Female genital mutilation (FGM) is defined by the World Health Organization as all procedures which involve partial or total removal of the external female genitalia and/or injury to the female genital organs, whether for cultural or any other non-therapeutic reasons. It is a superstitious belief practiced for preservation of chastity and purification, family honor, hygiene, esthetic reasons, protection of virginity, prevention of promiscuity, modification of socio-sexual attitudes (countering failure of a woman to attain orgasm), increasing sexual pleasure of husband, enhancing fertility and increasing matrimonial opportunities. Other reasons are to prevent mother and child from dying during childbirth and for legal reasons (one cannot inherit property if not circumcised).
Though it is practiced in more than 28 countries in Africa and a few scattered communities worldwide, its burden is seen in countries like Nigeria, Egypt, Mali, Eritrea, Sudan, Central African Republic, and northern part of Ghana, where it has been an old traditional and cultural practice of various ethnic groups. The highest prevalence rates are found in Somalia and Djibouti where it is virtually universal.
In some parts of Nigeria, the cut edges of the external genitalia are smeared with secretions from a snail footpad with the belief that the snail being a slow animal would influence the circumcised girl to “go slow” with sexual activities in future. However, FGM is often routinely performed as an integral part of social conformity and in line with community identity.
It is widely practiced in Nigeria, and with its largest population of 200,000,000, the country has the highest absolute number of cases of FGM in the world, accounting for about one-quarter of the estimated 115–130 million circumcised women worldwide. In Nigeria, FGM has the highest prevalence in the south-south (among adult women), followed by the south east and south west. Though it is practiced on a smaller scale in the north, but it is done in a more extreme form. Among, the population of Nigeria, women form 52% of it, and the national prevalence rate of FGM is 41% among adult women. Prevalence rates progressively decline in the young age groups.
FGM is a practice whose origin and significance is shrouded in secrecy, uncertainty, and confusion. Its origin is fraught with controversy, either as an initiation ceremony of young girls into womanhood, to ensure virginity and curb promiscuity, or to protect female modesty and chastity.
The ritual has been so widespread that it could not have risen from a single origin. Its practice in Nigeria, is classified into four types, namely; Clitoridectomy or Type I (the least severe form of the practice): It involves the removal of the prepuce or the hood of the clitoris and all or part of the clitoris. In Nigeria, this usually involves excision of only a part of the clitoris. Type II or “sunna” is a more severe practice that involves the removal of the clitoris along with partial or total excision of the labia minora. Type I and Type II are more widespread, but less harmful compared to Type III. Type III (infibulation) is the most severe form of FGM. It involves the removal of the clitoris, the labia minora and adjacent medial part of the labia majora and the stitching of the vaginal orifice, leaving an opening of the size of a pin head to allow for menstrual flow or urine. Type IV or other unclassified types recognized by include introcision and gishiri cuts, pricking, piercing, or incision of the clitoris and/or labia, scraping and/or cutting of the vagina (angrya cuts), stretching the clitoris and/or labia, cauterization, the introduction of corrosive substances and herbs in the vagina, and other forms.
The practice varies from country to country, tribes, religion, and from one state and cultural setting to another, and no continent in the world has been exempted. In most parts of Nigeria, it is carried out at a very young age (minors) and there is no possibility of the individual’s consent. Type I and Type II are more widespread and less harmful compared to Type III and Type IV. In Nigeria, there is greater prevalence of Type I excision in the south, with extreme forms of FGM prevalent in the North. It is said that practice of FGM has no relationship with religion, as Muslims and Christians practice it, but it is more widely spread in Christian predominated parts of Nigeria.
Female Genital Mutilation causes infertility, maternal death, infections, and the loss of sexual pleasure. Nationally, 27% of Nigerian women between the ages of 15 and 49 were victims of FGM, as of 2012. In the last 30 years, prevalence of the practice has decreased by half in some parts of Nigeria and is recognized worldwide as a fundamental violation of the human rights of girls and women and it reflects deep-rooted inequality between the sexes and constitutes an extreme form of discrimination against women. Many say it is inhuman and involves violation of rights of the children, right to health, security, physical integrity, freedom from torture and the right to life, especially when it results in death. Furthermore, since girls usually undergo the practice without their informed consent, it deprives them of the opportunity to make independent decision about their bodies.
Consequences of FGM
An estimated 100–140 million girls and women worldwide are currently living with the consequences of FGM. In Africa, about 3 million girls are at risk for FGM annually. Despite the increased international and little national attention, the prevalence of FGM overall has declined very little. The procedure has no health benefits for girls and women. Adverse consequences of FGM are shock from pain and hemorrhage, infection, acute urinary retention following such trauma, damage to the urethra or anus in the struggle of the victim during the procedure making the extent of the operation dictated in many cases by chance, chronic pelvic infection, acquired gynatresia resulting in hematocolpos, vulval adhesions, dysmenorrhea, retention cysts, and sexual difficulties with anorgasmia. Other complications are implantation dermoid cysts and keloids, and sexual dysfunction. Obstetric complications include perineal lacerations and inevitable need for episiotomy in infibulated parturient. Others are defibrillation with bleeding, injury to urethra and bladder, injury to rectum, and purperial sepsis. Prolonged labor, delayed 2nd stage and obstructed labor leading to fistulae formation, and increased perinatal morbidity and mortality have been associated with FGM. The mental and psychological agony attached with FGM is deemed the most serious complication because the problem does not manifest outwardly for help to be offered. The young girl is in constant fear of the procedure and after the ritual she dreads sex because of anticipated pain and dreads childbirth because of complications caused by FGM. Such girls may not complain but end up becoming frigid and withdrawn resulting in marital disharmony.
