In rural Nepal, particularly in the Karnali region, discussions about menstruation have long been stifled and stigmatized, excluding women and girls from proper healthcare as well as denying them full access to participating in the economy and other parts of society every month. The Karnali Water Activity, funded by the U.S. Agency for International Development, is working closely with local communities and the government to change the narrative around the practice of Chhaupadi. The Activity is focused on providing essential information and promoting sustainable behavioral change for dignified menstrual hygiene management through training and creating a supportive environment. It also involves advocating for equitable water access, sparking a transformative movement.
Despite being outlawed by the Supreme Court in 2005, Chhaupadi—the menstrual taboo that limits women and girls from participating in normal societal activities—still persists in Nepal. More than 70 percent of communities in certain mid-western districts continue to practice it, as revealed by the 2014 Multiple Indicator Cluster Survey findings. As a result, women in these traditional households may typically endure an accumulated seven years or more of isolation due to Chhaupadi practices over their lifetimes. The practice seems from ancient beliefs that a woman's menstrual cycle can somehow curse or poison crops. In these moments, challenges for women and girls extend beyond just menstruation, and encompass a range of issues like a lack of sufficient water, food, and sanitation, along with compromised family care. There have even been cases of women dying in the separate menstrual huts from wildlife attacks or smoke inhalation, while some women have even been raped.
The same survey indicates that nearly 60 percent of women refrain from attending social gatherings during menstruation, while a quarter seclude themselves in separate rooms at home, and 9 percent bathe in distinct areas.
But the narrative is changing. In Ema village, the Karnali team is training women to make their own sanitary pads as part of a social and behavior change campaign. This training is helping to empower 33 women, including Tara, a 41-year-old participant. Tara says: "I didn't know about pads to use during menstruation. Thanks to the training, I now make washable cloth pads at home. This cloth pad is easy to keep clean."
These sentiments echo those of 14-year-old Shrijana, who, before the training, relied on old cloths during menstruation. "I never thought pads could be easily made at home," she says. "Now, with the knowledge from the training, I am happy to use these washable cloth pads. After use, I can wash it with soap and water, dry it in the sunlight, and use it again."
Gori, a participant in her 60s, had a unique experience during the training session. Although she had never utilized cloths or pads during menstruation before, she enrolled to learn how to make them. Her enthusiasm stemmed from the prospect of personally crafting pads, with the intention of providing them to her daughter and daughter-in-law. She said: "While I don't need these pads personally, I can gift them to my loved ones, sparing them from the hardships I endured during menstruation." Gori's account reflects the blend of anticipation and concern that women experience as they strive to alleviate the burdens and enhance the health of their family members.
Meet Apsara, for example, a 22-year-old woman who, like many other women in her community, used to use old cloths during menstruation. Unaware of the option to make cloth pads at home, Apsara's perspective has changed after attending the pad-making training. "I am very happy after getting the pad-making training. I am also teaching my sisters to make and use them," she proudly shares.
The women and girls in these communities are not passive recipients of information; they are increasingly empowered and can exercise agency. Equipped with the knowledge and skills to produce reusable pads, they are making a positive impact on their menstrual health and overall well-being. The change—from dependence on old cloths and enduring societal taboos, to confidently devising their own solutions for a healthier and more dignified future—is significant.
This blog was originally published on DAI Global.
Story and photos provided by Pralhad Gairapipli, Karnali Communications Manager, and Ramesh Dhakal, Karnali Social Behavior Change and Outreach Manager. This initiative is a component of the USAID Karnali Water Activity, operating under the Social and Behavior Change Challenge grant and executed by the Himali Rural Youth Social Development Center (HIRYSDEC), a local non-governmental organization in Mugu district.