India Fights Tuberculosis with Technology

The Indian government has increasingly used technology to aid its fight against tuberculosis (TB). By using biometric and mobile technology, it has been able to better ensure that patients take their proper treatment. This mitigates the risk of spreading the disease and developing into multi-drug resistant TB.

For a disease that kills more than 270,000 people in India and a few million worldwide in other countries, developments in the fight against TB have been slow to come. The vaccine that is currently being used to prevent TB is more than 85 years old and is only effective against certain strains of the disease in children. The most widely used diagnostic test was created 125 years ago and misses half the cases. It also cannot detect strains of TB that are resistant to drugs.

India passed a law in 2012 that made TB a notifiable disease, which means that doctors are required to report an infected person to the government. To make the process easier, the government has rolled out a program called Nikshay in private and public hospitals. Nikshay is an electronic reporting unit that uploads case files and treatment processes onto a single database across the country. This makes it easier to track people who have contracted the disease and ensure that they are taking the proper treatment.

In some places, Nikshay has been compounded with Aadhar, a biometric identification system that was rolled out a few years earlier. Aadhar gives every Indian citizen a unique number that is linked to a biometric card. Coupling the data in Nikshay and Aadhar improves monitoring and evaluation, and makes payments easier as Aadhar can also be linked to a bank account.

Treating TB is a long and complicated process. Estimates show that fighting TB can amount to 39% of a household’s annual expenditure. An infected person needs to take 13-17 pills daily for six months. If he stops his treatment before the proper time, he runs the risk of developing multi-drug resistant TB, a more virulent and difficult-to-treat form of the disease.

Some state governments in India have begun to use the SIMpill, which was originally implemented in South Africa a decade earlier, to ensure that the treatment process is completed correctly. It gives patients pre-programmed medicine bottles that are able to monitor whether pills are taken at the right time in the right amount. Each time the bottle’s cap is opened the central server is notified. If there is a discrepancy or a missed dosage, the patient and caregiver receives a reminder text message on their phone.

In another innovative use of mobile technology, some states have rolled out the Mobile Technology for Community Health program, which sends patients SMS reminders about appointments, treatments and health tips. The central government has also initiated the Missed Call Campaign, in which a person can give a toll-free number a missed call and have someone call them back to answer their questions.

Sources: Gates Foundation, Gizmodo, MOTECH, Global Health Strategies
Photo: The Hindu


Controversial Land Acquisition Amendments Promulgated in India

Last month, the President of India promulgated the controversial Right to Fair Compensation and Transparency in Land Acquisition, Rehabilitation and Resettlement (Amendment) Ordinance despite massive public opposition. This means that even though the bill outlining the amendments has not yet passed in India’s Upper House to legally become a law, its content would still be enforced. Multiple farmer organizations have collectively filed a Public Interest Litigation (PIL) against the ordinance, labeling it as “unconstitutional” and an unchecked exercise of executive power.

The bill amends various aspects of the Right to Fair Compensation and Transparency in Land Acquisition, Rehabilitation and Resettlement Act of 2013, which replaced the colonial-era Land Acquisition Act of 1894. The aim of the amendments is to facilitate development projects with greater ease by expediting land acquisition.

But many argue that the amendments violate property rights of vulnerable communities and risk exacerbating economic and social woes. While the 2013 Act made the consent of at least 70-80% of landowners mandatory for a project to be carried out, the new amendments no longer require any level of consent for projects that are for national security and defense, rural infrastructure, social infrastructure, industrial corridors and housing for the poor.

The amendments also no longer mandate a Social Impact Assessment (SIA) to be carried out for these five types of projects or any Public-Private Partnership (PPP) project if the government owns the land. Opponents of the amendment fear that the categories exempt from the consent and SIA requirements are so broad that nearly all land development projects can be carried out without them.

The new amendments also weaken the previous Act’s provision that decreed land be returned to its original owners if it remained unused for more than five years after its purchase. As a report of the Comptroller and Auditor-General of India on Special Economic Zones found last November, land in India is often left undeveloped for long periods of time.

