Child Marriage: A Medical Dilemma
- Hannah Malcolm
- Oct 29, 2024
- 7 min read
Updated: Nov 4, 2024
Part 2 of 3
by Hannah Malcolm
It is unfortunate that all opinions agreed on a definition of consent that was nailed to a purely physical capability, entirely dissociated from free issues like choice of partner, sexual, emotional, or mental compatibility or other social considerations such as the girl’s personal development. — Dr. Jaya Sagade author of Child Marriage in India: Socio-legal and Human Rights Dimensions
During the medical camp for the Yenadi community, I remember seeing a large variety of health issues, from open and infected wounds as a result of trash picking, hair discoloration from malnutrition, and so much more. One thing that was apparent was the number of young pregnant women — some not even 20 years old — and the number of infants that were present in the area. It was difficult to fathom how these women carry, deliver, and raise their babies, often never seeing a doctor once in their lives.
▲ On July 26, 2024, a significant event unfolded in the town of Naidupet as Restoration Humanity and Society for Integrated Rural Development (SFIRD) collaborated to organize a pioneering medical and health camp specifically tailored for the Yenadis at Naidupet.
▲ The impact of the medical and health camp rippled through the Yenadi community, leaving a trail of positivity and gratitude.
As of 2021 there were 650 million child brides worldwide, each of those children at high risk of early pregnancy. This leads to the second highest cause of adolescent death during childbirth or pregnancy related complications (World Health Organization, 2024). Early marriage and adolescent pregnancy leads to a multitude of health dangers, whether it be increased risk of preeclampsia, internal ruptures, anemia, STDs, or overall increased maternal mortality. Furthermore, pregnant adolescents suffer increasingly with regards to malnutrition (Ribhu 2023).
Child marriage places a wall between people and healthcare. Since many are stuck working in low-paying jobs after marrying so early, getting access to health insurance becomes quite difficult. Many impoverished groups are isolated from main cities and as a result, access to medical resources becomes very limited. The addition of pregnancy-related complications and the lack of women’s health awareness only worsens that.
Child marriage doesn’t just have physical health effects — the mental consequences are great as well. With many of these children being sexually and physically abused, many mental health issues come with such early marriage and pregnancy. PTSD and suicidal thoughts are often a result of such conditions, and another cause of the loss of these children. Pregnant adolescents are also more likely to develop postpartum depression, due to their lack of physical and mental maturity and lack of support.
What’s being done: Judicial intervention on child marriage
The recent Indian Supreme Court case, Writ Petition (Civil) No. 1234 of 2017, Society for Enlightenment and Voluntary Action (SEVA) v. Union of India (UOI) discussed increased government action against child marriage. Many new programs and efforts were put in place to provide medical assistance for victims of child marriage.
This new ruling, emphasizes the provision of psychological aid in the form of regular support sessions and counseling. Psychological support groups will be implemented for at-risk youth in order to prevent the future generations from marrying early. Government actions like these are a huge step in getting poor communities healthcare, both mental and physical, and putting an end to the medical crises resulting from child marriage.
One of the many ways the Indian government has combatted this health crisis is through the issuance of Ayushman cards, which is a national public health insurance measure to provide free healthcare for low income earners. With poverty leading to lack of access to medical care as well as increased child marriage rates, providing underserved groups access to medical attention helps many families receive the care they need. Under this government initiative, people can visit health and wellness centers that are located closer to lower income communities to get more immediate care, including maternal and child health services.
These are some of the important directives issued during SEVA v. UOI, judgment date as of October 18, 2024 as listed in the Brief Pointers:
Children who are at risk of marriage at the hands of their family or relatives are expressly recognized as Children in Need of Care and Protection (CNCP). [Para 88]
The 2013 amendment to the Indian Penal Code (IPC) increased the age of consent under the rape provision from 16 to 18. However, the marital rape exception to the rape provision in Section 375 IPC continued to protect men for having sex with their minor wives. In [Independent Thought v. UOI (AIR 2017 SC 4904), the Supreme Court of India] removed the inconsistency and struck down the exception, so far [as] it related to minors. Further subclause (vi) of clause (d) if section 63 of Bhartiya Nyaya Sanhita 2023 prescribes the age of consent to be 18 years. [Para 80]
Healthcare providers, doctors, counsellors to be trained to address specific health risks associated with child marriage.
State authorities must develop and implement Individual Care Plans (ICP) for at-risk girl children, ensuring compliance with Section 10 of the JJ Act.
Relevant Ministries of Union Government to recommend allocation of a dedicated yearly budget for each state specifically aimed at preventing child marriages and supporting affected individuals.
What’s being done: Andhra Pradesh's state action on child marriage
According to the National Family Health Survey for 2019-2021 (NFHS-5), 23% of women aged 20-24 were married before the legal age. Among women aged 45-49, 47% were married below the legal age.
