The country is racing against time as world clocks tick towards Sustainable Development Goals (SDGs) deadlines on ending child marriages and poverty. JAMES CHAVULA writes.
It is 8am in Karonga. Beads of sweat racing down Paramount Chief Kyungu’s nose say it all. It is a sunny Wednesday morning. The supreme leader of the Ngonde has defied the shoreline district’s sweltering heat to hit the ground literally running and walking nearly 12.5 kilometres (km) from his royal residence to campaign for elimination of child marriages and teen pregnancies that worsen maternal deaths and poverty in the country.
“It’s not every day you see a Kyungu running like a boy, but I’m fighting a good cause,” the supreme ruler of Karonga and Chitipa says.
The two-hour walk from his Kasoba residence to Karonga town amplifies his certainty that girls must not only complete basic education but also go all the way to university and be what they want.
To Kyungu, the deadline for SDGs, which President Peter Mutharika and world leaders adopted last year, is drawing closer.
“We can win the struggle to eradicate early marriages and lessen maternal deaths by 2030 if only we commit to this cause,” he asserts.
There are no bragging rights for his long walk. Pregnant women from the rice-growing countryside travel longer distances to give birth at the hands of skilled health workers at Karonga District Hospital.
Six month, six deaths
Puffing, wiping out profuse perspiration, the grey-haired chief, who had admittedly never walked as long for almost 40 years, wants Malawians to unite to bring down intolerable figures of pregnant women who die giving birth in homes and on the way to hospitals.
“For the past six months, six lives have been lost,” said district health officer Dr Charles Sungani in February,
His office registered 13 deaths in 2014 and 11 in 2015, a toll reflective of the country’s high maternal mortality rates as almost 675 women and children die in every 100 000 babies born alive.
“Women in labour often come late to see skilled health workers as some have to travel up to 30km to reach the nearest clinic. Most of the health centres are located along the main road, the M1. Far-flung communities are denied health services,” he said.
Adolescent girls account for the majority of the deaths and complications in what remains one of the worst maternal mortality rates in Southern Africa.
Kyungu declares war on those rushing girls into marriage, ordering security agents: “Arrest all who marry girls aged under 18, even the teachers, police officers and health workers. Lock them up, giving me the keys and I will throw them in the lake.”
Child marriages and teen pregnancies put the adolescent girls at a high risk of maternal complications and deaths. In fact, birth-related conditions are leading causes of death among older adolescents in developing countries and the teens face higher rates of obstetric fistula, a devastating injury that can occur during an obstructed labour.
According to Foundation for Community Support (Focus) executive director Kossam Munthali, women and girls keep dying because healthcare facilities are few, far apart, under-funded and ill staffed.
Christian Aid has assisted Focus, which has been working with locals to eliminate risky practices that make childbirth and child survival risky in rural contexts, with K1.3 billion for improving the health of mothers and children.
The new deal will partly improve structures and service provision in some of 19 health centres in Karonga, Munthali says.
“More women are realising the importance of giving birth at the hands of skilled health workers. To overcome maternal and neonatal deaths, there is need to ensure reliable healthcare services are available closer to where Malawians live and to ensure girls stop marrying before they are ready for pregnancy,” he reckons.
Focus has worked with Kyungu and all traditional leaders in Karonga to put in place bylaws for safeguarding children, girls and pregnant women. The traditional leaders face fines as high as K50 000 for failing to clamp down on harmful cultural practices and women giving birth in risky settings or at the hands on unskilled birth attendants.
According to Sungani, girls getting pregnant before the legal marriage age of 18 exert immense pressure on the district where six women have died walking to the hospital since July.
The sector is sagging due to rapid population growth, shortage of skilled health workers, high disease burden and on-off drug supply.
“Ending adolescent pregnancies would lessen the pressure on the healthcare budget and greatly reduce maternal deaths,” Sungani indicates.
A good cause
United Nations Population Fund (UNFPA) report, Marrying Too Young, indicates one in two Malawian girls marry before their 18th birthday.
Minister of Health Dr Peter Kumpalume says: “It is shocking that children are being born to fellow children as young as 13. At 30, some of girls are already grandmothers.”
He thanks traditional leaders, including Kyungu, for championing the race against child marriages.
“If you are fighting a good cause, you don’t do it half-heartedly. We will not win the fight to end child marriages and neonatal deaths unless we work together and put all our energy in it,” he says.
According to Karonga district youth officer Kondwani Neba, the girls get pregnant as early as 10 due to risky sexual behaviour propelled by the lure of high money circulation associated with fishing, cross-border trade, sex work and long-distance trucking in the border strip,
Equally hazardous are traditions that induce girls to marry too young to give birth safely—and many quit school too prematurely to contribute effectively to break away from the vicious cycle of poverty in which almost three in four Malawians are trapped.
Lobola, for example, prompts some poor households to marry off school girls in exchange for cattle in the name of strengthening ties of newlyweds’ families.
However, Kyungu’s territory is notorious for kupimbila as some parents use their daughters as surety for debts—authorising well-to-do men to marry the girls regardless of age.
Kyungu warns against such violations of girls’ rights: “Don’t sell the future of underage girls for any sum of money.”