A toilet was constructed at the house of 16-year-old Ramita Saund of Nandegada. All members of the household always use the toilet, but Ramita is not allowed to use the toilet five days a month. The only reason for this is that she is menstruating. During menstruation, she lives in a barn far from home. At that time she could not use the toilet. She said that she had to go to the forest and river to defecate during menstruation. "You can't even come close to home during menstruation," said Ramita. "The family has banned the use of toilets during menstruation." According to the District Level Coordinating Committee for Drinking Water, Sanitation, and Hygiene, not only Ramita but also about 64 percent of women in Achham are deprived of using toilets during menstruation. According to Krishna Prasad Jaisi, spokesperson of the District Coordinating Committee, a recent study by the committee found that most of the women are deprived of using toilets as they live far away from home during menstruation. He said that most of the women still live in the cowshed during menstruation and defecate in the open despite the recent campaign to free the cowsheds in the district. Due to various wrong social values ​​and superstitions, most of the women in Achham are still living away from home during menstruation.  Achham has been declared open defecation free but about 64 percent of women while having menstruation are forced to defecate out in the open, Manju Mahat of the Women and Children's Office says that the main challenge of not becoming a complete sanitation district is women deprived of using toilets during their menstruation.