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Lack of education, unsupervised visits by older males, and superstition have all contributed.
LINGUEWAL, southern Senegal — During her pregnancy, 13-year-old Lama Sabaly would dream of someone crying, only to be shaken awake by her mother. The sobs she was hearing were always her own.
“I had a lot of thoughts running through my head, thinking about life,” Lama said. “I didn’t know what could make me pregnant. Only now do I know that being with a man gets you pregnant.”
In Lama's case, the man was married and in his 30s.
Lama lives in the Kolda region of southern Senegal which has impoverished villages known as strongholds of child marriage, where girls as young as 10 are given to men as brides. Though the practice is now largely declining, girls like Lama are part of an alarming, new trend rising from its ashes: teenage pregnancy.
Elementary school girls may not be married off, but they are still getting pregnant and health workers and families are struggling to cope.
“It’s wearing us out,” said community health volunteer Mahamadou Baldé, who runs the health post in Linquewal, a 600-person village, about 12 miles south of Vélingara.
“When a 13- or 16-year-old girl gets pregnant, she doesn’t have a husband. Her mother doesn’t have anything, her father either [and] the man, often a young man, who got her pregnant goes to Dakar. He leaves her all alone here.”
Despite youth talks he conducted, four girls in Linguewal's elementary school got pregnant last year, he said, shaking his head in discouragement.
Lama, now 14 and with a three-month-old son, was one of those four girls. She stayed in school, though most teen mothers drop out. She still dreams of going to university but is struggling to pass fifth grade.
Two of Lama's friends are already married, but her family, unlike most, had supported her desire to finish school. It made her pregnancy all the more devastating.
Lama’s fingers played over her lips as she talked, the tip of her index finger finding the dent above her upper lip. Once playful and open, she has become withdrawn. Though she stayed in school as her belly swelled, she was too ashamed to visit other compounds.
“People talk about you. It’s hard,” she said.
"The girls are ashamed,” Baldé said. “Rumors go around: Look at her, look at her face, she is pale, she is this, she is that. Girls try to push down their stomachs. They try to wrap them up tight.”
Lama didn't tell her parents until she was four months along. Though mad, they took her to the nurse in Kounkané, the road town 3 miles away.
“They only told me that the birth would be hard and that I had to go to the prenatal visits,” she said. “It was difficult. I had problems. I had labor pains starting Monday but didn’t give birth until Thursday.” After struggling to get to a rural clinic, Lama was about to be taken by ambulance more than 60 miles away to Tambacounda for a C-section when the baby came on its own.
Lama was lucky. It's estimated that nine women die every day from childbirth in Senegal. According to UNICEF, 401 women die for every 100,000 births in Senegal. That number is 11 in the U.S.
Though regional statistics aren't available, medical workers say the Kolda region is the hardest hit, largely due to women having babies too young and too close together.
Teen pregnancy in the villages is a complex, stubborn problem. Birth control is one solution, Baldé said, if only women would use it.
Senegal’s health ministry has organized talks with religious leaders in the region and launched education campaigns. An array of contraception methods — condoms, natural family planning, the pill, Depo-Provera shots — is accessible and affordable in health centers.
But a woman's husband will often forbid it, fearing it will encourage promiscuity, and young women are scared it will make them sterile if they haven't yet had a baby.
Older men, even teachers, having sex with minors is as big a problem as teenagers getting girls pregnant and then abandoning them, health workers say.
Some girls will intentionally get pregnant to avoid an arranged marriage to a man they don't like, and poverty motivates still other girls to trade sexual favors with men and boys for money, clothes or hair extensions, said Laura Massengale, a Peace Corps volunteer working extensively on teen pregnancy in her village of Foulamory, 7 miles outside of Vélingara.
“Their family members often turn a blind eye to this type of situation, to avoid the shame of discussing a taboo subject, or perhaps, sadly, to allow the girl to have this opportunity for funds,” Massengale said.
“Once the girls get in that situation, how many presents can you accept before you have to put out? And, at that point, can you negotiate a condom?” she said, noting that STDs, like gonorrhea, are also persistent problems.
In Lama’s case, it was chicken dinners. He would visit her compound and bring her meals. Maybe he was courting her as a second wife. It’s too late to know. He ran off to Dakar when she became pregnant, returning after the birth. Since then, he's been by once to see his son and give him his last name.
“The man ruined her,” villagers say of Lama.
Indignant, Lama's brother had blamed village elders for letting older men get away with impregnating minors, saying they were too superstitious, lazy or complicit to call the police.
"It's the men who deceive them,” Baldé said. “Men are so crafty. They contradict everything the health workers are saying. They tell the girls -- That's not true, if you don't do this you're not a good girl, or I'm going to ignore you."
"When you get pregnant like this,” Baldé said he tries to warn the girls, “you will have to stay here and marry a very poor farmer. If you get sick, he won't be able to take care of you.”
This month, Lama will take the exam that decides whether she can go to junior high. She is bright but has missed a lot of school, even with her mother and sister watching her son.
“I didn’t drop out of school because I wanted to learn. I wanted to know what would come in the future,” Lama said.
But Lama's future isn't much of a mystery. Odds are she will marry and have more children. Giving birth in Vélingara may have been the closest she'll ever come to leaving the village. Still, her favorite subject is geography.
“It’s important,” she said. “So you’ll understand, so you’ll know when you go there.”
This dispatch was updated to clarify information.
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