Yemen: "Bone ache" and depression - the lot of child brides

SANAA, 25 August 2010 (IRIN) - Long gone is the kohl, the henna paint and the white wedding dress she wore at her wedding. A life of hard work and early labour has caught up with Badria. Married at 14, she had her first child at 16 and then five more in quick succession, including three miscarriages. Now in her forties her body is succumbing.

"I was responsible for the children and working on our farm," said Badria.

Since her first pregnancy Badria has suffered from "bone ache", a condition for which the doctors gave her drugs, but were never able to diagnose or cure.

For 11 years she has suffered from a slipped disc after having to collect wood, fetch water, work in the field and have children from a young age.

"Most days I just feel sad," said Badria.

She also suffers from vaginal prolapse, where the muscles, ligaments, and skin in and around a woman's vagina weaken or break.

"These are all symptoms of early marriage," said Arwa Elrabee, a gynaecologist in Sanaa. "These marriages are mostly about suffering."

According to NGOs, health staff and researchers, there are many physical and psychological problems with early marriages, but no studies have been carried out on the long-term effects.

Medical complications

Elrabee sees around 100 patients a day. Her waiting rooms are full of black clad women wearing the 'niqab' (veil) common in Yemen. Many sit on the floor waiting patiently for their turn. "I have worked with women for 25 years," she said. "I see the effects of early marriages every day."

According to the 2008 International Women's Health Coalition report Child Marriage: Girls 14 and Younger At Risk, young girls run a higher risk of complications in pregnancy and childbirth than older adolescents because their bodies (bone structure, pelvis, reproductive organs) are not yet fully developed.

Many experience prolonged and obstructed labour which can lead to haemorrhage, severe infection and death. Other complications commonly include eclampsia and obstetric fistula, and vaginal and anal ruptures.

Numerous pregnancies from an early age and strenuous work take their toll. "Many women simply become handicapped by early marriages," said Elrabee.

Just under half of Yemeni girls - 48 percent - are married before they turn 18, according to the Washington DC-based International Centre for Research on Women. This is classified as "underage", according to the UN Convention on the Rights of the Child.

Depression

Apart from the long-term physical effects, Elrabee said the biggest issue among women over the age of 40, who were married early, is depression.

"These are women that had to face a lot of responsibility from a very young age," she said. "They feel depressed, unsatisfied, and many say they have never enjoyed life."

According to a report entitled Early Marriage in Yemen: A Baseline Study to Combat Early Marriage in Hadhramaut and Hodeidah Governorates, by Sanaa University's Gender-Development Research & Studies Centre (GDRSC), the often forced early marriages lead to an "unstable family life marred by conflicts and lack of attraction between spouses".

The study explains how very young brides are often overcome by marital life and new responsibilities such as looking after their husband's needs, housework and living with in-laws whilst deprived of parental affection.

"Broken women"

Husnia al-Kadri, head of the GDRSC, said many of the symptoms that women complain of are psychological.

"Many suffer from low energy and have phantom pains. This is particularly an issue when women hit the menopause. The women feel that they have spent their lives serving the family and when they can't have more children they feel that they no longer have a role to play," al-Kadri said.

"They have no education, they are illiterate, and they cannot express themselves," she said. "They can't even go to the hospital by themselves, which places another burden on the family."

She explained that if they do go, no basic services or counselling is available. "Instead of help, these women are often given sedatives."

Elrabee puts it simply. "The women when they are older are broken women."

Badria glances at her daughter. "My daughter is different from me. She has her future dreams; she is studying and working. She is independent and can marry when she wants."

"For me everything was enforced - I was never given any choices."

"If I had had an education I could have had a job - even a career. Instead I just work and sit at home and watch TV."