Ending Childhood Marriage Will Save Lives

Nike Foundation's campaign, The Girl Effect, introduced me to 13 year-old Kidan from Ethiopia. "I'd like to go to school," she says smiling. "My dream? A doctor. I'd like to be a doctor." She stares wistfully into the distance while grinding meal on her hands and knees. That she dares to dream elicits hope. Her mother speaks. The sentiment is cut short. "Kidan can not become a doctor. She is already engaged. She just doesn't know about it." A pregnant pause..."They will give us cattle."

This is not a story reserved for history books; it's something that's happening today. World-wide 82 million girls are child brides. While it is widely recognized that adolescent marriage violates human rights, often depriving girls of further education, most people don't recognize that it is a health hazard.

Child brides face high risk of abuse, rape, contracting HIV/AIDS and dying in childbirth. According to the UN Millennium Development Goals report, of the 536,000 maternal deaths last year, 70,000 were adolescents, making pregnancy the leading cause of death for girls age 14-19. Those who survive childbirth may live with obstetric fistula, a chronic condition caused by obstructed labor within their underdeveloped pelvis that leaves them leaking urine and feces. These girls are often isolated or abandoned by family and friends.

The correlation between childhood marriage and maternal mortality is clear.

According to the Child and Woman Abuse Studies Unit, 57 percent of girls in Bangladesh are married by age 15. Nepal has the worlds' highest level of child marriage with over 63 percent of girls married before age 18, and 7 percent married before age 10. Invariably, those regions with high child marriage, such as South Asia and sub-Saharan Africa, have high a maternal mortality rate. In fact, these two regions account for 85 percent of all maternal deaths. In developed regions, including the U.S., there is a one in 7,300 lifetime risk of maternal death. In sub-Saharan Africa the risk is one in 22.

The UN Millennium Development Project has recognized maternal mortality as a major problem and made reducing it one of its five goals. Although it aims to reduce the maternal mortality rate by three-quarters by 2015, it is not on track to do so, and in fact, has fared worst on this goal than any of its others. In part, this is because it does not explicitly identify elimination of child marriage as a distinct goal. The prevalence of child marriage is named as one of the problems which interfere with progress in three of the goals; improving gender equality and women empowerment, reducing child mortality, and improving maternal mortality.

To be sure, childhood marriage is not an easy problem to address. Some of the causes are poverty, parental desire to prevent sexual relations outside of marriage, fear of rape--which would shame the family and either ostracize or lead to the murder of the victim--lack of educational opportunities for girls, and traditional notions of the primary role of women and girls as wives and mothers. It's perpetuated by religions that aim to keep women subordinate and deeply-rooted cultural norms in which men are encouraged to dominate women--If a wife is a child you can guarantee male control.

It is critical, however, that we address the problem. 70,000 girls did not need to die.

Organizations such as The Population Council, International Center for Research on Women, International Women's Health Coalition and the White Ribbon Alliance for Safe Motherhood are working to stop child marriage. Deb Clark, Communications director of the White Ribbon Alliance, said "We are trying to break any barriers to healthcare and create cultural shift so that lives of girls and women are valued. Child marriage further promotes and places girls at risk for pregnancy." These organizations strive to ensure girls and women have access to reproductive health services, skilled birth attendance, emergency obstetric and post-partum care. All agree that access to lifesaving care before, during and after childbirth is a human right. In Yemen, the White Ribbon Alliance is at the forefront of a coalition to introduce a bill to raise the age of marriage--currently only 10 years.

Changing the perceived lack of social and economic value of girls is a crucial part of the solution. Shifting these harmful gender norms requires engaging boys and men in girls' empowerment. Continued law reform and enforcement, free and full consent by girls, birth and marriage registration, raising community awareness, equitable primary school enrollment, and increased international cooperation are necessary to end this appalling violation of human rights.

In addition to shifting these cultural norms, law enforcement has a role to play. According to the International Center for Research on Women's Knot Ready Project child marriage is against the law in many of the countries where the practice is epidemic. Those laws must be enforced.

2009 marks the 20th Anniversary of then Covention on the Rights of the Child. The United Nations Human Rights Council recently adopted a resolution recognizing preventable maternal death as a human rights violation but failed to address child marriage within the problem. The 12th session will be held in September. How better to commemorate the anniversary than to have a distinct goal that makes ending child marriage a priority.

Labeling these pregnancies as adolescent fertility obscures the reality: Children are being married to and impregnated by older men, in many cases, decades their senior. These children are too young to understand the implications, unaware their parents are marrying them off, and powerless to fight against the tradition. Certainly, we have the power to do something about this.

Children like Kidan deserve to have a childhood.

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