By Rachel Dixon, ITV News Multimedia Producer
Women in Gaza are resorting to using strips of the tents they need for shelter as a replacement for period products.
During Israel's war with Hamas, just under one million women in the territory have witnessed killings, attacks on their children and seen their homes destroyed.
But, behind the devastation caused by endless missile strikes and military sieges, a taboo topic is leaving the women of Gaza "paralysed".
Since October 7, while aid has been trickling into the region, the blockade on Gaza has seen very limited supplies enter the strip. This means period pads, tampons and contraceptive pills which women could use to delay or stop their cycle are in very high demand, charity Action Aid says.
"As a woman I don’t have anything to live, I don’t have water, I struggle during my period, there is no water to clean the blood. I cannot find pads for my period," said one woman living in Gaza.
Speaking about this is a taboo topic in the territory, so she has asked to remain anonymous.
She said: "We feel paralysed in front our children, we cannot comfort our kids and tell them you are safe.
"My wish only is to go back to my home, sleep in my bed and use my bathroom.
"We don’t need aid or money we want this war to end immediately, to stop this bleeding and killing of children and women."
The lack of water means keeping clean is near impossible, Riham Jafari says.
She is based in Bethlehem and as a communication and advocacy coordinator with ActionAid, women have been sharing their struggles with her.
Many of them have gone weeks without showering and are queueing for up to 30 hours to get clean in hospitals.
Only one of the three water pipelines from Israel to Gaza is working, leaving people with one-and-a-half to two litres of water per day.
This is below the globally recognised three litres needed for basic survival, and well under the 15 litres required per person per day to cover all water and sanitation-related needs, including washing.
A report by the United Nations in Gaza has also found "management of menstrual health, in a dignified and safe way is impossible."
It is not just those on their period, new mothers with post natal bleeding are also struggling.
Ms Jafari says: "Some women cut part of towels to use on their periods, this is not healthy.
"They are using parts of the tents or fibers. They cut off part of it to use it as pads and some of them are using their extra clothes as pads.
"If they do get pads from aid organisations, they use it for a long time, they’re using it for more than two days."
Wearing period products for too long can be fatal. If bacteria gets into the body it can cause toxic shock syndrome, which starts as flu like symptoms but can lead to fainting, difficulty breathing and in some cases death, the NHS says.
Many women in refuge camps are also struggling with privacy, they hide in their tents but with up to 20 people living in one, they are often surrounded by their extended family.
"One of the stories we heard is sometimes they go to houses which have not been destroyed by the bombs and ask if its possible to shower.
"Women feel very shy and self conscious to ask families. It is a difficult situation that they are forced to deal with," Ms Jafari says.
"When you’re dirty, think how you feel, you can’t talk or express yourself, you lack of self confidence to do anything."
How can you help?
Ms Jafari has said donating period products to Gaza is not helpful as charities cannot guarantee the aid trucks will be able to take them across the border.
"The only thing is to donate to humanitarian appeals to help them and keep calling for a ceasefire
"Because opening safe routes and humanitarian borders will ensure the delivery of products to the women," she says.
ActionAid, alongside its local partners such as Wefaq Association for Women and Childcare (WEFAQ), distributed hygiene kits - which include tissues, toilet paper, soap, sanitary pads and wet wipes.
The groups also constructed a 60 toilet and shower blocks in refuge camp Rafah, which will provide women and girls with private space. A donation of £15 could provide a hygiene kit for a person in need in Gaza – including enough toiletries and menstrual products to last a month. Support ActionAid’s appeal here: https://www.actionaid.org.uk/donate/emergency/gaza-crisis-2023
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