Despite Nepal's criminalisation of the practice, 77 per cent of Nepalese girls are being forced to sleep in so-called menstruation huts during their periods, a British-led study has found.

Key points: Many women are not permitted to enter the home, touch anyone, or eat certain foods during menstruation

Many women are not permitted to enter the home, touch anyone, or eat certain foods during menstruation Menstruation huts are often too cold in winter and lack sufficient ventilation

Menstruation huts are often too cold in winter and lack sufficient ventilation Some women who did not have access a chhau hut slept outside

The tradition, known locally as chhaupadi, considers menstruating women and those who have just given birth to be unclean and bringers of bad luck.

They are not permitted to enter the home, touch anyone, attend the temple or celebrations, or eat foods including fruit, vegetables and milk products.

While banished to these "chhau" huts they are vulnerable to extreme weather conditions, animal attacks, deadly environmental hazards and sexual violence, according to researchers from the University of Bath and the Kathmandu-based Centre for Research on Environment, Health and Population Activities (CREHPA).

Some have lost their lives. In January, a woman and her two sons — aged nine and 12 — were found suffocated in a chhau hut after lighting a fire to sleep next to overnight.

In August 2018, the enforcement of chhaupadi practices became a criminal offence, punishable by a three-month jail sentence and $37 fine.

Last week, more than a year after the law took effect, police made their first-ever menstruation hut arrest after the death of 21-year-old Parbati Budha Raut. She suffocated after lighting a fire for warmth in her hut.

Local police told The Kathmandu Post they were questioning the woman's brother-in-law to determine if he had forced her to sleep in the hut. To date, no convictions have been brought.

Fear and psychological stress

Researchers spoke to 400 girls aged between 14 and 19 in rural and urban areas of mid-Western Nepal. Focus groups were also conducted among older women.

Their findings — released today in the journal Sexual and Reproductive Health Matters — showed the laws had had very little impact on the practice, with 77 per cent of interviewees saying they were still required by their families to follow the custom.

Dr Melanie Channon said young girls felt trapped by the custom upheld by the older generation. ( Supplied )

"A lot of them talked about just how scared they were having to go and sleep in these different places," said Dr Melanie Channon from the University of Bath, who led the research group.

"Pretty much everyone had a story about somebody being [fatally] bitten by a snake."

Even among those who had not personally experienced danger, fear and psychological stress were taking a toll.

The practice, which is linked to Hinduism, also dictates that mothers should give birth without assistance, adding to the region's already high maternal mortality rate.

Those who did not follow the practice were largely Christian or Muslim families, or wealthier Hindu households with family members who had worked or travelled abroad.

Forced to sleep alongside animals

The huts leave women vulnerable to extreme weather conditions, animal attacks, deadly environmental hazards and sexual violence. ( Supplied: Melanie Channon )

Dr Channon, who inspected many of the shelters in the course of her research, described a typical hut as a very basic structure made from planks, where the girls often slept on the floor.

Most do not have locks, and many of the girls expressed fear of sexual assault.

The prevalence of such attacks is difficult to determine as sexual assault is "very unlikely to be recorded in this kind of culture", Dr Channon said.

Some women said they slept on the floor in barns with the animals. ( Supplied: Melanie Channon )

Some families did not have chhau huts at all, and the girls slept outside, on the veranda, or in some cases in the cow shed or with other animals.

Dr Channon spoke of one 20-year-old woman who slept on the dung-covered floor of a shed together with the family's cows and goats.

Women are told that if they did not follow the rules, they would cause "terrible things" to happen — such as a family member getting sick.

The report revealed chhaupadi beliefs were taking a heavy toll on the mental health of women and girls, leading to depression and low self-esteem.

But while many believed they were unclean, others had challenged this belief — even pretending they had not had their period — before waiting to see if anyone in their family got sick.

"They were quite savvy to it," Dr Channon said of some of the younger girls.

"But because the older generation really sincerely believes in it, there was nothing that they felt they could do. They felt trapped."

These practices were usually enforced by elders within their family and community, including mothers, grandmothers and other senior women.

"The other real issue we found was religious leaders who believe very strongly in this and weren't prepared to let anybody change," Dr Channon said.

"There were a lot of people who were basically saying: 'We have to wait for the older generation to die. I don't see how we can change this until that happens.'"

'Deeply ingrained cultural practices'

Destroying huts didn't end the practice, leaving girls to sleep outside. ( Supplied )

Enforcement of the law against chhaupadi practices has been difficult, as it requires women to testify against their own families.

In one village police had destroyed chhaupadi huts, but rather than end the practice the result was that many of the girls were forced to sleep outside instead.

Nepal's central police department and the Government's Department of Women and Children were approached for comment but did not respond by publication time.

Many interviewees suggested teachers, who were well respected in the community, could help educate families.

The report recommended changes to the way charities and NGOs spoke and thought about the issue of menstrual hygiene management.

Reframing the issue in terms of women's rights could ensure that all women enjoy the right to safe, healthy and dignified menstruation, it said.

"Until recently, efforts have focused purely on providing girls with clean toilet facilities, soap, water and menstrual products," the report said.

"Whilst important, this narrow focus excludes wider societal issues, such as the taboos and stigmas surrounding menstruation."

Jennifer Thomson, a researcher involved in the study, said "the mental and physical implications of girls and women being ostracised from their families and communities" needed to be addressed.

"This is about changing deeply ingrained cultural practices and behaviours, and while changing the law is important this study shows it's going to take much more than that," Dr Thomson said.