“We people aren’t blessed,” sitting on a wet, dirty floor wearing a torn yellow traditional Burmese dress, 19-year-old Sofia said. She lives in the Rohingya Refugee Camp Bathindi, in Jammu.

Sofia looked pale as she cooked food outside her tent. It was a hot day and her clothes were soaked in sweat. as she was kneading the dough with her hands, helplessness and the need for a nap were visible on her face. “It’s my second day of ‘mashik’ (menstruation)” Sofia said.

She is among hundreds of Rohingya Refugees women in Jammu And Kashmir who are facing the lack of menstrual hygiene. Sofia said she uses discarded pieces of worn clothes which she collects from the streets of Bathindi.

“These are the only things I have access to, for using during menstruation,” Sofia said, adding “at times, girls and women here use clothes or Cotton balls, polythenes, or rotting bags. We don’t have food to eat. Sanitary pads are beyond our imagination.”

Women and adolescent girls make up half of the Rohingya Refugees in the Jammu settlement. They are vulnerable to sexual and reproductive health issues.

Due to decades of continued violence, discrimination, and persecution in Myanmar, thousands fled to different countries to seek refuge in 2017. It is estimated that around 7,000 Rohingya have been living in different parts of Jammu and Kashmir after arriving in the city between 2012 and 2017.

Since then, the numbers have expanded, which has resulted in worsening health and well-being of women and girls, including menstrual health.

“Cloth ‘pads’ are commonly used [by the menstruating women] in our camps,” Sofia said. Menstrual health struggle is a constant for these Rohingya women who have the least access to normal sanitary pads.

Many Rohingya women end up using pieces of worn clothes, even leaves, mud, and polythene to absorb menstrual blood. Clothes pads are washed and reused. The women have no idea about the harsh consequences of reusing the same piece of cloth.

For the Rohingya, earning a livelihood is far more important than attending school. Nineteen-year-old Sofia, who along with her Rohingya family, had to flee from her home country to find a safer place for survival recalled, “I was 14 when I had my first period and wasn’t aware of what was happening. I was frightened and didn’t tell anyone and went behind the tents to clean blood with leaves and mud.

“I used to collect leaves from nearby trees and put them inside my panty to soak the blood flow. Privacy is non-existent in transit camps, so finding a place to clean blood is difficult.

“I used to avoid sitting in front of my family because I believed I had a severe disease. I couldn’t even ask my sister or mother. I would go collect leaves, wrappers, and old clothes to clean my menstrual blood.

“When I went to sleep, I put leaves inside my panty; my mother saw red blood stains on my feet and silently woke me up without letting any male member know. I started sobbing, my heart started pounding my chest, and I cried out of hesitation.

“I didn’t know what to say. My mother grabbed my hand, took me out of my tent, and offered me an old cloth.

“She advised me to use the fabric and wash them when no male family member was around. When I wash my menstrual clothes, I hide. Or I throw them far away from my tent.”

This is the situation despite the government’s pledge to provide equitable access to health services. However, some non-governmental organisations had responded to this crisis, and UN agencies were once involved to resolve the needs of the refugees in the camps.

However, the women in the camps say they have no access to essential materials, such as sanitary pads, and even underwear anymore. The NGO’s, and others who used to help the vulnerable community seem to have stopped their work here.

“It has been eight months we haven't received a single sanitary pad from anywhere. Through UN assistance we used to receive sanitary kits every month once.

“Now the only option left for us is to either use clothes or other materials,” Palveena, a Rohingya woman in her mid-30s who lives in a Jammu slum, said.

The non-governmental organisations that used to provide monthly kits claim they are running out of funds. One such NGO worker seeking anonymity said, “we are afraid of helping these people, we are questioned by investigative agencies for providing health care facilities. It becomes difficult for us to cater to the needs of these people.

“We don’t receive any funds, and are interviewed by agencies. Due to this, many volunteers have stepped back. When we are powerless, how can we help these people?”

The Rohingya women claim they have not received any safety kits for the past year. They say they have been going street to street to collect old clothes, discarded bags, and cotton balls to be used to manage their menstrual flow.

A local doctor who treats Rohingya refugees, including women, said it’s difficult for them to get access to even basic health care. “As a doctor it's my job to make them understand hygienic practices of menstruation. Most of them are using clothes which can lead to severe infection. They come here for medicines but most of them lack access to basic sanitary material”.

In one such refugee camp lives Noor Jahan, 32, uses old rags to absorb the blood. She then washes the rags for reuse. “No one is supposed to see your blood,” she said, adding, “I started menstruating when I was about 13 years old. Since then I have managed my periods using old rags.

“Once, I received sanitary pads from an NGO, and started using it, but it has been almost one year since I received any. Whenever we ask they say no one is sending them anything to distribute.

“I can’t afford to use sanitary pads. My husband earns Rs 150 in a day and sometimes returns home empty handed.

“How can we manage to feed our families? I sometimes wrap mud in a cloth and place it to capture the flow without staining my clothes.”

However poor practices of menstrual health can also negatively affect mental health. Women who suffer from ‘period poverty’ are more likely to report moderate to severe depression, according to Kamna Chhibber, a clinical psychologist.

“For teenage girls, having access to period products is essential. Practising poor menstrual hygiene affects mental well-being. Because it increases stress and pressure to manage multiple things.

“When you have an added pressure to manage physical health related conditions, it increases stress levels and makes you anxious. When you don’t have the right resources, right products, it can lead to a sense of deprivation. This can impact your mental health. As a result, they suffer in silence,” Chhibber said.

“Feminine hygiene is often overlooked in our camps,” 18-year-old Palveena said, adding “we are left to manage our monthly blood flow on our own. Many women are compelled to use mud and other material. These are not things that we can discuss with anyone.”

Inside refugee camps, finding a private space or moment is impossible. “There is a lack of privacy in camps or informal settlements. This makes it difficult to practise menstrual hygiene. When a person doesn’t have a permanent place to live any sort of comfort is least expected.