by Rose George
In the UK, the prime minister has promised a proper inquiry into the contaminated blood scandal, though at first the government wanted the Department of Health to investigate itself. There are hopes but not high ones. The death toll that will come from hepatitis C is unknown, because it is not routinely tested for. When doctors in a London hospital recently did a pilot study, they found that rates were three times as high as was believed. Only 250 of the 1,500 British hemophiliacs infected with HIV are alive. Sixty-two contaminated blood victims have died since plans for the new inquiry were announced in July 2017. Of 89 hemophiliac boys at Treloar College during the years of contamination, 72 are dead. I understand why hemophiliacs call themselves the “shut up and die” community: wait long enough, as some governments have, and probably there will be no one left to complain. I watch on YouTube a short film by Bruce Norval, a Scottish hemophiliac infected with hepatitis C, and a vocal campaigner. He filmed it outside, with him leaning against a concrete post. From the exhaustion in his voice, I suspect it is a prop in more ways than a staging one. He sounds weary, but there is force in his quietness. “I shall retain an absolute shame,” he says, “to be part of a country that would perpetuate such a crime.” He is sure that the British authorities who gave tainted factor to hemophiliacs without telling them and when they knew it wasn’t safe are stalling. They just have to wait sixteen more years and all the infected will be dead, of hep C or complications from HIV, of tainted plasma protein products or what he calls “manky blood.” It’s just math now. But they’re not gone yet. And they’re not done with wanting to know why something that was supposed to be safe, and that was supposed to give them life, gave them death instead. So “for that last little bit,” says Bruce, in his unsettlingly quiet tones, “we’re going to scream blue murder.”
A chaupadi shed, western Nepal
SIX
ROTTING PICKLES
For Radha dinner is served at seven. She crouches down behind a shed, a good distance from her house, then waits. She knows what the menu will be: boiled rice, the same as yesterday and the day before. She knows that it will be her little sister who serves it to her, throwing the rice onto the plate from a height, the way you would feed a dog.
In Jamu, this village in western Nepal, Radha’s status is already an inferior one. She is ironsmith caste, a low person. When she menstruates, her status drops further. She is only sixteen, yet for the length of her period, Radha can’t enter her family house or eat anything but boiled rice. She can’t touch other women, not even her grandmother or sister, because contact with her will pollute them. If she touches a man or a boy, he will start shivering and sicken. If she eats butter or buffalo milk, the buffalo will sicken and stop giving milk. If she enters a temple or worships in any way, the gods will be furious and take their revenge by sending snakes or some other calamity. Radha is allowed to go to school; many girls are not.
Where Radha lives, menstruation is dirty, and a menstruating girl is a powerful, polluting thing. A thing to be feared and shunned.
After dinner, Radha prepares for bed. Darkness falls fast in Jamu, and without electricity the villagers follow old rhythms and sleep with the dark. Radha’s parents are both absent: this village, like many in Nepal, has spit out its menfolk, mostly, to be migrant workers elsewhere, but also some women, like Radha’s mother. Most Indians know that Nepalese make good security guards. Gulf Arabs know them as construction workers, often dead ones who are crushed in stadia and scaffolding. So Radha lives with her grandmother and her sister, in a house of women. Their home has a solar-powered light, as does the one opposite, where I’m staying with my traveling companions: Anita, the communications and gender officer for WaterAid Nepal, and our photographer, Poulomi. Our hostess is the local schoolteacher. She seems nice.
The solar light is no use to Radha this week because her bed is elsewhere. She leads me over the thoroughfare of pebbles and rocks that passes for a road, suitable only for motorcycles, walkers, and snakes. We hike up a steep hill, through long grass, to a small lean-to structure. It looks like an animal shed, but it is smaller and meaner, its planks rough and scrappy, its shelter imperfect. This is where Radha must sleep because she is menstruating.
In the local dialect, Radha is now chau. Originally meaning “menstruation” in the Raute dialect of the far western region of Achham, it has come to mean “an untouchable menstruating woman.” This linguistic melt has also happened in English: “taboo” derives from either the Polynesian tapua, meaning “menstruation,” or tabu, meaning “apart.” The system of keeping girls and women apart is known as chaupadi (padi means “woman”).1 The shed is a goth. Radha hates it, whatever its name. “I’m forced to stay there. My parents don’t let me stay at home. I don’t like being there, it’s dark, there’s no light. In the winter it’s cold. I feel so scared.”
