JHOR MAHANKAL, NEPAL – 4 a.m.
Gauri Dulal leaves her house of mud and stone, carrying a small lamp into the predawn darkness.
Dulal, 44, heads toward a public tap shared by 10 families for her morning bath. She walks along the narrow road, passing other stone houses that stand silent at this early hour in Jhor Mahankal village development committee in the Kathmandu district of central Nepal.
As she nears the tap, she sees two other women bathing in darkness. They too are menstruating.
“The people in the village know that the menstruating women use the tap in the morning time, and they do not come to the tap in the morning unless it is very urgent,” Dulal says. “They do not want the menstruating women to touch their water.”
Nepalese Hindus believe water touched by a menstruating woman is impure and must be thrown out, she says.
On days when Dulal is not menstruating, she refrains from going to the tap in the morning to avoid the menstruating women.
Throughout Nepal, women share a common bond during their menstrual periods. For four days every month, the cultural customs of their communities and limited access to feminine hygiene products dictate the way they live, work, eat and sleep.
Hindu tradition deems things touched by menstruating women impure, says Pramod Bardhan Kaudinnyayan, a professor at Valmeeki Vidyapeeth, a college in Kathmandu, Nepal’s capital, specializing in Sanskrit education. Hindu families observe this tradition despite their increasingly modern lifestyles.
“The Hindu sacred writings state that women, during their menstruation, are considered to be impure for three days,” Kaudinnyayan says. “But in practice, most families keep women separate for four days.”
Nearly 82 percent of the population practices Hinduism, according to the National Population and Housing Census 2011 by the Central Bureau of Statistics.
After bathing this morning, Dulal quickly washes the cloth pads she used the day before and tucks them under her washed clothes so that nobody will see them. She has made several pads from two old saris, which she washes and reuses until they are too old and must be thrown away.
Dulal learned about sanitary pads from a college friend of her daughter’s, she says. But she has never used them.
“They are too expensive, and I do not know how to use them,” she says.
Menstruation is a taboo subject that is not discussed openly, so many women remain ignorant about innovations like sanitary pads and continue in the traditional ways of their mothers and grandmothers, Kaudinnyayan says. Further, sanitary pads are too expensive for poor women in rural areas, who do not earn an income and must rely on male family members for money.
A pack of eight sanitary pads costs at least 40 rupees (42 cents). This is a considerable sum in Nepal, where almost a quarter of the population lives on less than the equivalent of $1.25 a day.
Dulal begins doing outdoor chores. She is not allowed to work in the house during menstruation.
She does not mind being excluded from the housework, but sometimes her daughters, who are in their early 20s, rebel and ask her why they must follow these customs, she says. She responds that they cannot question the traditional ways.
When Dulal finishes cleaning the cattle shed, she feeds the animals, making sure she stays away from family members and neighbors.
“If others touch me during my periods, I will commit sin,” Dulal says. “The gods will be angry.”
If a woman fails to follow the traditions of untouchability during menstruation, her departed soul will not rest in heaven, Dulal says.
“It is believed in Hinduism that if a woman touches someone during menstruation, then she has to do a puja [prayer ritual] and also fast for one day to be cleansed,” she says.
About 200 kilometers (124 miles) away in Chhorepatan, a small town in Kaski district, Jyoti Subedi awakes to the sound of her mother-in-law softly chanting the morning puja to the gods at the little shrine in the family’s home.
Subedi usually performs the ritual offering of water, flowers, rice grains, tika powder and light to the Hindu gods for the family. But today, because Subedi is menstruating, her mother-in-law performs the ritual.
“In our culture, when we are menstruating, we do not touch shrines,” she says. “This is what we have been taught, and this is what I believe.”
Subedi, 18, is the mother of a 1-year-old girl. She and her husband, a salesman in the nearby tourist city of Pokhara, live with his parents in Nepal’s Western region.
Although many of these restrictions are common throughout the country, women living in the western regions of Nepal face harsher conditions, says Himalaya Panthi, social development manager at Nepal Water for Health, an organization working for clean drinking water and sanitation in Nepal.
In accordance with a custom known as “chaupadi,” menstruating women in these areas must leave their houses and live in cattle sheds or small huts that lack proper lighting and ventilation.
The custom stems from a superstition that something bad will happen to a woman’s family if she stays in the home during menstruation, Kaudinnyayan says. The folk belief is not grounded in Hindu scriptures.
Subedi’s in-laws are understanding and do not strictly enforce the rules, she says.
“We do follow our customs, but they are lenient too,” she says. “They don’t ask me to sleep outside the house. When I am menstruating, they don’t give me much work and allow me to rest. I am lucky that way.”
As Subedi has no household chores to do in the morning, she decides to sleep a little longer.
“I have time to rest and relax, which is good,” she says with a smile.
She makes herself more comfortable on the thin bedding she has put down on the floor of a special bedroom she uses during her menstrual period. On other days, she sleeps in a bedroom with her husband on a mattress in a wooden bed.
Dulal drinks a cup of hot tea after her morning chores in Jhor Mahankal and then goes out into her vegetable field. She inspects the potato plants, which will soon be ready to harvest, and prepares the soil for the mustard seeds she will sow next week.
When she works in the field while menstruating, she manages the menstrual flow with the cloth pads, she says.
“Since my first periods, I have used a piece of old sari as a pad, and I tuck it inside my petticoat,” she says.
She then begins the hourlong trek to the forest to collect firewood.
Dulal usually uses one cloth pad for an entire day, and sometimes blood leaks onto her clothing. She does not change the pad during the day because she is embarrassed to bring extra ones to the forest and fields, where there may be men and there are no bathrooms. She cannot go to the public tap to wash during the day, and she does not have a private tap at home.
Sometimes the rough sari fabric cuts into Dulal’s skin and causes pain in her genitals, she says. Sometimes she experiences itching and swelling.
“I frequently have these problems, but I haven’t gone for a checkup,” she says.
Traveling to a hospital is costly, and Dulal does not think her discomfort and pain require medical attention, she says. She has not heard of any infections or diseases caused by poor hygiene during menstruation.
Pema Lakhe, deputy executive director of Nepal Fertility Care Center, an organization in Kathmandu that provides sexual and reproductive health education and services, says a lack of pads and clean cloths during menstruation can cause health problems.
“Women have no knowledge regarding menstruation at all,” she says. “The lack of cleanliness during menstruation can lead to uterine infection and pelvic inflammatory diseases.”
There is no data available on the number of women who contract these infections and diseases as a result of unhygienic menstrual practices, Lakhe says.