Child marriage and the Vaginal Fistula disease
The consequences of child marriages are issues that cannot be relegated to the background, especially in an era where some parts of Nigeria believe that women belong to the “other room” or must end up in the kitchen.
According to the United Nations Children’s Fund, Child marriage which is defined as a formal or informal union below the age of puberty or below the legal age of majority is a reality for both boys and girls, although girls are disproportionately the most affected.
Section 23 of the Constitution of the Federal Republic of Nigeria says “a person under the age of 18 is incapable of contracting a valid marriage and if such a marriage does take place, it should be declared null and void and of no effect.” Contradictorily, Section 29(4b) of the same constitution technically approves child marriage
It says: “This is by its provision that any woman who is married shall be deemed to be of full age.”
Apart from the fact that child marriage decreases a girl’s development by resulting in early pregnancy and social isolation, it also exposes them to key ailment among others called the Vesico-vaginal Fistula popularly called VVF. Fistula is reportedly one of the worst epidemics that are predominantly caused by child marriages.
According to the international fistula foundation, an obstetric fistula is a hole between the vagina and rectum or bladder that is caused by prolonged obstructed labour, leaving a woman incontinent of urine or faeces or both.
Over time, it leads to chronic medical problems like frequent infections, kidney disease and infertility. Medically, when an under-aged girl has sex, gets pregnant and goes through childbirth, because her body is not developed enough for child bearing, she is highly exposed to a fistula.
Other dark sides of child marriage is evident in the fact that it interrupts a child’s education, limiting her of opportunities for career and vocational advancement, placing her at increased risk of domestic violence, and exposing her to life threatening illnesses such as Anaemia, High Blood Pressure (HBP), Humane Immune Deficiency Virus (HIV), Premature Birth, Malnutrition, Sexually Transmitted Diseases (STDs), Postpartum depression (PPD), and even suicide to mention but a few.
Businessday has a peculiar story to tell about a young beautiful Hausa girl who shared her ordeal in an experience on the said ailment.
She tried to keep the tears from coming out, but they rolled out uncontrollably as she was severely in pains. Please tell my story the little girl said.
My name is Hadija bida(names of victim has been changed to protect her image), i was married off on my 13th birthday to Alhaji Aminu, i soon became pregnant because sex was the only thing Alhaji cares about.
I heard about VVF when I was eight months pregnant, which I prayed to have a different story but my case was different, rather it was worse.
I had prolonged labour for three days but was not taken to the hospital to get proper care rather; i was left to the care of local midwives. I begged Alhaji to take me to the hospital but he refused “You are just being too lazy, what is there in giving birth at home,” that is the reply I get whenever I complain to Alhaji.
“My own mother gave birth to nine children at home, so why is your own different or do you have a crown in your vagina that should warrant treating you specially. Besides, I do not have that kind of money to waste”.I soon accepted my fate.
“The baby’s head came out and got stuck but the remaining body won’t even in that life threatening state my husband and his parents did not see reasons to take me to the hospital”
“A good Samaritan from my community secretly went to my parents who lives in another community and told them about it, which they came immediately to take me to the hospital as Alhaji disagreed but they insisted and took me to one health centre close by,”
“It was there the doctor forcefully pulled the baby out as the baby had already started decaying. To cut the long story short, I lost the baby but the most painful of the whole thing was that I got VVF (Vesico Vagina Fistula) and RVF (Recto-Vagina Fistula),” the little girl said with intense pain in her heart.
While at the health centre, Alhaji sent a divorce letter because I was taken to the hospital without his consent. I felt a lot of pain in my heart, i got VVF and RVF, Alhaji divorced me and left the problems for my parents i have resigned myself to pain and I accept it as the will of God
VVF occurs when the blood supply to the tissues between the vagina and bladder is restricted due to prolonged obstructed labour, leading the tissues to necrotize and then forming holes which urine passes uncontrollably ….some patients develop RVF where the holes form between the tissues of the vagina and recturn leading to the uncontrollable leaking of faeces
In a press release issued by international female rights advocacy platform, Girls not Brides, it was revealed that 65 percent of all cases of obstetric fistula occur in girls under the age of 18. The same report also revealed that ‘girls who give birth before the age of 15 are five times more likely to die in childbirth than girls in their 20s.
Out of the top 20 countries with the highest rates of child marriage across the globe, 17 are African countries, and Nigeria ranks at number 11. In neighbouring West African country, Niger, 76 percent of girls are married before the age of 18, while in Central African Republic the figure stands at 68 percent.
In Nigeria, child marriage has ancient cultural, religious and economic ties. It is believed that girls who marry after the age of 18 can become promiscuous, while other families give out their daughters to ‘escape poverty’.
The UNICEF in its 2017 report said that 43 percent of Nigerian girls are married off before their 18th birthday, while 17 percent are married before they turn 15. The prevalence of child marriage in Nigeria varies from region to region, with figures as high as 76 percent in the North Western region and as low as 10 percent in the South Eastern region.
In recent years, the Nigerian Government has awakened to the reality that VVF has become an embarrassing condition, not only for those living with it and those that would develop it, but also for the government which is confronted with these damning statistics
That is why under previous administrations there were attempts to address the problem. There was a National Strategic Framework for the Elimination of Obstetric Fistula in Nigeria 2011- 2015. It was the first real coordinated attempt to tackle the problem. But it turned out there was nothing strategic about it as new cases continue to emerge.
The current administration under President Muhammadu Buhari appeared to have set a 10-year target for the elimination of the VVF. Isaac Adewole, Minister of Health, said the federal government was determined to eradicate obstetric fistula from Nigeria in the next 10 years. But this target, as ICIR investigations revealed, is unrealistic and unattainable as things stand now in the country’s health sector.
The government has focused more on building fistula centres and offering free surgeries to victims than attacking the factors responsible for this condition for majority of girls and women in the country.
Another issue of concern is that of insurgency and the incessant kidnapping targeted at adolescent female folks in the Northern part of the country, scaring them away from school, causing their parents to remain in abject poverty thereby increasing the case of syndrome.