The state government of Andhra Pradesh has taken measures to ensure that this progress continues in years to come. In 2023, Child Marriage Prohibition Officers were appointed to assist in combatting the issue throughout the state.
The excerpts below list some of the duties of the Child Marriage Prohibition Officers:
Immediately act upon any information of the solemnization or proposed solemnization of any child marriage that may be received through any mode of communication, including in written or oral form i.e., through a letter, telegram, phone, e-mail, etc, or by any other means maintaining the confidentiality of the informant or source of information or suo-moto on any instance coming into his/her knowledge or reported in media and forthwith initiate all necessary action, including addressing the Police and Officers concerned.
Formulate concrete strategies for the identification, rescue, rehabilitation and reintegration of Victims of child marriages as well as follow up as per the provisions of Prohibition of Child Marriages Act 2006 & Juvenile Justice (Care & Protection of Children) Act 2015, 2021.
Activate the Child Welfare & Protection Committees ... in all the Schools in their jurisdiction.
Take all such measures as required to sensitize and promote awareness against child marriages and to prevent child marriage.
(The Andhra Pradesh Prohibition of Child Marriages Rules, 2023)
What’s being done: Collective community action on child marriage
▲ SFIRD staff conducted a Child Marriage Free India (CMFI) campaign at Chirala Govt. High School & Junior College and ZP High Schools in Bapatla on October 19, 2024.
▲ SFIRD staff, other leaders and speakers of the Child Marriage Free India campaign. Access to Justice Division of the Department of Justice, India furthers the cause of Justice, Legal Literacy & Legal Awareness.
To help close this gap between poor communities and healthcare, Society for Integrated Rural Development (SFIRD) and Restoration Humanity (RH) are working to provide the Yenadi community with monthly medical camps as well as to connect them to goverment-assisted medical care. This allows the people to receive care within their area without the need for travel. These medical camps also include health education, covering topics like personal hygiene and women’s and children's health in order to combat this health crisis.
Educating the community from a young age is key to helping spread a realization that child marriage doesn’t only prevent a bright future, but also can damage one’s physical and mental wellbeing. These children, as well as their families, need to realize that caring and investing in their health can ensure a longer more fulfilling life.
There is an old proverb in Tamil, a language that is spoken in the state of Tamil Nadu in India,and it says: எறும்பு ஊரக் கல்லும் தேயும் (erumbu ora kallum theiyum); which means: even an ant moving back and forth can carve a path into a rock. Likewise, a Child Marriage Free India is achievable; it will take a lot of persistence, support, effort and some frustrations notwithstanding. But like the ants, we will carve a path!
Patience and perseverance have a magical effect before which difficulties disappear and obstacles vanish. — John Quincy Adams
Thank you for being a part of this inspiring journey!
If you would like to know more: more.info@rhlife.org
To donate to Restoration Humanity: www.rhlife.org/donate
Sources:
All images used with written permission from Society for Integrated Rural Development.
Gausman, J., Kim, R., Kumar, A., Ravi, S., & Subramanian, S. V. (2024). Prevalence of girl and boy child marriage across states and Union Territories in India, 1993-2021: a repeated cross-sectional study. The Lancet. Global health, 12(2), e271–e281. https://doi.org/10.1016/S2214-109X(23)00470-9
Ribhu, Bhuwan. When Children Have Children. New Dehli, Prabhat Prakashan Books, 2023
Society for Integrated Rural Development. Child Marriage Free India,
Subiksha, P. and Kannappan, M. (2018). A Study on Child Trafficking in India. International Journal of Pure and Applied Mathematics, 119(17), http://www.acadpubl.eu/hub/
The Prohibition of Child Marriage (Amendment) Bill, 2021, No. 15/LN/Ref./June 2022 https://loksabhadocs.nic.in/Refinput/New_Reference_Notes/English/13062022_130250_10212057.pdf
UNFPA-UNICEF Country Profile: India (2020).
India Supreme Court; Society for Enlightenment and Voluntary Action v. Union of India, Writ Petition (C) No. 1234 of 2017
India Supreme Court; Brief Pointers on What all Supreme Court has said on the issue of Child Marriage in its recent Judgement. Dated October 18, 2024
The Andhra Pradesh Prohibition Of Child Marriages Rules, 2023
Jaya Sagade. Child Marriage in India: Socio-legal and human Rights Dimensions. Oxford University Press, 2nd ed. (2012) 41.
World Health Organization; Adolescent Pregnancy (2024) https://www.who.int/news-room/fact-sheets/detail/adolescent-pregnancy
The Andhra Pradesh Prohibition of Child Marriages Rules, 2023 https://www.crafap.org/wp-content/uploads/2023/06/G_O_Ms_No_31.pdf
National Family Health Survey (NFHS-5), 2019-2021; International Institute for Population Sciences https://dhsprogram.com/pubs/pdf/FR375/FR375.pdf
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