Chhulmutti: Separating Myths from Facts About UTI

Sandhya taking a session on UTI in a school

In our local vocabulary, we have a word for every disease or infection. During my conversations with adolescent girls and women in Supaul, one term surfaced again and again: chhulmutti (छुलमुत्ती). Although used colloquially, the term encompasses a broad range of symptoms associated with urinary tract infections (UTIs), such as urinary discomfort or a burning sensation.

Everyone I met had a theory about where it comes from. The most common explanation was oddly specific: “Agar lakdi mei aag laga ke naache ya ghume to chhulmutti ho jaata hai.” People get UTIs if they dance around fire or jump over burning wood.

Others linked it to “garmi,” seasonal changes, or bodily heat. These narratives have travelled across generations. They are coherent within the cultural context, but they have no connection to biomedical evidence.

Sandhya during community visits

What was missing was any mention of hygiene. As I spent more time with communities, the clearer the actual picture became. The everyday practices that actually increase UTI risk were so normalised that people barely noticed them.

Almost every woman I met drank very little water. Some barely finished a litre in an entire day because of discomfort using toilets outside the home. Several women do not wear undergarments regularly, and those who do often keep wearing them even when damp from sweat or moisture. Several girls used old cloth during menstruation, not fully dried or sanitised, and wore them for long hours.

Almost every woman, regardless of age, used strong soap to clean the vaginal area, believing this ensured “extra cleanliness.” In reality, this disrupts the vaginal pH and makes infection more likely. Equally common was the practice of holding urine for long hours, especially among school-going girls or women working in the field who either lacked access to safe toilets or avoided school toilets due to cleanliness concerns.

When these behaviours––low hydration, prolonged moisture, delayed urination, harsh cleansing practices––intersect, they create the ideal conditions for bacterial infections.

When I explained the actual cause, people were genuinely surprised. UTIs are bacterial infections, most commonly caused by E. coli entering the urethra and reaching the bladder. When left untreated, the infection can ascend to the kidneys, leading to high fever, severe pain, and long-term renal complications. What many interpret as “seasonal,” “heat-related,” or simply “bad luck” are actually preventable infections linked to hygiene practices and daily routines.

This disconnect between cultural explanations and biomedical facts shapes both prevention and care-seeking. When communities receive clear, practical, and context-appropriate guidance, behaviour change becomes far more attainable.

The narrative of chhulmutti is therefore not only about local myths. It reflects how people make sense of illness in the absence of accessible information, and it’s about how quickly things can change when facts finally enter the room.

Once these points were shared, many women said, “Humne kabhi isko is nazariye se nahi socha.” And that sentence captures the exact public health gap this myth reveals.