Long walk for water: How scarcity is breaking women in Maharashtra’s tribal belt

For generations, women across the tribal villages scattered through the Satpura ranges have spent much of their lives fetching water from distant streams, pits and wells. Now, doctors and health workers warn that this burden is taking a severe toll on their bodies.

Women interviewed across more than 20 remote hamlets in Akkalkuwa and Dhadgaon talukas described chronic pelvic pain, uterine prolapse, recurrent vaginal infections, miscarriages, kidney stones and debilitating back pain conditions they believe are linked to years of carrying heavy loads of water from childhood.

Ramabhauji Vadvi (59) holds an 18 mm kidney stone between his fingers in Chimapada village of Maharashtra’s Nandurbar district that he stores in a matchbox to show it to government officials someday. (Express photo by Purnima Sah)

Forty-year-old Bajubai Dhoma Vadvi of Khadkapani village says she has spent nearly her entire life carrying water.

“As I grew older, the size of the pots increased too. By the time I was 12, I was carrying the same load as my mother,” she says.

Lying on a mat inside her thatched hut while her daughter-in-law Mamta Vadvi massages hot oil onto her abdomen and legs, Bajubai recounts years of pain.

Mamta, 27, herself suffers from chronic abdominal pain, recurrent vaginal infections and severe backache. “She cannot fetch water anymore because she cannot stand for long. Her uterus keeps slipping down,” she says of Bajubai.

Married at 13, Bajubai became pregnant soon after.

“During my first pregnancy, I suffered a miscarriage while still carrying water in the ninth month. There was no choice. If women do not fetch water, the family has no water,” she says.

After fetching water, Mamta Vadvi (27) gives water to her three-year-old daughter Devika to drink. (Express photo by Purnima Sah)

She continued carrying water through subsequent pregnancies despite worsening symptoms.

“I constantly felt heaviness and pressure in my lower abdomen. During my last pregnancies, my uterus would slip down repeatedly. My mother-in-law, who had the same condition, suggested pushing the uterus back using my finger. Somehow the children were born.”

Bajubai later underwent multiple treatments for uterine prolapse, including the use of a vaginal pessary a ring-shaped device inserted to support the uterus. Two years ago, she underwent surgery after doctors detected a lump in her uterus.

The Indian Express visited 23 tribal hamlets across Akkalkuwa and Dhadgaon talukas, home to an estimated 28,000 people.

Across these villages, women reported spending three to four hours daily fetching drinking water. In some settlements, they make multiple trips every day.

In Guru Pada, women begin collecting water as early as 3 am. Carrying lanterns and torches, they walk through the dark to shallow pits where water slowly seeps through the ground. They wait for the pits to refill repeatedly before beginning a steep uphill climb carrying water home.

Gorak Vadvi (26) and Chiman Sonya Vadvi (27) show ultrasound reports confirming multiple kidney stones, a growing health concern in the water-scarce tribal villages of Maharashtra’s Nandurbar district. (Express photo by Purnima Sah)

Many women said they are forced to bathe and wash during menstruation in stagnant pools shared with livestock, exposing them to skin infections, urinary tract infections and other hygiene-related illnesses.

In many villages, healthcare facilities remain distant and difficult to access. Residents rely heavily on traditional healers known as pujaris.

Under a tree in Bohutipada, dried roots, herbs and forest stems are spread across a yellow cloth. Natwarji Naik, a third-generation healer, says women frequently approach him with complaints of abdominal pain, white discharge, infections and what villagers call a “weak womb”.

“Every month, I see nearly 50 to 100 women with such problems,” he says.

Girls as young as 4 start fetching water with their mothers and grandmothers and that’s how their jorney for a lifelong of fetching water begins in Nandurbar. (Express photo by Purnima Sah)

Natwarji prescribes herbal preparations made from forest plants such as Lohagul and wild banana stems, remedies villagers have relied on for generations.

Studies from Nepal have found strong associations between carrying heavy loads of water and uterine prolapse, spontaneous abortions and musculoskeletal disorders. A 2020 multi-country analysis covering 41 nations linked water collection burdens to poorer maternal and child health outcomes.

According to district health records, hospitals in Nandurbar recorded 20 uterine prolapse cases among women aged 25-45 between April 2025 and March 2026. Over the last six years, public hospitals have treated around 160 such cases.

Health officials caution that these figures likely represent only a fraction of the actual burden because many women never reach hospitals.

Natwarji Naik, a third-generation pujari from Bohutipada in Maharashtra’s Nandurbar district, displays forest herbs, roots and powdered mixtures that he claims are used to treat any health issue.(Express photo by Purnima Sah)

“Uterine prolapse in these regions is linked to a combination of factors including physically strenuous labour from an early age, repeated childbirths, malnutrition, chronic anaemia, poor menstrual hygiene and lack of maternal healthcare access,” a senior district health official said.

Doctors say women often continue strenuous work throughout pregnancy and resume labour shortly after childbirth.

“Over time, this weakens the pelvic support structures and makes women more vulnerable to uterine prolapse. By the time women reach reproductive age and undergo multiple pregnancies, their bodies have already endured years of physical strain,” a senior district gynaecologist explained.

Common complaints reported by women include pelvic pain, persistent white discharge, recurrent vaginal infections, lower back pain, prolonged menstruation, urinary problems and chronic abdominal discomfort.

ASHA worker Phulwanti Sudhnayan Vadvi, who works with nearly 500 women across several villages, says reproductive health problems are widespread but largely undocumented.

Keujah Ohalya,uses a coconut to trace underground water in Sitakhaipada in Maharashtra’s Nandurbar district, where many tribal hamlets continue to depend on traditional methods to locate water sources. (Express photo by Purnima Sah)

“Only four or five women have actually sought treatment. Most women simply continue living with the pain,” she says.

Social activist Nirmala Vasave, who has worked in the region for more than two decades, says the crisis intensifies every summer.

“We have repeatedly suggested small check dams, rainwater harvesting and groundwater recharge projects, but little has changed,” she says.

District Collector Mittali Sethi says the administration has initiated multiple interventions, including groundwater mapping, spring rejuvenation projects and Mission Jal Bandhu.

A major Narmada-based lift irrigation and drinking water scheme for Akkalkuwa and Dhadgaon is also being planned.

“One of the major proposals is a Narmada-based lift irrigation and drinking water project for Akkalkuwa and Dhadgaon. A Detailed Project Report for the project is currently being prepared and is expected to cover nearly 800 padas. The district has also launched Mission Jal Bandhu, under which groundwater mapping, spring rejuvenation and water conservation works are being undertaken in water-scarce villages.” Sethi says.

Guardian Minister Hasan Mushrif acknowledged that the burden of water collection has become a public health issue.

“I have learned about the challenges faced by women and girls who have been carrying heavy water pots for generations. We are concerned about the impact this has on their health, including pelvic floor disorders, uterine prolapse, chronic pain and musculoskeletal problems,” he said.

The administration, he added, would also investigate drinking water quality and assess the extent of school dropouts linked to water collection.