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TULEAR, Madagascar — Child marriage remains a great challenge in Madagascar, where it has a devastating effect on the lives of the girls involved. Alphonsine Zara, 35, who was married off traditionally at the age of 16, is still suffering from the harsh consequences of her early marriage.

“I became pregnant shortly after the marriage, but during the delivery there were complications. Sadly, my baby was stillborn,” she says. Her prolonged obstructed labour created a fistula – an injury to the birth canal that left a hold through which she leaked urine constantly.

Obstetric fistula is one of the most shattering consequences of child marriage, as young girls are especially prone to developing fistulas. Women suffering from obstetric fistula are often stigmatized in the community. “My husband abandoned me once the fistula appeared. For several years I was miserable, and people laughed at me because I smelled of urine,” says Alphonsine.

In 2011, she underwent fistula surgery provided through the United Nations Population Fund, UNFPA’s Campaign to End Fistula. This has alleviated some of her suffering, but she is still in need of second surgery.

Traditional customs persist

In 2007 a new law was passed in Madagascar, setting the marriageable age at 18 for girls and boys alike. Previously, girls could be married at 14 and boys at 17. Yet in rural areas, where traditional marriage ceremonies are common, a great number of girls are still married off before the age of 18.

Early marriage has several harmful effects on the overall well-being of the girl, who is not psychologically, emotionally or physically ready for conjugal life. Child marriage increases the probability of having children at a younger age, which increases the risk of sexually transmitted infections, including HIV/AIDS, maternal mortality and obstetric fistula – as seen in the case of Alphonsine.

Girls cannot refuse

Zara, 38, was also a victim of child marriage. She was forced to marry traditionally at the age of 15. “I had to accept, and if not I would be cursed,” she says.

According to the Demographic and Health Survey 2008-2009, 10 per cent of Malagasy women aged 20-24 were married or cohabiting before the age of 18.

In some parts of the country, a great number of girls still get married before the age of 18, especially in rural areas where traditional marriage ceremonies are common. “Forced marriage is still very common in our village, and girls cannot refuse. Early pregnancy is also commonplace, even among 14-year-olds,” says Zara.

A year after her marriage, at the age of 15, Zara had her first child. As a result of obstructed labour, her baby was stillborn, and shortly after the delivery she discovered that she was also suffering from fistula. Like many other women living with fistula, her husband abandoned her once the problem appeared. For more than 20 years, Zara lived in misery because of her ailment. Like Alphonsine, she was also repaired during UNFPA’s Campaign to End Fistula in 2011, and is now healed.

Training programme for survivors

As a part of its gender-based violence programme, UNFPA Madagascar works with the police, policy makers, women’s associations, local communities and traditional leaders in order to raise awareness on gender-based violence, including child marriage. All actors are encouraged to respect the legal age of marriage.

Alphonsine still lives alone in poverty, but is taking part in a joint project between UNFPA and the International Labour Organization (ILO), aiming to reintegrate women and girls who have undergone fistula surgery and survivors of gender-based violence into the community by teaching them a trade or a skill. “I would like to sell fish and start my own business. My hope is that this will give me a better future,” she says.

~ Borghild Berge and Guifty Banka