By Colleen Cahill, Board Member
Photos: left to right; Women attend Menstrual Health Training in Sindupalchowk, Nepal; Pema Tamang teaching Menstrual Hygiene in Neber; Women learn about their bodies during a leadership training in Kathmandu
I got my period when I was ten. I can remember my mom had this big smile on her face and how excited she was for me. I, on the other hand, was mortified and did not share her enthusiasm. My “Aunt Flow” has faithfully visited once a month for 34 years now and amazingly, her timing is always perfectly inconvenient.
For most of my life, I viewed menstruation as just a part of life and didn’t think much about it beyond that—until four years ago. The advertising agency I worked for took on a pro bono project to help an underfunded program bring awareness to menstruation issues in developing countries—specifically Africa. My eyes were opened.
In a different country, with different everything, having a period can become a major obstacle for women and girls. Unfortunately, this holds true for many in Nepal. Cultural, environmental and economic issues can get in the way of girls and women rising to their potential and living lives free of restriction.
With the help of Kesang Yudron, CCF has developed a very active Menstrual Hygiene Program. She serves as Program Manager in Kathmandu, Nepal. In honor of Menstrual Hygiene Day, we wanted to help our donors get to know Kesang better and go a bit deeper to understand what inspires her to do this work.
But first, since I told my period story, I asked Kesang if she would share hers. She graciously agreed saying hers was “fairly normal.” She attended boarding school in India where she had a safe place to talk about periods and pads were available at a nearby store. She was 14 when her “Aunt Flow” first came to visit.
She also dealt with the same challenges most girls face—getting teased and feeling embarrassed or shunned when she stained her clothes.
From a cultural standpoint, growing up with Tibetan Buddhist parents—who held a progressive outlook—Kesang had more freedoms than many in her country. Her mom was always very supportive, with one exception of not being allowed in the prayer room during menstruation. Her belief is that the Gods will get sick.
Kesang’s story varies widely from others in Nepal where it’s a common belief that a woman’s period is impure. Kesang says “this belief is manifested in different restrictive forms from not being allowed to go to your kitchen to not being allowed to go to places of worship. In many villages, women can’t touch flowers because of the belief it will cause wilting or if they touch a cow, their teeth will fall off. The list goes on and on.” She sees the perpetuation of these superstitions as society’s attempt to control women.
She continues, touching on the issue of Chhaupadi, a practice in western Nepal where menstruating women are banished to live in a shed during their period. This practice has proved dangerous over the years as women have died from smoke inhalation, animal attacks, landslides and other problems from poor conditions in these environments.
In her work, I asked Kesang if there was a significant period story that someone shared with her that stood out. She shared the following:
“During one of our [menstrual health] training sessions, one of the participants said that her family could not afford to buy pads so she used cloth during her period and said she developed rashes and an infection. This is a common story among many participants, where buying a Rs. 50 ($0.50) pack of sanitary napkins is a luxury that many cannot afford.”
For those of us in the West, where we largely have the means to purchase the proper supplies, infrastructure to dispose of them, and general support and education around menstruation health, we might find ourselves asking “Why is there a problem?”
Kesang says that in Nepal “there are several stories, where women don’t have the right access to knowledge about their bodies. What happens during menstruation, how to take care of your body during menstruation, how to take care of your health after birth and how to have conversations about it. Due to the lack of health care facilities, many take the advice of local village Jhankris (shamans) and sometimes it helps, but often it leads to bad health.”
She adds that “working in the Menstrual Health field, girls and young women face a myriad of problems from social stigma associated with periods to the lack of access to sanitary pads and information that is detrimental to confidence and growth.”
When I ask her what inspires her to carry out this work, she says “there is a culture of silence, when it comes to the topic of women’s bodies. It’s important to have a conversation and demystify the taboos surrounding this topic. Only when we start having a dialogue and working at a grassroots level can we normalize the topic of menstruation.”
