Thank you very much for inviting me here. I am always very pleased to come to the Asia Society, and particularly so around this set of issues. I want to say this evening that the comments that I make are primarily about India, and rural women in particular in India, as I have understood them, but what I say is broadly applicable to the sub-continent at large, especially to Pakistan and Bangladesh, and in different ways to Nepal. So if we keep that in mind, the comments that we have made tonight are not at all about Southeast Asia which in my experience is quite different from the sub-continent.
I would like to begin by paraphrasing Thomas Hobbes, who is probably familiar to most of you in saying as you could very well see-not just from Smita's comments but those of you who have had a chance already to look at the photographs-that the lives of most poor rural women in South Asia are nasty, brutal and short. And a lot of this has to do of course with caste and income differentials, but it also fundamentally has to do with sex.
Normally, in all societies of the world, more boys are born than girls. This is a fact of nature, and it happens because boy babies are more fragile than girls, and I guess somewhere along the line in evolution someone figured that out-more boys are born than girls. But in South Asia the skew in the number of births is greatly exaggerated and it is really the major region in the world where this happens. You get very, very great variation or difference between the numbers of males and females alive at any time. And the first manifestation of this comes now with technology in sex selective abortion in which women for a variety of reasons seek to abort female pregnancies. This is a well-know phenomenon occurring in India; it has been protested greatly by the women's movement in India; and national as well as state laws have been passed against it. However, as we all know, laws are not sufficient and basically the practice has been driven underground. We have seen continuing decline in the sex ratio in India for the last decade.
Now after birth girls also face continuing discrimination that includes, still in the 21st century, female infanticide at the moment that the babies are born-often by the traditional birth attendant who may be caring for the woman in her labor. As children, girls also die at much higher rates than boys due to neglect and driven primarily of course by poverty that forces their parents to chose which children they will feed and provide health care and education. Let me give three examples from rural India:50 % of girls, but 61% of boys are immunized; boys are twice as likely as girls to get healthcare; families spend 2-3 times as much on boys' healthcare as they do on girls'. Those girls who survive to the teenage years face both the cumulative insults that they have experienced in their childhood, including severe and moderate malnutrition. Most rural girls are married well before the age of 18 to older sexually experienced men. They enter marriage with no sexuality education, no contraception and certainly no power. They face extreme pressure to become pregnant immediately, and in that pregnancy and subsequent ones, to produce a son. They are physically immature and as I mentioned very severely or moderately malnourished, and they thus face very high risks of complications and death due to pregnancy. It is estimated in rural India that at least of every 100,000 live births, 440 women will die. This is by contrast to the rate of maternal death in the United States which is 11 women out of 100,000 live births. Further, because their husbands are older and commonly have had sexually experiences, both with other men and with women before marriage, these young brides are exposed very early to sexually transmitted infections which are devastating. Many of them cause infertility, and of course we now know that such infections facilitate the transmission of HIV-AIDS.