Educated Girls Become Empowered Women

“I ask you all so earnestly to open girls’ schools in every village to try to uplift them.  If the conditions of women are raised, then their children will, by their noble actions, glorify the name of the country.”

Swami Vivekananda (1863-1902)

(Swami Vivekananda introduced Hinduism and Yoga to the West)

 By Donna Shaver

The challenges Nepali girls face when growing up are complex and interrelated, and vary from social and cultural, to educational and economic. As in other parts of the world, gender discrimination takes many different forms, from an individual to a national level.  But the major underlying cause for gender discrimination is traditional son preference. A daughter is often considered a liability rather than an asset, because when she marries, she moves to her husband’s household.  With marriage, her responsibilities shift entirely to her husband and his family.

In many communities, having a daughter means a family will have to pay dowry in the future, yet another reason why many families prefer to have sons. Because of these social norms, many families see educating a girl as an investment without return and hence do not put a priority on her schooling. As a result, girls are often burdened with household chores that consume the time that could otherwise be dedicated to studying.

Our Dining for Women recipient this month is Nepal Teacher Training Innovation’s “Her Turn”, a program to empower adolescent girls ages 10-14 by educating them on health and leadership skills.

(To learn more about NTTI’s Her Turn, see the Program Fact Sheet for March 2013.)

UN Millennium Development Goals

Goal 2:  Achieve universal primary education

Target:  Ensure that, by 2015, children everywhere, boys and girls alike, will be able to complete a full course of primary schooling.

According to The Millennium Development Goals Report 2012, the percentage of primary school age children in Southern Asia enrolled in school has risen from 89% in 2004 to 93% in 2010.  According to the United Nations Development Programme, Nepal has achieved 93.7%.

Goal 3:  Gender Equality

Target:  Eliminate gender disparity in primary and secondary education, preferably by 2005, and in all levels of education no later than 2015.

According to the United Nations Development Programme, in elementary school in Nepal, there are 95 girls for every 100 boys.  The UNDP notes, with regard to the participation of women in government, that progress is being made, as “…an effective quota system brought in over 33 percent of the Constituent Assembly.”  But that assessment is tempered with the following caveat:  “However, women’s low status in the control of resources and political decision making remains, as does the high incidence of violence against women (including early marriage and sex selective abortions).  Serious measures should be taken to ensure the implementation of Nepal’s international commitments for women empowerment and gender equality.”

(For information on the value of girls’ education to the greater society, see “The Arguments for Investing in Girls”, Food for Thought, December 2012, pp3-5.)

The Challenges for Girls in Nepal

Girls face many challenges for which they are ill prepared.  Not only are they lacking formal education, they are lacking the information they need to remain healthy and thrive.  And most of all, they are lacking the power of self-determination.

Chhaupadi:   One of traditional practices that limit girls’ access to education is chhaupadi.  Based on the belief that a girl or woman is “impure” during her period, it’s the practice of isolating a girl or woman who is menstruating in a separate room, an outside hut, or even an animal shed for 7-11 days.  It is practiced in many communities, especially rural ones in the south, but it is not uncommon for urban families to close a girl in a dark room during her menstruation.  This practice, combined with the taboo surrounding menstruation, means that many girls have neither the supplies for, nor knowledge of, menstruation management techniques. Her access to hygiene and sanitary materials is limited, and it is impossible for her to go to school during those days. Every winter, there are media reports of girls or women who died during their isolation, either from the cold or from a health condition that could not be treated, because they were shut away.  Because of these tragic incidences, in 2005 the Supreme Court in Nepal ordered the government to abolish chhaupadi.  But due to political instability and current political deadlock, this order was never enacted.

Kamlari:  In some poverty stricken families from Tharu or Dalit (low caste or “untouchable”) communities, an alternative to marrying a daughter off early is for her to become a Kamlari.  The Kamlari system is a form of indentured servitude, where parents sell their daughter, sometimes as young as six, to another family, and she becomes their domestic servant. The buyers’ families are wealthier and usually from higher caste and hence more privileged, and it is not uncommon that they are prominent government or police officials from Kathmandu. The girls who become indentured servants are deprived of education, and their workload can be as much as eighteen hours a day. Their parents receive a small amount for their work, usually not more than US $50 per year, a significant amount of money to a poor Nepali family. Despite the claims that they are “part of the family”, because of underlying caste divisions, Kamlari usually have to eat separately and sleep in the kitchen. They are also vulnerable to various forms of abuse or domestic and sexual violence from their employers.  The Supreme Court banned the Kamlari system in 2006, but it still persists in many communities in the South and in the capitol.  (For information on the origins of Kamlari, see p.7.)