Opponents also criticize the amendments for increasing government officials’ immunity against prosecution. In the old Act, the head of the department that carried out the project would be responsible for any mismanagement or wrongdoing. Now, the head of the department and other civil servants are protected from prosecution until the government gives courts its permission to proceed.

The Modi government, which is behind the amendments, has defended them by asserting that they will attract foreign investors. Land acquisition laws for foreign companies have been riddled with red tape and slow bureaucracy. The World Bank rates India 142 out of 189 economies for ease of doing business. Many companies have dropped their investment plans after just a few years because of these impediments.

But lingering concerns remain about the government’s ability to carry out any provision of either the 2013 Act or its amendments. Indian bureaucracy is riddled with corruption, impunity and mismanagement. An estimated 75% of displaced people since 1951 are still awaiting rehabilitation. Many have not been given their due compensation.

Sources: The New Indian Express, The World Bank, One Law Street, One Law Street (2), The Weekend Leader, The Hindu
Photo: The Wall Street Journal

Effects of Open Defecation in India

The extent of open defecation in India presents a major health and safety issue. Worldwide, there are one billion people who do not have a toilet, and Indians make up 60 percent of this number. Of this 60 percent, the majority comes from rural areas. Activists and the government have advocated for the building of shared community toilets as a solution to the problem, but ingrained social norms and attitudes stop people from using them.

The government launched the Swachh Bharat Mission last year, which promises 110 million toilets built in the next five years in an effort to make India an “open defecation free country.” In an added bonus, the waste collected would be converted to fertilizer and other forms of energy. Lauded as a “sacred mission” that would coincide with the 150th anniversary of Mahatma Gandhi’s birth, this mission has gained approval from almost all sections of the government and society.

But most people from rural areas have shown an unwillingness to discontinue their habits of open defecation even if they are given toilets. Many people who already have toilets in their house forgo its use in favor of defecating in the open. In 40 percent of households that had a toilet, at least one member chose not to use it at all. They believe that defecating in the open is more natural and healthy, and that building a latrine in the house brings impurity to it. The two thousand year old Hindu text, called the “Laws of Manu,” encourages open defecation.

Community toilets also have the added problem of being—by nature—shared, and people from different castes, religions and economic status are not willing to use the same toilet, even if they come from the same village.

However, open defecation practices remain a huge health and safety risk, and issues will only increase as India’s population grows. There have been hundreds of cases of women being raped as they leave their homes after dark. In one notorious case, two women from Utter Pradesh were raped, murdered and hung on trees after they were defecating in an open field.

India’s dense population also means that even in rural areas, human feces are not easily kept away from fields, wells and food. Bacteria and worms in feces are often accidentally ingested. This results in a range of health problems from diarrhea to enteropathy, a chronic sickness that prevents the absorption of calories and nutrients. Many specialists believe that the problems open defecation causes are the reason 50 percent of Indian children are malnourished.

A government study comparing Muslim and Hindu households supports these conjectures. The study found that 25 percent fewer Muslim families defecated in the open and also had lower child morality rates than Hindu families—even though Muslims in India are poorer and less educated than their Hindu counterparts. In the few areas where more Muslims defecated in the open than Hindus, they had higher child morality rates.

Social norms and habits need to be changed if open defecation is to be successfully fought. Simply building more toilets will not do the job. The government has already taken some steps to educate people about the dangers of open defecation and reward those who use latrines. In Haryana for instance, it launched the “No Toilet, No Bride” campaign that urged women to only marry men whose home had a toilet.

Sources: Scroll, Government of India, The Economist, BBC,
Photo: Siasat

Cleaner Cookstove Technology Fails to Take Off


The Poverty Action Lab (PAL), a research organization from MIT, carried out a project that implemented new, environmentally friendly cookstoves for 2,600 households in Orissa, India. Each household contributed a small amount of money to pay for the building of the stove and was given training on its proper use and maintenance. Although the initial take up of the technology was high, families were only cooking 1.8 meals a week on the new stove three years after its implementation. Most had reverted to using their old cookstoves, commonly called chulas.

