International Women’s Day: “There are many girls suffering in silence, too shy to talk about health issues.”

Raju, a Sexual and Reproductive Health Volunteer supported by Community Partners International in Kutupalong Refugee Camp, Bangladesh, helps Rohingya women and girls to access health and hygiene services. (Jennifer de Perise/CPI)

Raju, 51, lives in Kutupalong Refugee Camp in Cox’s Bazar, Bangladesh. She works as a Sexual and Reproductive Health (SRH) volunteer supported by Community Partners International (CPI) and local partner Green Hill helping Rohingya refugee women and girls to access essential health services. To mark International Women’s Day, Raju spoke to Community Partners International about her work and community, and the health and hygiene challenges faced by women and girls.

What do you see as the major health challenges facing women and girls in the refugee camp?

Raju: “I frequently see pre- and postnatal issues, non-communicable diseases and sexually transmitted infections. Women face health challenges because of a lack of information and knowledge. They don’t have much privacy because they live in tiny shelters. This is particularly difficult for adolescent girls during menstruation.”

In your role as an SRH volunteer, how do you support women and girls to access health care?

Raju: “I share health information with women in the community. They feel comfortable talking to me about things they couldn’t mention to others.”

Can it be difficult for women and girls to access the health information and care that they need? If so, why? What are the barriers/constraints that they face?

Raju: “When we were living in Myanmar, we didn’t receive proper education. Women and girls have very little understanding of health and hygiene. On one household visit, a woman mentioned to me that she felt discomfort in her breast. I took her to the hospital and she was diagnosed with cancer. She received treatment but sadly passed away. I wonder if she might have lived if she had known about the symptoms and acted earlier.

Social taboo is also a big constraint. Many mothers and older women find it too difficult to talk to girls about menstruation before they start their periods. So, when they start menstruating, it’s very hard for them to cope with it.

One time I helped an adolescent girl who used a reusable sanitary pad without washing it properly. Her periods suddenly stopped for three months. I took her to the clinic and the doctor said she had an infection and needed surgery. Thankfully, she is fine now.”

Do you think that, as a woman, you can help fellow women and girls in the camp in ways that your male volunteer colleagues can’t?

Raju: “Absolutely. Just a few days ago I went to a house where I visited a new mother. She was having some post-pregnancy issues, something that she was not comfortable talking about to a male volunteer. Also, due to the cultural norms, she was staying inside the house with the baby for the first seven days. She was bleeding after giving birth and she had to take care of her newborn. As a female volunteer, I was able to enter her room and talk to her, something that a male volunteer could not have done. 

Also, things like family planning and sexual health are subjects that women often don’t feel comfortable talking about to a male volunteer. But they share those things with me. Elderly women sometimes face uterus problems and they mention it to me when I visit. Sometimes, at first, they don’t want to go through the hassle of doctors and hospitals. But I explain to them, “You have children to take care of. If something happens to you, who will take care of them? Come with me and get the treatment you need.” Usually, they agree.

In some households, adolescent girls are made to be fearful about periods. I counsel them and their parents about menstruation before they get their period so that they are not scared. Sometimes, girls face issues like having periods in school. If they know how to manage it, they don’t face any problems.

When it’s a male volunteer, there is a long chain of information. The girl talks to her mother, who talks to the father, who talks to the male volunteer. The main issue can get lost. That’s when a woman volunteer is very useful - young girls can talk directly with me and discuss their problems.”

What kinds of improvements/additional services do you think are needed to support women and girls in the camp to access the health information and care that they need?

Raju: “I would say a center for adolescent girls is very necessary - a place where they can share their issues and get the information they need about their health. I have a teenage daughter myself and I always try to make sure she is well informed and able to manage her health properly. But that’s not the case in every household. There are many young girls suffering in silence. Too shy to talk about health issues even to us, the women volunteers. I strongly recommend an adolescent center for them.”