Child Marriage:  This is perhaps the most serious challenge for girls, because of its prevalence and because of its devastating consequences.  For the vast majority of these girls, being married off means they will also drop out of school, will have limited access to resources, will have very little power in their new households and no control over their reproductive rights. They are also more likely to become a victim of domestic violence than peers who marry later.  The husband’s family very often expects a male child as soon as possible. Many early marriages are coerced by families, sometimes as a form of settling disputes, debts or as a part of local politics, where a girl is married to a man much older than her. Other marriages are initiated by the young girls and boys themselves.  Elopement is not uncommon (“love marriage” as opposed to “arranged marriage”). This trend illustrates another discriminatory social norm: a stigma attached to women considered past their “marriageable age”.  Many girls want to marry young to avoid it. The phenomenon of early marriage is difficult to challenge, because it’s so ingrained in Nepal’s culture.

Health Risks – Child Marriage

A girl is exposed to many health risks when she is married before she turns 18.   She is expected to become sexually active and bear children before her body has fully matured.  Since the concept of “impurity” extends also to childbirth, some girls and women have no assistance during and after childbirth. In case of complications, the risks of maternal and infant mortality rise.

• Uterine prolapse is a common problem amongst women in Nepal–a debilitating condition where the muscles and ligaments can no longer hold the uterus in place.  Uterine prolapse has a variety of causes, and has been linked to early childbirth.  The physical symptoms and discomfort are only a part of the problem. There is also social stigma against Nepali women who suffer from uterine prolapse, and their husbands, families, and communities often perceive them as “impure”.  This stigma and fear prevents girls and women from seeking medical help at early stages of the condition when treatment is easier and more affordable.   Reports of prevalence range from 9% to 44% of women.  In most countries, uterine prolapse is usually found only in post-menopausal women.  Yet, in Nepal, young women also suffer from it.  One study found that as many as 14% of cases occurred under 20 years of age. In some districts, that rate can reach higher than 23%.  Importantly, one study found that as many as 61% of women with uterine prolapse had their first child before the age of nineteen.
• Obstetric fistula is a debilitating condition that can occur when the baby’s head and/or shoulders are too large for the mother’s pelvis, resulting in obstructed labor–which can last for several days. Without skilled treatment, obstructed labor can lead to the death of the fetus and tearing on the walls of the vagina. This tearing results in a fistula, which was labeled by the World Health Organization as “the single most dramatic aftermath of neglected childbirth.” The risk of fistula in girls aged 10-14 is estimated to be as high as 88%, although prevalence is difficult to measure in rural areas.  But research shows that adolescent mothers are at particular risks because their pelvises are underdeveloped. Some estimates point to 200-400 new cases in Nepal each year,  but given the high risk, it is safe to say that these estimates are low.  While it isn’t clear how many occur in adolescent mothers, early pregnancy is one of the major risk factors. As with uterine prolapse, women and girls suffering from obstetric fistula face social isolation and shame from their husbands and communities because of the “impurity” associated with the symptoms. This further prevents many of them from seeking care and treatment when available. Obstetric fistula treatment has a 90% success rate, but most women don’t realize that it can be treated.

• Maternal Mortality:  Early pregnancy and child bearing also increases maternal and child mortality rates. Adolescent mothers in general, but particularly those from rural areas, are at a disproportionate risk of either maternal or infant mortality due to hemorrhaging and obstructed labor.  Maternal mortality is strongly associated with the age of mother and one study reports that early conception and marriage takes more lives than people in Nepal realize. Nepal’s maternal mortality ratio for women under the age of twenty is twice as high (297 per 100,000 live births) as women in their twenties (155 per 100,000 live births) and significantly higher than the country’s average (229 per 100,000 live births).
• Infant Mortality:  Studies have shown that infants whose mothers haven’t reached the age of 18 have a 35% to 55% higher risk of being pre-term or underweight than older mothers’ infants. Infant mortality rates are 60% higher if the mother is below 18. Even if the children survive their first year, they still have a 28% higher mortality rate before they reach the age of five than children born to older mothers. This data is associated with many factors, including the physical and emotional immaturity of the mothers, their malnutrition, and lack of access to social services and health care.
• Domestic Violence: Because young brides have little power, they are vulnerable to numerous forms of domestic violence from their husbands and in-laws. A bride’s youth means she has less power, education, and consequently, less access to resources that can guarantee her security. In one study, women who were married before they turned eighteen were twice as likely to have been beaten and threatened as women who married later. They were also three times as likely to report having been coerced into sexual activities than their peers who married after turning eighteen.
• Suicide:  A maternal mortality and morbidity study conducted between 2008 and 2009 revealed that the leading cause of death of women between the ages of 15 and 49 in Nepal (16%) was suicide. As many as 21% of these suicides were committed by girls under 18.  Nepal’s culture stigmatizes suicide, so it’s possible that these numbers do not accurately reflect the scale of the problem, as some suicides could be reported as accidents.  It is difficult to assess how many of these were related to early marriage, or domestic violence.