Indoor air pollution caused by chulas is the second largest health risk in developing countries, after unclean water. Over 70% of all households in India use them. Chulas burn cheap fuels such as firewood, coal or cow manure and create particle matter concentrations of 20,000 micrograms per cubic meter; the recommended limit is just 50. For the people who are around them — mainly women and young children — it is like smoking several packs of cigarettes a day. They cause 2 million deaths in India annually.

The new cookstoves were promoted as a cleaner alternative to traditional stoves that would save families from mental hardship and health expenditures. They would also make them more productive, as adults and children would miss fewer days of work and school. Finally, the stoves were advertised as being more cost-effective as they used less fuel and more time-effective because they decreased cooking times.

Medical checkups three years into the PAL study showed that because they were rarely used, introducing these stoves to poor households even at a very low cost did nothing to change health effects. High levels of blood pressure, a tendency to develop coughs and poor infant health remained the same. People showed the same risks of developing lung cancer, cardiovascular diseases and respiratory diseases.

In addition to causing health problems, chulas cause environmental damage. Worldwide, three billion people use them, or four out of every ten people. They collectively release 6 billion kilograms of CO2 into the atmosphere. That is triple the amount of the daily emissions from all private cars in the United States.

The main issue that seems to have stopped people from using their new stoves was that they required a lot more maintenance, and their unfamiliarity with the technology was an impediment to carrying out repairs. Households reported that they spent hours getting their stoves fixed and cleaning newly added chimneys. Their old way of cooking was easy to use and never broke. Moreover, it was familiar, so people were more inclined to revert back to it when their new stoves exhibited problems.

While the new cookstoves perform well in laboratories and have the potential to drastically decrease health and environmental effects, their effectiveness depends on them actually being used. India launched a National Biomass Cookstove Initiative (NCBI) in 2010 and plans to install 2.5 million cookstoves by 2017. Moreover, Hillary Clinton helped start the Global Alliance for Clean Cookstoves (GACC), which aims to install 100 million cookstoves by 2020. Both the NCBI and GACC would do well to conduct long-term studies before spending millions of dollars in initiatives that have little to no impact.

Sources: National Geographic, The Washington Post, Poverty Action Lab 1, Poverty Action Lab 2, Boston Globe, Ministry of New and Renewable Energy, Global Alliance for Clean Cookstoves
Photo: The Washington Post

Narmada Dam Estimated to Cause Further Environmental and Humanitarian Disasters

A recent study carried out by a team of experts and political figures found that increasing the height of the Narmada dam in India would submerge a much larger amount of land than had been officially estimated. Team member Soumya Dutta, an environmentalist and energy expert, warned that it would lead to a humanitarian disaster “worse than the Nepal earthquake”.

Last year, the Gujarat state government had approved a height increase of the dam from 122 to 139 meters provided that people whose lands would be flooded were compensated and rehabilitated (their consent to the increase was not taken into account). The new study’s findings call for a re-evaluation of the number of people that would need to be recompensed. When the dam was first contextualized in 1999 it was planned to be only 88 m high. Multiple Supreme Court rulings over the years have allowed a series of height increases, to the dismay of activists.

India’s long-contested Narmada Dam raises troubling conundrums for anti-poverty advocates. The dam is the second largest in the world after the U.S. Grand Coule Dam. It has provided drinking water, irrigation water, electricity and flood protection to thirty million people in drought-prone and underdeveloped areas. The government has lauded it as a steppingstone that would lift millions of people out of poverty.

But the dam has also inundated 37,000 hectares of forest and agricultural land, disrupted the river’s ecology and repeatedly flooded surrounding areas during the monsoon season. People who depend on this land and river are from India’s poorest and most discriminated against communities- Dalits, or untouchables, and tribals. Hundreds of thousands have been displaced without their consent and given neither adequate compensation nor rehabilitation.

Annie Raja, another member of the research team and general secretary of National Federation of Indian Women, emphasized that large-scale corruption and mismanagement surrounds the dam project. Rehabilitation sites often have no water, electricity, schools or hospitals. Thousands of families have received no compensation at all so far.

