Menstrual  hygiene  is  integral  to  women's  health  and  has  a  lasting  impact  on  women's  education,  livelihoods  and  security:  keystones  to  their  empowerment.  It  is  clear,  however,  that  little  or  no  account  is  taken  of  the  issue  of  menstrual  hygiene  in  humanitarian  response  plans  for  refugees.  As  part  of  the  WSSCC/UN  Women  Joint  Programme  on  Gender,  Hygiene  and  Sanitation  in  West  and  Central  Africa,  a  study  was  conducted  by  the  Demographic  Education  and  Research  Institute  (IFORD)  in  refugee  camps  in  Cameroon.  It  looked  into  the  difficulties  that  women  experience  during  their  menstrual  periods  and  reported  on  water,  sanitation  and  hygiene  infrastructure  in  the  camps.  The  study  reveals  infrastructure  gaps:  not  only  are  toilets  not  separated  for  men  and  women,  there  are  not  enough  of  them  for  the  numbers  living  in  the  camps.  All  the  women  surveyed  regretted  the  lack  of  space  to  change  and  manage  their  personal  hygiene.  The  toilets  are  difficult  to  use  during  their  periods  due  to  there  being  insufficient  water,  no  washing  lines  and  no  sanitary  equipment.  They  also  complained  about  toilets  usually  not  having  lockable  doors  or  even  any  door  at  all.  They  are  often  unlit  at  night,  increasing  the  risk  of  assault.  Due  to  the  current  state  of  the  latrines  in  refugee  sites,  99%  of  women  do  not  feel  safe  in  them.  The  survey  also  looked  into  the  types  of  sanitary  protection  used  by  refugee  women:  despite  a  diverse  range  (not  only  sanitary  towels,  but  also  scraps  of  cloth,  cotton,  handkerchiefs,  etc.),  one  type  of  protection  is  preferred:  single-use  sanitary  towels  distributed  by  UNHCR.  However,  there  is  a  lack  of  suitable  places  to  dispose  of  these:  only  about  a  third  of  women  get  rid  of  them  in  rubbish  bins,  while  others  throw  them  down  the  toilet,  behind  their  houses  or  even  into  rivers.