For over a month and a half now since the destructive deluge hit the southern belt of Punjab, Sabahat Arooj and her husband Izhar Syed have been visiting at least two to three rural settlements in the most remote flood-ravaged areas, initially providing them basic essentials like ration, cooked food and camps. But Sabahat realised many women and girls had other urgent needs too -- menstruation, pregnancies, newborn babies.

“When I go to these temporary tents, I ask families about their needs. I sit with them and take them into confidence when they tell me about their needs, and if they don’t then I ask directly if there was anything else they wanted. I’d notice some girls lying ill, and their mothers or grandmothers would tell me the issue and that they didn’t have anything to deal with. I started an online campaign, putting up videos of myself packing pads to tell other groups working in the field that these things should be packed into every ration pack going into the flood-affected areas,” she told Dawn over the phone.

As per the National Disaster Management Authority’s Sept 16 estimates, the catastrophic floods have killed 191 people in south Punjab since June, partially or fully damaged 60,241 houses, and affected a population of over 4.8 million in the region. While a host of groups and organisations reached out to the battered communities with food and temporary shelter, women and children’s health wasn’t even a matter of concern. This despite a UNFPA report stating around 73,000 women in the submerged areas were expected to deliver this month, needing immediate maternal health services.

Starting with their own resources and then through donations, Sabahat and Izhar have distributed dry ration, over 3,000 sanitary pads, 1,500 tents among other essentials in Taunsa and other tehsils of Dera Ghazi Khan district, Rajanpur district’s Rojhan tehsil and Fazilpur area besides Tank in Dera Ismail Khan. “We started handing out two packs to each family, including underwear and pieces of cloth for women who didn’t know how to use pads. I also guide the women on how to use pads.”

Not just that, the couple has also facilitated pregnant women, those who’ve recently delivered and their newborns with baby clothes, mosquito nets, juices and medicines. “I take along doctors from Lahore, Islamabad, Multan also -- a male and female, especially for pregnant women. We tell them we’ve also set up medical camps to provide a pack of medicines, juices, biscuits and calcium tablets,” said the university lecturer by profession.

Izhar, who deals in pesticides, says they’re now also providing charpoys, more mosquito nets, tents, water and gas cylinders, while they’ve accelerated appeals for donations to build a room in place of every house washed away. “Because of the conservative culture of the wasaib, people are ashamed of talking about pads so my wife goes to tents and camps and provides them herself. We are also trying to create awareness about menstrual hygiene, telling people that it’s as normal as breathing and bleeding from a wound. I also convinced other men to help us with it.”

Besides the Layyah-based couple, the Safe Delivery Safe Mother organisation also intervened last month to cater to the needs of pregnant women to ensure safe and healthy deliveries and post-delivery care for both the mother and baby. They designed maternity kits each of which included a delivery sheet, cord clamp, clean blades, towel, gauze, baby suits, wrapping sheets and caps, tablets preventing excessive blood loss, panjeeri and dates.

“Pregnant women are either cut off or have restricted facilities as health units have literally washed away. The main challenge is to get to the women. So various NGOs working on site in different areas got in touch with us about the needs there. The flood-affected areas were also mapped for pregnant women and there was a process to verify them. Since mid-August, we have dispatched over 400 maternity and delivery kits to various tehsils of Rajanpur and DG Khan districts, out of the 1,500 overall, as the entire belt is cut off. We have weekly dispatch cycles to those areas in collaboration with specific non-profit organisations. We also book air cargo that is then distributed through the medical camps our partner hospital has set up as well as our collaboration with the provincial health department units,” Mehreen Shahid, the founder of Safe Delivery Safe Mother, told Dawn.

The partnered hospital also trained and counselled local midwives on how to use the baby delivery kits. They have also prepared pamphlets in five local languages to distribute in relevant areas to tackle the acceptance and literacy issue, besides making a video on how to use the kit.

Another initiative focusing specifically on menstrual hygiene of women as well as transgenders is Mahwari Justice, led by students Anum Khalid and Bushra Mahnoor. Having impacted over 15,000 women in remote and rural settlements on the outskirts of DG Khan, Rajanpur and Layyah districts as well as Tank district in Dera Ismail Khan division, the girls have dispatched kits that include cloth pads, cotton pads, detergents, painkillers, sanitary pads, towel pads, and reusable pads.

“We find out about the demands of women and transgender persons from locals. Activist friends also survey areas. We have sent 4,000 cloth pads to Taunsa. Initially, we didn’t have support from any organisation or the government even; the only thing that helped spread the word was media coverage. It’s still difficult to put across to women that menstrual hygiene is also an essential need,” Khalid told Dawn from Multan.

However, fulfilling menstrual hygiene needs or even talking about them has come with a cost, if delivering aid was a challenge. In some cases, the women engaged in these activities faced downright hate and abuse.

In the case of Sabahat, she was the only or one of the couple of women engaged in relief work in the southern Punjab belt where the conservative culture discouraged even talking about menstruation openly.

Anum Khalid faced infrastructural and coordination challenges.

Published in Dawn, September 26th, 2022