III. Impact of Child Marriage on Women and Girls
Child marriage violates a range of human rights recognized under international law. These include: the right to bodily integrity and to be free from violence—as girls may experience verbal, physical, and psychological violence at the hands of spouses and their families and their own families; the right to education—which child marriage interrupts or ends; the right to decide when and who to marry; and the right to health.
Violence
A World Health Organization multi-country study on women’s health and domestic violence found that younger women, particularly those aged 15–19, and those with lower levels of education faced a higher risk of physical or sexual violence at the hands of a partner in almost all the countries studied, than older and more educated women.[68] Research suggests that spousal age difference is also a risk factor- associated with violence and abuse, including marital rape.[69]
Child marriage creates an environment that increases young brides’ vulnerability to physical, sexual, psychological, and economic abuse. Because early marriage limits young married girls’ knowledge and skills, resources, social support networks, mobility and autonomy, they often have little power in relation to their husband or his family.
In addition, the large age gap between child brides and their spouses makes them less able to negotiate when and how sex takes place in a marriage, including safer sex and family planning.[70] In South Sudan, a married girl or woman often leaves her maternal home to live with her husband and his family. Power and authority in the home is customarily held by men and older women, and this can place young married girls at greater risk of abuse and violence.[71]
Violence to Force Girls to Marry
As this report shows, girls who try to resist early and forced marriages may suffer brutal consequences at the hands of their families. In cases documented by Human Rights Watch, girls were physically assaulted and verbally abused. In some cases, they were held captive and even murdered by their families.
Aguet N. married in 2003 at the age of 15. She told Human Rights Watch that she was in school in year five and wanted to finish her education, but her uncles beat her and her mother to force her to marry a 75-year-old man:
This man went to my uncles and paid a dowry of 80 cows. I resisted the marriage. They threatened me. They said, “If you want your siblings to be taken care of, you will marry this man.” I said he is too old for me. They said, “You will marry this old man whether you like it or not because he has given us something to eat.” They beat me so badly. They also beat my mother because she was against the marriage.
Families also coerce girls into marriage. Anyier D., 18, told Human Rights Watch that her family forced her to marry a 40-year-old man when she was 14. She said,
I wanted to say no, but they cursed me. They really cursed me saying, “If you refuse to get married to this man you will never find happiness in your life for you will never have a home and you will be barren.”[72]
Eleven girls told us that their families restricted their movements after they became engaged. Atong G., 18, was engaged in July 2011 against her will. She was living with her parents because her husband-to-be has not completed paying the dowry of 70 cows asked for by her family. She told Human Rights Watch,
I am now confined at home. My family does not allow me to leave home because they think I will get another man…. I don’t even go to the market anymore or see my friends.[73]
Girls Murdered for Resisting Forced Marriages
Girls who refuse to accept or stay in forced marriages, or who elope because they want to marry someone not chosen or approved of by their families, are often at risk of violence and in extreme cases, may be killed by their families or husbands. Although this aspect of gender-based violence is not well documented, local women’s rights activists and media reports indicate that there may be many cases of murder that go unreported, especially amongst pastoralist communities that pay dowry in cows.[74]
Local women’s rights organizations pointed out to Human Rights Watch that society is generally tolerant of such violence because the girl is seen as having gone against her family’s wishes and societal norms.[75] As a result, perpetrators are rarely held to account, perpetuating a culture of violence against women in the country.
