Twenty-four-year-old Zahra* was still recovering from hemorrhoid surgery when the first earthquake hit Herat province on October 7, 2023. Her family of six spent three weeks living in a tent after part of their house collapsed in the disaster. The situation was even worse for Zahra, whose health was still fragile six months after surgery, because their area of Herat had only one functioning public restroom. So many homes were damaged that dozens of people lined up daily to use it.
Zahra quickly found herself stressed while needing to use the public washroom during the day and at night due to harassment by men and overcrowding. Sometimes, after standing in a line for hours, she found herself unable to use the toilet. One night, after a night of being unable to relieve herself, she suffered from severe constipation, which resulted in bleeding and infection. “I already had hemorrhoids. Constipation made me curl up in pain and unable to sit on the ground,” Zahra recounts to Zan Times.
Intense pain forced Zahra to go to the restroom at midnight. She was on the way with her 15-year-old sister when three young men crossed their path and began sexually harassing them. “They insulted us, saying we should not be out alone at this time if we were not whores. My sister pulled my hand to leave. She was petrified,” Zahra says. “At that moment, one of them tripped me, and I fell; I got up quickly, and we fled.” Her sister was so upset by the incident that she suffered a nervous breakdown: “Her speech was impaired, she had severe tremors, and my mother had to calm her down. Since then, she has cried every night, is scared, and has nightmares. Just last night, she had another nervous breakdown,” explains Zahra.
Zahra and her sister were terrified because they had no male family members sleeping in their tent. The next night, Zahra was again experiencing pain and thinking of going to the restroom when she noticed a man shining a flashlight toward their tent. Zahra stayed inside their tent, which resulted in a health emergency. “Because of the pressure in the rectal area, my large intestine tore again. I had a lot of bleeding,” she says. She had to undergo another hemorrhoid surgery. She’s angry that the operation was necessary: “Bleeding is very dangerous for me, and I shouldn’t have it.”
According to the latest assessments by the United Nations, the Herat earthquakes directly affected 48,347 families in 382 villages of Herat province, totalling around 275,000 individuals. Although there is no data about the precise count of mobile toilets available for earthquake-affected individuals, those who talk to Zan Times state that the numbers are low enough to become a tragedy for women.
Another woman whose health was seriously affected by the lack of public washrooms available to females in Herat province is Bibi Shirin*, a 38-year-old from Barik Ab village in Zindajan district. When the earthquake hit, she and her husband were only able to save their four children – their home was destroyed. After spending hours in an open field without any shelter or restroom, she experienced intense pain and thought that her menstrual cycle had come early, perhaps because of the stress and fear of the earthquake.
Bibi Shirin returned to their damaged house and dug through the rubble until she found her husband’s shirt. As she put the cloth inside her pants, she felt intense pain and realized she had been injured during the earthquake, perhaps when a wall fell on her. With no safe place for her to examine herself, she waited a few days before asking a neighbourhood woman for help. They saw “a piece of flesh and another white thing resembling intestines that had come out of my uterus,” she recounts. “That’s why there was bleeding. Because of what I felt between my legs, I couldn’t stay calm. There was no access to a doctor, so I had to push it back inside with my hand, but after that, I couldn’t breathe for a moment; the pain reached my bone marrow.”
A portable toilet arrived in Bibi Shirin’s village two weeks after the first earthquake, but by then she was suffering from an infection. Though she needed medical attention, she has been unable to find a female doctor, even a month after the disaster.
The lack of privacy in the devastated areas of Herat keeps affecting the health of the women in the province. Masooma* and her mother had returned to their damaged home to find clean clothes and sanitary pads because Masooma’s period had arrived when a strong 6.3-magnitude aftermath struck on October 8. “The earthquake was too fast, and the walls cracked. I wanted to open the gate when it slammed me into the wall,” she tells Zan Times. Her already-injured mother was severely shaken and required medical attention.
While Masooma’s father took her mother to the hospital, she returned to their temporary tent but couldn’t use the sanitary pad because her four brothers were also in the temporary accommodation. She went to the public toilet but the line was too long. “The emergency hospital had patients, so they discharged my mother quickly. Both of us were groaning in pain and had to bear it,” Masooma says. Finally, that night, she and her mother were able to use a restroom in a distant house.
That wasn’t the end of the health problems exacerbated by the earthquake. “There was no bread, water, or suitable shelter; bad enough, but the lack of a toilet was the biggest problem. I only drank a cup of water daily to avoid needing the toilet. I had to use one sanitary pad all day, which was very uncomfortable,” Masooma explains. In addition, wet ground under their tent worsened her back pain and her mother’s leg injury.
The situation is unlikely to improve any time soon. According to a report issued by the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) on October 17, the earthquakes have damaged multiple health centres in Herat, raising concerns about the spread of diseases in the province. OCHA says that it will need $173 million to secure food, health services, clean drinking water, and other essentials until March 2024 to address the needs of 275,000 earthquake-affected individuals in Herat.
*Names have been changed to protect the identity of the interviewees and writer. Laila Mandgar is the pseudonym of a journalist in Afghanistan.
