When the state falls short, feminists organize: sexual and menstrual health services during Israel’s war on Lebanon

Over one million Lebanese were displaced, including over 520,000 women and girls, as a result of Israeli aggression against Lebanon last fall, according to the Lebanese Ministry of Public Health.

With its population estimated slightly above five million, at least one in five Lebanese civilians was displaced as a result of Israeli aggression. Throughout the fall, Lebanese civilians suffered under constant fire from the Israeli military. Many fled to shelters, seeking safety from constant bombardment. Upon arriving at the crowded shelters, families may have received food packages, but few had access to hygiene products, including essentials like shampoo, medication, or sanitary pads. In some shelters, up to 500 women shared two toilets. Many shelters did not take into account the gendered disparity of displacement, so NGOs and local organizers stepped up to fill in the gaps.

For a Raseef22 collaboration with RNW Media, Lebanese photographer Yasmina Hilal photographed and interviewed two leading feminist organizations that supported women’s health services throughout the war: Jeyetna and omgyno.

Jeyetna is a feminist collective committed to menstrual justice by challenging taboos around menstruation in Lebanon through education and advocacy. The organization’s name highlights the discomfort surrounding periods: jeyetna, translation for “we got it” in Lebanese Arabic, a common euphemism for “I’m on my period.” Meanwhile, omgyno is a feminist health tech company seeking to redefine gynecological and sexual healthcare through accessible, user-centered design. Their mission is to empower users to take charge of their health by offering home test kits and virtual consultations with medical professionals and lab partners, so that tests may be done without additional costs or having to book an appointment.

The interviews were conducted in December 2024, and were slightly edited for clarity and style.

What inspired you to dedicate your career to sexual and reproductive health and rights (SRHR)? Were there any personal experiences that shaped your decision to work in this field?

Eliannore Boutros, omgyno: In 2021, I did an internship in Maribor, Slovenia, in a remote public hospital’s department of Obstetrics and Gynecology. When I got there I saw different opportunities in the system that I was not aware of. For example, aside from all the medical procedures and consultations we did, there was a part of the day where we called young women from the ages of 16 to 18 years old for free check-ups, and, more importantly, an awareness session on how to have a safe sexual life, the resources they can turn to, and where to seek help when they need it.

When I returned from Maribor two months later, I really wanted to implement something like that in Lebanon.

Vanessa Zammar, Jeyetna: It was my experience with period pain and the lack of consideration I received from medical personnel, and ten years of visiting the same doctor and not knowing what was going on with my body.

Doreen Toutikian, omgyno: I started my career as a graphic designer. Up until 2019, during Lebanon’s economic crisis, I was raising awareness around how design can be used for social impact. Then, once everything stopped and I had time to think, I wanted to use my design for social impact skills to create a project that meant something to me. As a queer woman who grew up in Lebanon, I realized taking care of my sexual and reproductive health was a challenge.

I had issues with the way doctors were treating me and friends of mine when it came to going to a gynecologist; I felt that we were there to make money off of us. I don't need [the doctor] to be my best friend. But, they should respect me—respect me when I have questions, not “yeah, yeah, you don't need anything” or “just take this pill.”

I sent out a survey in 2020, and I realized I wasn't the only one who felt this way, so I joined an accelerator and started omgyno. I started the company in Greece in 2021 because [of the crisis]. I applied for MIT Solve and MIT’s Social Impact Award. I won three awards which gave me the money to start the company and the operations in Lebanon in March of 2023.

What does sexual, reproductive, and menstrual health mean to you beyond physical well-being? How has your work changed your perspective on gender equality and human rights?

Nader, Jeyetna: At Jeyetna, we try to bring a social justice approach to period poverty. Period poverty is not just about a lack of access to menstrual products but also a lack of access to knowledge. A lot of women and girls don't have the knowledge required to navigate their experiences and talk about their periods because it's considered to be a taboo and an intimate subject. We can leverage our different backgrounds and experiences to bring a social justice based response, and make periods more of a public conversation.

Period poverty is not just about a lack of access to menstrual products but also a lack of access to knowledge.

Summer El Samra, Jeyetna: [Health] is not just limited to the physical aspect. As much as it is ridiculed and weaponized, there is such a mental and emotional aspect to it as well. We all know the experience of menstruating is difficult on the spirit, not just on the body. [Menstrual health] is a part of human rights; it is part of sexual health, physical health, and mental health.

Zammar, Jeyetna: The core issue, and this is what we tackle at Jeyetna, is the individualization of [menstrual health]. When you talk about periods or menstrual experience, it is perceived as something that should be dealt with individually and in private which translates into how it is perceived in the political sphere: it is not considered [in policy], not included in budgets. That’s a big issue because menstruation is a public health issue and public policy issue.