Samuel Dem, senior inspector in the Directorate of Alternative Education, told Human Rights Watch about a girl who was killed for refusing to marry a wealthy old man:
The girl was 17 years old and studying in Rumbek East County in Lakes State. The father decided to give her in marriage to an old man who had … 200 cows. The old man had never spoken with the girl. In our area, people don’t even inform the girl [if they want to marry her]. So the old man went and asked her family. Her family went to the cattle camp and saw the 200 cows. In the evening, they told the girl, “We want to hand you over to this man.” The girl refused. She said, “I don’t know this man. I have never spoken to him, and he is not my age.” Then some young people took the girl to a nearby forest. They tied her to a tree and beat her up until she died. There are so many other stories. [76]
Suicide
Girls who do not wish to marry or who want to escape forced marriages may also be at risk of suicide. Dem told Human Rights Watch that he is aware of cases of girls who have killed themselves “because they are forced to marry someone that they don’t love.” He said, “I am from Lakes State, and I know of so many such cases. There are also many cases like this in Warrap and Jonglei.” [77]
Girls who are forced into marriage suffer great emotional pain. Agata N. told us about her sister’s tribulations after she was forced to marry a boy who had made her pregnant:
My sister is having problems because she is married to a man she doesn’t love and the man doesn’t love her. She got pregnant and was chased to that boy. He doesn’t support her. The child doesn’t even look healthy. They don’t talk. Sometimes he doesn’t sleep at home. He doesn’t show concern when the child is sick. My sister says she might kill herself.[78]
Violence in Marriage
The majority of girls and women interviewed by Human Rights Watch said that they were abused by their husbands after the marriage. They told us that they were beaten and verbally abused for not being good at house chores, for not conceiving, for asking for financial support, or questioning their husband’s fidelity. Eight told us that their husbands kept them from contacting their family or friends, going to the market, or looking for a job. Other girls complained that their husbands constantly accused them of being unfaithful, slept at the homes of other women, or brought other women home.
Kolong K., 30, married at the age of 16. She told Human Rights Watch that she faced many problems in her marriage because she was young and did not know how to run a home:
I did not know anything about marriage when I got married. The man [husband] used to fight me all the time because I was unable to do the house chores. Sometimes he would fight me if I went to visit my lady friends. I liked to play football with other girls. I would go to play and be late to make food and he would beat me. We still fight. It has never stopped.[79]
Aguet told us that her husband also physically abuses her. “My husband beats me because he says I am not working for him well,” she said.[80]
Married girls may also suffer abuse by elder co-wives and other relatives. Alek P. guesses she is 16. She told Human Rights Watch that her uncles forced her to marry a 45-year-old man who already had a wife. She said,
The first wife is strong in the house. She saw me as an enemy and she did not accept me. She was harassing me all the time and even beat me, so I left.[81]
Christina G., 13, said she got married to escape from her alcoholic and violent parents. She now faces violence from her husband and father-in-law:
My husband is a casual worker but he does not support us. He is not at home a lot of times and does not tell me where he goes. If he comes home and does not find food, he quarrels and beats me. I tell him I don’t have money to buy food and he asks why I cannot go to the bush like other women to collect greens and cook them. But I don’t know what greens to get. Sometimes I even sleep hungry. I cry a lot and I regret why I got married.
I live with my husband’s family. My father-in-law also quarrels [with] me about lack of food in the house and says his son married a lazy woman. I sell firewood to make money. Sometimes I get two or five pounds in a day and sometimes I don’t sell. At home I had problems, and here I have more problems. I will persevere in the marriage as I have nowhere to go.[82]
Some of the girls and women interviewed said that their husbands did not allow them to leave home, or to visit friends. Gloria C., pointing to a scar on her right hand below the elbow, told us,
My husband told me not to go to the market, visit friends or my relatives. If I did, he would quarrel [with] me and beat me. One time he was beating me and the wood broke and got into my hand.[83]
Marital rape is common in South Sudan, although, as earlier noted, it is not recognized in law. Seven of the girls whom Human Rights Watch interviewed said their husbands had forced them to have sex. Ageer M. told us her husband raped her, aided by his brothers:
I had refused to have sex with him, but he forced me. My brothers-in-law used to lock me up in the house during the day so that I don’t go anywhere, and so that I can have sex with him.[84]
Margaret B. told Human Rights Watch that her husband physically, emotionally, and sexually abused her. She said,
I had fibroids and was in a lot of pain. Sex was painful. If I told my husband I had pain, he would get out shouting that he was going to look for sex elsewhere because I had refused him. Sometimes he would have sex with me anyway.[85]
Leaving Violent Marriages
Victims of early and forced marriages may be unable to leave abusive marriages because of economic pressures, lack of family support, and other social circumstances, worsening their vulnerability. Ayen C., 21, told Human Rights Watch that she married at 14:
My in-laws were abusing me saying, “We have given out our cows for you and you are not producing.” My husband was also complaining that he had wasted his cows on me and I could not give him children. He talked with bitterness, always complained, and sometimes was verbally abusive. I was very sad, very stressed. I had nowhere to go. I could not go to my father because it is him who had forced me to get married. I decided to stay even if it meant dying in the home. Even if he had been beating me, I would have stayed because in our culture people stay in marriages with problems.[86]
Penina W. spoke about her abusive marriage and her difficulty getting help:
After a few months of getting married, he became very different. He did not allow me to go out to the market or to visit my friends and relatives. If he saw me talking to my friends, he got upset and quarreled or beat me. I could not talk to friends whom I knew before marrying him, and this was making me very sad. Life was very difficult for me. I told my uncle about these problems and he said since I am married I should take care of my problems. I went to the headman and the headman told me to go back to my husband and sort out our problems.[87]
Limited Literacy, Access to Education
My father refused me to go to school. He said it is a waste of money to educate a girl. He said marriage will bring me respect in the community. Now I have grown up and I know that this is not true. I cannot get work to support my children and I see girls who have some education can get jobs.
