In an operating room of Kirtipur Hospital in Kathmandu, Nepal, reconstructive surgeons Dr. Farzana Bilquis Ibrahim and Dr. Pramila Shakya lean over the tiny hand of their patient, a one-year-old girl whose finger was crushed in a car door.

As the two women discuss how to repair the injury, a male colleague interjects to suggest they remove the girlโ€™s fingernail to assess the damage beneath. Dr. Ibrahim looks up. โ€œSheโ€™s a girl, yes? Letโ€™s give her a chance to keep her nail,โ€ she says, before outlining a plan to save it.

The decision may seem inconsequential, but in Nepal, a patriarchal and primarily Hindu societyโ€”where many people believe physical imperfections are a sign of karmic misdeeds in a past life, and a womanโ€™s value is often based on her ability to marry and produce sonsโ€”it could have far-reaching consequences. This little girl lucked out.