Child marriage remains widespread in developing countries across the world.

More girls in South Sudan are marrying at a young age amid the mass displacement and starvation that have accompanied civil war there, according to international aid agencies.

Read More: South Sudan: The Deadly Consequences of Child Marriage

According to UNICEF, 9% of South Sudanese girls were married by age 15, and 52% were married before their 18th birthday, in 2015. In the Rumbek region, that figure has spiked to more than 60% over the last year, according to Isaac Karkon, head of South Sudan’s humanitarian arm in the region.

While child marriage is widely practiced, the increase has mostly been seen in the Lakes State and Babr el Ghazal regions in South Sudan. Cows are used for payments and dowries, which Human Rights Watch call a “key driver of child marriage” as families see daughters as a source of wealth.

Read More: Child Brides Sold For Cows: The Price of Being a Girl in South Sudan

Karkon said that people are dying from hunger. “So, if you have a mature daughter you give her up to let the rest survive,” Karkon told The Associated Press.

In 2012, 13-year-old Eliza was forced by her father to marry a 35-year-old man from their village in the South Sudan town of Rumbek. She was traded for 50 cattle, according to The Associated Press, which did not use the girl’s last name.

“The worst part was having sex,” she told The Associated Press. “I don’t know what he wanted from me and it was so painful.”

Two years into the marriage at the age of 15, Eliza gave birth to a daughter. As the youngest of her husband’s five wives, she said he neglected her and the baby, never providing medicine. After a few years of marriage, Eliza’s father took her back. The husband didn’t pay the dowry and her father didn’t like the way she was being treated.

Today, Eliza is now studying to become a doctor, but she is the exception.

Some aid groups and local institutions are making efforts to reduce child marriage. South Sudan’s leaders should “choose to prioritize legislation that explicitly sets 18 as the minimum age of marriage,” The Human Rights Watch told the Associated Press.

“Poverty is pushing people into situations they might not have had to be in before,” said Sister Orla Treacy to The Associated Press, head of the Irish-run Loreto Secondary School in Rumbek, the region’s only all-girl boarding school.

Treacy and her staff require each girl’s guardian to sign a form promising not to remove the child from school until she has graduated. So far, it appears to be working. When the policy began in 2008, 50% of the girls were being taken out of school for early marriage. Now the number stands at less than 2%.

Child marriage remains widespread in developing countries across the world.

Read More: Educating Girls, Ending Child Marriage

According to the Council on Foreign Relations, women between the ages of 20 to 24 who report on being married before eighteen, are found in South Asia and West and Central Africa, where an estimated two out of five girls are married as children.

In Syrian refugee communities in Jordan, child marriage has rapidly increased. Between 2011 and 2014, the rates of child marriages almost tripled, from 12% to just under 32%. In Lebanon, 41% of young displaced Syrian women are married before eighteen, according to Girls Not Brides, a global partnership to end child marriage.  

Other countries included: Chad, northern Cameroon and Nigeria in Africa; Malaysia and Indonesia in Southeast Asia; and Afghanistan in the Middle East.

Global Citizen campaigns against child marriage, which often prevents girls from attaining a full education. You can take action here.