Current situation in Nigeria
FGM is widespread in Nigeria. Some sociocultural determinants have been identified as supporting this avoidable practice. It is still deeply entrenched in the Nigerian society where critical decision makers are grandmothers, mothers, women, opinion leaders, men and age groups. It is an extreme example of discrimination based on sex. Often used as a way to control women’s sexuality, the practice is closely associated with girls’ marriageability. Mothers chose to subject their daughters to the practice to protect them from being ostracized, beaten, shunned, or disgraced. We learnt that places like middle belt or north central there are some tribes that operate in catch them young in any festive period to debase these young girls and strip them of their dignity and freedom.
So, those who do not want to be part of it, usually take their children away and have refused to go home to avoid being forced to do it. In fact, many have become refugees in others countries for fear of forceful FGM practice in some parts of Nigeria. The practice was traditionally the specialization of traditional leaders’ traditional birth attendants or members of the community known for the trade, and there is, however, the phenomenon of “medicalization” which has introduced modern health practitioners and community health workers into the trade. Obviously. the WHO is strongly against this medicalization, and has advised that neither FGM must be institutionalized nor should any form of FGM be performed by any health professional in any setting, including hospitals or in the home setting.
Efforts to eliminate it Nigeria
It is true that tradition and culture are important aspects of any society in helping to mold the views and behavioral patterns of the society; many believe that traditions and cultural beliefs and practices like FGM are unhealthy, harmful and must be abolished through multidisciplinary approach involving legislation, health care professional organizations, empowerment of the women in the society, and education of the general public at all levels with emphasis on its dangers and undesirability.
In Nigeria, FGM is being tackled by WHO, United Nations International Children Emergency Fund (UNICEF), Federation of International Obstetrics and Gynaecology (FIGO), African Union, the Economic Commission for Africa (ECA), and many women organizations. Intensification of education of the general public at all levels has been done with emphasis on the dangers and undesirability of FGM. It could be recalled that in 1994, Nigeria joined other members of the 47th World Health Assembly to resolve to eliminate FGM and steps taken to achieve that include establishment of a multi sectorial technical working group on harmful traditional practices (HTPs), conduct of various studies and national surveys on HTPs, launching of a regional plan of action, and formulation of a national policy and plan of action, which was approved by the Federal Executive Council for the elimination of FGM in Nigeria.
Also in 1995, Platform of Action adopted by the Beijing conference called for the eradication of FGM through the enactment and enforcement of legislation against its perpetrator. However, there is no federal law prohibiting the practice of FGM in Nigeria. . This is seen as the main reason for the slow progress on declining the prevalence of FGM. Despite the increased international and little national attention, the prevalence of FGM overall has declined very little. The prevalence depends on the level of education and the geographic location.
A medical practitioner, Dr Gabriel Omonaiye said it is very clear that there is no single benefit derived from FGM, and no scientific evidence that women who have been mutilated are more faithful or better wives than those who have not undergone the procedure.
He stated that FGM would even make females to be more promiscuous since they do not easily reach orgasm. “It is observed that circumcised women do not easily reach orgasm, it will be somehow difficult for one man to satisfy them. As a result, they may want to look outside, thinking that their spouses are not capable.”
Omonaiye also explained that FGM exposes females to various diseases due to the unsterilized objects used in the processFamilies and Communities should also be supported in their efforts to abandon the practice and to improve care for those who have undergone FGM.
An educationist, Mrs Uju Linda Christian described Female genital Mutilation as a dangerous practice in so many ramifications.
She noted that though it had been on for quite a long time, so may not be so easy to be abolished, what is expected is the desired education and awareness that would discourage those who are still practicing it to stop. “Like we all know, FGM needs to be abolished. But because it is all about tradition, it ay not be easy. All we need is proper education on the consequences of such practice. By so doing, it would gradually stop.
Christian was also of the view that there is also need for law to be promulgated against that, so that whoever that indulges in such practice would be prosecuted. “Our law makers should see what they can do about. There are campaigns going on against the practice at the moment because female Nigerian children are being exposed to danger through such practice.”
Also, founder of The Progressive Women and Youths Advocacy Organization Dr Mrs Vivian Obi said the practice is so barbaric and therefore should be abolished.
She was also of the view that there should be a law in Nigeria to make the practice a crime due to its negative effects. “The practice makes a female not to reach her orgasm join time, it causes bleeding, causes infection and death. In fact, 90 percent of females who went through genital mutilation are at risk and makes them never feel the honey in the pudding.”
Obi noted that with improvement in education and social status of women and increased awareness of complications of FGM, most women who underwent FGM disapproved the practice and only very few are prepared to subject their daughters to such harmful procedures. “The more educated, more informed, and more active socially and economically a woman is, the more she is able to appreciate and understand the hazards of harmful practices like FGM and sees it as unnecessary procedure, refuses to accept such harmful practice and to subject her daughter to such an operation.”
Obi further explained that there is a need for legislation in Nigeria with health education and female emancipation in the society. “Through legislation, anyone found guilty of the practice, should be jailed. The process of social change in the community with a collective, coordinated agreement to abandon the practice “community-led action” is also essential.”
She stressed the need for the issue to be discussed with law makers or local representatives on making laws against FGM in Nigeria.
Moreover, many are of the view that efforts should be taken at the grassroots to join in the crusade to say “NO” to FGM anywhere it is practiced among the people because it is crude, dangerous, wicked, unhealthy and not required by any religion.