Chhaupadi practice in Nepal – analysis of ethical aspects

Introduction

Menstruation is defined as a periodic, normal, healthy shedding of blood and tissues from the uterus that exit the body through the vagina.¹ It marks the beginning of womanhood, a unique phenomenon among females which starts around the adolescent age (11–15 years) of their lives, a key sign of reproductive health and a way of preparing for pregnancy.² However, there are several taboos in many parts of the world concerning menstruation, menstrual blood, and menstruating girls/women. Some of those taboos are based on religious grounds while others have their roots in culture and tradition, and they are manifested in the form of different practices. For example: in Islam, women are not expected to pray and fast, and not allowed to have physical relationship during menstruation. Likewise, under Jewish tradition, anything and anyone touched by menstruating women are considered ritually impure.³ One such practice in existence is separating girls and women from the rest of their family during menstruation considering them impure. The degree and type of separation, however, differs among communities. It might take a form of keeping the women in a separate hut at the edge of the village, a case of extreme separation as seen among Indonesian Huaulu, or keeping them apart around the house but in a separate hut as seen among the Dogons of central plateau region of Mali.⁴ One such practice called Chhaupadi is in existence in certain parts of Nepal and it involves separating menstruating women from the rest of the family.

Chhaupadi at a glance

Nepal is a geographically small, yet culturally, linguistically, and ethnically diverse south Asian country situated between the People’s Republic of China and India. Although constitutionally a secular country, a vast majority of the Nepali population follows Hinduism and the religion plays an important role in Nepali life and society.^5,6 Geographically, Nepal is divided into mountains, hills, and plains and for the administrative purpose it has been divided into five development regions.⁷ Out of these five regions, mid-western and far-western (development) regions lag behind the rest of the country in terms of overall development and gender equality. In these regions scarce employment and livelihood opportunities are common and everyday life is difficult for most people. In the regions already grappling with complexities of caste, religion and ethnicity, the historical patriarchal socio-cultural system adds particularly to the plight of women.⁸ Although the scale of problem varies between communities, the status of women in these two regions is a reflection of the status of Nepali women in general where they are treated as second-class members of the society with lesser autonomy, power, and freedom compared to men.⁹ Furthermore, a general lack of education and awareness of their social and legal rights means that they are also victimized in the name of social rituals, norms, and traditions.

Chhaupadi is one such traditional practice which has been in existence in the far- and mid-western regions that banishes women from their house during their menstrual bleeding. This practice is derived from a Hindu tradition that relates to secretions associated with menstruation and childbirth.¹⁰ The word Chhaupadi is derived from a local word used in the Raute dialect of Achham district in the far west where Chhau means menstruation and padi means a woman.¹¹ Under this practice, women are considered impure during their periods and are therefore required to refrain from participating in normal daily activities. They are forced to isolate themselves and sleep inside a small shed/hut made up of mud and stones without windows and locks, usually known as goth. These huts are especially prepared 20–25 meters away from their own residential homes and are sized around 1×2 m. Such sheds lack doors, are very narrow, dark, tight and congested, and have cold dirty floors, where women sit and sleep.¹²

Chhau is considered to be of two types, major chhau and minor chhau. In minor chhau (monthly menstruation) women have to live in these sheds for up to 5 days and in major chhau the stay lasts up to 11 days, which is mainly the period after childbirth and menarche. On the last day the women take a bath, wash their clothes, bedding and return home.¹³ However, even on the last day, they are not allowed to purge themselves in public water sources. Therefore, the women practicing Chhaupadi have to bathe and clean their clothes in “Chhaupadi Dhara”, a separate well or tap near the village.¹⁴

Rationale behind Chhaupadi

Many traditional Nepali Hindu families impose certain restrictions against women when they are having their periods. Chhaupadi is a manifestation of such restrictions, but in a more severe form. It is primarily driven by a superstitious belief among the people that if women stay at home during their periods, which is considered a phase of impurity, it will infuriate the Gods and consequently that wrath will negatively affect the entire family. There are also beliefs that if the menstruating women touch cattle it will die, if they cross a water source it will dry up, if they touch some fruit it will fall off before it ripens, and so on. As a result, they are not only banished from their residential homes to live in cramped huts but are also not allowed to touch their husbands or even their brothers, cattle, fruit bearing plants and crops. If they touch someone accidentally, one must be purified, for example with cow urine, which is considered holy. They should not walk into the premises of temples and are prohibited to attend any religious ceremonies, even weddings, in the belief that they are impure. Women are not allowed a nutritious diet like milk, meat, fruits, and green vegetables and they have to survive only on rice, salt, and some cereals/dry foods. There is always a fear of harm if they touch something accidentally.¹⁴

