New Ladakhi Girls Health and Empowerment Project • Ladakh, India • Summer 2019 ​ Stanzin Angmo, North Yarmouth Academy ‘16, Bennington College ‘20

Background and Importance: The New Ladakhi Girls Health and Empowerment Project seeks to introduce ​ sustainable and healthy menstruation in Ladakh and empower women by opening conversations on menstruation and women’s health issues. Ladakh is geographically one of the most sparsely populated and remote regions in India. It is culturally and historically connected to Tibet, Buddhism is the predominant religion, and its people speak Ladakhi, a Tibetan dialect. Today, Ladakhi society is going through rapid and mostly unplanned development due to tourism and modernization. While these changes are creating more job opportunities and connections with the outside world, people’s cultural perceptions about gender roles and women’s sexuality remains mired in traditional, patriarchal points of view. Attitudes towards menstruation are particularly damaging as the term for menstruation is “tsogpo,” meaning “dirty” in Ladakhi. A menstruating female is impure and banned from entering temples and prayer rooms. Ladakhi elders consider menstruation a trigger for trouble and risk in young women, as pregnancy before marriage is unacceptable, yet nobody wants to educate people about the female reproductive system and birth control options, because they believe it will promote promiscuity among the younger generations. Once girls reach puberty, they face restrictions that boys do not; families often try to keep young girls at home, limiting their ability to participate in community activities. Due to this belief and the way girls are raised as a polite and submissive gender, they are never encouraged to take distinct roles in society. Many remote villages do not have good schools, health centers, and hospitals. As a result, many women face difficult health issues, and young girls are horrified when they menstruate for the first time. Nearly every girl I know struggles to understand her body better, especially the female issues of menstruation, cervical cancer, STDs, and menopause. Low literacy levels help perpetuate unhygienic practices and make people more vulnerable to stigmatization. There is a belief that women shouldn’t bathe or even wash up during menstruation. It is a very delicate topic that cannot be freely discussed, even between a mother and her daughter. Because of the promotion of such unhygienic behavior and an overall sense of shame in seeking out information regarding their sexual health, women become susceptible to severe reproductive health issues, such as infertility. Similar to millions of women in India, women in Ladakh don’t have access to sanitary napkins and information about hygiene and health. Most women in Ladakh use cloths and rags during menstruation. (Pads are expensive and not readily available in many remote villages.) Women and girls who use cloths fear drying the fabric openly in the sun due to the belief that it is sinful to let men see them.The rags women have to use are not very comfortable for working outside on the farm or doing household work. They are also not leak proof, so they constrain women from doing many activities including attending school, because of the fear of getting stains. Women who use sanitary napkins have nowhere to get rid of the used pads, and often dispose them in the soil, which is very toxic, or burning them, which releases poisonous dioxins. The constraints imposed by menstruation often lead to less involvement of women in the decision-making part of communities and government. The stigma surrounding female sexuality and menstruation perpetuates gender inequality and suppresses our voices. I believe that working to remove the social stigma surrounding menstruation requires education of both genders and building Ladakh’s capacity to provide an array of choices in female hygiene products, as well as forums for consciousness-raising conversations between women and girls. To encourage female leadership, we must demystify menstruation and diminish the generations of shame endured by our women. Multiple initiatives are being taken up all over India to empower women and to reduce the stigma that surrounds menstruation, but due to the geographic barriers, few initiatives have reached Ladakh.Therefore, there is a need for someone to go out there and support rural women who cannot get access to the information otherwise. Only then will Ladakhi women feel empowered to connect their voices to women around the world who are similarly seeking a more egalitarian and peaceful world.

