By Kim Crane

In a country with entrenched menstruation taboos, health educator Urmila Chanam breaks through the silence to spread knowledge and empowerment.

A year ago, Urmila Chanam set out on a journey traveling from village to village through rural India in a grassroots campaign to break menstruation stigma, myths, and taboo, and empower young women with information about their bodies. Today, she is gearing up for an even bolder effort leading up to the second International Menstrual Hygiene Day on May 28.

As Urmila prepares for new events in even farther flung communities, she fears the dangers awaiting women activists who rattle the patriarchy, and she worries about growing religious fanaticism in her country. But when she pictures standing in front of a new group of young women, her greatest fear is always silence.

“What if they don’t respond?” she wonders. “What if I ask them something and there’s no answer? What if I smile and people don’t smile back?”

Urmila is talking about her Breaking the Silence Campaign, which gathers adolescent girls and women together in whatever space a community has available: a government school, broken down temple, old hospital, a spot near the well, under a tree, a rice paddy field, or even construction sites. There, Urmila brings vital menstrual hygiene and health information out into the open.

Urmila, who hails from a remote part of Manipur state in north-eastern India, feels a close kinship with the faces gathered around her. Her life has diverged in important ways from many of their stories, but she recognizes their reluctance to talk and smile in public. She is attuned to the challenges faced by girls who are often married off in their teens, and the accumulation of shame and silence around their bodies.

This is why that moment in every training when Urmila hears a chorus of women and girls saying the word “vagina” out loud feels like a miracle. They are breaking taboos and speaking openly with each other. Girls and women who have silently suffered shame during their periods and ignorance about their physiology, now have an instant support group. It is a miracle that Urmila hopes to see spread throughout her country.

Urmila’s efforts have been a labor of love. Her work is not coordinated by an NGO. She is a committed activist with a day job as an HIV/AIDS and public health development worker, and another job as a freelance journalist. In conjunction with in-person trainings, the Breaking the Silence Campaign has raised awareness about menstruation through social media, introducing interviews, information, a hotline, and quizzes to engage both women and men. Urmila also started the ‘My Pad Campaign’ and mobilized the donation of 10,000 sanitary pads in just one month to be distributed to girls and women in need. Inspired by the achievements so far, Urmila has set her sights on ending menstruation stigma in India for good.

It’s a stigma that has led to public health consequences in the country. According to a recent study, of the 355 million menstruating women in India, only 12% use sanitary napkins. Poor menstrual health can cause fungal infections, reproductive tract infections, and urinary tract infections, which can lead to cervical cancer. Women who practice unhygienic practices are also vulnerable to infertility. The Cervical Cancer Free Coalition reports that cervical cancer kills around 72,000 women in India every year, more than anywhere in the world, constituting 26% of the 275,000 deaths worldwide.

Many schools in India lack adequate bathroom facilities, and when schools fail to provide an environment where girls can manage their periods without humiliation, many opt to stay home. As many as 23% of girls in India drop out of school when they reach puberty.

Urmila knows her efforts have changed the lives of individual girls, but she hopes she is also doing something much bigger: demonstrating a solution that works. After her first year of one-off trainings, Urmila took a question she was asked to heart: How can this powerful campaign become sustainable and continue on after she leaves a community?

Urmila says she is willing to work with “anybody who can help me form a bridge and find and reach adolescent girls and women who the media cannot reach.” This year, as she travels to different regions, she is partnering with local stakeholders to ensure that there is always someone in the state who is trained to continue creating impact. Most of the stakeholders are civil society organizations with established outreach mechanisms and a strong reputation in local communities. Urmila is also exploring some less conventional partnerships, approaching individuals in leadership positions, recruiting a popular rock band AJ as a brand ambassador, and even working with regiments in the Indian army. Another key goal this year is to surface data to back the need and efficacy of such programs. Urmila already has twelve events lined up with partners in two different states. These partners will continue analyzing the data she collects and promoting the campaign once she has moved on to the next community.

The menstrual hygiene movement in India is relatively young and has been slow to take root. “Menstrual hygiene should be included in school curriculums and girls should have access to separate toilet facilities with running water,” says Urmila. In 2012, the Government of India initiated for the first time a focused effort called the ‘Nirmal Bharat Yatra’, in partnership with international NGOs and civil society, to link  water supply, sanitation and menstrual hygiene management. Since then, she says, advocacy efforts have been stepped up at the national level, and the government has made strides to mainstream menstrual hygiene management.

Urmila cautions, however, that like most policy, the budget isn’t always there to implement the recommendations, and even when there are resources, there is corruption along the line. “They are not enacted,” she says “until people make a lot of noise in the media and the grassroots.”

