Dechen Dolkar

Tshering Lhamo, a 21-year-old student at the Drasktso Vocational Training Center for Special Children and Youth, is forced to stay at home during her menstrual cycle because she cannot change her sanitary pad at the center.

Tshering Lhamo, who performs tasks using her feet instead of her hands, is capable of changing her sanitary pad and even eating with her feet. However, due to the lack of appropriate facilities, she is forced to sit on the floor to change her sanitary pads.

Her younger sister, Ugyen Tshomo, explained that they have provided her with a separate toilet to use, which no one else is allowed to use in their house. They live with their elder sister, who runs a business in Thimphu.

Tshering Lhamo said that she does not attend school for two to three days during her menstrual cycle because there is no separate toilet available for her to change her sanitary pads.

“Some of my friends also stay home during their menstruation cycle. For girls with disabilities, we need toilets that are comfortable to use and that have water and soap,” she said, highlighting the need for accessible and inclusive facilities.

She also expressed her desire for a menstrual product that would be user-friendly for a person with disabilities like herself. Currently, she uses disposable pads and prepares her undergarments by lining them with pads.

Her sister assists her with getting dressed and accompanies her to the institute every morning. Ugyen Tshomo said that her sister prefers to walk to and from the center rather than using public transportation.

Deki Tshering, deputy chief programme officer under the division of health and well-being in the Department of Education Programme, said that they have constructed inclusive toilet facilities for people with disabilities to change their sanitary pads. The focus is on creating inclusive toilets with ramps and easy disposal and access to sanitary pads.

“We are making the environment friendly for them depending on their needs,” Tshering said. The availability of sanitary products and innovative solutions, however, depends on the market, she added. 

Menstrual health and innovations continue to present challenges in Bhutan. Research shows that the impact of menstrual health innovation remains low in middle and low-income countries.

Over the years, adolescent girls and women in low-income countries have faced challenges in managing their menstruation with dignity and comfort. Many girls and women in rural areas report inadequate supplies for managing menstruation and resort to using tissues, toilet papers, rags, or undergarments alone.

Efforts to address menstrual and hygiene management range from non-governmental organisations distributing sanitary products and supplies to girls, to more holistic approaches involving communities or teachers, as well as improvements in school toilet facilities.

Globally, social entrepreneurs are developing a wider range of new products, such as underwear with insertable cotton wool or other absorbent materials, reusable sanitary pads, and disposable sanitary products made from local plant materials or other environmentally-friendly and potentially biodegradable materials.

However, in Bhutan, menstrual products are not considered essential items and are subject to taxation.

To overcome these challenges, policymakers and civil society organisations should provide education and guidance while considering the specific types of menstrual products used by individuals. Increased variety in menstrual products for different needs would also be beneficial.