How, in your opinion, does the constant turmoil in our region impact our access to, and understanding of, sexual and reproductive health and rights?

Nader, Jeyetna: Iraq, where I grew up, has endured so many wars over the past few years which have directly affected women and girls’ access to menstrual education and menstrual justice, and it’s the same for the rest of the region.

Toutikian, omgyno: Before we talk about the war [in Lebanon], our region is extremely patriarchal, which has allowed women’s needs to be completely disregarded in the medical sphere. Generally, men are doctors and gynecologists and women just have to trust them. Only if you follow the “you're a virgin, you get married, you have kids” path do you go see the gynecologist, and you basically put your entire sexual and reproductive health in the hands of this one man who is supposed to take care of you and birth your children.

Look at the unavailability of healthcare in our country: we don't have any type of social support. There are some places you can go for free services, but this is nowhere near where other countries are at. I live in Greece right now and every year I get a free HPV test which is the standard in the EU and UK—this does not exist in our region. There is also no subsidized HPV vaccine, despite how common it is.

I lived in Scotland, and there were clinics run by the NHS specifically for sexual reproductive health. I was there as a foreigner, and [anyone]—students, foreigners, young women—could get free sexual health consultations and medications. For the first time, I realized I don’t have to go to the doctor feeling so scared and ashamed that something might be wrong with me.

So, if you want to protect yourself from HPV—which kills women at a ridiculous rate every year, with more than a 50% mortality rate—it's completely disregarded. Most people who I’ve surveyed have never had a doctor ask them about HPV, or test them for it, even though they've been sexually active. And of course, if you do want to get the HPV vaccine or test for it, it's very expensive. You have to get three shots and it costs you around $600.

Also, there are no hotlines or safe spaces or clinics for women to go to. You have Marsa which is a sexual health center and a partner of ours, and we love what they do, but that’s not enough.

Boutros, omgyno: I was fortunate enough to work in both private hospitals and public hospitals , as well as pharmacies and primary health care centers. For the less privileged, who can't afford to go to the private and fancy hospitals, as soon as we have crises—be it a safety crisis, a security crisis, a political crisis, even an inflation or economic crisis—the last thing prioritized is sexual and reproductive health. [Regarding] screenings for cervical and breast cancer, this year we saw a drop in the number of women who got their breast cancer screening because of the war, they cannot travel, they cannot afford it, they cannot reach it, and so on.

This year we saw a drop in the number of women who got their breast cancer screening because of the war, they cannot travel, they cannot afford it, they cannot reach it, and so on.

How do societal stigma and cultural taboos impact our understanding of sexual health and reproductive rights in the Middle East? Have you faced resistance or pushback from communities or authorities? How have you navigated these challenges?

Nader, Jeyetna: You get funny looks and stares when you talk about it, especially our name, ‘Jeyetna.’ People are like, “are you seriously calling a collective that?” The other day I was at the bank and I was mentioning it, and people were like “this is a taboo, you shouldn't be calling it that.”

El Samra, Jeyetna: There is this [perception] that because we are working on sexual and reproductive health, that means that we are teaching women and people about their bodies in terms of sexual pleasure and not also reproductive functions and roles. [Some people] say it means that we are pushing people to lose their virginity, that we are pushing them to have sex outside of marriage, or do something ‘sinful’ or ‘wrong.’ There is this incorrect correlation, or cause-and-effect, that is upheld by our societies. It’s also considered wrong because it's something completely private—but it's not a question of privacy, actually, it’s the belief that it's better if you are limited in your knowledge, because that is a form of control.

At Jeyetna, we keep our work on the low because we want to make sure that the work that we do with communities is safe, and to safeguard its continuity. We keep a low profile on social media, we don't really advertise or post about events, and even if we do public events, our first concern is safety and how to navigate risks.

At Jeyetna, we keep our work on the low because we want to make sure that the work that we do with communities is safe, and to safeguard its continuity. We keep a low profile on social media, we don't really advertise or post about events, and even if we do public events, our first concern is safety and how to navigate risks.

Zammar, Jeyetna: Menstruation is a topic that is silenced globally, people everywhere are shy to talk about it, it’s not only in the Middle East. Gen Z has access to social media and so with them, the discourse and language around periods has expanded. There is a normalization of saying “I’m on my period,” which people in my generation wouldn't dare to say. I think the topic of menstruation is silenced across cultures, languages. But, regardless of the language, menstruation is often associated with sickness, something you shouldn't talk about out loud. This shows up in how people use euphemisms and nicknames to refer to menstruation, rather than scientific words.

