In sharp contrast to her questioner, who tip-toes around the delicate subject, Akhi Sultana belts out a full-throated response that is audible to everyone in a room full of strangers.

“Before, when I had my period, I could not change my rags or wash properly,” the 16-year-old says, referring to the strips of old saris that poor Bangladeshi women use to manage menstruation because they cannot afford tampons or sanitary pads. “I always felt shaky and afraid because there was no privacy in the latrines and no water nearby to wash with,” Ms Sultana says. “Now there is a water pump adjacent to the latrine and it is private.”