Health impacts of Chhaupadi

Chhaupadi has several health impacts associated with it. The menstruating women are forced to endure freezing temperatures in winter and sweltering temperatures in summer inside the goth. This can cause life-threatening health problems like pneumonia, diarrhea, chest infection, suffocation, and respiratory tract infection.¹¹ During those days although women are forbidden from going inside the house they are still expected to do more laborious work outside like carrying heavy loads, digging, collecting firewood and grass despite the lack of a nutritious diet and comfort. As a consequence, the rate of prolapsed uterus is high among this group.¹⁵ Even the mothers who have recently given birth are confined within goth. Postpartum mothers are weak and feeble and to make it worse, they have to look after their newborn child by themselves. Because of poor nutrition and vulnerable living conditions, neonatal and maternal mortality is high in those regions where Chhaupadi is common.¹⁶

Chhaupadi also has an impact on psychosocial well-being of the women and girls. Isolation from family and social exclusion results in depression, low self-esteem, and disempowerment among girls. Furthermore, there is also a fear of sexual abuse and assault at night alongside the attack of wild animals and snake bites. Most of the deaths due to wild animals are not revealed and neither are the cases of rape, fearing for the future of the unmarried daughter.¹²

Chhaupadi in the context of international agreements on human rights and reproductive rights

Universal declaration of human rights, article 25 states “Everyone has a right to live standard life with adequate health care, security, food, clothing, housing and necessary social services”.¹⁷ World Conference on Women’s Rights, the Beijing declaration and platform for action has agreed that “Women and girls’ human rights are an inalienable, integral and indivisible part of all human rights and fundamental freedom”.¹⁸ Vienna declaration and the program of action (paragraph 38) calls for “the eradication of any conflict which may arise between the rights of women and the harmful effects of certain traditional or customary practices, cultural prejudices and religious extremism”.¹⁹ Since Chhaupadi as a traditional practice violates the rights of women as human beings and as members of a reproductive age group it is not hard to see that the practice is a case of direct violation of all these international laws and declarations.

Chhaupadi in the context of national laws addressing human rights

Nepal’s interim constitution of 2007 ensures right to equality in its article 12 and right to reproductive health in article 20. In particular, article 29(2) mentions “No one shall be exploited in the name of any custom, tradition and usage or in any other manner whatsoever”.²⁰ More specifically, in May 2005 the supreme court of Nepal issued a directive to the Nepal government for the formulation of laws to eliminate Chhaupadi. In 2008, the ministry of women, child and social welfare promulgated guidelines to eliminate Chhaupadi.¹⁴

Although made illegal by the Nepali law and as a violation of international laws and agreements, Chhaupadi as a tradition is still alive in parts of Nepal mainly because it has been promoted and preserved by the society for generations. As such, Chhaupadi gives rise to several legal and ethical concerns. Those ethical concerns will now be discussed in the context of liberalism and communitarianism.

Liberalism and Chhaupadi: a matter of personal freedom

Liberalism is a branch of philosophy which proposes that individuals need to be treated with respect, as ends in themselves, not as means to other individuals’ ends.²¹ Liberalists are of the idea that since human beings are capable of developing and implementing their decisions about how to live, they have the right to do so.²² In general it can be said that liberalism has its focus on individual well-being and individual rights. In broad political sense it refers to minimal government control over individual pursuits, which are believed to be undertaken by individuals guided by their inherent rationality for overcoming obstacles to good life.²³ The same idea is discussed here in terms of societal control over women’s liberty in relation to Chhaupadi. Here the women of mid- and far-western Nepal who are forced to be banished under Chhaupadi are thought of as rational individuals who should be able to realize full freedom over how to pursue their interests and go about their daily lives.

From the liberalistic stand, one can argue that it is a matter of individual choice and freedom of the women in every household living in the mid- and far-western regions of Nepal on how to go about running their daily lives, whether they are menstruating or not. Deciding to enter the kitchen in their own house like on any other day, spending the night in their own cozy bed like on every other night and showing their veneration to their deity of choice by visiting the temple of their choice like on any other occasion should be a matter of personal choice. The same applies to having nutritious food and going to school. None of these daily pursuits should be influenced by some pre-defined societal norm which attempts to prescriptively govern the ways women pursue their daily lives in such a way that the women are treated as the means to the ends of superstitious community beliefs.

