In Nepal, approximately 290,000 women and girls menstruate every day. However, 82% of those living in rural Nepal use unhygienic and potentially dangerous menstrual hygiene management methods. A study from UNICEF revealed that 1 out of 3 girls in South Asia knew nothing about menstruation prior to getting their first period.

Based on societal ignominy, menstruation’s direct barrier to girls’ health and education remains a hushed conversation. As a result, both household dialogue and policy making discussions often leave menstrual hygiene management (MHM) off the table.

Menstruation signals a girl’s entry into womanhood and reproduction. It is a crucial time for adolescent girls to learn about their bodies and their health. Silence and stigma surrounding menstruation impinge on girls’ lives, as the inability to manage menstrual hygiene affects education, physical health, psychological and emotional well-being, as well as overall quality of life.

Old taboos surrounding menstruation die hard in rural Nepal. One extreme example is the customary practice of ostracizing women and girls from their own homes during their periods, known as ‘Chhaupadi pratha’. Chhaupadi – which is based upon the belief that menstruating women are impure – prohibits menstruating women and girls from inhabiting any public space and socializing with others.

The effects of Chhaupadi are extremely dehumanizing and psychologically stressful, with young girls being told that they will bring bad luck on their families if they enter their own homes during menstruation. In addition to being emotionally degrading, Chhaupadi places women and girls at risk of rape, abduction, snakebites, animal attacks, and malnourishment. Forced to sleep in rickety huts without adequate insulation or ventilation, women and girls face illness exacerbated by the cold and unhygienic conditions or in extreme cases, even death due to asphyxiation from improperly ventilated heat sources.

Despite being outlawed by the Nepalese Supreme Court in 2017, Chhaupadi retains a foothold in the country’s western region and continues to put constraints on the potential, action and participation of women. Even in regions where Chhaupadi is not practiced, taboos surrounding menstruation still severely affect Nepalese women and girls. Many modern households in Kathmandu still prohibit menstruating women from entering kitchens or temples, eating with the family or sleeping on their own beds.

Managing menstruation in resource-poor settings is often challenging. Buying a sanitary napkin is a luxury most rural women can’t afford, and so many end up using cloths, rags and – in extreme cases – straw, sand or even ash as menstrual absorbents. Such challenges are further increased by societal taboos, ignorance and embarrassment around menstruation.

The plight of women in Nepal deeply motivated me to break the silence around menstruation by starting a dialogue, and so I founded a Project called ‘In Her Hands’. It aims to destigmatize menstruation and encourage conversation through…

  • Advocacy campaigns on menstrual hygiene management
  • Focus group discussions
  • Facilitating access to sanitary materials and physical infrastructures like female friendly toilets and safe water sources
  • Capacity building activities for adolescent girls

The goal of our initiative is to start a dialogue around menstrual hygiene and liberate girls and women from silent suffering. We are working towards ensuring that girls have a voice in their communities so that their menstrual hygiene needs are taken into account. We also want to make sure that they have full control over their bodies, and that they are part of a world in which every woman and girl can manage her menstruation in privacy, safety and dignity.

The pilot project was conducted in the village of Ramdaiya Bhawadi in Janakpur, Nepal. Since beginning in early 2017, our work has benefitted more than 500 women and we are looking forward to expanding to other areas of need in the near future. The initiative has sparked conversation about a topic that many people previously felt uncomfortable talking about. It has also helped facilitate policy change at the local level while catalyzing action and commitment towards securing the basic human rights of girls and women.

Despite increasing evidence for taking urgent action, menstruation remains a neglected public health, social and educational issue that requires prioritization, investment and concentrated effort at national and local level. I believe that girls and their individual stories should be at the forefront of development and if menstrual hygiene management is included as a part of the conversation surrounding policy changes, we will be able to spark change.

Project ‘In her hands’ has recently been awarded the ‘Student Project for Health Competition 2018’ by Foundation for Advancement of International Medical Education and  Research (FAIMER). It was also recognized as one of the Top 12 finalist projects in the Opportunity Desk Impact Challenge 2017 by the Opportunity Desk.

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