[And regarding the war], ya’ani, distributing disposable pads is not our work, but we have to do this because no one is doing their job. I’ve been counting boxes for eight weeks. Like why? ‘Anjad? Now, we’re back to reusable products, which is what we usually do, but the first two months of the war was all disposable pads, keef?

We distributed 5,000 boxes in Beirut! Beirut! It’s Jeyetna who did that. Jeyetna handled the response for official shelters in Beirut. We distributed more than 20,000 packs in six weeks. It means we reached more than 20,000 people.

We were not doing the delivery ourselves, bas mara when we did all those shelters, thirty shelters in Beirut, it was seven hours, me in the truck with the guys from a truck company that did it for free. Eh la’, ya’ni keef?

Jeyetna handled the response for official shelters in Beirut. We distributed more than 20,000 packs in six weeks. It means we reached more than 20,000 people.

Toutikian, omgyno: You don't do projects like this and not get pushback. If you say that you’re a feminist organization, there’s already pushback because of that. There’s also challenges as a social impact company: we provide services and we are not getting funding like we should. When it comes to investments, I’ve had investors tell me that women in the Middle East don't have sex, that this is something for Western people. And I would ask them, “if the men are having sex, who are they having sex with?”

Representing a taboo subject in the Middle East naturally causes this pushback, but I can tell you that in Lebanon, from the communities we work with and who use our home-testing kits, there's been a lot of positive feedback. So we know for a fact that the people who need us and have used our services, are very, very grateful.

Boutros, omgyno: In Lebanon, the kind of resistance you face comes either from a religious perspective that women should only have a sexual life to build a family, that pleasure is not something to be discussed here, and if you’re not married you shouldn't have a sexual life at all. Another kind of resistance is linked to geographic and geopolitical situations: if you’re working in more remote areas, you have fathers that don't allow their girls to see the gynecologist because they’re not married. If you’re doing an educational session on menstruation, you might have fathers say, “are you encouraging my girls to have sex with strangers by educating her on her period and STIs?”

What do you think are the biggest obstacles to advancing SRHR in the Middle East? What are the most common myths or misconceptions about sexual and reproductive health in the region?

Toutikian, omgyno: There's no government support, the patriarchal system doesn’t help you, there are no safe spaces, nowhere to go for free. Plus, we all know the myths that are prevalent from here all the way to India and Pakistan, right? Like when you have your period, you’re dirty, there's all this eeeuuuhh and ickiness about periods which is a way to make you feel more distant about this “thing” that you’re not supposed to know about or take care of.

You would be surprised by how many myths are perpetuated by the doctors themselves, our research has shown that [some] traditional doctors use these fear tactics to keep women coming to them and dependent on them. This does not only happen in Lebanon, by the way. It also happens in Greece, where we are also operational. For example, doctors have said that using a menstrual cup can lead to infertility which is completely untrue. Sometimes, when a woman is married and she has high-risk HPV, meaning she’s at risk of cervical cancer or has cervical cancer and needs it removed, the doctor, to save the reputation of the family or the man, will not tell her this. If she isn't educated enough, [she won’t know] that this is an STD her husband probably passed on to her. They’ll say “oh, maybe you got it here or there,” they’ll just make stuff up because they’re protecting [patriarchal] values. I think these types of myths are really the ones that hurt the most.

El Samra, Jeyetna: There isn't a universal culture in the Middle East, but there are some common traits. Sexual health—everything related to the body, education, and the liberation of the body from the medical institution and the patriarchal system—is always accused of being a product or weapon of the West. It’s not really perceived like we too have bodies, we too are owed rights and autonomy over it. Plus, it is really believed that sexuality goes against religion, as a sin. It's considered to be something sinful or deviant which it's not. That makes it harder to work on sexual and reproductive health. Halla’, ma’ el global pushback against feminist movements, it's more and more difficult because people seem to lose sight of reality, what is true and what is pseudoscience and propaganda, which is ironic because these are the arguments of such movements [against us].

Zammar, Jeyetna: The link between marital status and sexual and reproductive rights is the main barrier for people who are looking for answers when they are facing issues in their menstrual and reproductive rights. That obstacle has been very permanent in the region.

What role do men and boys play in advancing SRHR, and how do you engage them in conversations?

Toutikian, omgyno: Of course men should be involved in this. The same way I said we should teach sex ed in schools, boys should be involved in this and understand that this is a 50/50 thing. Most men are not really aware of how serious HPV is because nothing happens to men in most cases, but it could kill women. I think that in general, if people saw real equality in relationships, in sex, then we would have ways to have these conversations more easily; there would be ways to talk about STI and protection before you start a relationship, just like any other conversation.

