Child marriage (finally) seen as a health issue (in addition to one of human rights)

This was cross-posted to my new professional blog.

As someone who takes particular interest in the intersection of health and human rights, I am glad to see this issue gaining the attention at the crossroads it deserves. Child marriage, which has been covered in recent years by such high-profile publications as National Geographic, has long been decried a human rights violation of young girls around the world. It garnered special attention with the story of Nujood Ali, an extraordinary young Yemeni girl who, after being married off at age ten to a man three times her age, escaped to a courthouse and demanded a divorce. She published her memoirs in 2009, which put the Middle East in the spotlight for the problem, but child marriage happens all around the world – and, in the case of Haiti, much closer to home than we Americans usually tend to think. Now, as my colleague Tom Murphy has pointed out on Humanosphere, child marriage is beginning to receive the attention it needs from the global health side as well.

Long considered an issue of human rights, the conversation about child marriage is shifting to that of health and education. Girls married too young are denied the educational opportunities of their peers and are put at greater health risks, such as HIV and teen pregnancy.

What may seem like a distant problem, child marriage is found in every part of the world. Ending the global practice will unleash opportunity for millions of women and girls.

(Side note: I promise that Humanosphere is not the only global health blog I follow, but I find it to be one of the most informative and well-rounded, so I link back to it a lot. Perhaps I need to lengthen my blogroll.)

At a glance, it’s easy enough to see both the health and the human rights problems with child marriages. First and foremost, the girls are married against their will, or without full knowledge of what it happening to them. Many of the girls are raped and abused; a few high-profile cases have featured girls who died of internal bleeding or fistula after their “husbands” finished with them. Teenage pregnancy, being cut off from education, perpetuating poverty cycles. The list goes on and on.

Unfortunately, it is just as easy to see that the solutions are not so simple; as the National Geographic feature points out, we cannot just “rescue” the girls by carrying them off into the sunset, as Nick Kristoff occasionally does. The reasons for these traditions are culturally ingrained and have to be addressed at the community level.

Efforts to reduce this number are mindful of the varied forces pushing a teenager to marry and begin childbearing, thus killing her chances at more education and decent wages. Coercion doesn’t always come in the form of domineering parents. Sometimes girls bail out on their childhoods because it’s expected of them or because their communities have nothing else to offer. What seems to work best, when marriage-delaying programs do take hold, is local incentive rather than castigation: direct inducements to keep girls in school, along with schools they can realistically attend. India trains village health workers called sathins, who monitor the well-being of area families; their duties include reminding villagers that child marriage is not only a crime but also a profound harm to their daughters.

Global Health News Last Week

POLITICS AND POLICY

  • South Africa’s government has set out its plans to introduce a universal health care scheme with a pilot program in 10 areas by 2012 and nationally over the next 14 years.
  • The U.N. must make reducing salt intake a global health priority, sayUK scientists. Writing in the British Medical Journal they say a 15% cut in consumption could save 8.5 million lives around the world over the next decade.
  • IRIN reports on the story of Daniel Ng’etich, a Kenyan man who was arrested and jailed for not continuing his TB treatment.
  • Dr. Jill Biden is leading a high level American delegation toKenya, which includes Raj Shah, to look into the American response to the famine crisis in the Horn of Africa.
  • A report on the state of maternal health in South Africa by Human Rights Watch has uncovered some alarming trends.

PROGRAMS

  • WHO has launched a new website to help those combating malnutrition. eLENA, a new e-library, gathers together evidence-informed guidelines for an expanding list of nutrition interventions. It is a single point of reference for the latest nutrition guidelines, recommendations and related information.

RESEARCH

  • A TB vaccine designed for those with HIV enters phase IIb trials this week in Senegal. The vaccine works by boosting response of T cells already stimulated by the traditional BCG vaccine.
  • Female smokers are more at risk for heart disease than male smokers, finds a systematic review and meta-analysis published in the Lancet.  This is a concern, as smoking rates are increasing in young women worldwide.
  • Scientists are in the second phase of research into using microwaves to kill malaria parasites in mice.
  • A USC researcher has developed a lentiviral vector that can track down HIV infected cells which can potentially act as a marker for targeted elimination of infected cells.
  • People living with HIV who receive the proper ARV treatment have no greater risk of death compared to people without HIV, finds Danish researchers.
  • Around 30 genetic risk factors for developing multiple sclerosis have been discovered by a UK-led team.
  • A new study, showing that a simple blood test can accurately determine the sex of a fetus 95 percent of the time, is great news for parents at high risk of having a baby with rare genetic diseases. But it is bad news to those concerned that the tests could be used to abort a fetus based on gender.
  • British researchers have discovered that the introduction of spermless male mosquitoes can lead to fewer malaria carrying females.
  • A device which can test blood for HIV/AIDS in a matter of minutes has been developed by University of Columbia scientists.

DISEASES AND DISASTERS

  • As if it did not have enough problems already, Somalia is now facing cholera epidemic, World Health Organization officials said.
  • In an August 4 article, Trustlaw’s Lisa Anderson exposes the “silent health emergency” faced by child brides around the globe.  Not yet physically mature, they face grave danger in childbirth, due to narrow pelvises. Girls younger than 15 years of age have a five times greater risk of dying during delivery than women over 20; most of these deaths occur in developing countries that lack adequate and accessible pre- and postnatal care.
  • Amid contradictory government statistics, a volunteer group in Japan has recorded 500,000 radiation points across the country.
  • A Mexican teenager is the first officially known person to die from vampire bat induced human rabies infection. The 19-year-old victim was a migrant farm worker in theUnited States.
  • An estimated 500,000 people in West Africaare infected with lassa fever every year, the World Health Organization (WHO) said on Wednesday, amid calls for more money to be spent on preventing its spread.
  • Over at Global Pulse, Human Rights Watch researcher Katherine Todrys guest blogs on the HIV epidemic in Uganda’s penitentiaries.Uganda, she explains, has often been presented as a success story in the global fight against HIV/AIDS, and has received over $1 billion from the US for AIDS programs. Many HIV-positive Ugandans have been excluded from these efforts, though, including gay men, drug users, sex workers, and prisoners.
  • Sleep apnea, a fairly common and treatable disorder that causes people to stop breathing momentarily while they sleep, may lead to cognitive impairment and even dementia.
  • Although cases of sexual violence have been under-counted during some wars, during others, such as the ongoing unrest in Libya, they have been vastly over-counted.
  • All patients getting cancer treatment should be told to do two and a half hours of physical exercise every week, says a report by Macmillan Cancer Support.