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.
To address the issue, the Nepal Fertility Care Center has been conducting educational programs in three districts in central and eastern Nepal since 2011. The programs teach schoolgirls – and sometimes their mothers – about menstruation hygiene, Lakhe says.
In January 2014, the programs began promoting a homemade sanitary pad that can be washed and reused hygienically, Lakhe says. This pad has three layers – cotton, denim and a waterproof synthetic fabric – and an outer covering of cotton. It is more absorbent and can be reused more times than the cloth pads made of old sari fabric.
“As the project is an initial phase, the price has not been determined yet,” Lakhe says. “Nevertheless, it will be less than 100 rupees ($1.05) per pad. The pads will be cost-effective, as one pad can be reused for more than one year.”
Government agencies also plan to focus on menstrual hygiene once the new fiscal year begins in July.
“Nepalese women have problems of sanitation and hygiene,” says Bhogendra Raj Dotel, section chief of the Adolescent Sexual and Reproductive Health Program of the Ministry of Health and Population. “Lack of attention to sanitation is causing health problems. We will keep this as a priority area in the next fiscal year.”
Poor hygiene can cause bacterial infections of the urinary and reproductive tracts, skin rashes, itching, burning and genital sores, Dotel says.
Despite the challenges women face during menstruation, some find peace in the customs.
Laxmi Biswokarma, 34, lives in Gatchida, a small village in the Kaski district. Here, houses are scattered on the hillside, and the unpaved roads are dry and dusty.
Biswokarma lives with her husband’s parents, two teenage daughters and a 3-month-old son. Her husband works as a migrant laborer in Qatar.
Biswokarma wakes up three hours later than she would if she were not menstruating. It is the fourth day of her period, and she is enjoying the break from indoor morning chores, she says.
“It is easier when we are menstruating because we don’t have to do the household chores like cooking,” Biswokarma says. “So we get time to rest, which is good.”
She nurses her son and then bathes him with water her daughters have drawn from the stream nearby. Untouchability customs do not prevent Biswokarma from caring for her baby during her menstruation.
Subedi has her midday meal and then does light fieldwork. She tends a nearby field where the family grows rice and maize. She helps her father-in-law clear weeds but has to ensure she does not have any physical contact with him.
She does only light work during her period because she tires easily, she says.
“I take good rest and do not do heavy work during my menstruation,” Subedi says.
Subedi stops working now and then to wash and change her cloth pad.
“I change three to four times a day, depending on the flow,” she says.
Her cloth pads are made from old saris and other pieces of fabric. She has never used sanitary pads because she cannot afford them.
“Our mothers and grandmothers have been using cloths, and up to today, no one has had any problems or illnesses," she says.
Nobody has explained to Subedi what kind of health problems she could inherit from poor hygiene during her period, she says.
In Gatchida, Biswokarma eats the lunch prepared by her mother-in-law. She then heads to the field to cut some grass for the cattle and to collect firewood.
“Sometimes it is difficult to work in the fields when I get a bad stomach pain,” she says. “But I have to continue working because there is no one else to look after the cattle.”
Biswokarma used to have severe menstrual cramps and a heavy menstrual flow when she was younger, she says. Acting on a traditional belief that bad spirits cause illness and pain, her family took her to a “jhakri,” a tantric priest who Hindus believe wards off evil with chants and pujas.
But these visits did not make her feel better. Her family never took her to a doctor or a hospital because they did not believe it was a medical condition but rather that an evil spirit had taken over her body.
She continued to have severe menstrual cramps until she became pregnant with her first child, Biswokarma says. She has not had menstrual cramps since that pregnancy.
Coping with hygiene and cramps while working in the fields are not the only challenges menstruating women face. They also often miss cultural and family celebrations.
In Jhor Mahankal, Dulal has returned home, carrying enough firewood to last several days. She has finished her midday meal, cooked by her daughter. Dulal accepts that she is not allowed to cook in the kitchen, even for herself, during menstruation.
Dulal and her daughters also use special crockery during their periods, she says. The family keeps it separate from the crockery it uses.
As Dulal’s daughters and mother-in-law prepare to join in the funeral rites of a neighbor, she knows that she cannot visit the grieving family until after the seventh day of her period. For pujas or marriage ceremonies, the waiting period is four days.
Dulal feels sad about missing the funeral but has resigned herself to the traditional restriction, she says.
“If it is a ceremony that has been planned in advance, like a marriage ceremony or a puja, and there is a possibility it will be during the time of my menstruation, I take medicine to not get menstruation,” Dulal says.
She buys the pills in her village but does not know their name, Dulal says. She has to take one pill every day until the ceremony or puja is over. Her period begins once she stops taking the pills.
As the family will not return until late, one of Dulal’s daughters leaves food for her evening meal. She has never gone without food during her menstruation because her family and neighbors always provide it, she says.
With her family yet to return, she decides to go to sleep early.
Dulal usually sleeps with her husband on a mattress in a wooden bed. When she is menstruating, she sleeps in her daughters’ bedroom, which her husband and son never use. The room has two low beds on which Dulal’s daughters usually sleep. But during menstruation, the women sleep on the floor atop old bedding specifically reserved for their periods in order to avoid contaminating the beds.
Dulal spreads the old bedding in a corner of the bedroom and goes to sleep.
Biswokarma nurses her baby and then goes to sleep. The baby sleeps with her on the old bedding. When Biswokarma is not menstruating, she sleeps in another room on a wooden bed with a mattress.
Tomorrow will be the fifth day of her menstruation. Early in the morning, she will go to the nearby river to bathe and wash the clothes she has worn during her period. After that, she can resume her normal life.
"Menstruating is a part of our lives, and the customs we follow are also a part of our lives,” Biswokarma says. “I just take it as part of my normal day.”
GPJ translated this article from Nepali.
The events in the “Day in the Life” of Dulal, Subedi and Biswokarma did not happen on the same day. The reporters documented the details during four days of menstruation and combined them into one day’s timeline.