—Mary K., Yambio County, March 7, 2012
The 2008 Child Act and Transitional Constitution (articles 14 and 29) provide for the right to free and compulsory primary education for all citizens without discrimination, including on the basis of gender, among other grounds.[88] It states that no child shall be subjected to exploitative practices or abuse, harmful to his or her education, health or wellbeing.[89]
Child marriage frequently interrupts girls’ education or deprives them of it altogether. Most of the girls and women interviewed—43 out of 61— who had attended school, left after three to five years of primary education. Mary K., from Yambio County, said,
My father refused me to go to school. He said it is a waste of money to educate a girl. He said marriage will bring me respect in the community. Now I have grown up and I know that this is not true. I cannot get work to support my children and I see girls who have some education can get jobs.[90]
The Ministry of Education told Human Rights Watch that they do not collect data on the number of girls who drop out of school to get married or due to pregnancy.[91] However, the director general for education in Western Equatoria State said that despite the lack of statistics, “from what we see in schools, drop-out rates due to marriage and pregnancy are very high.”[92] A head teacher at a school in Bor County, Jonglei State, told us,
Parents sometimes don’t allow girls to attend school. There are very many girls dropping out because of marriage. Dropout rates are very high once they reach teenage years, especially between ages 15 and 17. I have not seen many that drop out to stay at home. Most drop out to get married.[93]
Out of the 61 girls interviewed who had been in school, 39 told us that they had dropped out to get married. Fourteen had dropped out due to pregnancy.
According to Alfred Lodiong, deputy director of the Directorate of Gender Equity and Social Change, part of the Ministry of General Education, Juba,
Parents sell their girls. They don’t value education; they value cows. The question is how to make them understand that education is more valuable than cows.[94]
Some parents keep girls out of school, especially after they have reached puberty, for fear that schooling may expose them to risks of premarital sex and pregnancy that would decrease their chances of getting married or fetching a high dowry upon marriage. One woman told us, “Sometimes a girl becomes big in school and boys start noticing her. Bad things can happen, so it is better she gets married.”[95]
There are also fears that education makes girls “strong headed” or less traditional so that they do not make “good” wives. A member of a group of elders that we interviewed about their views on girls’ education, told us,
Education is not good. It brings much freedom to the woman, and she will not listen to you. You can even lose a woman you have married with so many cows because of education.[96]
Human Rights Watch interviewed 15 girls who were married and in school attending alternative education programs. However, the majority of girls we spoke to had dropped out of school and said it was difficult to continue school after marriage or becoming pregnant. Some of the reasons given by girls were lack of money to pay school fees, lack of child care and unavailability of adult classes, or the need to do chores. Others said that their husbands would not allow them to continue school after marriage alleging that they were unfaithful if they insisted on going to school.
Atong G. told us, “I was going to school in class five. I stopped school after getting engaged because my husband said other men will see me.[97]
Those girls and women who had not returned to school after marriage said they regretted not being able to complete their education. Akur L., 19, was married at the age of 13 in 2003 and dropped out of school. She told Human Rights Watch,
My uncles forced me to marry a man who was old enough to be my grandfather. I was going to school and in class six. I liked school. If I was given a chance to finish school, I would not be having these problems, working as a waitress and having separated from my husband.
