The Body as Evidence: Menstruation, Sanctions, and Survival

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Across cultures and history, the female blood has often been coded as ‘impure’, a marker used to exclude and control women’s presence in both public and private spaces, and in conflict zones this ideology manifests as layers of shame and scrutiny around menstruation. Shame core function is to silence.

Some things in War are documented in endless detail: weapons systems, battle strategies, the trauma of returning soldiers. But some experiences of war rarely enter the archive.

For girls growing up under sanctions in Iraq in the 1990s, one of those experiences was menstruation.

When I began researching the 1991 Gulf War, I was not surprised by what I found. I left Iraq in 2003, and every time I returned to the archives, the pattern was the same: most studies centered on returning American soldiers.

My research focuses on health. The absence of serious work on the war’s impact on the population inside Iraq was soul-crushing. The indifference was deafening.

Most publications, American, of course, focused on PTSD or exposure to chemical weapons among returning fighters. A smaller number examined menstruation among female soldiers. Until then, I had never considered the question: how did soldiers manage menstruation in combat? Reading their accounts, I encountered narratives filled with shame and resentment. Women were repeatedly asked, by the public and by the state, to explain how their bodies would function on the battlefield.

In 1992, I was twelve. I had just survived the Gulf War, after growing up through the Iran–Iraq war that preceded it. Much of my childhood was shaped by conflict. Violence entered our lives not only through advanced weaponry, whose names I learned before my eleventh birthday, but through the quieter violence of survival.

I began menstruating a year after the war, during the years of the so-called “international sanctions.” The sweeping UN sanctions imposed after 1991 collapsed Iraq’s economy and drastically restricted imports, including many basic medical and sanitation supplies. We were told these sanctions targeted the regime of Saddam Hussein. But for the sanctions to punish the regime, the sanctions had to go through us first: our households, kitchens, and bodies.

Meanwhile, some Western feminist narratives framed Iraqi women as oppressed victims in need of “liberation,” using the rhetoric of saving women to justify military intervention. Yet these arguments ignored the very real suffering caused by sanctions, the absence of food, medicine, and even menstrual products, and erased the voices of the women living through these policies. The focus on abstract ideals of freedom or liberation masked the structural violence that made survival itself a daily battle for girls and women.

Like many girls, I was already learning the early shame expected in a patriarchal society. Yet there was an additional, internationally imposed layer of shame: there were no sanitary pads, no cotton, no gauze.

I remember a secret conversation with a childhood friend who seemed far more prepared than I was.

“How long will this happen?” I whispered.

“Until we dry up,” she said, laughing.

“What do you mean, dry up?”

“Until our fifties.”

I was horrified. This pain, this vulnerability I had just discovered, would now accompany me for decades. My female body, already a visible liability, was now a bleeding one.

Sometimes the pain kept me in bed for days. But in my household, missing school was not allowed. My parents, newly socially mobilized first generations of their families to enter and graduate formal education, believed education was our only survival possibility, for the present and the future.

So, I went to school.

I went in pain, with no painkillers, wearing makeshift rags that compromised my body, my movement, my dignity, and my health.

The school bathrooms did not work. We could not change. We could not even urinate. A “good girl” held her body in silence, squirming, shivering, trying to make herself invisible as she waited seven long hours to return home. Every glance from a teacher or classmate felt like accusation. The shame was not just social, it was physical, a pressure that weighed on every movement, every thought. Shame in these moments was not just personal, it was weaponized, used to silence girls and women, curtail their movement, and undermine their potential long before society even gave them a chance to thrive.

What feminist scholars have shown is that menstrual blood has never been ‘just’ biological, it has been a political and cultural symbol used to enforce boundaries, control women’s movement, and signal their exclusion from full participation in community life.

For years after the war, there was no running water, no clean water either. Bathrooms themselves became phantoms of a pre-war life.

At home, we boiled our blood-soaked rags to prevent infection. Cotton had become like sugar and flour under sanctions: practically gold.

Hospitals had none.
And who were you, little girl, to ask for cotton?

Women had to make bread in their homes or rely on neighbours who baked in their tanours. Most of the bread was dry, hard, barely edible, but we ate it anyway, because hunger was non-negotiable. Each pang of emptiness made the blood in my body sharper, heavier, impossible to ignore. To bleed while hungry was not just pain, it was a daily reminder that our bodies were disposable, and our suffering invisible.

I realized I was one of those unlucky girls: I bled heavily. I lost a lot of blood, and in the heat, dehydrated and hungry, I fainted occasionally at school. I quickly developed anaemia, a poverty that stayed with me till now.

Sanctions policy rarely speaks about menstruation. Yet sanctions reorganize the most intimate parts of daily life. The politics of sanctions entered our bodies every month. Hunger and bleeding became inseparable markers of vulnerability.

And still, the absence of period products, functioning bathrooms, and privacy for women and girls in conflict zones is rarely recognized as violence.

But what do we call a system that forces a twelve-year-old girl to bleed in pain, while hungry, without medicine, water, or dignity? If that is not gendered violence, what is?

The historical roots of menstrual exclusion, from purity codes in religious tradition to taboos that mark female blood as pollution, echo in how women’s bodies are treated in humanitarian and security contexts today.

And this is not just history. In conflict zones today, from Gaza to Sudan to Yemen, girls and women still face the same invisibility: denied period products, private bathrooms, and dignity. What I lived as a twelve-year-old is being repeated across generations, across borders, under different wars and sanctions. Recognizing these everyday violences is not optional, it is central to any conversation about gender, survival, and justice in conflict.

Dr Khuloud Alsaba is a scholar of global health, gender, and conflict. She holds a PhD in Social Policy from the University of Edinburgh, where she studied as a Chrystal Macmillan Scholar and was awarded the Sir William Darling Memorial Prize for contributions enhancing the University’s global reputation. She has over 15 years of experience in the Middle East working with international organisations, UN agencies, and civil society to advance evidence-informed policy and equitable responses to crisis, development, and public health challenges.

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