Making the Difference Between Life and Death
Ms. Swapna MAJUMDAR (India)
The number of girls enrolled in Bohramal middle school in Sitamarhi district in the Indianstate of Bihar outnumbers that of boys. But these numbers don’t tell the real story. By the time
girls reach Class 8, their absence becomes conspicuous due to the high prevalence of earlymarriage.
Sitamarhi, which shares its geographical borders with Nepal on one side, is among the moresensitive districts in Bihar. Not only is it known for its high rates of migration, but also for its
vulnerability to cross-border and inter-state trafficking. The district with the highest HIV
prevalence rate in the state, Sitamarhi is plagued by a high incidence of early marriage, thus
exacerbating the vulnerability of adolescents.
According to the teachers of the school, all the girls who had passed out of Class 8 in 2015 hadbeen married off by their parents. “Early marriage was a big challenge,” said Vinita Kumari, amiddle school teacher. Kumari, who has been teaching Classes 6-8 for the last five years, statedthat the marriage of all the girls who had passed out of Class 8 last year was not seen as anythingout of the ordinary as it was part of the culture in the village. This also meant that most of them
did not continue studies.
Gulaichi Kumari, a young 14-year-old student of Class 8 at the Bohramal middle school got
married at the end of March this year. In April, her friend, 16-year-old Pinky Kumari, also inClass 8, followed her example. Neither girl was sure that they would be able to study further
although they wanted to. But at least they made it to Class 8. Anuradha was unable to do eventhat. Anuradha, a student of Class 7, got married in the first week of March, 2016. She had no say
in her marriage. An orphan, she lived with her relatives and was not given any choice in thematter. She has also dropped out of school.
Official statistics state that the school dropout rate is very high among marginalised groups,
especially adolescent girls (66%). The National Family Health Survey (2015-2016) reveals that inSitamarhi 50.5% of the women aged between 20 and24 have gotten married before 18, and 11.7%
of women aged between 15 and19 were already mothers or pregnant at the time of the survey.
When early marriage is coupled with a lack of sexual and reproductive health information,
girls are unable to escape the vicious circle of having too many children, too quickly. The likelihoodof girls aged between 10 and 14 dying in pregnancy and child birth is five times higher than that ofwomen aged between 20 and 24. An estimated 6,000 adolescent mothers die every year in India.
Further, children born to teenage mothers and mothers under the age of 20 years are much more
likely to die in infancy than children born to mothers above the age of 20.
However, the presence of women like Sadhna, a community service provider, is making thedifference between life and death.
When Sadhna Kumari, a government accredited health worker working in Belsand block in
Sitamarhi district, found that the pregnant 16-year old daughter-in-law of her neighbor had given
birth at home, she rushed to their house although it was late in the night. Unfortunately, the child,
weak and born prematurely, did not survive. In Sitamarhi, 106 children die for every 1000 live
births, according to government statistics.
Although Sadhna was deeply saddened by their loss, she took the opportunity to convince themother-in-law that she would not insist on another grandchild until her young daughter-in-law
recovered physically and mentally. In fact, Sadhna extracted a promise that they would wait for atleast three years before the next baby. By this time not only would Pinky, her daughter-in-law,turn 19 and be better prepared for motherhood, it would also reduce risks of infant mortality.

Over the next three years, Sadhna kept a constant watch over the family. She also provided
reproductive and sexual health information as well as contraceptive pills so that Pinky could plan
her family and delay motherhood. In January this year, Sadhna’s hard work bore fruit when Pinkygave birth to a healthy girl at the local primary health centre.

Bohramal girls