We need to do more to save our girls

Soila* is 15. She should be in school soaking up new knowledge and playing in the great outdoors and occasionally wondering when she will get home to listen to her favourite music. Instead, she is lying in the intensive care unit, an inch away from death, with tubes running out of every orifice. All this because of teenage motherhood, but the problem runs much deeper.

Soila has grown up in a culture that to date treats girls and women like property. One day while she was skipping happily in the plains with her friends on her way to the local school, her father was talking to a 57-year-old village elder on her suitability as his fourth wife.

Unbeknown to Soila, the deal was struck and a ceremony arranged, and for the second time in her life, she was to suffer untold trauma. Just a year before, she had undergone the female genital cut. Gripped by terror and wearing an ashen face, Soila squatted with her peers as her innocence was cut off by a rusty blade amidst thundering applause.

 She was lucky to have survived physical injury without the infection and complications that usually accompany female genital mutilation. And like most children do when faced with trauma that they don’t know how to deal with, she buried the memory in the deep recesses of her mind and tried to live a normal life, but not for long – a few bony cows changed hands, so Soila left everything she knew and became the wife of a man old enough to be her grandfather.

Fourteen months later, she went into labour. When labour set in, the traditional birth attendant who was no less menacing than the woman who had cut off her genitals several months earlier, was by her side. To say Soila went through torture would be a gross understatement.

When she got to hospital, she was in a coma, all swollen up, with eyes sealed shut and lips caked with dry blood. Her unborn baby was still in the womb, but he was no more. She had a caesarean section to remove the baby, whose body had already started to decompose. Soila was battling sepsis, high blood pressure and kidney failure. It was a wonder she had survived the ordeal. She had laboured for over 26 hours and due to the absence of monitoring, her elevated blood pressure was not picked up and she was only taken to a nearby health centre when she started convulsing.

TRAUMATISED GIRLS

The midwife who received her sprang into action, started emergency care and initiated the referral process to the health facility where we were. Specialists battled to correct her physiologic derangements, brought about by the high blood pressure, organ failure and sepsis. She would require dialysis for several weeks as her battered kidneys attempted to recover. A brain scan showed her coma was a result of brain swelling. She was terribly lucky to escape a stroke.

Medicine alone was not going to do it for her. We all prayed and rooted for this little girl to make it. It took five days for us to see a ray of hope.

Soila progressed from fluttering her eyelids, to breathing on her own and eventually was discharged from the intensive care unit amid cheers from the team. However, she was terrified. She had no comprehension of what she had just been through. She was in a strange place, surrounded by strange people and was no longer pregnant. She asked about her baby and we all squirmed. Nobody had the courage to break the news to her.

Along with the grief of mourning her baby, Soila had to deal with a new problem. She had developed a vesico-vaginal fistula (VVF), an abnormal connection between her bladder and her vagina, that led to constant leakage of urine. Her physical recovery was progressing well but her emotional and psychological health was in the doldrums.

How did a 15-year-old child come to carry such an overwhelming burden? Child brides are right here in our midst. While the rest of us “civilised” Kenyans go about our lives without a care, some of our harmful cultural practices continue to claim the lives of our children.

We have fought hard to prevent neonatal deaths and improve child health for those under five, significantly bringing down the grim numbers through immunisation, improved nutrition, improved hygiene and sanitation and treatment of childhood illnesses. However, we are not yet paying enough attention to the six to 18-year-old age set. The disadvantaged adolescent girl from a poor socio-economic background in the city slums, the orphaned rural girl who lost her parents to HIV and the girl in the rural community who is still subjected to harmful cultural practices have all happened under our watch.

Soila is a good example of why girls under 18 should not be getting pregnant. Young age is a well-recognised risk factor many life-threatening pregnancy complications. We didn’t work so hard to keep her alive as a child, to callously toss her aside in teenage.

Interventions needed to prevent teen pregnancy must be employed, whether we like them or not. Law enforcement must step up its campaign in prosecuting those marrying off children. Sexuality education among the children must happen. If providing contraception for sexually precocious teens is what it takes, let’s do it. Pious outrage will mean nothing when a girl is dead!