But the Supreme Court of India ruled in 2000 that the benefits of the dam “are so large that they substantially outweigh the costs of the immediate human and environmental disruption”, citing a ratio of 100:1 of beneficiaries to affected people. It maintains the position that sacrifices have to be made for development- whether people agree to them or not.

Through the troubled history of the Narmada Dam, activists have argued that the long-term so-called benefits of the dam do not stand up to scrutiny. Degrading the environment exacerbates food insecurity. Intensifying the plight of India’s most vulnerable people deepens inequality and makes it harder for them to climb out the poverty trap. Turning a deaf ear to people’s concerns weakens democracy.

Moreover, dams do not last forever. Eventually, reservoirs silt up, and huge amounts of money go towards maintaining them. Some dams have to be removed altogether after a few decades. More than a thousand dams have been taken apart in the last century in the U.S. alone. Reservoirs are also hugely detrimental to the environment. Worldwide, they account for an astounding 4% of all human-made climate change. The resulting fluctuations in weather patterns are highly detrimental to those who depend on the land for their livelihood.

Since the 1980s, the Narmada Bachao Andolan, or Save Narmada Movement, has carried out mass protests and hunger strikes. Activists have refused to leave areas there were to be flooded. This grassroots pressure forced the International Monetary Fund (IMF), which was lending money to the Indian government for the dam’s construction, to conduct a review of the project. It decreed that it did not meet its environmental and resettlement guidelines and withdrew its loans in 1993. While the Indian government has managed to raise money from other sources to cover the costs of the dam, the same concerns remain.

The controversy surrounding the dam raises more philosophical questions about India’s future. As Arundhati Roy, a famous Indian author and winner of the Booker Prize, asks, who owns this land; who owns its rivers- the government or the people who live off it? Can the lives of people be pushed through a cost-benefit analysis machine for the sake of overall “development”? Should the environment be sacrificed to help secure to livelihood of millions of people?

Sources: Indian Supreme CourtUnited NationsScrollBusiness StandardThe Greater Common Good by Arundhati RoyInternational Rivers

Smartcards Reform India’s Corruption-Plagued Social Program

The biometric Smartcard, with its secure payment infrastructure, has the potential to revolutionize India’s corruption-plagued NREGA (National Rural Employment Guarantee Act of 2005) program. NREGA is the largest government workfare program in existence, covering 800 million people or 11% of the world’s population. It aims to improve conditions in India’s poverty-stricken rural areas by guaranteeing villagers a hundred days of paid labor a year. But widespread fraud and serious flaws in management divert an astounding 85% of the program’s funds away from intended beneficiaries, according to studies by the Poverty Action Lab.

In 2010, Andhra Pradesh, a state in southern India, began giving Smartcards to its NREGA-eligible population of 19 million in an effort to combat wasteful spending. Although the program does not yet cover the entire state, successes documented by the Poverty Action Lab have been inspiring so far. The time passed between working on a NREGA project and receiving payments fell by 29%, and the money people received increased by 24%. Beneficiaries further benefited by having to pay less in bribes.

The state’s government now directly transfers NREGA payments to a recipient’s Smartcard, circumventing corrupt middlemen. These Smartcards include the person’s photograph and contain a chip holding his biometric and bank account information. Beneficiaries collect their money after biometrically authenticating their identity, usually through fingerprinting.

Studies show that using Smartcards would save Andhra Pradesh $32.8 million annually by plugging financial leakages, and a further $4.3 million every year through the time saved by both workers and officials. The Smartcard program is therefore highly cost-effective- implementing the entire system took only $4.1 million.

Unsurprisingly, more than 90% of users prefer the new Smartcard program. Under the previous system, officials regularly over-reported owed payments to the government and under-paid workers, pocketing the extra money themselves. Less than 4% of workers could regularly access the labor provided by NREGA because of inept local administration. Even if they did manage to secure employment, payments were so unreliable that people were sometimes driven to commit suicide.

