Nyaya Health

Posted by Ranju Sharma

In early January, The Kathmandu Post reported the death of a woman in the district of Achham during her stay in a “Chhaupadi goth.” She was found dead in the shed on the fifth day of her stay; her eight-month-old son, who stayed with her, was found unconscious. Two weeks before this, another woman from the same district had died during in the same way.

“Chhaupadi pratha” is a social ritual followed by people in some regions of Nepal.  This ritual regards as women “impure” during their menstrual cycle; it is known to have initially originated centuries ago from a belief that gods and goddesses become angry if any woman stays in her home during that time.  Following the ritual, women are made to live in sheds outside their homes called “chhaupadi goths.” A menstruating woman cannot touch anyone; if anyone touches her, the person needs to be purified by taking a bath and drinking cow’s urine. Specifically, she is not permitted to touch pregnant women or trees, because of the idea that the “fruit” each are bearing will die or will be malformed. Menstruating women are not permitted to participate in religious ceremonies, nutritious food is forbidden, and warm clothing is not allowed. Yet, they are still expected to participate in hard labor, carrying out the daily chores that they would normally do, such as working in the fields, fetching firewood, washing clothes, and so on.

A chhaupadi goth is sometimes built within the household premises, but in other cases, they are isolated from the villages, up to a mile away from the houses.  Most sheds can barely fit two people: they tend to be around six feet wide and four feet high and made of mud, stone and wood with no windows (Ghimire, SBMJ 2005) Mostly, the women stay in the shed for four or five days. At the end of the ritual, they take a bath; wash their clothes and bedding and return home. There are two kinds of “chhau” (menstruation): minor chhau and major chhau. During minor chhau, the stay lasts four to five days. During major chhau, which occurs after childbirth and during menarche, women are obliged to stay in the goth for ten to eleven days.

A chhaupadi goth in Achham, near Bayalpata Hospital where Nyaya works

Due to the unhygienic nature of these huts, women tend to suffer from various infectious diseases. Diarrheal and respiratory diseases are quite common. In severe situations, cases of malnutrition are also seen. As women are made to stay in the mud shed after childbirth, the mother’s and the baby’s health is compromised. Laxmi Vilas Ghimire, in a Student BMJ article entitled “Unclean and Unseen,” points out that this ritual is a leading reason for high infant and maternal mortality in the western region of Nepal. Complicating these issues even more, women are sometimes raped during their stay in the huts, given their physical isolation from the village. Only a minority of these cases are likely to be reported given the social stigma associated with such incidents.

Despite the diseases and deaths that are occurring during or following the stay in the chhaupadi goth, it is difficult for people to discard the practice as it has been followed by their families for centuries. A woman in the Ghimire Student BMJ article comments, “I cannot leave the system that has been in practice for hundreds of years just on the grounds of illness and difficulties. We have to bear that.” Moreover, social dynamics play a huge role in reinforcing the ritual. Recently, another Kathmandu Post news article reported the news of a family being ostracized from the society for not following “Chhaupadi pratha”. Gagan Singh B.K. from Chhatiwan village in Doti district, in a VDC council meeting appraising the women working against the “Chhaupadi pratha”, said that his family had been facing hostility from the society for the last five years because he had asked his wife not to follow the ritual considering the unsafe nature of the outdoor sheds. Most societies in Nepal are patriarchal where male dominance goes unquestioned; women are regarded as the “secondary citizens”. Majority aren’t empowered enough to protest if their basic human rights are violated and those who care to do so are detested by the society, including women who themselves are the subjects of such violations. This ritual certainly has not sustained solely on the basis of religion or culture. One can argue, what if the ritual obliged men to spend a few days in a Chhaupadi shed every month by virtue of a naturally unpreventable biological phenomenon. Would the ritual have still existed? Would the society have reprimanded those who chose to stop observing such ritual considering the adverse effects the ritual has on one’s well being? Perhaps not.

Unfortunately, only a few government and non-government organizations have been involved in education or advocacy work regarding this practice. Radio Nepal broadcasts awareness programs addressing the ‘chhaupadi pratha’ and advocating reproductive health rights of women biweekly (Ghimire, SBMJ 2005). In 2009, the government of Nepal published a protocol for the eradication of the “Chhaupadi pratha” as directed by the Supreme Court of Nepal. We hope that, through continued education and advocacy campaigns, the health of women can be prioritized, and measures can be taken to minimize health risks associated with practices such as this. Nyaya Health remains committed to health for all, and in particular has made efforts to target its health and community programs towards women.

Tags: Achham, Bayalpata, chhaupadi, Gender Equality, global health delivery, Human Rights, Ranju Sharma, rural nepal, social justice