Accountant turns Socialpreneur
Kesang traveled stateside in 2004 to study accounting at College of St. Benedict/St. John’s University in Minnesota and afterward, landed an internship with a firm there. Her tenure there was short-lived as she returned home when her father passed away. She decided to stay in her home country to help her family and saw an opportunity to act on a deep interest in social enterprises and working with women.
She started out by securing a grant from USAID to develop a fair trade knitting company that now partners with 50 women in Nepal. Kesang says “her mother has been a strong influence, she being a Tibetan refugee and working with women, has taught me what it means to be an active participant in the community.”
Menstrual Health Training participants in Nepalgunj
What’s the Conscious Connection?
Denise Attwood, CCF Board Chair, and husband, Ric Conner, CCF Co-Vice Chair, met Kesang’s parents many moons ago in Kathmandu during the 80’s through their fair trade work at Ganesh Himal Trading. Kesang was just a wee one at the time. Over the years, Kesang says Denise has been a kind and encouraging mentor often asking Kesang to provide CCF with a prospective from the ground. Together they’ve built an easy and impactful partnership.
With the knitting company up and running, Kesang began an offshoot group in 2018 sewing environmentally friendly cloth menstrual pads while at the same time, giving women an income source. It was also during this time that CCF was doing some outreach at a medical clinic in Baseri and would purchase the menstrual kits from Kesang for the women going to the clinic. The snowball started rolling.
How did taking menstrual health training to the villages come about?
There is an extreme lack of menstrual health education in Nepal. Most private and public schools have little or no training on this topic. Mired by myths and taboos surrounding menstruation, villages around Nepal are where training is needed the most.
We first started with a pilot project of training 27 people in Kathmandu. All who attended gave us very positive feedback and they wanted to go back to their villages and give the training in their communities.
What goals do you hope to accomplish through menstrual health training?
Our goal is to inform and provide access to information on Menstrual Health and Hygiene across Nepal so women have a choice to live in dignity, equality and justice.
What role does CCF play?
CCF has been a proactive international partner who has been open to understanding the layered complexity of issues surrounding the Menstrual Health and Hygiene program. We wouldn’t be able to do all this work without the cooperation and support from CCF.
Who teaches the menstrual health courses?
We have a nurse, community health volunteers and other partners in our network who are in the health field who come to give MHM training in their communities.
Did you work with partners that helped with the educational content?
Yes, we have been working with health experts and public health experts from the Radha Poudyal Foundation and German International Development Agency. These organizations have been specializing in menstrual health related issues in Nepal. We also have a team of female health volunteers who are at the forefront of the rural health care system in Nepal.
What content do you cover during the training?
We focus the content of the courses on the groups that we are training. If we have a group of young girls it will be more focused on stigma, biology of menstruation and with a group of women, we have a more detailed conversation on menopause and health illness related to sexual and reproductive health.
Photos: Training materials and menstrual kits being carried up to the hillside villages in the Sindupalchowk district. The trainings have been well received by the village communities.
Where do you conduct your training sessions?
The villages are located all across Nepal. Our trainers have to take the local bus, then hike for a day or two to reach remote hillside areas. There is little road access and the main goal is to focus on where the need lies.
What is the cost of bringing the courses to the villages? Is it more expensive to take it to more rural areas?
As we have to hire people or animals to carry the pads and food supplies to remote hillsides, the costs for the training is more expensive.
What are the biggest challenges bringing education to the villages?
As Nepal is a very religious and patriarchal society, there are a lot of myths that need to be demystified. It takes time to change thought and behavior surrounding menstruation. We are taking everything as a step by step process to normalize the conversation.
What aspects of teaching these courses are the most difficult for the teachers?
The topic of menstrual taboos can be challenging when some of the taboos come from Hinduism. The teachers have to walk a thin line of not offending anybody and explaining menstruation through a scientific perspective.
Are the participants receptive?