Smartcards are a “game changer for governance”, said Palaniappan Chidambaram, the former finance minister of India to the BBC. The federal government currently spends 7.9% of its budget on financing NREGA. The use of Smartcards has the potential to eliminate wasteful spending and free up funds to help the 179.6 million Indians living below the poverty line- 20.6% of the world’s poor, according to the Brookings Institution- at no extra cost.

Press Freedom in India Threatened by Corporatism

January 1, 2015

rajdeep sardesai and sagarika ghose
Rajdeep Sardesai and Sagarika Ghose

Narendra Modi’s election as India’s prime minister brought hope to millions. He was heralded as the forger of India’s new path, one that would bring prosperity, efficiency and, at the very least, less corruption, after a disastrous decade of Congress Party rule. Newspapers commented excitedly that government officials had finally started to come to work on time. But Modi’s election is not all sunshine and rainbows- his growing influence over the media industry through his friend and benefactor, Mukesh Ambani, has serious implications for India’s freedom of press.

Ambani, India’s richest man and owner of Reliance Industries Limited (RIL), India’s second-largest publicly listed company, announced in 2012 that it would be investing in Network18, one of India’s largest news organizations. Network18’s stock prices had been falling dramatically over the last few years; like many other media companies around the world, it was suffering from downsizing and cutbacks. RIL seemed to be its savior.

But as Rahul Bhatia reports from Caravan Magazine, an investigative journal, the RIL’s ownership of Network18 had pressured its news channels and magazines to bias the Modi over his contender, Rahul Gandhi. An independent think tank in Delhi, the Centre of Media Studies, found that CNN-IBN, an affiliate of CNN and a channel under Network18, covered Modi for an average of 72 minutes while it covered Gandhi for only a measly 18 minutes. Although other channels had also spent more time covering Modi, CNN-IBN’s coverage was much more disproportionate.

Raghav Bahl, the founder and managing director of Network18, had apparently asked Forbes India’s editors whether they “really needed to” continue covering stories on RIL. The editors began to question Bahl’s open support of Modi; according to Pankaj Mishra, writer for Bloomberg, Bahl had transformed “major news channels and websites into propaganda outlets for Narendra Modi and his right-wing Bharatiya Janata Party”. Mishra’s article also underlined the fact that Ambani gained $800 in a single day after exit polls declared Modi the winner. He compared Ambani’s domination of the media to that of Silvio Berlusconi’s.

After RIL’s acquisition of the Network18, both Rajdeep Sardesai, widely respected editor in chief of the IBN18 Network, and Sangarika Ghose, deputy editor of CNN-IBN, resigned. As reported by the Times of India, Sardesai wrote in a letter to his employers: “Editorial independence and integrity have been articles of faith in 26 years in journalism and maybe I am too old now to change!” Freedom House downgraded India’s press freedom score this year, citing “increased interference in content by media owners in the run-up to the 2014 elections”.

The Telecom Regulatory Authority of India (TRAI), an independent organization mandated by the government, underlined in its 2014 report that there had been a marked increase in the “corporatization of media, desegregation of ownership and editorial roles, and decline in autonomy of editors/journalists”, and remarked that its concerns had been echoed by both the President of India, Pranab Mukherjee, and Vice-President Hamid Ansari. TRAI recommends that the government impose more stringent ownership restrictions on corporations entering the media industry.

India’s democratic institutions are severely flawed in countless ways. But the presence of a free media has played a significant role in helping India evolve in the right direction. For my project, I would like to monitor corporatism in the media in India since Modi’s rise to power and determine its effect on the freedom of press and democracy. Indians have been willing put the past behind them and overlook Modi’s troubling role in the 2002 Gujarat Riots, but such plainly anti-democratic behavior in the run up to the highest office in the country is highly troubling for India’s democratic future. People often call Indira Gandhi’s imposition of a state of emergency the darkest time for press freedom since India’s independence. But Modi’s election might also be the onset of a new dusk.

