Female Genital Mutilation - A Heinous Practice
By Cecile Ndoh Enie
Female Genital Mutilation (FGM) or female circumcision is one of the oldest and most harmful, traditional or cultural practices affecting the health of women and girls in some communities around the world.
According to a Wikipedia report, the traditional cultural practice predates both Islam and Christianity. A Greek papyrus from 163 B.C mentions girls in Egypt undergoing FGM. It is widely accepted to have originated in Egypt and the Nile valley at the time of the Pharaohs. Evidence from mummies has shown FGM present. While the spread of FGM is unknown, the procedure is now practiced among Muslims, Christians and Animist.
A World Health Organization Report (WHO) stated that, between 100 – 140 million girls and women in the world are estimated to have undergone such procedure, and 3 million girls are estimated to be at risk of undergoing FGM every year. In addition, FGM has been documented in 28 African countries as well as several countries in Asia and Middle East. Some form of practice has also been reported from other countries including certain ethnic groups in Central and South America. There is also evidence of increasing number of girls and women living outside Europe, who have undergone or may be undergoing FGM.
In Cameroon, it is practiced in some villages in the South west, Far North and Eastern Provinces. Around 60% of all Nigerian women experience FGM and it is most common in the south, where up to 85% of women undergo it at some point in their lives.
The practice varies from area to area. In this regard, some perform the operation on infants as young as a few days old or on children between the ages seven to ten years or adolescents and often-on women who are about to marry. More so, the type of surgical forms differs.
WHO separates FGM procedures into four types, - The removal or splitting of the clitoral hood termed Hoodectomy. The excision of the clitoris with partial or total excision of the labia minora, also known as Khafd, meaning reduction in Arabic. The excision of part or all of the external genitalia and stitching/ narrowing of the vaginal opening known as infibulation. What are left are a very smooth surface and a small opening to permit urination and menstrual discharge. The artificial opening is some time not larger than the flammable end of a matchstick. It is the most extreme form and accounts for about 15% of all FGM procedures. Infibulation is also known as Pharaonic circumcision. The fourth type is other forms and may not involve any tissue removal at all. This includes a diverse range of practices, including prickling the clitoris with needless, burning or scaring the genitals as well as ripping or tearing of the vagina or introducing herbs into the vagina to cause bleeding and a narrow vagina.
Like other crude traditional practices such as widowhood, women perform FGM and this ritual is mostly accompanied by celebrations and often takes place in a special hidden place away from the community. The women Excisors who carry out these operations acquired their skills from their mothers or female relatives. They are also the community’s traditional birth attendants. In most cases anesthetic is not administered instead, three or four women hold down the child while the operation is done and this takes between 10 – 20 minutes depending on its nature. The wound is treated by applying mixtures of local herbs such as, earth, cow-dung, ash or butter depending on the skills of the Excisor.
The motive behind FGM is on the grounds that, it decreases women sexual desire, hygiene aesthetics, facility of sexual relations, fertility, preserving the women’s virginity before marriage and fidelity then after, marking the coming of age of the female child and controlling sexuality. Although FGM is practiced within particular religious sub-cultures, the arguments used to justify FGM vary. They range from health- related to social benefits.
Generally, largely rural women living in traditional societies preserve the practice. Some societies hold in order to be clean for marriage, female circumcision is a pre -condition. Among the Bambara in Mali, it is believed that, if the clitoris touches the head of a baby being born the child will die. The clitoris is seen as the male characteristic of a woman. In order to enhance her femininity, this male part of her has to be removed.
Health wise, complications resulting from deep cuts and infected instruments can cause death. Hemorrhage can occur during circumcision, or accidental cuts to other organs can also lead to heavy loss of blood. Acute infections are commonplace when operations of infibulations are carried out in unhygienic surroundings and with un-sterilized instruments like - kitchen knife, razor blade, a piece of glass or even sharp fingernails. Even so, tetanus and general septicemia, chronic infection can also lead to infertility and anemia. Considering the same tools are usually repeated on numerous girls, it increases the risk of blood-transmitted diseases including HIV/AIDS.
Haematocolpos or the inability to pass menstrual blood (because the remaining opening is often too small) can lead to infection of other organs and also infertility, obstetric. The most frequent health problem results from vicious scars in the clitoral zone after excision. These scars open during childbirth and cause the anterior perineum to tear, leading to hemorrhaging that is often difficult to stop.
Psychologically, most children experience recurring nightmare. Girls, who are FGM victims, have come to terms with the fact that they are not like majority of their friends. Thus, mood swings and irritability, constant states of depression and anxiety have all been noted among infibulated girls.
The practice violates among other International Human Rights Laws, the right of the child to “enjoyment of the highest attainable standard of health as laid down in Article 24 (paras 1and 3) of the convention on the rights of the child.
Still from a WHO report, many countries have put in place policies and legislation to ban FGM. The number of women who do not want to continue the practice is increasing, and there are indications that the prevalence is declining in some countries, and that it is less prevalent in younger than in older age groups.
Despite, these successes however, the overall decline has been very slow. Hence, to accelerate the process of abandonment of the practice, there is an urgent need for increased and improved work by all actors, since there is evidence, now that we know what is necessary to stimulate large- scale and speedy abandonment.
More so, some highly successful projects, increased knowledge about FGM and the reasons for its continuation as well as experiences with a vast variety of interventions, possible to significantly reduce the prevalence within one generation. This momentum suggesting that such a change is possible and that the willingness to invest the necessary resources can be achieved.
WHO is working on several fronts to contribute to the elimination of FGM. WHO is also contributing by supporting and initiating research within several fields. Another important contribution from WHO is working towards improved health care for the millions of girls and women who are living with the consequences of FGM.
The United Nations Fund for Population Activities recognizes February 6th as the International Day against FGM. The push to end FGM by WHO and other Global Health Organizations have been for several decades but, due to the importance in traditional and religious life, the practice remains in many societies.