Women's health

The real reason so many underage Rohingya girls are getting married (and pregnant)

The scenario revealed itself as thousands of minor Rohingya girls started to visit medical centres.

Unable to do anything else to protect their daughters from the jaw of brutal sexual assault by Myanmar’s military forces and Mogh extremists, helpless parents in the country’s strife-torn Rakhine state are marrying off their underage daughters in a bid to save them from the assaulters.

The scenario revealed itself as thousands of minor Rohingya girls started to visit medical centres at refugee camps in Cox’s Bazar for pregnancy-related diseases.

Soon after giving birth to a baby, the girls in Rakhine expect another, because they think that the state of pregnancy is the only means to protect themselves from the brutalities of the army and Mogh (Rakhine Buddhists), narrated expectant women who frequently visit the medical centres.

Speaking to the Dhaka Tribune, Dr AZM Zajid, coordinator of a medical centre near Panbazar at Balukhali of Ukhiya upazila, said: “Every day, some 3,000 to 5,000 Rohingya people visit this centre with numerous diseases. Of them, 400 to 500 are expectant mothers who come to receive treatment for pregnancy-related complications.

“Many of them are suffering from various risks associated with pregnancy and childbirth. We have to struggle to provide treatment to this many patients at a time.”

Quoting victims, Zahid said: “In Rakhine, girls are married off at a very young age as their parents hold the belief that army men and Mogh would not target their married daughters.

“And the girls expect baby soon after their marriage. As a result, they each have five to 12 children. Even, we have treated expectant mothers as young as 12/14.”

Marrying off underage girls has apparently become a social convention, he added.

Social convention

In the same vein, male counterparts of the Rohingya women said they too prefer the women to conceive at a young age.

“This has already become a custom in our society. The earlier a girl is married off, the better. Nobody wants his mother, wife and sisters to be violated [at the hands of army men], said an elderly Rohingya refugee, Abdul Zabber.

Fearing stigma, many such girls initially declined to talk to the Dhaka Tribune when the correspondent approached them for their accounts. Later, some of them admitted that they had to agree to wedding proposals as per their families’ will, as they were at a constant risk of losing their virginity to the soldiers and Buddhist extremists.

Moreover, the problems of child marriage and early pregnancy are getting even worse due to illiteracy among the girls and lack of family planning campaigns in Rakhine.

On Wednesday, when taking treatment at the Panbazar medical centre, Rohingya refugees Mubina Begum, Sapura Khatun and Ramija Begum described why girls in the state prefer being pregnant all the year round.

According to the trio, army men, assisted by local Buddhists, rape Rohingya girls for hours at a stretch after picking them up from their homes, an organised campaign of sexual assault against the Rohingya Muslims that has been continuing for decades.

They burst into tears as they described their terrible ordeal to the correspondent.

Ramija wiped away her tears remembering her 14-year-old daughter Shahena, who never returned home after the Mogh had kidnapped her one year ago.

According to Dr Pintu Kanti Bhattacharya, deputy director of the Directorate General of Family Planning, Cox’s Bazar, there are over 30,000 expectant women among 603,000 Rohingya refugees who have fled to Bangladesh from Myanmar since August 24, after ethnic conflicts in Rakhine sparked the most rapid human exodus since the Rwandan genocide in 1994.

Since then, 700 to 1,000 babies have been born in Bangladesh, while over 10,000 women will be delivered of their babies soon, he said, adding that every day seven to eight babies are born at different medical centres in the camps.

Dr Pintu stressed the need for bringing the Rohingya women, who have taken shelter in Bangladesh, under the directorate’s family planning campaigns.

“Apart from treating the women infected with various diseases including malnutrition, seven medical teams comprised of 200 health workers are counselling them on birth control. The teams are also carrying out awareness building campaigns to this end,” the official continued.

According to reports released by the UNHCR, International Organization for Migration and other stakeholders, 120,000 pregnant and lactating women are in dire need of nutrition support in the refugee camps.

Dr Mejbah Uddin Ahmed, health and family planning officer in Ukhiya upazila, said: “Most girls who fled Rakhine are rape survivors. We have yet to identify all of them.”

Stigmatised and therefore reticent, the victims are too shy to share their ordeal with the physicians. As a result, listing and treating them have become a cumbersome task, he added.

This article first appeared on Dhaka Tribune.

We welcome your comments at letters@scroll.in.
Sponsored Content BY 

Relying on the power of habits to solve India’s mammoth sanitation problem

Adopting three simple habits can help maximise the benefits of existing sanitation infrastructure.

