Where WASH Saves Lives: Creating New Traditions in Nepal

In the past, Nepalese girls like these would have been subject to the taboos of chhaupadi — not being allowed to use the family toilet or sleep in the family home during their menstrual period. Photo credit: USAID/Nepal

On her first night of menstruation, and for every night of her period, 15-year-old Roshani Tiruwa was expected to leave the warmth and safety of her family home and sleep in a tiny windowless hut barely large enough to stretch out in. She ate less dinner than usual because, by custom, women are not allowed to eat dairy at this point in their cycle.

It was December 2016, winter in western Nepal, so the nights were cold. Tiruwa started a small fire in the poorly ventilated hut to try to stay warm until morning. The smoke was thick, but at least it provided enough heat so she was able to fall asleep. But in the morning, Tiruwa did not wake up. She suffocated, another victim of chhaupadi.

The more stringent practices of chhaupadi, an ancient system of taboos surrounding menstruating women, were outlawed in 2005, but they persist in several districts in far western Nepal.

Like many women in the region, Tiruwa was told to sleep in a chhau goth or menstrual hut during her period. There she was vulnerable to cold in the winter and snakebites in the summer. Because she was considered unclean, she was forbidden from using the family toilet during her period so she had to defecate in the open, increasing the risk that she and all the other women in her village adhering to the tradition would spread disease. New mothers are also usually expected to sleep with their infants in the chhau goth for the first few weeks after giving birth, sometimes resulting in the death of a newborn from respiratory ailments.

In Nepal, small huts, called chhau goth, have been home to women and girls during their menstrual periods for centuries. Photo credit: USAID/Nepal

Tradition holds that if chhaupadi is not observed, crops will wither, wells will dry up, and illness will strike the family. “Traditional healers will say that if a woman doesn’t follow chhaupadi, something bad will happen to her family,” explains USAID Environmental Health Specialist Pragya Shrestha. “So some women have very strong feelings about chhaupadi. They say ‘I have to protect my family.’”

USAID’s Safe WASH (water, sanitation, and hygiene) II project aims to help women do just that. It has a broad goal of improving sanitation and hygiene behaviors in four far western districts — Kailali, Kanchanpur, Darchula, and Achham — including reducing the negative aspects of chhaupadi.

Shrestha, a native of Kathmandu, was saddened to learn the details of how chhaupadi has been practiced in rural Nepal. “I felt pain within myself when I went to those regions and talked with those women,” she explains.

Ganga Kumal was one of them. Her municipality was declared a chhaupadi-free zone after the practice was outlawed in 2005 and the chhau goths were demolished, meaning she had to stay in her house during her period. But after decades of observing the taboos, this arrangement made her uncomfortable. “I returned to staying outside the house during my menstruation period,” she says. “I even stayed under a tarpaulin since the goths were all destroyed. I used to suffer during the rainy season and even got sick.”

Kumal goes on to say “I realized that just destroying the goths and declaring a chhaupadi-free zone is not the solution.”

Safe WASH II is trying a new approach to chhaupadi to ensure sustained behavior change. USAID’s local consultants spoke with Nepalese religious leaders, who have found nothing negative about menstruation in the Hindu holy texts. They did find, on the other hand, support for the protection of women. Shrestha says that the project will build on the community ties established in the previous four-year WASH activity to engage at a deeper level with these religious leaders and with traditional healers. “Traditional healers have a dual role,” she explains. “As the keepers of tradition they enforce chhaupadi; as healers they want to lead their communities to health. USAID will engage the progressive elements of this gatekeeper group to reimagine and introduce a safe, holy chhaupadi tradition that celebrates the positive power of women. We think that it will work, because some progressive traditional healers want change, but we don’t know yet.”

Though outlawed in Nepal for more than a decade, chhaupadi is still being practiced in remote villages in far western Nepal, but even there attitudes are starting to change. Photo credit: USAID/Nepal

One challenge will be to convince older women that change will not endanger their families, and importantly, not invalidate their lifetimes of having made this type of sacrifice for their family. In this patriarchal culture, a wife traditionally has the least say in the household. During their menstrual periods, wives may at least experience the power that comes from making a sacrifice, and they may hesitate to give that up. Further, for some, it can be a time of escape from household routines and for camaraderie with friends in a shared community chhau goth, even if it is uncomfortable, undignified, and unsafe.

The Safe WASH team is not looking to eliminate women’s sense of agency related to chhaupadi. The hope is that traditional healers and religious leaders can harness community energy, from both women and men, to transform the meaning of the menstrual taboos.

The core of Safe WASH II’s work is with village WASH Coordinating Committees, organizations whose goal is to have an open defecation free village and prevent waterborne disease at the local level. Since menstruating women are forbidden from using their household toilets, they must defecate in the countryside, meaning that villages are unable to achieve the open defecation free goal. Each committee is encouraged to develop an action plan around the slogan “Sanitation and hygiene for every person, every day.”

One by one, the project is making a difference. Kumal says that “I now realize and understand that menstruation is a biological process after participating in awareness classes organized by Safe WASH II. I am now staying inside my house, use my kitchen, and consume nutritious food during my menstruation period.”

Rambha Devi Khadga, a widow in her late forties, also learned about menstrual hygiene from Safe WASH II. “I used to stay in the chhau shed away from my house, and the memories of those chhau goth are still fresh in my mind. I had many sleepless nights in the shed with my peers; there was not enough room to extend my legs,” Khadga says. “I am grateful that I regularly participated in the meetings organized by the Safe WASH II project about the importance of nutritious food, the use of the toilet, and safety issues during menstruation. I, along with my daughter, not only stay inside my house but also use the toilet during menstruation nowadays.”

Woman by woman, USAID’s educational efforts are helping to transform a dangerous cultural practice and replace it with new and safer traditions, in the hopes that Roshani Tiruwa will be the last chhaupadi fatality.

By Christine Chumbler


To subscribe to Global Waters magazine, click here, and follow us on Twitter @USAIDWater. This photo essay appears in Global Waters, Vol. 8, Issue 3; for past issues of the magazine, visit Global Waters’ homepage on the USAID website. For more information about USAID water and sanitation efforts, click here. For more information about USAID/Nepal, click here.

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