Thursday, December 04, 2008

Meanwhile, in Nigeria

Child brides are common and this results in fistula being common, too:

Northern Nigeria has one of the highest rates of child marriage in the world: nearly half of all girls here are married by the age of 15.

The consequences have been devastating. Nigeria has the highest maternal mortality rate in Africa and one of the world's highest rates of fistula, a condition that can occur when the pressure of childbirth tears a hole between the vagina and the bladder or rectum. Many women are left incontinent for life. Up to 800,000 women suffer from fistula in Nigeria.

"They marry young, they get pregnant young, they deliver young and they pick up the fistula," said Kees Waaldijk, the chief consultant surgeon at the Babbar Ruga hospital, the world's largest fistula clinic, in the northern state of Katsina.

Most cases happen to young girls during their first pregnancy, and nearly half the patients at Babbar Ruga are under 16.

Dr Waaldijk operates on up to 600 women a year, with no electricity or running water. He sterilises his equipment in a steel casserole pot that sits on a gas camping stove. Rows of girls and women - some as young as 13 - lie listlessly on rusty hospital beds, each connected to a catheter.

The smell of urine is overpowering and many of the women have been cast out from their communities. Some have been divorced by their husbands - it is estimated that up to half of adolescent girls in northern Nigeria are divorced. "If nothing is done the woman ends up crippled for life: medically, socially, mentally and emotionally," Dr Waaldijk said.

The numbers given in this quote on married and divorced adolescent girls are unlikely to be quite correct, by the way, because they would leave no space for unmarried girls. But the problem of fistulas is a real one, a horrible one, something which the teens themselves cannot avoid but at the same time something which can make them ostracized by their communities.

The rest of the linked article discusses Nigeria's attempt to set a higher minimum age for marriage. But this is resisted by some:

Other vocal opponents to the Act include village heads and elders - almost all men - highlighting the tribal and cultural constraints that hamper attempts to stamp out child marriage.

"It is important we have the right to marry our girls young so there is no risk of pregnancy outside marriage. It is to preserve the purity of our girls," said Usman, an 84-year-old man from the village of Yammaw Fulani, who married a 14-year-old girl four years ago. "We will never accept this law," he said.

Now contrast that use of 'purity' with the way the fistula sufferers smell.