Blossom Medical Awareness By Farheen Bawahab/Medical School Graduate


Blossom Medical Awareness

Ladies, its that "time of the month" again. Cramps, bloating, possibly mood and appetite changes. Sounds like “Aunt Flo” is about to pay a visit. What do you do? How do you welcome “Aunt Flo?” Personally, I first check my Period App on my phone, to see if I am on time. I then go to my bathroom and take out pad and put it on. In the bathroom I double check to make sure I have enough pads for the rest of Aunt Flo’s stay. If I am out when Aunt Flo arrives, I just head to the nearest bathroom and whip out a pad from my purse and put it on. Quite simple right? Almost a no-brainer. So now what if it wasn’t that simple? What if you have no bathroom, no clean underwear, no tissues, no pads or tampons? What is a girl to do?

We as women can understand the extra care our bodies need, especially when our periods come around each month. We can understand the stress, frustration, and/or embarrassment of not having a pad or tampon when you need it. Now imagine if this was the case every time, month after month, year after year. Hard to imagine, right? Eighty-six percent of non-homeless women report having started their period in public without supplies and 79% have been forced to use toilet paper or some unhealthy and unsafe object because their period started without hygiene products. Eighty-six percent of non-homeless women! So then what about all the homeless women out there? What do they do in these situations? One homeless woman stated that she wraps toilet paper around her underwear during her menses. Her inadequate options were toilet paper, reused cloths or ruining her only pair of underpants. Our sisters out on the streets of San Francisco suffer from this distress every month. Among the seeming endless list of the problems they face on a daily basis, the lack of basic hygiene and products leads to whole separate list of problems.

We as San Franciscans are not unaware or oblivious to the rampant homelessness we see everyday here in our beautiful city by the bay. What we may not be aware of is the numerous hygiene and medical problems our homeless sisters and brothers face. It's easy for us to forget that in addition to not having food or water, clean clothes or a roof over their head, homeless men and women face a long list of health issues as well. Issues that may be are simple and preventable or easily treatable. But for someone living on the streets, this "simple" medical issue can evolve into a chronic and serious illness. A "simple" cough or cold, or a broken arm, can be taken care of by walking into our doctor’s clinic or urgent care, or for some issues we don’t even need to leave our homes, a simple band-aid or disinfectant, will do the trick. But for the homeless, such “simple" solutions are out of reach.

Many illnesses, such as; Hypertension, Diabetes, Headaches/migraines, Pneumonia, certain STDs, can affect both men and women. No gender bias there. In addition to the general list, women have a whole other list of medical issues that are specific to just their gender.

Poor management of menstruation and the lack of daily cleaning of genitals can lead to various reproductive tract infections such as UTIs and yeast infections, bacterial vaginosis (which can then lead to higher risk of adverse pregnancy outcomes such as preterm labor), acquiring STDs, and Pelvic Inflammatory Disease. Menstruation creates abnormally moist conditions in the urogenital area that promotes opportunistic infection and imbalance in microbiota. Poor menstrual hygiene can even lead to severe illnesses like Toxic Shock Syndrome.

Homeless women are subjected to unsafe conditions. These include the less talked-about daily issues such as health and hygiene to bigger threats such as assault. If a homeless woman is sexually assaulted or raped, aside from the tragedy and emotional and mental trauma, there are medical consequences as well. It is important that a woman in this situation be fully tested and examined for various sexually transmitted diseases and reproductive tract trauma. Sadly, homeless women lack access healthcare leaving them and their babies at increased risk; homeless women experience a higher number of adverse birth outcomes when compared with the general population. Homeless women are 2.9 times more likely to have a preterm delivery, 6.9 times more likely to give birth to an infant who weighed less than 2,000 g, and 3.3 times more likely to have a small-for-gestational-age newborn. The rate of unintended pregnancies is higher among homeless women than other American women. Abortion access may also be difficult to reach, and having access to a proper care during and after the procedure is vital. Infection, sepsis, damage to the cervix, perforating the uterus and even death can follow even a properly conducted abortion.

I struggled a bit when writing this article. There are so many contributing factors to the ongoing homelessness crisis here in San Francisco, I didn't know where to start. It’s a vicious cycle or tornado of issues, all inter-related. A person living on the street does not have access to the basic human necessities, such as access to food, clothes, shelter, cleanliness or sanitary products, etc. Getting sick or unwell is inevitable, though, and proper health care becomes a lesser priority for our sisters on the streets, who must grapple with other concerns such as where she will sleep that night.

We San Franciscans don’t wait until the crisis finally gets fixed by our government - we can start tackling the health crisis our homeless are facing ourselves! One person at a time One woman at a time.

Blossom Project invites you to join us in helping to provide period products and basic medical information to homeless women through our Blossom Bags and Street Medicine project.