Akur said she wanted to return to school but there was no school for adult learners in her area of Jonglei state.[98]
Anyier D., 18, told Human Rights Watch that her uncles forced her to leave school in 2008 to marry an old man she did not know. She was 14, and in class one. She said,
I would wish to return to school even if I have children. People think that I am happy but I am not because I don’t have an education. I don’t have something of my own and I am only cleaning offices. If I had gone to secondary school, I would get a good job.[99]
The girls and women interviewed by Human Rights Watch who had returned to school following pregnancy or marriage enjoyed learning and appreciated the benefits that would come with having an education. Penina W., 21, told Human Rights Watch why she decided to return to school:
I stayed with my husband for four years but because I did not conceive, he became distant and abusive. The fifth year he chased me away. I got another boyfriend who is the father to my young boy. But he has refused to marry me or take care of the child. I stay with my younger sister and my child. My sister finished senior three and got a job. So I decided to return to school so that I can also get education and get a job.[100]
Penina completed primary school and passed her final examination. She plans to go to secondary school, although she said she did not have the school fees or someone to look after her baby while she goes to school. She is cultivating food crops that she sells and uses the money to buy food and save for her school fees.
Denial of the Right to Full and Free Consent to Marriage
If someone comes in the right way and asks for the hand of the girl in marriage, we can give out the girl. The problem is when she decides on her own to get married to someone who is not chosen by the family.
—Chief Akech Malek, Bor County, March 14, 2012
The Transitional Constitution gives women the right to consent to marriage, but this legal provision is largely symbolic.[101] As testimonies in this report show, girls are commonly forced by their families to marry.
Generally, child marriage involves the imposition of a life-long partner on children. Child marriage is also considered forced marriage since children are not legally capable of giving free, full, and informed consent to marriage.[102]
In terms of international law, older children have the right to participate in decisions about whom and when they marry as soon they have the maturity to understand the implications of their decisions.[103]
But no matter what their age, children’s traditionally low status in many African societies and well-entrenched cultural beliefs undermine their ability to oppose the wishes or opinion of a parent, guardian, or elder. Some families in South Sudan coerce or force girls into marriage and use violence, threats of death or being cursed, or the need to protect family honor and family well-being.
Almost all the girls we interviewed, including those aged 17-18, told Human Rights Watch that they had been forced into marriage; and that no one had asked for their views on whether they wanted to get married or to the chosen person.
Furthermore, many of the girls we interviewed told us that no one had explained to them the responsibilities that come with marriage, including issues around sexual relations, childbirth and childcare, and other family obligations.
Rosa B. married before she had reached puberty. She told Human Rights Watch,
I did not know what is involved in marriage. I had been hearing other women talking about having sex between men and women when they are married. I was scared of having sex for the first time. I was not ready for it.
Rosa said when she asked her elder sister about what to expect in marriage, she advised her, “to provide whatever my husband says, and to respect and obey him and his relatives because he had paid dowry for me.”[104]
Penina W., 21, married at 14 and is separated from her husband. She said,
I did not know anything about what it means to be married. I got married because I was hoping that the man will support me because I was suffering at home.[105]
Health Consequences
Early marriage contributes to violations of the right to health.[106] It puts girls at greater risk of dying or ill-health as a result of early pregnancy and childbirth.[107] Their children also face higher mortality rates.[108] These increased risks are not only related to age, but also to girls’ low levels of education, low social and economic status, and lack of access to health related information and services.[109]Household responsibilities and other factors that may cause stress and anxiety may further aggravate the negative outcomes of pregnancy.[110]
When they are physically more mature, girls have a better chance of surviving pregnancy and are able to better care for their children. [111] Studies have also shown that girls who continue their education, especially until completing secondary school, are more likely to invest in their own children’s education, enabling future generations to become economically independent and positive contributors to society . [112] On the other hand, children of young and illiterate mothers tend to face their same cycle of childhood deprivation and abuse. [113]
Obstetric Fistula
Early marriage is a major risk factor for fistula development—a devastating childbirth injury that leaves its victims with urine and/or fecal incontinence that causes infection, pain, and bad smell, and triggers stigma and the breakdown of marriages, loss of employment, and challenges in family and community life.
