Girls who marry early face abuse and health issues

The impacts of child marriage are plenty and far-reaching. Dr Richa Amatya, psychiatrist, says psychological problems in child marriage start with adjustment issues, which is mostly true for the brides. “They find it difficult to adjust in a completely new environment,” she says. Ruby Khan, activist, says the girls are blamed for not handling the family well and that adds to their woes. “Families aren’t empathetic toward her. They choose to verbally and physically abuse her rather than understand what she might be going through,” she says. Khan further mentions that the bride’s condition gets even worse when dowry is involved. Rajkumar Mahato, chairperson, Chandranagar Rural Municipality, Sarlahi, Province two, agrees the groom’s family isn’t always satisfied with the money/property received as dowry. “The bride is forced to ask more from her parents,” he says. They want the bride’s family to cover the cost of their son’s education, buy him a vehicle, and even pay for the cost of sending him abroad. “In case a bride fails to do so, she is physically assaulted, tortured, or, worse, killed,” he says.

There is, however, a reason why they don’t walk out, says Khan. Most girls she has encountered have been stripped of their hopes and dreams of having a career. “They leave their education mid-way or parents don’t even let them go to school in the first place, thinking she will get married anyway,” she adds. They have neither any skills nor education to find a job or make a living. On top of that, they already don’t have any money. “Being completely dependent on the husband and his family for survival they have no choice but to endure violence,” she says.

Dr Amatya adds that sometimes they also put up with abuse hoping things will turn around. “Many believe that people might change and treat them well if they wait a little longer,” she mentions. Secondly, they also fear that the situation might get worse if they speak up. “Compartmentalizing their problems is one of the root causes of psychological issues, which only gets worse with time,” she says. She further mentions that sometimes mental health issues can be genetic. Living in an abusive environment adds to their already existing issues, leading to chronic depression, anxiety, and other problems. Some of them even resort to substance abuse or worse. “Young girls getting married to much older men is another problem,” says Nisha Paudel, Surkhet district coordinator for Aawaaj, an organization actively working against child marriage. Khan says when the husband passes away, the wife, who is still young, is often emotionally and physically tortured by her in-laws. Some are even blamed for killing their husbands. “They are accused of witchcraft or bringing bad omens,” she adds. In some cases, the husbands choose to get a divorce. “I have mostly seen that happen in Muslim communities,” says Khan. The girl is then responsible for singlehandedly raising her children. “She is kicked out of the house and her own family doesn’t want her to return.” Sangita BK, social mobilizer for Aawaaj, says the problem of the age-gap is also seen in second marriages. “Remarrying is already frowned upon by many and the family doesn’t treat them well either,” she says. The most common reason for remarrying, she says, is because single mothers look for emotional as well as financial support to raise their children. “They have no choice but to endure the misbehaviors in order to have a roof over their heads,” adds BK. The situation is even worse for children from their first marriage. “Our society doesn’t easily accept a step-child,” she says, “And the mother asks them to compromise along with her in case the child is abused since they have nowhere else to go.” She further mentions that it’s usually the stepdaughters who suffer the most. A few years back, a 14-year-old girl was found to have been abused by her stepfather for years. It began with inappropriate touching and led to rape. The stepfather, without her knowledge, made her undergo multiple abortions. At the age of 14, she got pregnant again, but the abortion wasn’t successful. She gave birth and had several health complications after it. “Girls have a lot of health complications when they get pregnant very early,” says Manju Shahi, a community nursing director at Rural Municipality Health Department, Thantikandh Rural Municipality, Dailekh, Karnali Province. Most girls give birth around the age of 16-20. At this age, she says, the uterus isn’t mature enough to have a safe pregnancy. Also, she mentions that these girls don’t have a good knowledge of taking care of themselves during pregnancy. They aren’t aware of the importance of a balanced diet and most of them survive on packaged food. “They also have to do household chores and don’t get enough rest, making the pregnancy even more complicated,” she says adding all that often leads to deformities in the infant, premature birth, and complications for the mother. “There are instances where we have lost both the mother and the child,” she says. Some of the most common health issues are pelvic inflammatory diseases (infection of the reproductive organs), uterine prolapse (a condition where pelvic muscles and ligaments are weak and can no longer hold the uterus in place), eclampsia (seizures that occur during pregnancy), and over-bleeding as well as tearing of skin and ligaments while giving birth. But despite trying to do what’s best for the mother, Shahi says many are only concerned about the baby. One of her patients, a 16-year-old, who was suffering from uterine prolapse, had her uterus fall out during birth. “I suggested they take her to the hospital as pulling the baby out would put the mother at risk,” she says. The family wasn’t bothered and that led to complications for the mother. Additionally, many girls are forced to work within days after delivery and that, Shahi says, leads to problems while breastfeeding. Nirjana Bhatta, national coordinator for Girls Not Brides-Nepal, a network of organizations working against child marriage says not all women are aware of the use of contraceptives or sexually transmitted infections (STI). “Some of them don’t even realize they have contracted STI,” she says. Secondly, most of these women have had multiple children before the age of 25, and have no knowledge of family planning. “This only weakens their reproductive health and leads to serious issues in the future,” adds Shahi. Girls have little understanding of reproductive health issues and are uncomfortable discussing them. “Most of them avoid seeing a medical professional or don’t visit health posts unless it’s an emergency,” says Laxmi Rawat, a health assistant working in Thantikandh Rural Municipality, Dailekh, Karnali Province. She further adds that they are financially dependent on their husbands or their family, and are reluctant to share their reasons for visiting a doctor. “Prolonging treatment worsens their health conditions, forcing them to go to the hospital which many can’t afford,” she adds.