Project Summary/Objectives: For this project, I aim to go to the most remote villages of Ladakh in the Changthang ​ and Zanskar regions on behalf of New Ladakhi Girls (NLG), which is a organization my friend Tsewang Chuskit (2018 Davis Fellowship recipient for the New Ladakhi Girls Women’s Traveling Library) and I started in 2015 to promote health awareness and empowerment of women in Ladakh. We have been doing different projects every summer since then, such as Adolescents’ Health in 2015 and Mental Health and Emotional Wellness in 2016. The people from the Changthang region are familiar with NLG, and we’ve led multiple talks in the past on women’s health issues, including menstruation. However, they have never had a focused engagement on the array of choices possible for menstrual hygiene. The Zanskar region is recognized by locals and sociologists as the most underdeveloped region of Ladakh, enduring many economic and educational challenges without much progress in comparison with other districts. Thus, there is a strong need for education and health resources. The major goals of the project are to educate all people—women, men, boys, and girls—about menstruation and the best practices for hygiene and the disposal of products; to encourage open conversation on menstruation; to introduce sustainable menstruation-product options, and to explain the impacts of each product they use on the environment. The project will provide vital presentations on the basic biology behind menstruation. Jamyang Foundation, which supports nuns’ monasteries in many regions of India including Zanskar, has asked NLG to do the project at their nunneries near the Padum region of Zanskar. We will also be going to the schools in the villages and invite the villagers. When there is electricity, we usually show our slides on the screen and talk through them in Ladakhi language, but if there is no electricity, we simply give talks and have a discussion. Usually, the presentation lasts 30-40 minutes, and we always stay an extra 30 minutes for questions. For the Changthang region, we will speak at three different villages: Mudh, Nyoma, and Hanley. I expect around 600 women, including young girls, in Nyoma, 150 in Mudh, and 70 in Hanley. After the presentations, we will distribute the pads and each woman who wants to use the product will be given two pads for free so that she can switch the pads during her period. Women who are interested in using the cups will be given one for free. Before going to the villages, my first task in June will be to convene a summit in Leh with our network of government, health care, and education professionals. Participants will include NLG mentors: Dr. Iqbal of Sonam Norbu Memorial (SNM) Hospital in Leh, Dr. Landol of the Himalayan Health Initiative, Principal Konchok Wangmo of the District Institute of Education and Training (DIET), and faith leaders from Islamic, Christian, and Buddhist organizations. We will listen to each other, building consensus about how this project can be done effectively without threatening the existing culture—especially in introducing products that most women are completely unfamiliar with. Most of the leaders have been very supportive and were prominent mentors to our projects in the past. They help us with providing data about health issues and other information about specific places in Ladakh. One of my other aims is to provide people with menstrual products from EcoFemme (https://ecofemme.org/), which is a ​ ​ women-led organization based in South India that promotes and revitalizes menstrual practices that are healthy, dignified, affordable, and ecofriendly. They make washable cloth pads and sell them all over the world, which provides livelihoods for the local women in India who make them. The pads are made from cotton and structured exactly as a pad, with a leak-proof layer and wings with buttons that hold comfortably around the underwear. It is very comfortable and can be used for five years, and it will easily decompose in the soil when disposed. I aim to purchase the foldable pads (one of the few kinds of washable cloths they make) and also include their message in our talks. The foldable pads are preferable, especially by women in Ladakh, because when you dry them, they don’t look like a pad exactly, so women feel much more comfortable drying them openly in the sun. I will also introduce women to menstrual cups from Boondh, an enterprise with a social mission to make the menstrual cup available in India at affordable prices with great quality, comfort, and usage support as an economical, environmentally friendly and healthier alternative. Considering the shortage of water, freezing temperatures in winter, and busy agricultural work, menstrual cups are one of the best options as they can be rinsed easily, do not need to be dried, and don’t have to be changed every three hours. However, the women will be very hesitant to use them due to cultural barriers, but I will educate them about the benefits of menstrual cups (that they are harmless to their bodies) and how to properly use them. I will purchase around 500 menstrual cups in case any women might be interested. The goal of introducing sustainable menstruation products is not to force women to use the cloth pads or menstrual cups but to provide them with information, make the resources available, and open their minds to alternatives. I will leave the decision to them about what they want to use. From my own knowledge, I know that older women prefer cloths to sanitary napkins, and these pads from EcoFemme will be the best resource for them.

Timeline: If I am selected as a recipient for this honorable project, I will instruct EcoFemme to start producing the pads ​ in March and April, and the project will take place between June and August. The summit will happen in mid-June with the prominent leaders of Ladakh, and after that, NLG will travel to the Changthang (3-4 days) and Zanskar (5-8 days) regions to distribute the pads and organize talks on menstruation in different villages and schools.

Conclusion: Through this project, I aim to empower women and girls in my homeland by educating them about their ​ bodies, encouraging them to talk openly about their health, especially menstruation, and most importantly, including men and children in the conversations. Openness about menstruation as a natural part of growing up will spare so many girls the trauma and isolation they so often feel upon getting their first periods; it will encourage young girls to have self-confidence and allow them to live healthy lives, which will in return shape the community they live in. Women are half of every population and the central caretakers of families; empowering them is a requirement to make a peaceful society. This project, in particular, will allow people to support their daughters’ and sons’ confidence equally, thus raising leaders who will raise their voices to contribute to the emerging global conversation about gender equity, women's rights, and equal access to education.