When the Water Rises, Women’s Health Is Left Behind
The lost homes and cut roads make the headlines. The pregnant woman who can't reach a clinic and the girl with nowhere private to manage her period rarely make the headlines.
In Uganda, floods are usually counted in lost homes and cut roads. Less often counted is the pregnant woman who can't reach a clinic, or the girl with nowhere private to manage her period.
A study in Kasese found that flooding limits access to reproductive health services through damaged facilities, lost privacy, dignity and security, disrupted outreaches, displacement and destroyed transport networks. Women displaced far from working clinics reported higher transport fares, and about 300 displaced households lived in a camp with limited water and sanitation.
None of this starts with the water. Chelangat Esther Labu, President of the Youth Advisory Committee at SRHR Alliance Uganda, says the barriers are already there in ordinary times. Speaking about adolescent services in general, not floods, she asks: "The services may exist, but are they youth-friendly? No, they are not. Half the time, they are not."
Privacy is the detail that stands out. Even on a normal day, she says, an adolescent may struggle with "accessing some of these things confidentially." In a displacement camp, where families share tents and latrines, that problem is no longer a matter of stigma alone. There may simply be no private place to ask, or to be seen.
UNFPA's emergency response to floods and landslides in Bundibugyo, Sironko and Bududa shows how many people are affected. Of 44,992 people displaced, 10,378 were women of reproductive age, 5,594 were adolescent girls, and 1,351 were pregnant. Forty sexual violence survivors received post-rape care within 72 hours.
In research on the Bidi Bidi refugee settlement, heavy rains and floods fed food and firewood insecurity linked to higher sexual and gender-based violence risk, while poor sanitation made menstrual hygiene harder. UNFPA notes that Uganda's refugee caseload has grown sharply, particularly from South Sudan, so these pressures reach people who have already fled once.
Take away income, food, and fuel, as a flood can, and the choices narrow further. She also says, "sexual violence and coercion really are at the peak, and this undermines prevention." Where a girl has to walk far for firewood, or depends on someone else for food, that risk has an obvious route in.
That is why she argues for looking beyond clinics: "Livelihood works hand in hand with SRHR."
The pattern is not unique to Uganda. UNFPA's emergency guidance warns that in floods or wars, communities are suddenly cut off from reproductive health information and services, while needs persist and escalate, and many displaced women are pregnant and facing delivery in dangerous conditions. In Zimbabwe, where floods in 2026 left 134 dead, a bridge over the Mwenezi River was swept away in March, the kind of loss that can turn a clinic from a short trip into an impossible one.
As Uganda's rains continue, the question for health planners is whether midwives, contraceptives and post-rape care are pre-positioned too.
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