Nestled in the mountains of Nepal’s remote Ruby Valley, the village of Sertung can only be accessed by foot — a two-day hike from the nearest road. Homes are made from stone with tin roofs and do not have toilets or running water.

Brother’s Brother Foundation provided funding for 18 families to install permanent toilets outside their homes through the “One Home One Toilet” campaign led by nonprofit organization Himalayan HealthCare (HHC). The campaign aims to transform the Ruby Valley by providing families in the area with the supplies, training, and education needed to build and maintain their own toilets. 

BBF’s grant gave 78 people in Sertung access to toilets and indirectly impacted 4,000 others by preventing the spread of diseases from poor sanitation like cholera, dysentery, and gastroenteritis. 

Data collected by HHC has found that approximately 35% of all diseases in the Ruby Valley are gastrointestinal infections related to a lack of sanitation, poor hygiene, or fly-borne diseases. Fatalities from these infections are highest among children, new mothers, and the elderly. But dysentery aside, finding a place outside to use the bathroom poses enough risks on its own. 

“Before [having toilets] we had to go to the river or the forest. Leeches, ledges, and cliffs in the rain were dangerous. We also did not have water to wash,” Dhan Maya Tamang says in a video taken outside her home in Sertung. Her husband finished building a toilet for their family of four in the spring. HHC staff asked her about how it had changed her daily life. 

“As women we were always afraid someone would see us,” she says. “Now it’s so easy. We are so grateful.”

Tamang would say more but can’t, explaining, “I speak poor Nepali, so all I can say is thank you so much.” 

The extreme poverty and illiteracy found in the Ruby Valley reflects a caste system that, despite being declared unconstitutional in 1951, still has pervasive effects today. The region is mostly inhabited by the Tamang and the Dalit, two groups that were formerly classified at the bottom of the Nepalese caste system as the “Untouchables.” 

Geographic isolation from cities and large communities has hindered the Ruby Valley’s economic growth and access to healthcare for decades. Things took a significant turn for the worse in 2015, however, when a 7.8-magnitude earthquake struck Nepal. The recent pandemic has only exacerbated the region’s recovery. 

BBF formed a relationship with HHC during the response to the earthquake in 2015 and 2016. Grants to HHC funded a livestock program that distributed 816 animals to 242 families in the Ruby Valley who were on the brink of famine and helped reconstruct a school building for 567 students in the village of Lapa. In 2020, BBF began contributing to HHC’s “One Home One Toilet” campaign by funding 15 permanent toilet installations for families in Tipling village. The project provided toilet access to 71 people and helped protect more than 3,300 members of the community from diseases. 

The toilets installed through BBF’s partnership with HHC do more than meet communities’ immediate needs—they’re also designed to stimulate the local economy. The door and walls surrounding the toilet are made from locally sourced wood and rocks, while HHC purchases materials unavailable in the Ruby Valley in Dhading Besi, the headquarters of Nepal’s Dhading District. 

HHC relies on mules and porters—people who carry supplies for a fee—to help bring the supplies up the mountain. It’s the first step in connecting the Ruby Valley with the rest of Nepal—physically through items but also socially. As more toilets are built in the region, the hope is this progress will pave the way for other public health-related projects in the area.