LOS ANGELES, CA (Catholic Online) - The head of the reproductive health department at the ministry of public health Sadia Fayeq Ayubi says that while early marriage of girls younger than 16 years is illegal, girls as young as 13 are frequently married, often to much older men.

In 2013 alone, 53 child marriages have been reported, said Nazia Faizi, a representative of the rights department at the ministry of women's affairs.

The figure does not provide an accurate picture of the situation since "there are more unreported cases in the rural areas where women are more deprived and have no rights or access to legal help," Faizi says.

Child marriages are most common in four Northern provinces of Kunduz, Sarpol, Faryab and Heart. Women's "access to justice is poor," she says.

Girls are coerced into marrying young as many families consider it a matter of shame if their daughter is not married by the time she is 16. Young girls are also often "traded" in marriage to save family honor, or in compensation for a crime committed against a member of the family the girl is being married into.

Although Sharia law allows the marriage of post-pubescent girls, the decision to take a husband lies entirely with the girl herself. She cannot be forced, and she has the right to reject the offer. While this may be the case on paper, the reality for millions of girls is very different.

A serious reproductive health condition arising among teenage brides is fistula. A condition that is common among women and girls who receive little or no professional medical care during pregnancy and labor, the most common variance of fistula is characterized by a passage between the birth canal and an internal organ like the rectum.

Fistula leads to a host of related medical problems including incontinence, bladder infections, infertility and kidney failure.

Dr. Hafiza Omarkhail, head physician of the Malalai Maternity Hospital identifies fistula as a "rampant female problem" here, exacerbated by childhood marriages."

One in 50 Afghan women is likely to die of pregnancy-related causes, according to the 2010 Afghanistan Mortality Survey. The lifetime risk of pregnancy-related death is five times as high in rural areas as it is in towns and cities.

In addition, divorce rates, suicide and self-immolation are on the rise, Parwin Rahimi, in charge of the women's support department at the Afghanistan Independent Human Rights Commission says. A study based on hospital reports and Health Ministry records showed that over 2,300 women and girls in the 15 to 40 age group attempt suicide annually.

© 2013, Distributed by NEWS CONSORTIUM.