Communitarianism and Chhaupadi: the community’s perspective

Communitarianism is a branch of philosophy which focuses on the notion of community and emphasizes the idea of prioritizing community goals over those of individuals. As such its principles are in direct disagreement with the ideas of liberalism and libertarianism, both of which have their emphasis on individual rights and personal choice over community obligations and expectations.²¹ This line of thinking is further divided into two types universalistic communitarianism and relativistic communitarianism. Universalistic communitarianism is based on the idea that there is a single true form of good society and its associated virtues. Therefore its proponents believe that all societies should adopt and follow one pre-defined way of thinking and living which has been endorsed by them as virtuous. On the other hand, relativistic communitarianism sees morality and virtue of a society as inherently contextual for pursuing the common good.²¹

In communities where Chhaupadi is a well-accepted practice among community elders, husbands, mothers-in-law, traditional healers, and priests (who have profound influence in the community) and also the practicing women in many cases, the continuity of this practice to them is one way of preserving a tradition which has been in existence for a long time with a focus on purity, aimed at pleasing the venerable deities believed to take care of the community. Those who support this practice as a justifiable one, regardless of whether or not it is a good practice from an objective outsider’s perspective, do so on the grounds that it is done for the purpose of overall common good of the women, families, and the community as a whole. They believe that letting women live inside the family house instead of the secluded goth, allowing them to enter the kitchen and welcoming them into temples will infuriate the Gods and that wrath can inflict serious consequences on the family and the entire community.

This could easily be interpreted as a case of a women-suppressing baseless argument from the standpoint of, for example liberalism, or a matter of enforced social tradition from the standpoint of universalistic communitarianism. But on the contrary, from the perspective of the community members, it could also be understood as the people’s belief in the existing tradition, and their belief in the idea of contextual morality and virtue within a society. They could on the same grounds instead argue and ask, “What harm could one be doing by attempting to protect the entire community (the common good) from the consequences emanating from non-allegiance to restrictions to be observed during menstruation?”

The assessment by an outsider based on the principles of universalistic communitarianism might find Chhaupadi a superstitious and baseless practice being perpetuated as a result of illiteracy, ignorance, and overall backwardness which uses powerless women as scapegoats, the insiders on the other hand might earnestly believe that non-compliance to this “tradition” would mean suffering and harm to the community, which is against their relativistic idea of common good.

Chhaupadi as a public health issue: beyond philosophical debate

This philosophical debate leads us to a point where one might want to align themselves with one side of the argument based on their belief of whose goals and priorities should come first - those of the community which has one set of beliefs regarding this issue or of the women who are affected by this practice for whom it is an issue of oppression and their alienation of personal freedom. But when Chhaupadi is viewed as a public health issue, an issue which directly involves the health (and is also a matter of life and death in many instances) of thousands of helpless women in some of the poorest and most remote Chhaupadi parts of the world, it extends beyond a merely philosophical argument of the centrality of community goals versus individual freedom.

The health effects on women resulting from this practice are manifold. The isolated women are at a high risk of suffering from hypothermia during winter and dehydration leading to heat stroke during summer. Lack of running water in those huts leads to poor hygiene and subsequent infection. Isolation of menstruating women for a prolonged period of time with no one to talk to or share their feelings with can be a reason behind fear and depression in the long run. A prolonged period of isolation after childbirth is serious in the regions where maternal mortality ratio and neonatal mortality rates are relatively very high. It is also important to note that infection and hypothermia are major factors responsible for the death of neonates in Nepal.^24,25 In addition to poor nourishment, the risk of animal attack, snake bites, and rape attempts make it very hard for women to go through the ordeals of seclusion inflicted by Chhaupadi.

Therefore, from the public health standpoint, there are several arguments one can make on why this is a harmful practice that undermines the health and well-being of girls and women (and in many cases of the newborns) and present a case for the abolition of the practice, which is already banned by law but continues to exist due to strong community beliefs and deep-rooted traditions and the fear of boycott from the community in case any family tries to ignore the practice.^26,27

Conclusion

This article focused on general discussions about Chhaupadi practice existing in mid- and far-western regions of Nepal, which involves isolation of women during menstruation, the ethical debates surrounding this practice (communitarianism versus liberalism), and its public health significance. The philosophical debates on issues like this which involve strong societal sentiments and beliefs are bound to divide people based on what they think is of prime concern, the attempt to belong to the community norm in the belief that individual freedom is less important an issue as compared to what the community deems necessary for the common good, or an attempt to raise voices of personal freedom and be able to reject the community beliefs that do not necessarily address issues of individual interest. But it is not hard to see from a public health point of view that the practice has negatively affected health and well-being of many young girls and women. Despite that and despite it being declared illegal by the legal justice system, the practice continues to exist because of illiteracy, ignorance, traditional belief system, gender disparity, and power difference. The only way to abolish this practice is through mass awareness and education at the community level. That calls for a prolonged multi-sectorial involvement of the government as well as national and international non-governmental organizations (which is existent even at present) in areas of education, health, women empowerment and livelihood to increase the ongoing social awareness among affected Nepali communities about the natural character of menstruating and the harmful practice of Chhaupadi. This also requires a lot of patience with the recognition that age-old practices do not die easy.

Disclosure

The authors report no conflicts of interest in this work.

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