The noise level is picking up across India as training efforts like Urmila’s are popping up in different regions; social entrepreneurs are devising innovative solutions, such as the online resource and educational comic book Menstrupedia; and donors and international agencies are increasingly prioritizing menstrual hygiene in their agendas.

“I want to be the ambassador to voice what is required at the policy level,” says Urmila. Her ultimate dream is to have policy makers learn from her campaign, and she has been carefully documenting her efforts to that end. She hopes to see the government take on the responsibility of providing menstruation education in biology classrooms to reach all girls in the country.

Urmila begins every training with a game of lies. She says that after 10 minutes of telling each other lies, the girls all forget they aren’t supposed to be talking and smiling. They laugh as a young girl claims she is 50 years old, or a woman declares she has 11 husbands. “But how,” Urmila asks them, “do you know these are lies?”

“In every state, in every community, in every language group,” Urmila says, “somebody will always say, ‘We know what is a lie because we also know what is the truth.’”

She wants women to know that the tradition that teaches women that menstrual blood is impure is a lie. Women are told that they are not supposed to go to school when they are menstruating; they are not supposed to touch kitchen utensils; they are not supposed to worship; they are often compelled to leave their home and live elsewhere when they are menstruating. “Do you want to know the truth?” Urmila asks her captive audience.

Urmila finds that most are hungry for basic biological information about women’s and men’s bodies. Though the girls usually cover their faces with their dupattas in embarrassment when Urmila begins talking about the penis, this is often the only straightforward information they have had on the subject. In her three hour training, Urmila covers the physiological process of menstruation. She teaches girls how to manage their menstruation every month without pain or humiliation. She distributes sanitary pads and shows girls how to wash and care for reusable pads and dispose of them in an environmentally friendly manner. She teaches yoga for menstrual pain. Perhaps most importantly, she affirms their experiences, that women not only endure physical pain around their periods, but psychological pain when they are treated as dirty and impure and prevented from sharing information openly. In her trainings, she creates a safe space for girls to speak up.

Urmila recognizes the power of this transformation because it is the same transformation she herself experienced. Although she grew up in a successful, highly educated family when she got her first period she had no clue what was going on. Like the majority of women in many regions in India, Urmila wasn’t aware of menstruation when she started her period. When she saw blood, she thought she was dying. Because of taboos around the topic, no one had warned her or helped her prepare.

She was given a piece of polyester fabric that became hard with use, hurt her thighs, and caused her to dread that time every month. She was 27 years old when she first learned there were other options. “Menstruating days have never been enjoyable or comfortable for me,” she said. It wasn’t until she started working on menstrual hygiene as a journalist much later that she realized her period didn’t have to be something to fear.

After winning national recognition, the Laadli Media and Advertising Awards 2012-13, for her menstrual hygiene journalism, Urmila took it as a sign that perhaps she was meant to do more on this issue. She knew she didn’t just want to engage as a journalist, but to work as a trainer, as an activist, and an ambassador for breaking the myths around menstruation.

While the recognition of her work encouraged her to develop the Breaking the Silence Campaign, Urmila says that this journey to this campaign has been at least 5 years in the making. She attributes her current success to the seeds of community and solidarity that were planted before there was ever a campaign, or even the idea of it.

As the youngest in her family, Urmila didn’t speak much growing up. “There was no one to hear me when I wanted to speak,” she says. After hitting a low point of isolation and low self confidence in 2010, Urmila logged into World Pulse for the first time and found a supportive community that listened to and celebrated her emerging voice. In the years since, she has relied on sisters near and far to help her realize her vision. “I am confident because I have sisters who stand with me in spirit.”

And they have stood with her in more tangible ways as well: advising her on curriculum, sewing reusable pads for her to distribute, coordinating logistics, suggesting training opportunities, reviewing grant proposals, donating money, meeting her with a friendly face in a strange city. “Breaking the Silence has not been an individual success,” Urmila declares. Her voice gets soft as she speaks about the number of people, including men, who have helped volunteer or supported her cause on social media. Her journey may appear a solo one, as she travels alone to each new community, but she is buoyed by support and encouragement from all over the world.

Urmila wishes for other activists—in menstrual hygiene or any field—to experience the benefits of a network of support. She advises someone in the position she was in a few years ago, with the seed of an idea and reservations about where to begin, to start by opening her heart to others and speaking up. She hopes that women who have been afraid to speak or who have internalized messages that the Internet does not belong to them, will find their way online and find a supportive community to help share their vision with the world.

Urmila’s pieces of training prove the power of a few words spoken out loud. By discussing the taboo subject of menstruation, a seal has been broken. Urmila hears women speaking the names of their body parts without shame. She sees women connecting and breaking through the isolation of taboos and societal restrictions. And she knows change can’t be far behind.