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World

How Well Do War And Women's Health Mix?

AUDIE CORNISH, HOST:

How well do war and women's health mix? Colonel Anne Naclerio has been at the forefront of some of that research. She's a medical doctor who chaired a task force on women's health for the Army. And she's just co-edited the book "Woman at War" which looks at the effects of deployment on women's physical and mental health. Welcome to the program.

DEPUTY SURGEON ANNE NACLERIO: Thank you - happy to be here.

CORNISH: Back in 2011, you actually led a women's health assessment team in Afghanistan where you got to speak with about -what was it? - 150 servicewomen about the challenges they faced while being deployed. Describe some of the issues that they raised.

NACLERIO: Yeah, that is correct. We got to speak to about 150 women across the theater, and a common theme that we heard was that women basically were serving successfully, is big picture. But there were a lot of what sounds like fairly simple issues that they hadn't been educated on or aware of what they could do before deployment to increase their success and protect their health while downrange, things as simple as women's hygiene issues, how to urinate in the field, how to maintain their hygiene, options on menstrual regulation and/or menstrual suppression for periods where they are in austere environments for prolonged times.

CORNISH: So what are some of the remedies or solutions that you think would help deal with some of these more basic needs? You talked about hygiene and things like that.

NACLERIO: I think the key is we have an obligation to - I like to use the word provision. We like to provision women for success, and that is everything from providing the education and materials. For instance, something as simple as a female urinary diversion device - that's a device that allows women to urinate into a bottle if they're in the back of a - let's say - an armored personnel carrier in hostile territory, where their male colleagues can urinate simply into a bottle, that would allow them to or to urinate standing up. Those are devices that have been in our inventory for years, yet what we heard from women was they weren't educated that they even existed.

CORNISH: Essentially, you're arguing that these provisions are simple ones and that it's actually not unusual to make this kind of accommodation - right? - even for men. I mean, are there examples of things that have changed over the years in terms of what the military provides?

NACLERIO: That's correct. I would say - I mean, to use a historical example, in Vietnam in our earlier wars where we had trench foot, we learned very quickly that this was a major cause of morbidity in our soldiers, and we didn't say, oh, we're not taking soldiers with feet. We said, we need to make sure their provisioned for. They need better boots. They need clean, dry socks, and they need to be educated on how to do good foot hygiene. I think that what we're seeing with our women with, you know, vaginal infections or urinary tract infections is just the same. I had women tell me they would withhold, they would dehydrate themselves purposely, and they would wear diapers.

CORNISH: Do you get the sense that they're also - people are worried about asking for any quote, unquote, "special treatment," and as a result, people aren't stepping up to raise these issues.

NACLERIO: Well, I definitely think they don't want to be, like, I need to go to the clinic for this female issue. And there is some data that shows that, some early research, so they soldier on. But these conditions are distracting, and they're simple to prevent. And that's what we have an obligation to do.

CORNISH: Colonel Anne Naclerio, thank you so much for speaking with us.

NACLERIO: Well, thank you for having me.

CORNISH: That's Colonel Anne Naclerio. She's Deputy Surgeon for U.S. Army Europe. She spoke with us from Wiesbaden, Germany. Transcript provided by NPR, Copyright NPR.