Written by Drokpo Nepal’s Program Manager, Pema Yangkyi Gurung

Where there is magnificent beauty there is often great difficulty. The Upper Tsum Valley in Nepal is no exception. Renowned for its breathtaking scenery and rich cultural legacy nestled within the Himalayas, it also is home to isolated communities where women, in particular, endure significant hardships. There is little transportation except by foot, minimal health care and little education. Patriarchal structures are still in place, sanitary facilities are lacking and cultural taboos abide.

Why does this impact women in particular? Transportation is a significant barrier that prevents the flow of essential goods and services due to the region's remote location and rough terrain. Women endure significant hardships due to the high cost and limited availability of menstrual products, impacting their hygiene and overall well-being.

Patriarchal structures have labeled this natural process of menstruation as "dirty," with "hidden silences," and "code words." A lack of sanitary facilities, limited access to period education and education in general as well as the continued existence of cultural taboos all have contributed to poor menstrual hygiene habits among women residing there. 

Ani Tsering, a nun at the Rachen nunnery and one of the beneficiaries of Drokpo's "Language and Literacy Program." said, "Most nuns clean the vulva area with soap, sand, and leaves whenever they have irritation or an excessive flow of white fluid from their vulva area."

Our NGO Drokpo Nepal, which is dedicated to Himalayan women, was asked to help address the concerns and challenges faced by women in this region of the Tsum Valley. After brainstorming we decided to offer Menstrual Hygiene Management (MHM) sessions providing hands-on training in how to make sanitary pads. We also wanted to provide each woman with educational materials and their own reusable menstrual kit. We collaborated with Conscious Connections Foundation (CCF), a US non-profit organization that provided funding for menstrual hygiene manuals, kits, and training for 435 women in the high Himalayas who are economically and geographically disadvantaged.

The journey to Upper Tsum Valley from Kathmandu involved 12 hours of jeep travel and 4 days of hiking. We started our trek over steep terrain, muddy roads, and narrow routes while the rain poured heavily and the path was slippery. The hike was often disrupted by landslide-prone sections and swollen rivers. Despite the challenging and adventurous journey through the rough mountains, our four-women team persisted and made it to our first targeted settlement (Chhokhangparo) in the high Himalayas.

Initially, we encountered a number of challenges in organizing and managing feminine hygiene programs because there was no village hall or workshop space. Similarly, the daily routine of fieldwork and domestic chores for the villagers caused problems with project planning. The initiative could not have been implemented without working in collaboration with the Mother’s Group, the locally based Kyimolung Foundation, and the local government of Tsum Valley. Despite challenges such as the lack of community halls, we were able to create a temporary workshop area utilizing gompas, villager house yards, and riverbanks for the menstrual workshops.

We established an inclusive environment during the period literacy program where young girls, women, and nuns could engage in open discussions regarding period health. At first, the participants showed hesitation and shyness during the workshop, but as the session progressed, their eagerness and openness to the conversations revealed many things about their desire for change and knowledge. We organized meals and provided toys for women’s children which made sure that moms could completely participate in the period management session and pad-making instruction without any interruptions. 

In our training sessions, we equipped women, nuns, and young girls with knowledge about the menstrual cycle, highlighting the importance of hygiene maintenance and family planning and guiding them toward appropriate menstrual products. Additionally, we allowed them to touch and feel the menstrual products, both traditional and modern, and some were startled to see tampons and menstruation cups for the first time.

Our team made sure to go beyond information-sharing, demonstrating to them how to do yoga as a means of relieving period discomfort, and providing a safe space for them to discuss any concerns they may have about their cycles. It was through these conversations that our team learned that most of the women frequently turn to temporary solutions like handkerchiefs and headscarves due to cost constraints. This alone can result in a number of health issues. Many of the participants also had misconceptions and insufficient knowledge regarding menses. A large number of respondents didn't know where or why women menstruate. Some, on the other hand, view the natural cycle as dirty blood and think that they might be menstruating from their hips because their language refers to menstrual blood as (རྐེད་པ་) Kaypa, which translates to the waist area.

Following the workshop, late in the evening, after the women’s daily work, we had a quick one-on-one conversation with women from several villages about various kinds of menstrual health-related issues. I could still clearly recall some of the women's remarks. A sixty-year-old woman from Nyakyu village said, "In the Tsumpa language, menstruation is still strongly described as "Naepo" by many people, which means bad." Another woman, in her late forties, from Chumling village said, "I have been using my head scarf during my period since the beginning because there were no sanitary pads available when I was younger.” She kept on saying, “Most of the young girls here bear the pain even during severe period cramps due to shyness and they keep the pain to themselves.” At the same time, one young girl said, "Most of us used sanitary pads despite their cost, and we dumped the used pads into the nearby lands or into the river."

Throughout the whole journey, our initiative empowered women in 12 villages and 2 nunneries in the Upper Tsum Valley by addressing period shame and fostering self-reliance through hands-on training in the production of reusable pads and awareness sessions regarding managing their menstrual hygiene. Our intention was to equip women with the skills to produce reusable sanitary pads and handle menstrual hygiene with dignity. Our team believes that nobody deserves to feel guilty about something over which they have no control. Menstruation is a physiological process that occurs naturally and needs to be managed properly. Menstruation kits with essential hygiene products like cloth pads, soap, and cotton underwear were distributed, with participants agreeing to use them after learning about environmental impact and cost-effectiveness at the end of the session.

This journey wasn't just a hike; it was a mission to break barriers, challenge stigmas, empower communities, and demonstrate that change can be started even in isolated areas of the Himalayas. These mountain women envision a future where young, nuns, and older women can be empowered by destigmatizing menstrual stigma, embracing period literacy, and sustainable menstrual practices.