Our Work in Uganda
Fiona Rushbrook and Ben Woollan, The Unmentionables' former Head of Mission East Africa
Uganda is the third largest refugee-hosting country in the world, now a temporary home to over 1.4 million refugees. The majority of these refugees are from South Sudan, who have fled fighting and persecution from the ongoing civil war.
With one of the most progressive refugee policies in the world, Uganda provides new arrivals with documentation, land, tools for homesteading, rights to work and travel, and access to education and other basic services. Refugees are encouraged to live within integrated settlements, alongside Ugandan communities.
However, despite this context, the volume of refugees arriving and staying long-term in Uganda is putting considerable pressure on the country’s resources and capacity for humanitarian actors to support. With over 86% of South Sudanese refugees being women and children, health, education, and protection services are particularly constrained.
Access to sexual and reproductive health information, care, and products are significantly underfunded. This is particularly concerning given the high levels of child pregnancy, unwanted pregnancy, sexually transmitted infections (including HIV/AIDS), sexual and gender based violence, and use of survival sex within the refugee settlements.
The Unmentionables first expanded to Uganda in 2017, working in partnership with local NGOs to deliver basic menstrual management training to hygiene promoters and to distribute reusable sanitary kits and bras to over 1,530 women and girls in Rhino Refugee Camp Settlement.
However, more comprehensive sexual and reproductive health interventions were needed, as well as greater understanding on the best implementation models in the refugee context. This is why The Unmentionables has placed a strong focus on research and monitoring in Uganda.
In partnership with the Community Development Centre (CDC), a local NGO, The Unmentionables has conducted a joint field assessment on menstrual hygiene management and focus groups on access to information and care for broader sexual and reproductive health issues. These assessments have targeted men, women, boys, and girls, and have revealed significant gaps in knowledge and access to information and dignity products, particularly sanitary and washing items. Many women and girls were reportedly managing their periods in uncomfortable and unhygienic ways, felt ashamed, and were missing out on school, livelihood opportunities, and full participation in community life as a result of menstruation.
CDC and The Unmentionables have worked on an integrated and community-led approach to improving the menstrual hygiene condition among the refugees in Rhino Camp Refugee Settlement. In February 2018, we trained eight local MHM volunteers, men, and women in the biology of menstruation and taught them key messages in managing menstruation safely and with dignity. Alongside CDC, we supported their MHM volunteers to conduct education events across three areas of the settlement, reaching almost 1,000 women and girls. Each participant received a comprehensive reusable sanitary kit, containing adjustable underwear, reusable sanitary liners, bucket, and soap to facilitate washing.
Post-distribution monitoring was conducted approximately one month after these events, targeting 10% of beneficiaries. This monitoring revealed that of those questioned, 38% learned about menstruation the day it first happened to them. Before the distribution, 54% used cloths or rags to manage their periods.
While 58% said that they could participate fully in daily activities during menstruation, 11% do not go to the market, 8% do not attend school, and 7% do not collect water. Small numbers of women also refrained from cooking and participating in community activities and family life. All women noted an improvement in their ability to engage in these activities after the education event and receiving a reusable sanitary kit.
Of those interviewed, 99% found the MHM education provided was helpful and 100% felt comfortable and safe during the events. New lessons learned included understanding the menstrual cycle, the reasons for pain, as well as the use and care of disposable and reusable products. Women and girls shared that they wanted more knowledge – more time, topics, local languages used in education tools – and expanded programs to reach all women and girls, especially adolescents.
With regards to the reusable sanitary pads, 82% had tried using the kits. The majority found them comfortable and of good quality, and 99% said they would continue using these products. Some mentioned improvements could be made to the underwear to ensure they survive frequent washing, and another suggested further sizing to be provided for different shapes of women. Several women requested a towel/wrap to use during bathing, and all requested more soap to ensure long-term use of the products and personal cleanliness.
This kind of feedback will be invaluable for CDC and The Unmentionables in planning future projects in Rhino Camp Settlement. Women and men, both refugees and members of the host community, have asked for more information on sexual and reproductive health and even more access to intimate hygiene products. However, sustainability and local engagement is key. 84% of the women interviewed said they would be willing to make more liners for their underwear if they were taught how to do so, and all need a regular access to low cost soap.
If you want to help us expand our projects in Uganda, shop our Dignity Warehouse to fill these needs.