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WHEN a cyclone lashes a coastal district or floodwaters submerge the land, we tally houses destroyed, acres lost and embankments breached. Yet, the gravest damage often appears only after the waters recede: women with no safe place to manage menstruation or access contraception; latrines washed away, contaminating handpumps; fishers and day labourers deprived of income for months; girls forced into early marriage as families descend into debt. These silent harms — to sexual and reproductive health and rights, water, sanitation and hygiene, and livelihood — are not side notes. They are central to survival, dignity and recovery and they warrant national attention equal to that afforded to the storms themselves.

Cyclone Remal, which made landfall on May 26, 2024 and affected an estimated 4.6 million people across eight coastal districts, is a case in point. More than 800,000 people sought refuge in cyclone shelters where privacy was minimal, sanitation overwhelmed and women’s specific needs largely ignored. This is no small matter: inadequate sanitation heightens the risk of disease outbreaks while disruption to sexual and reproductive health services leads to unplanned pregnancies and greater danger during childbirth. Gendered harm also intensifies during crises. Rapid gender analyses repeatedly record surges in gender-based violence after cyclones.

In the hardest-hit divisions during Remal, pre-existing rates of partner violence were already high — 44 per cent in Barishal, 57 per cent in Khulna — and 37 per cent of households feared that violence would worsen as incomes fell and caregiving burdens rose. The United Nations Population Fund’s work in Bangladesh further highlights the heightened risks of sexual exploitation and abuse among displaced women and girls. These are not hypothetical warnings but patterns observed after every major disaster.

Water, sanitation and hygiene systems remain a weak link. Bangladesh has extended basic services to most households; however, quality often falters during emergencies. By 2022, around 91 per cent of the population had access to basic drinking water and 81 per cent to basic sanitation, but safely managed services were far scarcer, varying sharply by wealth and region. When floods or storm surges swamp tubewells and latrines, the poorest families fall back on unsafe water and temporary pits, fuelling disease and stigma. For girls, the intersection of water, sanitation and hygiene with sexual and reproductive health is stark. Lack of hygienic spaces and supplies causes many to miss school. UNICEF estimates around 30 per cent of Bangladeshi girls lose 2.5 school days each month due to menstruation.

During disasters, managing periods becomes even harder, with studies from flood zones describing women unable to wash or dry menstrual cloths safely, harming health and mental well-being. Livelihood is, meanwhile, the key to any recovery. Cyclones and river erosion repeatedly wipe out the assets of fishers, farmers and informal workers. Past storms such as Sidr, Aila, AmphanÌý caused extensive household damage and prolonged loss of income, with some communities reporting over 95 per cent of families affected. Bangladesh remains one of the world’s hotspots for climate-related displacement, with roughly 700,000 people uprooted each year by flooding and erosion. Without targeted support, families cope by skipping meals, withdrawing children from school or marrying off daughters to ease financial strain.

What should national attention look like? First, treat sexual and reproductive health as lifesaving by default. Bangladesh’s Standing Orders on Disaster has become more inclusive, but reproductive health is still inconsistently put into practice. The Minimum Initial Service Package for reproductive health must be financed, pre-positioned and activated with every emergency, without exception. That means stocking dignity kits with menstrual supplies, ensuring clear referral pathways for obstetric emergencies and survivors of gender-based violence, and deploying mobile reproductive health teams alongside health and sanitation services. The United Nations Population Fund applies these measures during cyclones; they must be institutionalised and funded nationally rather than left to ad-hoc aid.

Second, make every shelter and service ‘women-friendly.’ New or retrofitted cyclone shelters should include separate, well-lit toilets for women and men, lockable bathing areas, accessible water points, bins for menstrual waste and private spaces for pregnant and breastfeeding women. Community-led models in coastal districts have proven this both feasible and effective. At the same time, Bangladesh’s National Strategy for Water, Sanitation and Hygiene in Health Care Facilities must be fully implemented so clinics can function with safe water, sanitation and hand hygiene even when roads are submerged and power is cut.

Third, climate-proof water and sanitation infrastructure. Building back better must not mean reinstalling shallow tubewells and pit latrines in flood-prone areas. Investment should focus on raised, flood-resistant latrines; elevated, salinity-proof water systems; and decentralised sludge management that works even when transport routes fail. Existing World Bank-supported programmes already do some of this — scaling them to the most hazard-exposed areas would curb post-disaster disease and speed recovery.

Fourth, protect incomes with cash and jobs rather than rations alone. When markets reopen, unconditional cash assistance allows families to make dignified choices — paying rent, buying hygiene supplies, meeting urgent needs. Grants for women-led enterprises, including menstrual product micro-businesses, and cash-for-work schemes to build resilient sanitation or drainage can restore livelihoods while strengthening defences. Evidence shows these approaches are practical and can be combined with reproductive health and sanitation services for greater impact.

Fifth, measure what matters. Post-disaster assessments should not stop at counting damaged houses. They must ask whether women delivered babies safely, whether girls managed menstruation with dignity, whether households regained income promptly. Disaster dashboards should track continuity of reproductive health services, availability of women-friendly sanitation in shelters and clinics, and time to income recovery, disaggregated by gender, age, disability and region. Bangladesh already gathers these data in sector systems; the task is to integrate them for decision-making.

Bangladesh has earned international recognition for its success in saving lives through world-class early warning and evacuation systems. The next challenge is to prevent the hidden harms that follow: maternal deaths, gender-based violence, waterborne disease, lost years of schooling and poverty traps that lead to child marriage and chronic malnutrition. Meeting this challenge requires aligning budgets with commitments — earmarking funds for reproductive health in emergency spending, reserving resources for women-friendly sanitation in every shelter and clinic, providing contingency financing for livelihoods and holding authorities accountable at local level.

Disasters will not stop; climate change ensures that. But whether they leave deep scars or merely temporary bruises is up to us. If Bangladesh prioritises reproductive health, sanitation and livelihoods as core elements of disaster risk reduction rather than afterthoughts, then when the next storm strikes, families will not have to choose between safety and dignity, between evacuation and livelihood, or between a daughter’s schooling and a meal. That is the measure of true preparedness.

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Raihan Riaz is a senior research associate (climate change and disaster risk reduction) at the Network for Information, Response and Preparedness Activities on Disaster.