El Samra, Jeyetna: You know [men and boys] usually have this knowledge, even if it's unscientific or incorrect, and they tell women what their body does from a medical perspective that only focuses on their reproductive capacity and not their pain, or different possible disorders, or even pleasure. So it's really important that men and boys listen and not dismiss the struggle and pain of menstruation, see it as something that is embarrassing or dirty, or that women should keep it to themselves. If I had the flu, I wouldn't be treated that way, so why would I be treated differently if I have my period? Men have a lot of responsibility in calling out misogynistic and disrespectful behavior, and they should do better.

Boutros, omgyno: The brother, father, and husband have a lot of impact on how women can access sexual and reproductive health services, especially in more remote areas. It is essential to try to inform them as much as we can. It's not enough to break the stigma with one woman.

What we're trying to do here is make a change that will go to generations beyond ours. I was fortunate to be in a family that is very open-minded and empowering and I can see how I turned out: I can advocate for myself and for other women around me. It is a hard step, but when we involve men and boys with sexual health, we make the topic less of a taboo. If we are at a school, for example, explaining periods and sanitary pads, there is no need to take the boys out of class. When we normalize this as something that everyone will have at some point in their lives, it will change the mentality in a family and change the perception for future generations.

I was fortunate to be in a family that is very open-minded and empowering and I can see how I turned out: I can advocate for myself and for other women around me. It is a hard step, but when we involve men and boys with sexual health, we make the topic less of a taboo. If we are at a school, for example, explaining periods and sanitary pads, there is no need to take the boys out of class.

What advice do you have for young women in the Middle East seeking accurate information about SRHR in the region?

El Samra, Jeyetna: Nowadays, we thankfully have a lot of resources to look into things. It’s still growing in terms of knowledge, research, or people working on these topics. There are a lot of content creators and knowledge that is intersectional, personalized, and reflective of different experiences and walks of life. Try to find yourself in what you’re looking for.

Zammar, Jeyetna: Don’t only have one source of information; ask your family, or ask others around you—diversify your sources. There’s not one source that’s right. If you’re not sure about what you read online, ask your doctor if you feel comfortable with them. It’s important to have that conversation openly with different people you trust and you’re comfortable with. There’s a real lack of data, and there's a lot of communal knowledge that could be transferred inter-generationally that can't be transmitted because of this hush-hushing and taboo.

Boutros, omgyno: My advice would be to really read and get informed as much as you can. I'm always sharing innovative approaches to women's health. What we do at omgyno is an innovation to women's health, but what we [often] see at hospitals, are cases where women take an innovative, paramedical approach and end up harming themselves in the process. When you get informed you become empowered to make your own decisions. It's important that you, as a woman, make your own decisions related to your body. Never listen to the doctor just because he said so. Ask to understand, and make sure you’re convinced.

What are your hopes for the future of SRHR in the Middle East, and what steps do you believe are crucial to achieving them?

Nader, Jeyetna: To have free access to menstrual products, because it's so hard to access these products in the region, and to have the needed education to know how to use them. Destigmatizing the use of tampons, for example; in Iraq, it's a taboo to ask for a tampon in the pharmacy or to even sell it.

Toutikian, omgyno: Governments should wake up to [sexual and reproductive health] being a reality, they should work with organizations like us and Marsa, and publish data to highlight the seriousness of HPV and cervical cancer for women. I think that they should encourage sex ed programs in schools and universities so that the education is there from the beginning. We should be subsidizing HPV vaccines so that boys and girls can be vaccinated from a young age. If governments just did these three things, a lot could be solved. We know a lot of people don't have their own phones to access [sexual health] services online, and if [governments] took this into consideration, they would know that these services save lives and lower medical costs.

El Samra, Jeyetna: To have more spaces in the Middle East and Arabic speaking countries to host conferences to discuss such topics, so we don't have to rely on the West to have such conversations and to be able to work together on important topics.

Zammar, Jeyetna: I hope there is proper nation-wide planning that does not rely on the shoulders of small collectives like ours because this requires planning, statistics, and financial means that states and other big entities have. In Lebanon, we’re always patching, patching, patching on a small scale. But to go beyond just the immediate need—to be innovative, to have proper care that is comprehensive, that includes school curriculums, proper training for doctors—requires so many resources.  This subject needs to get outside of the system where only if you know a center, you can refer someone.

Boutros, omgyno: We’re seeing so much progress right now with so many NGOs and even primary healthcare centers working towards women’s health. I hope that at some point, at least in Lebanon, the Ministry of Public Health will have a budget specifically for women’s health. I also hope to see more women standing up for themselves, and more men standing up for their wives and daughters, because I feel that if we empower women enough then they can empower their families and their communities.