(For an expanded version of the text on child marriage and the attendant health risks, see page 7.)
Dowry: Although dowry is illegal, it is still widely practiced throughout the country, especially in Terai, in Madhesi and in Muslim communities. The dowry system is related to the old law that prohibited a married woman to own any property – the items received in the dowry were supposed to belong to her. In 1990, the Supreme Court ruled that women can own property regardless of their marital status, but the dowry system still prevails. While reliable statistical data does not exist, there is a lot of anecdotal evidence in the media of dowry disputes between families. When a husband’s family is not satisfied with the bride’s dowry, they use her as leverage to pressure her parents for more goods or money. The pressure can take very drastic forms, from harassment and violence, to extreme cases of in-laws burning a girl with kerosene or pouring acid on her. Some girls have died as a result of dowry dispute.

Unfortunately, in many traditional communities, the younger and less educated a girl is, the lower the dowry requirements. This perpetuates the prevalence of child marriage especially among poor families, who prefer to pay as little dowry as possible.

Social and Economic Challenges:

The social and economic challenges for girls are interrelated with Kamlari, early marriage, and chhaupadi. All three significantly limit girls’ access to education, which results in their lifelong disempowerment. Usually child brides are forced to drop out because they are expected to assume women’s duties in the household, which consume most of their days, leaving no time for studying. The younger they are, the less education they receive, and the wider the spousal age gap, the less power they have in their new families in relation to their life’s choices, their reproductive rights such as timing and spacing their children, and their access to resources.

In terms of economic consequences, young brides are also much more likely than girls who marry later to remain in poverty. They are unable to develop life skills or relevant livelihood opportunities.  Uneducated girls and women, caught in the cycle of poverty, are unlikely to know their rights, or become active citizens and leaders.

A dramatic challenge that many girls fall victim to, is human trafficking. While no reliable data exist, it is estimated that about 10,000-12,000 girls and women get trafficked from Nepal to India every year. They end up either as bonded labor as domestic workers, or as bonded prostitutes in Mumbai’s infamous red light district. Some Nepali girls’ features are considered especially attractive, and that’s why so many of them end up in this dire situation. These girls face a whole range of health risks: HIV/AIDS, STDs, psychological trauma and very high rates of sexual violence.  Traffickers often use the technique of promising marriage to a rich, high caste man, and pay the parents a small amount of money.  This however is often not the case, and the girl is sold as a bonded laborer or a sex slave in a brothel instead.

The Origins of Kamlari

The economic and social imbalance between Tharu families and the people who ”buy” their daughters stems from caste hierarchy and from developmental and political events of the 50s and 60s. After malaria–to which Tharu people were immune–was eradicated (in an operation conducted by WHO and USAID), other groups started migrating into the area and claiming Tharu lands. Illiterate Tharus became landless and were forced to work as agricultural laborers on the lands that they had cultivated for generations, but that now belonged to new settlers. To this day many of them remain landless and unable to break the cycle of poverty.

Child Marriage and Health Consequences:  Expanded Text

Child Marriage:  This is perhaps the most serious challenge for girls, because of its prevalence and because of its devastating consequences for life. While the legal age to marry in Nepal is 20, last year’s Ford Foundation annual report estimates that 51 percent of girls are married off before they turn 18, and over 10 percent before they turn 15. These numbers put Nepal in 8th place on the list of countries where this harmful practice is most prevalent. For the vast majority of these girls, being married off means they will also drop out of school, will have limited access to resources, will have very little power in their new households and no control over their reproductive rights. They are also more likely to become a victim of domestic violence than their peers who marry later.  The husband’s family very often expects a male child, quick. Many early marriages are coerced by families, sometimes as a form of setting disputes, debts or as a part of local politics, where a girl is married to a man much older than her. Others are initiated by the young girls and boys themselves – couples eloping are not uncommon (“love marriage” as opposed to “arranged marriage”). This trend illustrates another discriminatory social norm: a stigma attached to women considered past their “marriageable age” – many girls want to marry young to avoid it. The phenomenon of early marriage is difficult to challenge, because it’s so ingrained in Nepal’s culture. Today’s girls’ grandmothers often got married off at 10, and so the age at marriage keeps increasing, but considering that still more than half of girls are married off before the age of 18, it seems the progress is much too slow.  (For health consequences of early marriage please see below.)