The risk of obstetric fistula is heightened by young married girls’ poor socio-economic status, and lack of education and access to appropriate reproductive and maternal health care. However, studies show that physical immaturity is the key risk for girls under 15[114] because their pelvises are not fully developed and thus susceptible to obstructed labor—the main cause of fistula.[115]
About 5,000 girls and women in South Sudan suffer from fistula each year. [116] A doctor at Juba teaching hospital told Human Rights Watch that although the hospital lacks accurate fistula statistics, they see many cases of teenagers with obstructed labor, not only from Juba but other states in the country. [117] “I see many girls who come here with obstructed labor. You know their bodies are still young,” a midwife at a government hospital in WES told us. [118]
Victoria J. married in 2009 at 14, and became pregnant shortly thereafter. She said,
I started labor in the morning on a Friday…. The nurse kept checking and saying I will deliver safely. On Monday she said I was weak. The doctor decided to operate on me. At operation they found the baby was dead. The doctor said the baby had died due to the long labor. After that I found out that urine was coming out all the time.[119]
Limited Access to Contraception
A midwife at a government hospital told Human Rights Watch that it was difficult to offer family planning services to women because many husbands want their wives to continue having children. She told us,
It is very difficult to offer family planning services to women. Sometimes husbands come and complain that their wives are not giving birth because we are giving them family planning. Even some of my colleagues don’t want to do it because of this intimidation.[120]
Margaret B. told Human Rights Watch that her husband forced her to stop using contraception although she was not ready to have another child:
After the third child I used an injectable contraception. My husband allowed me to take it two times then he refused saying that he wanted another child. I was not ready. I had just had surgery to remove fibroids. But he is my husband and I had to obey him. So I stopped the injection and that is when I got pregnant with my fourth child. I had many problems with the pregnancy.[121]
Limited Access to Health-Related Information, Inability to Make Healthcare Decisions
Many of the girls we interviewed lacked accurate reproductive health knowledge. We spoke to some girls who displayed a lack of basic knowledge about sexuality and contraception, while others said they did not have this knowledge before getting married.
Girls told us they did not discuss sex with their parents, and those that had been to school said they did not receive sex education. Gloria C. said she got pregnant at 14 or 15. “I didn’t know that I would get pregnant by having sex,” she said. “I was just playing sex.”[122]
A nurse in Western Equatoria State commented about this issue in her community:
Girls here are very sexually active. They say they are “playing” sex (South Sudanese common expression for sexual intercourse). But they have very little information about pregnancy and contraception.[123]
Human Rights Watch interviewed 10 girls who told us that they became pregnant after their first sexual encounter. All believed that they would not get pregnant because it was their first time. All of them said they did not have information on family planning and contraception. Other girls who were married also told us they did not have this information.
Young married girls also have limited ability to make decisions about their health and that of their children. They are relatively powerless in their families, and often lack the autonomy, information, and economic means to access contraception and other reproductive health care. Violence and discrimination in the home may also limit their uptake of reproductive and sexual health services, even in cases of emergency.
Rosa B., 20, thinks she married at the age of 12. She told Human Rights Watch that she gave birth to her first child at home because, “My husband refused me to go to the hospital. He told me there is an old woman who helps other women and I will use her.”[124] Rosa said that after delivery, her right leg was paralyzed and she could not walk well for two months. She told us that her husband sought traditional treatment for her although she kept asking him to take her to the hospital.
Christina G. is also not sure of her date of birth but says her mother told her she is 13. She told Human Rights Watch that they live near a hospital, but when she went into labor,
My husband refused me to go to hospital. I labored at home for three days with a traditional birth attendant before he agreed to take me to hospital. The doctor said my body was too young. He operated on me to remove the baby.[125]
Mental Health Consequences
Child marriage deprives girls of their childhood and adolescence, a time necessary to develop not only physically, but emotionally and psychologically. It burdens them with adult responsibilities for which they are unprepared, including those related to marriage and childbearing. The practice curtails girls’ freedom and denies them the chance to develop their intellect and independent identities.[126]
Early marriage can have profound psychological health consequences for girls, particularly younger girls, and these consequences may impact women throughout their lives. Early marriage inflicts great emotional stress on girls who are forced to move from their parents’ home to that of their husband and in-laws, who are strangers to them. They are obliged to have sexual relations, although many might not be fully developed physically and emotionally.