Participants are generally a mix of shy, curious and receptive. It is uncommon for Nepali women to talk about their periods or sexual/ reproductive health in their family or friend settings. At the beginning of the training, women tend to be shy to talk about their periods, but by the end of our three day sessions, there is a paradigm shift in behaviour and learning around menstruation.
Are these women-only courses or can men attend?
Both men and women can attend.
How do the men respond to these training sessions being held in their villages?
Unfortunately, there are less men compared to women in the training program. Some of the male participants were curious and interested in learning more about the other sex. We had a participant, Yogendra Tamang, who was in our first MHM training group. He and his wife used the learnings and gave MHM training in their villages of Sertung, Hindung and Neber.
As the saying goes, you need two to tango, we need more male participants to be champions of the struggles faced by women during menstruation.
What aspects of the training do the participants enjoy the most?
Participants enjoy the drawing sessions and group skits that are really fun and everybody gets out of their comfort zone.
What are the key issues you believe Nepali women need to learn from the training?
Knowing more about menstruation and what’s happening to women’s bodies is a key issue that all women need to know. The more we know, the more we can take care of our bodies. During our training, we’ve met young girls who’ve missed 5 days of school every month because of the shame associated with periods and we know that leads to girls falling behind on their education.
Pema Tamang (front right) with her training participants in the Sindupalchowk district of Nepal.
What feedback do you get from attendees?
Many attendees ask for more training related to women’s health. When we conducted our first three day training, there was a lot of information that the participants had to pick up within a short amount of time. They wanted some kind of reference or booklet to remember all this information so they can share it with their families and community.
Some participants also want to get more information on family planning and contraceptives.
Can you tell us about a favorite experience you’ve had during the training?
It’s wonderful to see women be brave and speak up about the discrimination they have faced. All of them are in a safe space to talk about their bodies. We also delve into the LGBTQI experiences of menstruation in Nepal which is very eye opening for many participants.
Do you have plans to offer more training? Expand on the course content?
We are in the first phase of our Menstrual Health and Hygiene training in the villages. This phase is mainly to start having honest conversations about the body and anatomy. We delve into gender equality and gender roles. We cover a lot of topics and in our next phase of the training, we would like participants to start having discussions about more complicated notions like gender and consent.
Are there challenges you see going forward?
One of the biggest challenges is menstrual stigma and shame is tied with religion and culture in Nepal. It’s difficult to change attitudes, beliefs and behaviors that our society has had for thousands of years. We are taking small steps to change the conversation around menstruation.
What do you have planned for the future of the program?
We plan on expanding our program to including conversations to challenge gender stereotypes; gender roles, gender inequality in regards to sex, body and relationships. We’ll also be reaching out to more villages through our existing network.
What is your vision for CCF’s menstrual health program?
My vision is that through CCF’s menstrual health program, we can create a bridge of learning and hope so all girls and women in Nepal can have a dignified menstruation.
When women and girls are given a platform to learn and grow, they will reach their full potential of confidence, hope and opportunity.
There are many NGO organizations in Nepal you could work with in Nepal, why do you choose to work with CCF?
CCF has been a receptive, understanding and proactive partner, who’s heart is in the right place of caring and wanting to help the people of Nepal. Over the years, most of the members have had a strong bond with this beautiful Himalayan country and its people and you can see it in their work.
CCF has had to postpone menstrual health trainings in Nepal due to Covid19. The Nepali government has had to issue heavy travel restrictions country-wide to keep people safe. In the meantime, work continues on the menstrual health manual we are developing for the training sessions as a leave-behind reference piece.
CCF estimates the cost per participant to attend a menstrual health training at $20 per person. These are two-day sessions, chalk-full of information and conducted in remote regions of Nepal where menstrual health education is in great need. Once travel bans are lifted, we’ll be resuming this important work, but we can go farther and reach more girls and women with your help.
Please consider sponsoring a girl or woman to attend menstrual health training in nepal.
$20 makes a difference in a life and starts a ripple effect of good!