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Thursday, April 17, 2014
- In Afghanistan, the maternal mortality rate is on the rise; hospitals are filling up with anaemic women and girls; and in over 200 districts, high schools are devoid of even a single female pupil. These issues are not unrelated – they are all products of a grave social problem in this country of 35 million people: early child marriages.
According to Sadia Fayeq Ayubi, head of the reproductive health department at the ministry of public health, early marriage (of girls younger than 16 years) is illegal in Afghanistan yet girls as young as 13 are frequently married, often to much older men.
In 2013 alone, 53 child marriages have been reported, said Nazia Faizi, a representative of the rights department at the ministry of women’s affairs.
And although that number is less than in previous years, it does not provide an accurate picture of the situation since “there are more unreported cases in the rural areas where women are more deprived and have no rights or access to legal help”, Faizi added.
Child marriages are most common in four northern provinces: Kunduz, Sarpol, Faryab and Herat, where women’s “access to justice is poor”, she said.
Girls are coerced into marrying young. Many families consider it a matter of shame if their daughter is not married by the time she is 16 years old.
Sometimes, young girls are also “traded” in marriage to save family honour or in compensation for a crime committed against a member of the family the girl is being married into.
According to Sayed Salahudin Hashimi, a preacher in Abu Bakr Siddiq Mosque in Khair Khana, Kabul, although Sharia law allows the marriage of post-pubescent girls, the decision to take a husband lies entirely with the girl herself: she cannot be forced, and she has the right to reject the offer.
But while this may be the case on paper, the reality for millions of girls is very different.
Nayela, a teenager hailing from the Sarpol province in northern Afghanistan, is currently in the Malalai Maternity Hospital in the capital city of Kabul for treatment of fistula.
A serious reproductive health condition arising during childbirth, fistula is common among women and girls who receive little or no professional medical care during pregnancy and labour. One of the most common forms of the condition, obstetric fistula, is characterised by an abnormal passage between the birth canal and an internal organ like the rectum.Both painful and humiliating, fistula leads to a host of related medical problems including incontinence, bladder infections, infertility and kidney failure.
As happens with many victims of fistula, Nayela delivered a stillborn child and sustained severe internal injuries during the process. When it became clear that her condition would linger on, her husband and mother-in-law drove her out of the house.
Her mother subsequently brought her to the hospital for treatment, which involves surgery.
Dr. Hafiza Omarkhail, head physician of the Malalai Maternity Hospital where Nayela is now awaiting treatment, identifies fistula as a “rampant female problem” here, exacerbated by childhood marriages.
Nayela’s father died when she was very young and by the time she was a teenager her grandfather had forced her to marry a 40-year-old man, for what he claimed were “financial reasons”.
Now she is suffering the consequences, along with scores of other girls battling both the pressures of early marriage as well as a weak maternal health sector.
According to Sadia Fayeq Ayubi, head of the reproductive health department at the Public Health Ministry, girls are married off between 13 and 17 years, and are often pregnant between 17 and 19 years of age.
This statistic is put in sharper perspective when viewed alongside national maternal mortality statistics: one in 50 Afghan women is likely to die of pregnancy-related causes, according to the 2010 Afghanistan Mortality Survey. The lifetime risk of pregnancy-related death is five times as high in rural areas as it is in towns and cities.
But the survey’s maternal mortality rate of 327 per 100,000 live births in the survey area — which excluded parts of the country disrupted by conflict — is significantly lower than the 1,400 per 100,000 live births assigned by United Nations agencies and the World Bank for the same year.
Meanwhile, divorce rates, suicide and self-immolation are on the rise, said Parwin Rahimi, in charge of the women’s support department at the Afghanistan Independent Human Rights Commission (AIHRC).
In 2010, former Deputy Health Minister Faizullah Kakar completed a study based on hospital reports and Health Ministry records, which showed that over 2,300 women and girls in the 15 to 40 age group attempt suicide annually.
That same year, 100 cases of self-immolation were registered at the Herat City Hospital – 76 of those women succumbed to their burns.
Experts and advocates suspect that early marriages are playing a role in pushing an increasing number of women to these desperate, often fatal, acts.
Rahimi believes it is a “legal flaw” that girls can be married as young as 16 and allowed to start a family.
Most of these teenage brides face exploitation and unimaginable violence at the hands of their husbands and in-laws. They have little access to justice, and more often than not their stories go untold.
Child marriages could also explain the high drop-out rate for girls in Afghanistan – according to the international development organisation BRAC, 82 percent of Afghan girls drop out of school before the sixth grade.
The Education Ministry says the situation is worse in rural areas, where girls rarely manage to finish school. It is estimated that 70 percent of Afghan women are illiterate.
Although most girls are resigned to their fate, some fight back.
Nineteen-year-old named Mahjooba was engaged to her cousin when she was just a child. When she refused to marry him, the family became violent.
“I had continued my studies up to Class Nine. I passed an exam for admission to nursing school. When my aunt’s family got to know, they did not want me to continue with my studies. But I did not agree with their decision. I was divorced,” she said.
The AIHRC has been pushing for the registration of marriages in court as a solution to child marriages.