As discussed, young married girls may suffer social isolation and restricted freedom of movement. They may have few options to socialize and participate in public life, and experience feelings of worthlessness, depression, and suicidal thoughts. [127] They are expected to take on household chores and care for children and families while themselves children. They are denied access to education, and often lack support when faced with marital problems.
Many of the girls and women interviewed said they were unhappy in their marriages and regretted having been married early. Many broke down crying during the interviews when they recalled the suffering they had endured in the forced marriages, and their lost opportunities for happiness and personal development.
[68] WHO, “Multi-country Study on Women’s Health and Domestic Violence against Women: Initial Results on Prevalence, Health Outcomes and Women’s Responses: Summary Report,” 2005, http://www.who.int/gender/violence/who_multicountry_study/summary_report/summary_report_English2.pdf (accessed February 15, 2012), p. 8. The multi-country study found that in all the countries studies, except Japan and Ethiopia, girls in this age bracket were more vulnerable to physical and sexual abuse by a partner, non-partner, or both, than older women.
[69] Robert Jensen and Rebecca Thornton, “Early Female Marriage in the Developing World,” Gender and Development, July 2003, vol. 11, no. 2, pp. 9-19.
[70] IPPF, “Ending Child Marriage,” p. 11; Robert Jensen and Rebecca Thornton, “Early Female Marriage in the Developing World,” pp. 9-19.
[71] ICRW, “Too Young to Wed: Education & Action Toward Ending Child,” 2005, http://www.icrw.org/files/publications/Too-Young-to-Wed-Education-and-Action-Toward-Ending-Child-Marriage.pdf (accessed June 12, 2012), p. 11. See also, Robert Jensen and Rebecca Thornton, “Early Female Marriage in the Developing World,” Gender and Development, pp. 9-19.
[72] Human Rights Watch interview with Anyier D., Bor County, March 15, 2012.
[73] Human Rights Watch interview with Atong G., Bor County, March 15, 2012.
[74] For some media reports on such cases, see “South Sudan’s Human Rights Commission Condemns Forced Marriages,” Sudan Tribune, March 8, 2011, http://www.sudantribune.com/South-Sudan-s-human-rights,38222 (accessed January 31, 2012); Manyang Mayom, “Lakes State: Girl Killed in Forced Marriage Dispute,” Sudan Tribune, February 11, 2011, http://www.sudantribune.com/Lakes-state-Girl-killed-in-forced,38046 (accessed January 31, 2012); Paan Luel Wël, “International Women's Day: Promotion of our Women Rights vs. Preservation of Our Cultural Heritage,” Sudan News Agency, March 15, 2011, http://www.southsudannewsagency.com/opinion/articles/international-womens-day-promotion-of-our-women-rights-vs-preservation-of-our-cultural-heritage (accessed January 31, 2012).
[75] Human Rights Watch interviews with local women’s rights organizations New Sudan Women's Federation and Skills for South Sudan, Juba, April 2012; Statement by High Commissioner for Human Rights Navi Pillay, May 11, 2012, http://www.ohchr.org/en/NewsEvents/Pages/DisplayNews.aspx?NewsID=12148&LangID=E (accessed February 12, 2013).
[76] Human Rights Watch interview with Samuel Dem, senior inspector, directorate of alternative education, Ministry of General Education and Instruction, Juba, September 9, 2012. Lakes State is inhabited mainly by the Dinka ethnic group, a pastoralist community who value cattle a lot. Dowry for the Dinka is paid mainly in cattle.
[77] Human Rights Watch interview with Samuel Dem, senior inspector, directorate of alternative education, Ministry of General Education and Instruction, Juba, September 9, 2012.
[78] Human Rights Watch interview with Agata N., Juba County, March 19, 2012.
[79] Human Rights Watch interview with Kolong K., Rokon County, March 22, 2012.
[80] Human Rights Watch interview with Aguet N., Bor County, March 15, 2012.
[81] Human Rights Watch interview with Alek P., Bor County, March 15, 2012.
[82] Human Rights Watch interview with Christina G., Yambio County, March 8, 2012.
[83] Human Rights Watch interview with Gloria C., Yambio County, March 7, 2012.
[84] Human Rights Watch interview with Ageer M., Bor County, March 15, 2012.