India’s sanitation problem is well documented – the country was recently declared as having the highest number of people living without basic sanitation facilities. Sanitation encompasses all conditions relating to public health - especially sewage disposal and access to clean drinking water. Due to associated losses in productivity caused by sickness, increased healthcare costs and increased mortality, India recorded a loss of 5.2% of its GDP to poor sanitation in 2015. As tremendous as the economic losses are, the on-ground, human consequences of poor sanitation are grim - about one in 10 deaths, according to the World Bank.

Poor sanitation contributes to about 10% of the world’s disease burden and is linked to even those diseases that may not present any correlation at first. For example, while lack of nutrition is a direct cause of anaemia, poor sanitation can contribute to the problem by causing intestinal diseases which prevent people from absorbing nutrition from their food. In fact, a study found a correlation between improved sanitation and reduced prevalence of anaemia in 14 Indian states. Diarrhoeal diseases, the most well-known consequence of poor sanitation, are the third largest cause of child mortality in India. They are also linked to undernutrition and stunting in children - 38% of Indian children exhibit stunted growth. Improved sanitation can also help reduce prevalence of neglected tropical diseases (NTDs). Though not a cause of high mortality rate, NTDs impair physical and cognitive development, contribute to mother and child illness and death and affect overall productivity. NTDs caused by parasitic worms - such as hookworms, whipworms etc. - infect millions every year and spread through open defecation. Improving toilet access and access to clean drinking water can significantly boost disease control programmes for diarrhoea, NTDs and other correlated conditions.

Unfortunately, with about 732 million people who have no access to toilets, India currently accounts for more than half of the world population that defecates in the open. India also accounts for the largest rural population living without access to clean water. Only 16% of India’s rural population is currently served by piped water.

However, there is cause for optimism. In the three years of Swachh Bharat Abhiyan, the country’s sanitation coverage has risen from 39% to 65% and eight states and Union Territories have been declared open defecation free. But lasting change cannot be ensured by the proliferation of sanitation infrastructure alone. Ensuring the usage of toilets is as important as building them, more so due to the cultural preference for open defecation in rural India.

According to the World Bank, hygiene promotion is essential to realise the potential of infrastructure investments in sanitation. Behavioural intervention is most successful when it targets few behaviours with the most potential for impact. An area of public health where behavioural training has made an impact is WASH - water, sanitation and hygiene - a key issue of UN Sustainable Development Goal 6. Compliance to WASH practices has the potential to reduce illness and death, poverty and improve overall socio-economic development. The UN has even marked observance days for each - World Water Day for water (22 March), World Toilet Day for sanitation (19 November) and Global Handwashing Day for hygiene (15 October).

At its simplest, the benefits of WASH can be availed through three simple habits that safeguard against disease - washing hands before eating, drinking clean water and using a clean toilet. Handwashing and use of toilets are some of the most important behavioural interventions that keep diarrhoeal diseases from spreading, while clean drinking water is essential to prevent water-borne diseases and adverse health effects of toxic contaminants. In India, Hindustan Unilever Limited launched the Swachh Aadat Swachh Bharat initiative, a WASH behaviour change programme, to complement the Swachh Bharat Abhiyan. Through its on-ground behaviour change model, SASB seeks to promote the three basic WASH habits to create long-lasting personal hygiene compliance among the populations it serves.

This touching film made as a part of SASB’s awareness campaign shows how lack of knowledge of basic hygiene practices means children miss out on developmental milestones due to preventable diseases.

Play

SASB created the Swachhata curriculum, a textbook to encourage adoption of personal hygiene among school going children. It makes use of conceptual learning to teach primary school students about cleanliness, germs and clean habits in an engaging manner. Swachh Basti is an extensive urban outreach programme for sensitising urban slum residents about WASH habits through demos, skits and etc. in partnership with key local stakeholders such as doctors, anganwadi workers and support groups. In Ghatkopar, Mumbai, HUL built the first-of-its-kind Suvidha Centre - an urban water, hygiene and sanitation community centre. It provides toilets, handwashing and shower facilities, safe drinking water and state-of-the-art laundry operations at an affordable cost to about 1,500 residents of the area.

HUL’s factory workers also act as Swachhata Doots, or messengers of change who teach the three habits of WASH in their own villages. This mobile-led rural behaviour change communication model also provides a volunteering opportunity to those who are busy but wish to make a difference. A toolkit especially designed for this purpose helps volunteers approach, explain and teach people in their immediate vicinity - their drivers, cooks, domestic helps etc. - about the three simple habits for better hygiene. This helps cast the net of awareness wider as regular interaction is conducive to habit formation. To learn more about their volunteering programme, click here. To learn more about the Swachh Aadat Swachh Bharat initiative, click here.

This article was produced by the Scroll marketing team on behalf of Hindustan Unilever and not by the Scroll editorial team.