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 girl’s fingernail to assess the damage beneath. Dr. Ibrahim looks up. “She’s a girl, yes? Let’s give her a chance to keep her nail,” she says, before outlining a plan to save it.

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