Child Marriages in India: An Acceptable Form of Human Trafficking

cmarriage2 (1)

Although the International Center for Research on Women reports that it has almost 40% of the world’s child marriages, India has decided against co-sponsoring a UN human rights council resolution aimed at eliminating child, early and forced marriages. The government has given the unconvincing explanation that the resolution’s vague definition of “early marriage” prompted this response- even though India’s laws, which defines a child as someone below 18 years, are in line with the UN’s definition. Whatever the reason, be a desire to avoid scrutiny or pessimism about reaching the resolution’s goals, India’s gesture reveals its inability to seriously tackle child marriage for what it is- a form of human trafficking.

India’s long history of child marriage has dulled both Indians and the rest of the world to its atrocities. Akshay Tritiya, sometimes called “Child Marriage Day”, is an auspicious event still celebrated every year in which multitudes of girls are married off by their parents. In most of rural India child marriage is commonplace and viewed as normal. More urban areas see it as a troubling tradition that will be eradicated naturally alongside modernization and economic development. However, neither perception accurately reflects the reality of child marriage. Child marriage is not only forced marriage, it is also displays many of the characteristics of human trafficking. But while human traffickers face harsh penalties in India, laws against child marriages range from non-existent to minimal.

A child bride is a victim of forced marriage because she is unable to give her consent as a minor. Like a victim of human trafficking, she is usually stuck with her fate for life, experiences mental and physical abuse (including forced labor and sex), and lacks opportunities because of her poor health and education. She has no possibility of being free. The Palermo Protocol, a UN convention to eliminate trafficking of women and children, states human trafficking as:

“…the recruitment, transportation, transfer, harboring or receipt of persons, by means of…the abuse of power or of a position of vulnerability or of the giving or receiving of payments or benefits to achieve the consent of a person having control over another person, for the purpose of exploitation. Exploitations shall include…sexual exploitation, forced labor or services, or slavery or practices similar to slavery…” (Palermo Protocol 2000).

The parts of this definition that apply most to forced marriage are underlined. Child marriage can be divided into the two halves of human trafficking: coercion, which occurs before the marriage, and exploitation, after the marriage. Both violently desecrate the fundamental human rights of women and children.

In a study published by Gender and Development, Ouattara et al show that coercion takes place before the marriage, where the girl’s parents “abuse their power” by imposing a marriage on their daughter, who, being young or powerless, is “in a position of vulnerability”. The US Bureau of Consular Affairs published an informational flyer on forced marriages that states that a girl who refuses the marriage set up by her parents often faces “isolation and threats or acts of physical and emotional abuse”. “Benefits” to the girl’s parents would include not having to pay for her ‘upkeep’ (important if they are facing poverty, as the majority of Indians are) and ensuring that they do not face social stigmatization if the girl decides to marry outside her caste or have pre-marital sex.

When the girl’s parents hand her over to the groom and his family, there is always dowry money involved, fulfilling the “giving or receiving of payments” part of the definition. In fact, the younger the girl is, the lower the dowry will be. This encourages parents to marry off their daughter as soon as possible. The fact that most victims of child marriage come from poverty-stricken backgrounds where the girl-child is always seen as a burden and neither the parents nor the child have had an education exacerbates the problem.

The “transfer, harboring or receipt” of the victim occurs when the girl moves to her husband’s house after marriage. Here, her husband and in-laws now have complete control over her actions. This control is compounded if the bride is still a child. This control leads to “sexual exploitation, forced labor or services”.

Once the girl is married, her exploitation begins, and it can take many forms. Rape is one of the most devastating. Just by definition, sexual intercourse within a forced marriage is rape because the woman did not consent to the marriage itself. Data from the 2013 ICRW report shows that sex within a child marriage, where the groom is often many years older and the girl is a minor, is even more devastating. But more generally, sex within forced marriages tends to be especially abusive as compared to normal marriages. Women who get married as minors are three times more likely to experience sexual abuse and PTSD.

The study by Ouattara et al shows that that the age group of 15 and below has the second highest vulnerability to sexual abuse. The most vulnerable are the girls whose dowry had already been paid in full. This points to a disturbing commodification of the girls- once they had been paid for, their husbands can use them any way they wanted to. Girls married at a very young age are often forced into having sexual intercourse even before the onset of menstruation, which is terribly painful. In about half the cases of marital rape, the girls made their husbands aware of their unwillingness to have sex because of the pain. In 80% of these cases, the rapes continued unabated.

