By Safeena Wani
Leh: In Tangste village of Leh, health worker Noor Jahan invited ASHA colleagues for an awareness camp. It was their last chance before nomadic families began migrating across the Changthang plateau. Each spring, she said, women leave without access to doctors or clean water. By summer, many return with the same complaints: itching, infections, and burning sensations in their genital area.
“These women often come with complaints of vaginal itching and abnormal discharge. A few days ago, two women were referred to Leh. At private clinics, they were diagnosed with yeast and urinary tract infections and prescribed antibiotics,” said Community Health Officer Dinchin Dolkar.
For Dolkar, treatment rarely breaks the cycle. “The infections keep returning. It’s linked to unhygienic conditions and the lack of clean water during migration,” she said.
Life in these windswept highlands is harsh. With little water and no nearby medical centres, women remain trapped in recurring reproductive health problems.
“Most women are given antibiotics. Specific infections are hard to detect because there are no laboratories or microbiologists outside Leh. Our nurses use VIA screening — a visual inspection with acetic acid to spot abnormal bacterial growth — and refer women with symptoms to the district hospital. Many are given Metronidazole or Doxycycline,” said Dr Padma Dolma, a gynaecologist at Leh’s Sonam Norboo Hospital.
For Ladakh’s nomadic women, these infections are not just medical issues but symptoms of a drying climate.
Living in heat and scarcity
In the vast, mountainous landscape of Ladakh, herds of pashmina goats move slowly across the slopes like a line of ants. For Kunzes Dolma, each day begins with a trek to graze them, a task she cannot avoid.
“It’s too hot during the day to take the herds out. I sweat a lot and get headaches by evening,” she said, referring to the month of July, when temperatures in Leh hovered around 35 degrees Celsius.
Dolma carries water, but it’s rarely enough. “These routes used to be lined with glaciers, and even the springs were full. Now, in many places, we can’t find a drop of water,” she recalled.
With less water and constant sweating, maintaining hygiene becomes difficult. Dolma was treated for a yeast infection at a local health camp and given pessaries for five days. “Some grazing paths in Rupshu valley still have rivers flowing. But uphill, water is very scarce,” she said.
In Igoo village of Leh, Stanzin Angmo spends her mornings ensuring the little water available reaches her fields. Many men have migrated to Leh city for work after crops like wheat and barley became hard to grow. With help from a local NGO, an artificial glacier was created in Igoo to irrigate fields during sowing season. “We had good harvests in 2023 and 2024. But this year, it’s too hot. The small streams we used to drink from are full of plastic and fertilizers,” she said.
Even at home, she added, the Jal Jeevan Mission supply is erratic. “In summer, we get water two or three days a week for a couple of hours. They say there’s a technical fault or the staff is on leave. We store what we can, but it’s never enough for bathing or washing.” During winter, frozen pipes cut supply for weeks.
According to Sonum Lotus, Director of the Meteorological department, the Himalayas are warming steadily. “July and August now touch 34-35 degrees Celsius,” he said.
Thin air and low humidity intensify the heat and accelerate glacier melt. “The meltwater quickly drains into the Indus system, leaving Ladakh itself dry,” he explained.
A 2025 United Nations report confirms this local reality: between 2011 and 2020, the Hind-Kush Himalayas, which include Ladakh, lost about 65% of their glaciers, threatening the region’s food, water, and health security.
A 2019 study, by International Centre for Integrated Mountain Development found that global warming is reshaping these glacier-covered peaks. If current emissions continue, the study warns, the Himalayas could warm by five degrees, and two-thirds of their glaciers could vanish by 2100.
Fragile systems
For nomadic tribes of Changthang, water sources shift along their migration routes. In some spots, the government has installed borewells and solar pumps, but families often continue to rely on streams. “If the solar pump works, it helps. But often the tap stops working, and then it’s useless,” said Dolma.
Most of Ladakh’s water comes from glaciers. Studies show rising temperatures have melted them faster while erratic rainfall and depleted groundwater have cut supply. Nearly 40% of Ladakh’s glacial area has shrunk, drying springs and rivers.
At Tso Kar Lake, tea-seller Stanzin Dolker said the solar pumps installed under Jal Jeevan Mission last year rarely function. “The wiring gets damaged or the motor clogs with mud,” explained Lundup Jamyang, an engineer with the Public Health Engineering Department. “After every winter, pipes also burst due to freezing.”
Between 2022 and 2023, 58 solar pumps were installed in Rupshu block, some near nomadic settlements. “JJM isn’t designed for nomads since they move often, but we tried to place pumps near their camps. Maintenance is the challenge and parts have to come from Leh, 150 kilometres away,” Lundup said.
Each broken pump means another season without water.
The cost on the body
Health workers often question Kunzes Dolma’s thick clothing. They remind her that older layers made from yak or sheep wool allowed airflow, unlike the synthetic fabrics now common. “They don’t understand our work. By evening, the cold winds hit when we return, and we need these layers,” she said.
But these layers which comprise shirts, sweaters, jackets, multiple pants trap sweat and heat. Rarely washed during migration, they create perfect conditions for fungal growth.
Health educator Mohd Bhairk, who runs awareness programmes in Leh, said hygiene is inseparable from water access. “When we talk to nomadic women about bathing or cleaning during menstruation, they remain silent,” he says. “They always ask where is the water? Some go months without washing.”
Even though ASHA workers distribute sanitary pads, most women still use cloth. “Sometimes unwashed,” Bhairk added, “because there isn’t enough water to clean and reuse them.”
Primary Health Centres in remote Ladakh lack laboratories to detect infections. “We can only do basic tests such as hemoglobin, urine, blood sugar, blood pressure,” he said.
Dr Padma confirmed that more women now come with recurring vaginal or cervical infections. “Earlier, water was available and temperatures were manageable. But now, with rising heat and drying sources, hygiene is a major challenge for women who keep moving across eastern Ladakh. The dry air here favours fungal infections. I see more such cases in Ladakh than I did in Delhi. Sweat, synthetic clothes, and lack of cleaning worsen it,” she said.
A World Bank study noted that poor menstrual hygiene can lead to reproductive and urinary infections, infertility, and childbirth complications, conditions increasingly visible in Ladakh’s warming highlands.
In the midst of this, it is the women’s bodies that bear the cost.
(Safeena Wani is a freelance journalist and a member of 101Reporters, a pan-India network of grassroots reporters)
