Menstrual Exile: Nepal’s Chhaupadi and the Policy-Practice Divide

Despite criminalization, Chhaupadi, the practice of exiling menstruating women and girls to isolated sheds in Nepal, persists, exposing a stark disconnect between public health policy and reality. This commentary argues that deeply ingrained socio-cultural norms, socioeconomic disparities, and implementation challenges hinder eradication efforts. The practice, linked to severe health risks and human rights violations, underscores a critical need to move beyond legislation and engage communities in dismantling the beliefs that perpetuate menstrual stigma. Empowering girls through education and strengthening law enforcement is crucial. Furthermore, addressing the urban-rural divide by improving access to healthcare, sanitation, and education is vital to creating an enabling environment for change. This commentary calls for a multi-sectoral approach and a united front to achieve a Chhaupadi-free Nepal, where menstruation is no longer a source of shame but a natural and celebrated facet of womanhood.The crimson stain of menstruation, a natural biological process, tragically transforms into a mark of shame and exile for countless women and girls in Nepal. The practice of Chhaupadi, where menstruating women and girls are banished to isolated and squalid sheds, exposes a stark and tragic disconnect between public health policy and reality. 1 These "Chhaupadi huts," ranging from dilapidated stables to basic mud structures, become sites of deprivation and danger. 1 Denied access to basic sanitation, clean water, and adequate shelter, women and girls endure not only physical hardship but also social exclusion. 2 They are rendered untouchable and excluded from participating in communal activities, including attending school while they are menstruating. 2This enforced isolation into "Chhaupadi huts" carries grave consequences, increasing their vulnerability to infections, hypothermia, and respiratory illnesses, as well as the threat of sexual assault and animal attacks. 1 The recent death of a teenage girl from a snake bite in August 2023 serves as a chilling reminder of the deadly consequences of this persistent practice. 3