Girl Child Marriages that lead to Obstetric Fistula in Ethiopia

It was a year ago, when I used to tutor a little boy in my city. The little tiny boy had a sister who is tinier than him. And what registered in my mind was the doll which the little girl dragged around her always; not able to carry the doll that was bigger than her tiny structure, the girl was yet determined to keep the toy close enough to her, preventing anybody nearing it. I realized that this toy was precious to this girl; I also realized how much more precious the girl herself was.

People say that children are gifts from God. And the gifts did not carry any inequalities and differences when they came to the world from God. But the world has created these inequalities and differences between these gifts; the world has categorized these precious gifts by sex. The world has taught humans to esteem one sex category, and discriminate the other. Long lived traditions and practices are still to be seen in the face of earth even today, especially in the developing worlds, where economic instability, corruption, wars and poverty have overtaken the people, that in countries like Ethiopia, females are treated unequally and differently.

I won’t give it to you; she is my baby” screamed the little girl when the woman whom I assumed to be the child’s nanny tried to take it from the girl.

A few months back I happened to visit this family again. The little girl was still little in size. But she did not carry the big doll along with her anymore.

Where is the big dolly?” I asked. The mother smiled. “She was a relative of ours; she has gone to attend a wedding; you know, she is poor, and so I let her take the doll as a gift to the bride.”

I was stuck by astonishment. “What kind of a bride would want a doll as a wedding present?”

“The bride is a little girl, she is only eight and still loves playing with dolls. She is being married to a young man who is in his twenties.”

Government laws and systems in these countries do not bring fear to the people who are still bound by traditional practices and especially those who live in poverty. Though, knowing the fact that child marriage destroys the lives of the girl children as well as their health when they reach adulthood, there is no reduction in giving away girls as brides in Ethiopia.As per UNICEF, Child marriage often compromises a girl’s development by resulting in early pregnancy and social isolation, interrupting her schooling, limiting her opportunities for career and vocational advancement and placing her at increased risk of domestic violence. Child marriage also affects boys, but to a lesser degree than girls.

Child marriage which is giving in marriage before the age of 18 is a violation of human rights. In the developing countries such as in Ethiopia, there are many negative elements that place a girl at risk of marriage, and the primary cause above all is poverty. Families who face extreme poverty, exchange their girls for a ransom with the groom’s family, or they give their girls in marriage, considering it to be a less burden on their own family. There are also ignorant and the innocent believe that marriage brings with it ‘protection’, and parents who fear their daughters will be unprotected with them, who fear of defaming their family honor, culture and religion, give away their young girl children in marriage following these practices.

In Ethiopia, the rate of girl child marriage is three times higher in the Northern region of Amhara [75%], than in the capital city of Addis Ababa [26%]. Child marriage is also popular among certain tribes and population groups in Ethiopia. And this practice on young girl children has many effects on their tender health: increased risk for sexually transmitted diseases, cervical cancer, malaria, death during childbirth, premature infant deaths and child deaths, and most of all the dangerous of all, the obstetric fistulas.

The international community marks the 23rd of May as the international day to end obstetric fistula. But in the first place does the majority of the world know what ‘obstetric fistula’ is. Obstetric Fistula is one of the most serious and tragic injuries that can occur to women during childbirth.

Obstetric fistula is a severe medical condition in which a hole develops either between a woman’s vagina and bladder or one or more of her internal organs; or between the rectum and the bladder after severe or failed childbirth, and when adequate medical care is not available. This hold develops over many days caused by prolonged, obstructed labour without treatment when the pressure of the baby’s head against the mother’s pelvis cuts off blood supply to delicate tissues, where the dead tissues falls away leaving a hole. United Nations informs that this condition typically leaves women incontinent [incontinence of urine and/or feces].

Women who suffer OF also suffer from social isolation, depression, and deepening poverty, as majority of them are abandoned by their husbands and banished from their communities because of the nasty odour. Many of the women who are affected by OF, live with the condition for years, and even decades as the treatment to OF is quite high and unavailable and these women who are caste away from the society and living in extreme poverty and negligence could not afford any kinds of medical treatments.

The sub-Saharan Africa is one of the worst regions with high numbers of young married girls and women suffering with OF, amongst other regions such as Asia, Arab and Latin America. Almost 2 million women from these regions, live with OF, and about 50 – 100 thousand cases of OF develop each year from these regions. And even though OF could be prevented and erased out fully, the current failures in health systems, corruption, and unavailability of material and financial resources in these regions neglect the importance of meeting these essential basic needs of girls and women. Delaying the age of first pregnancy, terminating harmful traditional and religious practices and timely access to health care can avoid women being affected by OF and make it preventable.

Ayalnesh is from Northern Gonder in Ethiopia. She doesn’t know how old she is. In the remote village people give birth in the house, and there is no Hospital to prepare a birth certificate. Ayalnesh was given to a husband when she was very young – still a child. In her young age, she became pregnant, but lost her first child with prolonged. Her tender young body was not resistant enough to go through the harsh and prolonged labour. Hence this resulted in getting affected by the dangerous illness of obstetric fistula. Ayalnesh was not able to control her urine and stools and finally her husband who was not happy with her condition, sent her back to her parents’ house, abandoning her forever.

The uneducated and old fashioned poor society in Ayalnesh’s village did not understand the health reasons behind Ayalnesh’s condition. “Even my family found it hard to accept my foul smell. The villagers mocked at me. They said that I was possessed by demons. My parents too believed that I have been cursed and contracted by an evil spirit. My family considering me a shame on them, eventually caste me away from their house, forced me into a small shack. Everyone refused to visit or speak to me. Though food and water were provided, that is all I got, and I was left abandoned, isolated the rest of the time. I could not even sleep as I suffered much pain. I slept on one side for some years which gave me greater difficulties. I was always wishing to be dead” Said Ayalnesh with tears.  

Though Ayalnesh is not the only one in Ethiopia in this kind of a situation, she was one of the very few lucky ones who soon received help from a foreign medical group from Australia, who had put up a hospital for those suffering from OF. The medical staff from the hospital educated her and the family on her health condition, and repaired the fistula hole. She was also treated with physiotherapy, but as her condition was so bad that it was possible for her to walk about without support.

Young Ayalnesh became crippled for life.

Lily  | Ethiopia