[85] Human Rights Watch interview with Margaret B., Yambio County, March 7, 2012.
[86] Human Rights Watch interview with Ayen C., Bor County, March 15, 2012.
[87] Human Rights Watch interview with Penina W., Yambio County, March 7, 2012.
[88] Transitional Constitution, art. 29 (1).
[89] Ibid., art. 17 (1d).
[90] Human Rights Watch interview with Mary K., Yambio County, March 7, 2012.
[91] Human Rights Watch interview with Michael Jalom, director general for education in WES, Yambio County, March 12, 2012.
[92] Ibid.
[93] Human Rights Watch interview with Jacob Malual, head teacher at Mamer Primary School in Kohlnyang, Bor County, March 14, 2012.
[94] Human Rights Watch interview with Alfred Lodiong, deputy director, Directorate of Gender Equity and Social Change, Ministry of General Education, Juba, September 10, 2012.
[95] Human Rights Watch interview with Rebecca Deng, community member, during a focus group discussion with women in Bor County, March 14, 2012.
[96] Human Rights Watch interview with Chief Mandit Ber during a focus group discussion with chiefs and elders, Bor County, March 14, 2012.
[97] Human Rights Watch interview with Atong G., Bor County, March 15, 2012.
[98] Human Rights Watch interview with Akur L., Bor County, March 15, 2012.
[99] Human Rights Watch interview with Anyier D., Bor County, March 15, 2012.
[100]Human Rights Watch interview with Penina W., Yambio County, March 7, 2012.
[101]Transitional Constitution, art. 15.
[102] UNICEF Innocenti Digest, “Early Marriage: Child Spouses,” No. 7, March 2001, http://www.unicef-irc.org/publications/pdf/digest7e.pdf (accessed April 20, 2012), p. 4.
[103] Article 12 of the Convention on the Right of the Child notes that States parties shall assure a child who is capable of forming his or her views the right to freely express those views in accordance with the age and maturity of the child. CRC, art. 12. However, there are challenges in determining the age a child should be before he or she can ‘consent’ fully and freely to marriage and sexual relations, and with full understanding of the implications of such a union, including the risks of underage marriage. See, UNICEF Innocenti Digest, “Early Marriage: Child Spouses,” No. 7, March 2001, http://www.unicef-irc.org/publications/pdf/digest7e.pdf (accessed April 20, 2012), pp. 9-11 for a discussion on the difficulty of determining full and free consent to marriage for different categories of children under the age of 18.
[104] Human Rights Watch interview with Rosa B., Yambio County, March 9, 2012.
[105] Human Rights Watch interview with Penina W., Yambio County, March 7, 2012.
[106] According to the World Health organization, reproductive health and rights, “… implies that people are able to have a responsible, satisfying and safe sex life and that they have the capability to reproduce and the freedom to decide if, when and how often to do so. Implicit in this are the right of men and women to be informed of and to have access to safe, effective, affordable and acceptable methods of fertility regulation of their choice, and the right of access to appropriate health care services that will enable women to go safely through pregnancy and childbirth and provide couples with the best chance of having a healthy infant.” WHO, “Reproductive Health,” undated, http://www.who.int/topics/reproductive_health/en/ (accessed October 20, 2012).
[107] Poor health remains a significant problem in developing countries. It was estimated that 287 000 maternal deaths occurred worldwide in 2010. WHO et al., Trends in Maternal Mortality, 1990-2010,” p. 1.
[108]Young mothers are less likely to get prenatal care and often do not have enough information about proper nutrition while pregnant to nurture themselves and babies. Babies born to young mothers run a 30 percent increased risk of dying during their first year of life. Babies may have a low birth weight as a consequence of their mother’s poor nutritional status while pregnant, and babies with low birth weight are 5 to 30 times more likely to die than babies of normal weight. See Population Action International, “How Family Planning Protects the Health of Women and Children,” May 1, 2006, http://www.populationaction.org/Publications/Fact_Sheets/FS2/How_Family_Planning_Protects_the_Health_of_Women_and_Children.pdf (accessed March 12, 2012), pp. 1-2; Nawal M. Nour. “Health Consequences of Child Marriage in Africa,” November 2006, http://wwwnc.cdc.gov/eid/article/12/11/06-0510_article.htm.
