Girls suffer effects of early marriage

By Alice Emasu

Child marriages are rampant in most communities in Uganda. Youth activists argue that it is poverty, which is responsible for pushing many young people into early marriage.

Consequently, many young women are suffering from obstetric fistula, a condition where the affected woman leaks urine and feaces through her vagina. This can be food for thought among the stakeholders to reflect on while marking the International Youth Day today.

The activists however, agree that the consequences of child marriages are being felt more by the girls.

Brian Kironde, programme associate at the United Nations Population Fund (UNFPA), says the plight of young women has been ignored.

Many young couples, he says, can’t adequately bring up their children. They can’t look after their families well and are unable to engage in meaningful economic activities.

Poverty has forced girls into marrying early

He says as a result, many young people live in the vicious circle of poverty. “Even their young husbands will have dropped out of school prematurely. They are unlikely to earn higher incomes because they can’t get well-paid career jobs,” Kironde observes.

But above all, poverty exposes young people to contracting the HIV virus and many of them end up dying prematurely because they cannot afford the ARTs.

He says UNFPA realised only two years ago that the problem of obstetric fistula was big in the country and that it affected mainly young women. But the UN urgency focusing on improving reproductive health among young people, according to Kironde, is proud that through support from her partners, UNFPA has managed to have tangible results to show for their determination.

Mitigation of the impact and elimination of obstetric fistula is one of UNFPA’s top most priority intervention today. So far, UNFPA have jointly worked with its partners to strengthen their support for the provision of medical equipment, hospital facilities like repair beds and trained medical workers.

He says UNFPA is currently working with the government and other development partners like the Engender Health and AMREF among others, to support the clinical services commission in the Health ministry for better interventions against obstetric fistula. So far, only 23% of the problem of fistula has been addressed.

“We are now working to rollout the programme for fistula to the post-war areas in the country such as eastern Uganda. We want to equip selected hospitals and have a good number of interested gyneacologists trained in handling the patients.

We are thinking of turning one of the regional referral hospitals in eastern Uganda into a fistula training and repair centre. We have realised the problem is big in eastern Uganda,” he says. Anthony Mbonye, the assistant commissioner, Reproductive health in the Ministry of Health, agrees with him. He says the government has a national programme aimed at addressing fistula challenges.

“We have been training doctors and at the same time repairing fistula women in Soroti, Gulu, Arua and Masaka districts among others,” Mbonye says.

Fatma Mrisho, the UNFPA country representative in Uganda, says fistula is a reflection of the failure to manage delivery. It shows how much gap there is for the government to reach the women with health services.

“We need to have a deliberate programme to inform and support the communities against fistula. We need male involvement in prevention of pregnancy and abortion complications. We need to support these men to be readily available to support the women during pregnancy, labour and delivery,” she adds.

She recommends that the fight to end fistula has to begin from a family level. She says for the communities to protect women from fistula, they need information to help them to prepare for delivery. They need information on the danger signs of labour.

She says UNFPA aims at ensuring 80% of the mothers get access to skilled medical attendants at birth.

Many medical workers are reluctant to specialise on repairing fistula because they know that often the patients can’t afford the cost of repairs.