The ICRW 2013 report reveals  that the treatment of the girl within a forced marriage extends to other forms of physical abuse. Women married as children are two times as likely to be beaten, slapped or threatened by their husbands. India has one of the highest rates of domestic violence in the world, and the highest for women under 18. Renuka Chowduhury, junior minister for the Ministy of Women and Child Development, said that 70% of women in India suffered from domestic violence at some point in their lives.

Child marriages to much older men occur often, and they contribute to the abusive power dynamics. The 2009 UNICEF study shows that women who marry at a younger age are also more likely to believe that it is acceptable for a husband to beat his wife. Husbands are not the only ones who abuse the girls, however. Members of the husband’s family often abuse the girl themselves.

As Ouattara et al’s study demonstrates, it is hard for the girl to get help because she is often socially isolated and cannot turn to other family or friends. Once married, she is often cut off from society because she is overburdened by domestic and family responsibilities. This isolation, according to the Ministry of Women and Child Development, “poses a host of challenges that limit [the girls’] ability to promote their health, development, and well-being”. Child brides have much less of a chance to be educated, come into contact with government organizations or NGOs, or to own any assets- in short, anything that helps them be more independent.

Finally, the health risks associated with forced marriages are disturbingly high, and are especially prevalent among child brides. The 2009 UNICEF report show that child brides have a much higher chance of contracting HIV because their partner is usually an older man with more sexual experience. Low condom use exacerbates the presence of HIV and other STDs. Moreover, childbirth is another health risk for both the mother and child. Girls younger than 15 are five times more likely to die in childbirth than are women 18 or older. If they do survive, they suffer from anemia and malnutrition, and their babies are less likely to live.

Taking into full consideration everything that a girl being forced into marriage has to go through, there seems to be little doubt that a victim of child marriage is a victim of human trafficking. Simply because child marriages are much more socially accepted does not mean that the law should delve out any less of a punishment for child marriages than for human trafficking.

But the laws in India concerning forced marriages are disturbingly inadequate and under-enforced. There is no specific law prohibiting forced marriages per se, although the Bureau of Consular Affairs states India does at least recognize it as a violation of fundamental human rights. India has, however, passed the Prohibition of Child Marriage Act in 2006. Legally, marriage can only take place if the man is 21 and the woman is 18- but the maximum sentence for someone participating in and helping to organize a child marriage is just two years.

More troubling is that some laws the government has passed are actually detrimental to the child bride. Although the girl has the opportunity to annul her marriage by the time she is 20, her marriage will automatically become valid once she passes this age. Ouattara et al’s study shows that this closes the window on an easy annulment of the marriage and encourages families to simply “wait it out” until it is too late.

In terms of sexual abuse, the law is severely lacking. It explicitly states that sex within marriage is not rape. It only recognizes marital rape if the girl is 15 years old or below. However, the man is only punished if the girl is 12 years old, and even then with only two years of imprisonment. In contrast to these flimsy and antiquated laws, the laws concerning human trafficking are much more severe. Anyone even taking part in human trafficking might be sentenced a minimum of 7 years to a maximum of life imprisonment.

Forced marriages in India, of which child marriages make up the majority of cases, should be criminalized as harshly as human trafficking. They display many of the same characteristics of human trafficking, but are not given the same importance because it is a social norm. Passing harsher laws would increase the risk of forcing women and children into marriage. The girl would also have more of a reason to come forward if her marriage could still be annulled after she turned 20, or if she were sure her husband would go away to jail for a much longer time. Also, stronger laws against marital rape would help prevent them.

Overall, more severe forced marriage laws serve to underscore the seriousness of this issue. People in India should no longer accept forced marriage and what goes on in it as normal. The Palermo Protocol must also reflect this reality. It should recognize that a girl who is forced to marry is stuck with her fate for life, experiences mental and physical abuse (including forced labor and sex), and lacks opportunities because of her poor health and education. She has no possibility of being free. This girl is a victim of human trafficking.