[109] WHO and UNFPA, “Married Adolescents: No Place of Safety,” 2007, http://whqlibdoc.who.int/publications/2006/9241593776_eng.pdf (accessed October 2, 2012), p.22.
[110] Save the Children, “State of the World’s Mothers: Children Having Children, 2004” May 2004, http://www.ungei.org/resources/files/SaveTheChildren_SOWM_2004_final.pdf (accessed October 10, 2012) p. 14.
[111] The organization Save the Children has found that higher levels of education also contribute to an increased use of contraception and reduced rate of infant mortality. Save the Children, “Women on the Front Lines of Healthcare: State of the World’s Mothers, 2010,” http://www.savethechildren.org/atf/cf/%7B9def2ebe-10ae-432c-9bd0-df91d2eba74a%7D/SOWM-2010-Women-on-the-Front-Lines-of-Health-Care.pdf (accessed April 11, 2012), p. 32.
[112] UNICEF, The State of the World’s Children,” p. 64; UNICEF Innocenti Digest, “Early Marriage: Child Spouses,” No. 7, March 2001, http://www.unicef-irc.org/publications/pdf/digest7e.pdf (accessed April 20, 2012), p. 16.
[113] UNICEF Innocenti Digest, “Early Marriage: Child Spouses,” No. 7, March 2001, http://www.unicef-irc.org/publications/pdf/digest7e.pdf (accessed April 20, 2012), p. 16.
[114] Ibid. p. 12.
[115] The term obstructed labor indicates a failure to progress due to mechanical problems such as a mismatch between the size of the presenting part of the fetus and the mother’s pelvis. Some mal-presentations such as a brow presentation or a shoulder presentation will also cause obstruction. Pathological enlargement of the fetal head and ineffective uterine contractions may also obstruct labor. These different causes of difficult labor may co-exist. J. P. Neilson et al., “Obstructed Labour: Reducing Maternal Death and Disability during Pregnancy,” British Medical Bulletin, vol. 67 (2003), pp. 191-204; Nawal Nour, “An Introduction to Maternal Mortality,” Journal of Obstetrics and Gynecology, vol. 1, no. 2 (2008), pp. 77-81; and WHO, “Obstetric Fistula: Guiding Principles for Clinical Management and Programme Development,” 2006, http://www.endfistula.org/webdav/site/endfistula/shared/documents/publications/who_obstetric_fistula.pdf (accessed September 15, 2012), p.3.
[116] Ibid.
[117] Human Rights Watch interview with Dr. Mergani Abdalla Mohamed, Juba Teaching Hospital, March 17, 2012.
[118] Human Rights Watch interview with a senior midwife at Yambio state hospital, Yambio County, March 8, 2012.
[119] Human Rights Watch interview with Victoria J., Yambio County, March 8, 2012.
[120] Human Rights Watch interview with a senior midwife at Yambio state hospital, Yambio County, March 8, 2012.
[121] Human Rights Watch interview with Jane F., Yambio County, March 8, 2012.
[122] Human Rights Watch interview with Gloria C., Yambio County, March 7, 2012.
[123] Human Rights Watch interview with a senior midwife at Yambio state hospital, Yambio County, March 8, 2012.
[124] Human Rights Watch interview with Rosa B., Yambio County, March 9, 2012.
[125] Human Rights Watch interview with Christina G., Yambio County, March 8, 2012.
[126] UNICEF Innocenti Digest, “Early Marriage: Child Spouses,” No. 7, March 2001, http://www.unicef-irc.org/publications/pdf/digest7e.pdf (accessed April 20, 2012), p. 12. As mentioned earlier in the report, girls in South Sudan are considered ready for marriage when they reach puberty. A significant number of girls interviewed by Human Rights Watch were married before the age of 15. The CRC covers everyone up to age 18 and regards childhood as a process of development – one that does not end with a definitive physical maturity marker.
[127] Population Council, “Understanding Sex Without consent Among Young People: A Neglected Priority,” Brief no. 7, July 2007, http://www.popcouncil.org/pdfs/TABriefs/PGY_Brief07_NonconsensualSex.pdf (accessed September 12, 2012), p. 3.