The international community has already recognized the devastating consequences of this practice. Article 16 of the Universal Declaration of Human Rights from 1948 states that men and women of full age have the right to marry and to found a family, they are entitled to equal rights as to marriage, during marriage and at its dissolution, and that marriage shall be entered into only with the free and full consent of the intending spouses. The Supplementary Convention on the Abolition of Slavery specifies forced marriage, and marriage before “suitable minimum ages of marriage” as a form of slavery. Article 16 of The Convention on the Elimination of All Forms of Discrimination of Women (CEDAW), ratified by Nepal in 1991, states that States Parties shall take all appropriate measures to eliminate discrimination against women in all matters relating to marriage, and in particular shall ensure the same right freely to choose a spouse and to enter into marriage only with their free and full consent; the same rights to decide freely and responsibly on the number and spacing of their children; to have access to the information, education and means to enable them to exercise these rights; and that the betrothal and the marriage of a child shall have no legal effect, and all necessary action, including legislation, shall be taken to specify a minimum age for marriage. More recently, the issue has been brought to international agenda: The Elders, founded by Nelson Mandela, initiated the Girls Not Brides Campaign in 2011. In May 2012, the US Senate unanimously passed the International Protecting Girls by Preventing Child Marriage Act. It stipulates that child marriage is a form of child abuse and a violation of human rights.

Uterine Prolapse:  One common problem amongst women in Nepal that is related to early childbirth is uterine prolapse – a debilitating condition where the muscles and ligaments can no longer hold the uterus in place. While uterine prolapse can be caused by inadequate child spacing, lack of proper rest after childbirth and demanding labor during pregnancy, it has also been linked to early childbirth. Symptoms can include pelvic pain, frequent urination, painful sexual intercourse, vaginal bleeding, reproductive and urinary tracts infections, difficulty walking, and urinary incontinence, which severely compromise an affected girl’s ability to perform daily activities like walking, manual labor, sitting, or lifting her baby. The physical symptoms and discomfort are only a part of the problem. There is also social stigma against Nepali women who suffer from uterine prolapse. They are often perceived as “impure” by their husbands, families, and communities. Some have reported that their refusal to be sexually active with their spouses due to the pain and discomfort has led to marital rape, domestic violence, and the husband abandoning her and/or taking on a new wife.

The stigma and fear associated with uterine prolapse also prevents girls and women from seeking medical help at early stages of the condition when treatment is easier and more affordable. Because of the social stigma related to the condition, it is difficult to determine the prevalence of uterine prolapse in Nepal; however, reporting rates range from 9% to 44% of women. In other countries, uterine prolapse is usually found in post-menopausal women. Yet, uniquely in Nepal, young women also suffer from this condition. One study found that as many as 14% of cases occurred in women before they reached the age of twenty. In other districts, that rate can reach higher than 23%. Perhaps most significantly, one study found that as many as 61% of women with uterine prolapse had their first child before the age of nineteen. Studies have also shown that most women, a majority of whom were married before they turned 18, began to have symptoms after their first childbirth.

Obstetric Fistula is a debilitating condition that was eliminated in the developed countries at the end of nineteenth century due to availability of cesarean sections. Obstetric fistula can occur when the baby’s head and/or shoulders are too large for the mother’s pelvis. This often results in obstructed labor that can last for several days. Without skilled treatment, obstructed labor can lead to the death of the fetus and tearing on the walls of the vagina. This tearing results in a fistula, which was labeled by the WHO as “the single most dramatic aftermath of neglected childbirth.” The risk of fistula in girls aged 10-14 is estimated to be as high as 88%, and while it is, again, difficult to accurately assess the prevalence of the condition in girls in rural areas, research shows that adolescent mothers are at particular risks because their pelvises are underdeveloped. Some estimates point to 200-400 new cases in Nepal each year. While it isn’t clear how many of these occur in adolescent mothers, experts agree that early pregnancy is one of the major risk factors. Similarly to uterine prolapse, women and girls suffering from obstetric fistula face social isolation and shame from their husbands and communities because of the “impurity” associated with the symptoms. This further prevents many of them from seeking care and treatment when available. While obstetric fistula treatment has a success rate of 90%, most women don’t realize that it can be treated.