Menstrual health and hygiene are critical health, gender equality and well-being issues for rural girls in most Pacific island nations. Educational opportunities for girls are negatively impacted by cultural taboos and limited school sanitation or menstrual hygiene options. In East Kwaio, Solomon Islands, religion and spirituality determine daily life. Biological, socio-cultural and spiritual processes of menstruation determine the layout of mountain hamlets. In coastal villages, menstruation is not discussed openly and women and girls typically manage menstruation alone. In both Kwaio settings, menstruation can restrict girls’ access to formal education. Our story tells how one determined Kwaio woman used a chance encounter with a young girl as the impetus for her, and our, work to improve menstrual health for schoolgirls, other women and girls. Women leaders from a local conservation group, two local schools and a local health service initiated culturally-appropriate solutions with girls at the schools. A pad-making initiative and a parallel awareness-raising programme promoted sexual and reproductive health, and gender equality, for girls in this remote Pacific setting. We describe how partnerships, led by those closest to the issue, can effect local transformation to encourage reproductive and educational justice for girls in Solomon Islands, and other Pacific contexts.