In the winter, Radha sleeps on the tiny enclosed ground floor, no bigger than a crawl space. The summer accommodation is an earthen floor on a platform above, four foot square, which is open to the elements except for a grass roof. There is not room even for one person to lie down, but tonight there will be three. Radha’s relative Jamuna is also menstruating, and she’ll be sleeping here along with her one-year-old son. Radha appreciates the company, as Jamuna’s presence may be some protection against drunken men who conveniently forget about untouchability when it comes to rape. The stigma keeps women silent, but rapes of those confined to these sheds are common enough to appear as occasional items in newspapers in faraway Kathmandu, and common enough for some women to look down or away whenever I ask them about it. Also common are snake attacks and deaths. (During my visit I see three snakes in three days. Large ones.) In early December 2016, fifteen-year-old Roshani Tiruwa lit a fire to keep warm in her chaupadi shed and suffocated.2 The following summer, Tulasi Shahi was fatally bitten by a snake as she slept in her uncle’s cowshed in western Nepal.3
Sometimes there are four or five women in Radha’s family shed, an unthinkable number. There are always other options, though never the safety and warmth of her own home. Farther along the plateau, I watch with disbelief as a fourteen-year-old girl shows me her sleeping arrangements for the night: the bare ground outside her family’s house. She has rigged up a mosquito net, tying it to posts just high enough so her body can lie horizontally under it. She will sleep on dirt and discarded corn husks. A bed of rubbish. It’s only the third time she has had her period and already she is resigned. What can she do?
* * *
Jamu is remote. We take a two-hour flight from Kathmandu to Nepalgunj on Buddha Air, during which I watch and listen with stupefaction as an old woman asks for the window to be opened so she can spit, then—as the window doesn’t open, thankfully—spits all the way to our destination into a bag, with gusto. After that, there is a four-hour drive on a road that is mostly potholes linked by afterthoughts of tarmac. Occasionally Anita gets out and builds makeshift bridges out of boulders so our jeep can cross unexpected torrents. Finally we are tipped out with our packs at a river, where we wrap electronics in plastic safety and wade through thigh-high water because there is no other way. We are in the midwestern part of Nepal but not Himalaya country. Hills, not mountains. Lush greenery, not rocks and sheer drops. It is one of the most beautiful places I have ever seen, and I am here to look for one of the ugliest things I have ever heard of.
A 2010 government survey found that up to 58 percent of women in Nepal’s far west regions reported having to live in a shed while they were menstruating.4 But Jamu is in the midwestern hills, where the survey judged rates of severe discrimination (staying in a shed; being given separate food) to be less than 10 percent.5 I expected to find progress here. It’s easier to get things to lowlands, even by foot with no vehicle access. Things like emancipation and equality and the idea that women and girls shouldn’t be banished to unheated sheds because of their biology. So I was worried, with that unforgivable concern of someone who wants a story, that the chaupadis would be gone.
A group of women gather to talk. One said, Where would you like to sit? We move to the ladder that leads to the residential part of the house, on the first floor. But she stops us. “I can’t come, I’m on my fifth day.”
We sit outside on the ground instead. We are all women: us with our nosiness and notebooks, the villagers sitting patiently, ready for another round with the well-intentioned. One woman sits with a scythe in her hand. Her name is Nandakala and she is also menstruating. She says, along with the others, that chaupadi is necessary. If menstruating women don’t observe the taboos, bad things happen. A buffalo could climb a tree. Men would start trembling and fall ill. Snakes will be brought by the sin. A woman becomes animated at this: “Yes, it’s true. A big snake came into my house. We all saw it.” Another says, “If I touch something, I’ll get ill, so why should I think chaupadi is a hardship?” Chaupadi keeps them safe. In this group setting, nobody protests. It is our tradition, they said. It’s what our parents and grandparents did, so it’s what we do. I ask what they say when people come and tell them chaupadi is wrong. Do they admit to being in favor of it? “We won’t lie. We’ll say what we’ve said to you.”
But as she has her picture taken in her chaupadi shed, a hundred yards away, Nandakala is more frank. She isn’t worried about rape. The men have all left to work in India or Dubai: who is left to do the raping? She tells Poulomi, “Of course I hate it.” In the winter it’s cold. In the summer it’s hot. The restrictions are stifling and unfair. “Why should the gods punish us? Why should women be punished? But what the hell can we do?”
In the next village, we stop at a house with a view of the rushing Bheri River, so blue and wild. In this cluster of houses, 90 percent have a chaupadi shed. In one, there is a cup and bowl belonging to a female guest who had just left. They will stay in the shed until the sixth day, then be cleansed with fire and taken into the house. The guest must have been unmarried: married women have to observe chaupadi for only three days, not the full five or six. The woman of the house told us, “I don’t believe in this but my mother-in-law does.”
This is not a simple story of patriarchal men imposing evil restrictions on suffering women. Chaupadi is driven by women. It is perpetuated by the grandmothers and the mothers-in-law and the mothers. Nandakala, brave in private, moved to Mumbai with her husband for six years, where they didn’t practice chaupadi. And so he fell ill. He got eye pain, knee pain, he shook. I made him sick, said Nandakala. The taboo was wrong yet true. So now she does chaupadi.
In the next village, a schoolgirl on her period talks to us. We know she is menstruating because she won’t come near us. She says, “I can’t go into the house, I can’t touch water, I’m not allowed to touch men.” Yet she must do chores. She must fetch the shopping. “I have to say I’m menstruating and the shopkeeper throws the stuff at me.” Sometimes she doesn’t use words but shows him, somehow, her unwillingness to take something from him and he understands. Yet she has touched boys at school and nothing happened. “Of course menstruation is dirty,” she said, sitting in her chaupadi with her schoolbooks that should have told her different. “It’s a dirty thing.”
