Myths and menstruation: Overcoming Pakistan's period taboo.

ISLAMABAD: Bent over her hand-crank sewing machine, Hajra Bibi carefully stitches sanitary pads for the women of her mountainous village in northwestern Pakistan, one of many rural areas in the deeply conservative country where periods are still taboo.

"I am responding to a crisis," said the 35-year-old mother, sitting in front of her small, doily-covered work table in the village of Booni, close to the Afghan border.

"Before, Booni's women had no idea what sanitary towels were," she explained. Less than a fifth of women use sanitary pads in Pakistan, local charities estimate.

Traditionally women have used rags and cloth to soak up their menstrual blood, but the stigma around periods and a lack of reproductive education means hygiene standards are poor and many contracted infections.

As with other areas of rural Pakistan, menstruating women were viewed as unclean and limited in what they were able to do.

Bibi was given training to make the disposable sanitary pads, made of cotton, plastic, and cloth, by the Aga Khan Rural Support Program (AKRSP) -- an NGO working with Unicef -- in a scheme that aims to change attitudes to women's health.

She took up the work to support her family because her husband is disabled and they have little income. Each pad takes around 20 minutes to make and is sold for 20 rupees (13 US cents).

Initially her work disturbed the local community.

"At first, people were asking me why I was doing this, some were insulting me," Bibi recalled.

But now, "girls in the village can talk about their periods," she said proudly, adding that she was fighting "for the basic needs of women".

Infection and education

In Pakistan, Unicef has warned that in some cases information about menstruation has deliberately been withheld from women as a "means of protecting their chastity".

"This in turn negatively impacts their physical and emotional health," it said in a 2018 report.

Historically, the women of Booni have used cloth, but according to Bushra Ansari of AKRSP the taboo surrounding periods meant many were ashamed to dry them outside, unaware that damp cloths are a breeding ground for bacteria.

In addition, female family members often shared the same menstrual rags, increasing the risk of contracting urinary and reproductive tract infections, explained Wassaf Sayed Kakakhail, a doctor in the region.

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