describing intervention
Compendium
on MHM
Disposal, Waste
Management &
Laundering
I prefer to bury because someone can see it if they throw
it in the latrine; and men are using the female latrines.
26
Rohingya Woman, Rakhine State, Myanmar4Examples of Menstrual Disposal Strategies for Communal Toilet Facilities
Back to
Piped Disposal Chutes in Hospital Toilets & Bathing Spaces contents
Location
A hospital serving Rohingya refugees and the host
community outside of Cox’s Bazar, Bangladesh 1 Introduction
Organization
2 Review of key
Médecins Sans Frontières (MSF) – Holland MHM concepts
Basic Information
3 Consultation
Female toilets and bathing/shower spaces were
equipped with a disposal chute system. This included
4 Female-friendly
100mm (4”) PVC piped chutes that provided a discreet toilets
disposal option from directly inside the stall. The PVC
pipes were inserted into the back wall of the toilet 5 Menstrual materials
disposal
which led directly to colored-coded buckets placed
directly outside of the toilet blocks and shower facilities.
6 Menstrual materials
The buckets, coded red to indicate that they should waste management
be disposed together with medical waste, were then
emptied daily at the on-site incinerator. As this disposal 7 Washing, drying
& storage
solution may be new to many girls and women, clear
signage and education on proper use is essential. 8 Information,
education &
Benefits communication
Women can dispose of waste easily and discreetly,
without fear that other women or cleaners will see that
waste or associate it with them. This system works well
within the context of a medical facility, where there is
a clear and active waste management and disposal
system, with trained sanitation staff on hand.
Challenges
Materials may get stuck in the pipe, causing blockages
Compendium
to occur; buckets require semi-regular emptying
on MHM
and final disposal. Patients, males or children may
Disposal, Waste
get curious about the bucket’s purpose as they are
Management &
visible behind the toilet blocks. However, the clear
Laundering
color-coded system across the hospital complex for
classifying medical waste may reduce the likelihood for
inadvertent interacting with this waste.
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