* * *
Twenty-one liters, give or take. That is how much menstrual blood I’ve discharged over the past thirty-five years.6 I’ve never done that calculation before now, because why would I? I’m not supposed to celebrate, calculate, or in any way highlight my menses. Nor am I supposed to use that old-fashioned word, though I like its lyricism (it comes from “monthly”). Some other words: Uterus. Yuck. What a horrible word. Vagina: even worse. Menstruation sounds like a disease. Menarche, endometrium: what do they even mean? Euphemisms are everywhere. Having written a book on sanitation, I’ve become expert at them. Languages have always contained them. Not many diaries or records exist that record what women felt about or called their periods, but the historian Sara Read, in a survey of menstruation in early modern England, gathered a few names: the Visit, the Courses, Terms, Those, Monthly Sickness, Time Common to Women, Months, Gift, or Benefit of Nature.7 Euphemism: “To use a favorable word in place of an inauspicious one.” Euphemizing is the opposite of blaspheming. The same magic was supposed to work when the Cape of Storms was renamed the Cape of Good Hope, yet it stayed just as stormy. Perhaps that wishful thinking is why menopause is known as “the change,” a bland word that holds none of the distress and despair of endless hot flashes, depression, brain fog, and eradication of libido. Or maybe euphemisms are a way of sticking women’s health in the dark and unspoken corner where it’s supposed to belong.
Once in India, I was puzzled when my friend Sabrina started talking about “chumming.” Chums are Indian periods. There are at least five thousand other terms, according to a recent survey carried out by the makers of a women’s health app called Clue, in partnership with the International Women’s Health Coalition. Here are a few: on the rag (a term that always made me look at student rag weeks in a different light), the curse, shark week, having the painters in, Aunt Flo, and the infinitely useful “time of the month.” Northern Europeans resort to fruit: lingonberry week in Sweden, strawberry week in Germany. The French supposedly call it ketchup week, which is disappointing: I’d have expected at least a gastronomic jus de something or other. You may want to applaud the creativity of these, but they are all just part of a linguistic scaffolding of shame and secrecy.8
Some other things I’m not supposed to confess: the time in an Indian restaurant in Paris when I bled all over a silk cushion, and I’m mortified twenty years later. All the occasions when I had no sanitary products and resorted to wads of toilet roll in my pants. The time when a school friend started her period and none of us told her she had bled through her pale-blue summer uniform. (I’m sorry, Sally.) For something so red and vivid as menstrual blood, it is very, very quiet.
Only half of it is blood, anyway. Every month I and two billion other women discharge blood but also epithelial endometrial layer, the underlying lamina propria, and vaginal and cervical mucus. Most is the lining of the womb, the thick and rich endometrium that is meant to host an embryo. In the words of a 1966 puberty education film, the endometrium makes the uterus “a soft, nesty place.” The whole process seems mechanically simple. But menstruation makes no sense. Evolutionary principles dictate that things that cost us should also benefit us. Yet we lose 30 to 50 milliliters of blood and tissue per month and get pain, bloating, depression, and attendant symptoms. What is the benefit? Other species don’t bother menstruating because they retain their womb lining. We are in a minority among species, and among mammals, to bleed every month. The only other animals known to menstruate are apes, Old World monkeys, the elephant shrew, and four varieties of bat including Desmodus rotundus9 (which I cite because it is a vampire bat, and its name means “two-thirds of the way around”).
There have been many theories. Maybe menstruation is the womb ridding itself of nasty toxins from sperm from all the sex we’re having. Except, levels of promiscuity don’t correlate with the amount of blood we lose: monkeys have sex like rabbits (which produce an endometrium only when they copulate, a practice I find entrancingly optimistic). But monkeys and apes bleed less than women. Or perhaps it is more economical for the body to rid itself monthly than to keep a constant endometrium, as many
other species do.
A better and more interesting theory is the conflict hypothesis. Our endometrium is so thick and nesty because our embryos are so invasive and parasitical. According to this, humans are one of the rare species to have “maternal-fetal conflict.”10 In other animals, the embryo and its surrounding placenta attach only superficially to the womb lining. Human embryos are greedier: the embryo and placenta attach to the endometrium but then burrow through it, tearing open arterial walls and diverting them to pass blood to the growing embryo. In this way, the fetus has a direct line to the mother’s main blood supply. “It can manufacture hormones and use them to manipulate her,” writes the biologist Suzanne Sadedin. “It can, for instance, increase her blood sugar, dilate her arteries, and inflate her blood pressure to provide itself with more nutrients.”11 It can also, according to sexual health researcher Dyani Lewis, dampen a mother’s response to insulin so that “a greater slice of the circulating sugar pie is placenta-bound during its nine-month residence.”12 This is a hemochorial pregnancy, and it is a battle between two sets of genomes. Fetal genes want to ensure their own survival so suck up as many resources as possible.
