PUBLIC HEALTH ISSUES

Female genital mutilation/cutting (FGM/C) is a culturally entrenched global practice that not only is considered an evident human rights violation but also has resultant health and social repercussions on girls and women. (World Health Organization). As a matter of fact, it has been implicated in serious health consequences, significant morbidity, health burden, and poor health indicators.

Human rights, Genital Mutilation Concept

What then is Female Genital Mutilation?

Female genital mutilation (FGM) otherwise known as “female genital cutting,” or “female circumcision” is an umbrella term that includes all procedures that involve partial or total removal of the external female genitalia (the vulva), or other injury to the female genital organs, for non‑medical reasons.

Classification of FGM

In 2008, the World Health Organization (WHO) reviewed the classification of the four types of FGM, which includes:

Type 1 (clitoridectomy) involves partial or total removal of the clitoris, and in very rare cases, only the prepuce (the skin surrounding the clitoris);

Type 2 (excision) involves partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora and

Type 3 or infibulation is the narrowing of the vaginal opening by removal and suturing of the small and/or labia majora, with or without removal of the clitoris.

Type 4 involves all other harmful procedures performed on the external genitalia for non-medical reasons (such as cutting, pricking, piercing, scraping, cutting and burning) genital mutilation.

The female external genitalia

How prevalent is Female Genital Mutilation?

More than 200 million girls and women alive today have been cut in 30 countries in Africa, the Middle East and Asia where FGM is concentrated.

In Arica, an estimated 91.5 million girls and women aged 9 years and above have undergone the procedure and about three million girls are at risk for it annually.

In Nigeria, the prevalence of FGM in the country is 29.6%. It ranges from 2.7% in the North-East to 53.4% in the South-West. That, FGM is more prevalent in the South western of Nigeria.

Performers of FGM

FGM is performed largely by traditional practitioners (traditional circumcisers and traditional birth attendants) and worrisomely and increasingly by health professionals mainly doctors and nurses/midwives.

How it is done

  • FGM is carried out using special knives, scissors, razors, or pieces of glass.
  • On rare occasions sharp stones have been reported to be used.
    Finger nails have been used to pluck out the clitoris of babies in some areas in the Gambia.
  • The instruments may be re-used without being cleaned.
  • The operation is usually performed by an elderly woman of the village specially designated this task, who may also be a traditional birth attendant (TBA).
  • Anaesthesia is rarely used and the girl is held down by a number of women, frequently including her own relatives.
  • The procedure may take 15 to 20 minutes, depending on the skill of the operator, the extent of excision and the amount of resistance put up by the girl.
  • The wound is dabbed with anything from alcohol or lemon juice to ash, herb mixtures, porridge or cow dung, and the girl’s legs may be bound together until healing is completed.

Reasons for FGM

Socio-cultural reasons: some communities believe that unless a girl’s clitoris is removed, she will not become a mature woman, or even a full member of the human race. Female genital mutilation is believed to ensure a girl’s virginity.

Hygienic and aesthetic reasons: it is believed that a woman’s external genitalia are ugly and dirty, and will continue to grow ever bigger if they are not cut away. Removing these structures makes a girl hygienically clean.

Religious reasons: Some communities believe that removing the external genitalia is necessary to make a girl spiritually clean and is therefore required by religion.

    Woman holding her crotch

Problems Associated with FGM

  • Injury to the adjacent tissue of urethra, vagina, perineum and rectum
  • Haemorrhage
  • Shock
  • Acute urine retention
  • Infection
  • Failure to heal
  • Difficulty in passing urine
  • Pelvic infections
  • Infertility
  • Difficulties in menstruation
  • Painful sexual intercourse
  • Sexual dysfunction
  • Feeling of betrayal.
  • Fear
  • Suppression of fear

How do we prevent this practice?

  • Women empowerment; this is key to the elimination of the practice.
  • The media can play a crucial role both in bringing correct information to households and in informing people about positive social change that may be taking place in communities.
  • Legal measures should be accompanied by information and other measures that promote increased public support for ending the practice.
  • The amendment, adoption and enforcement of laws should be done in consultation with community and religious leaders and other civil society representatives.
  • Medical ethics standards must make it clear that the practice of female genital mutilation upon children or women violates professional standards as well as a patient’s human rights.
  • The governments have legal obligations to respect, protect and promote human rights, and can be held accountable for failing to fulfil these obligations.
  • Accordingly, governments need to take appropriate legislative, judicial, administrative, budgetary, economic and other measures to the maximum extent of their available resources.

FGM is never a solution to promiscuity. It is an outright violation of human and inhumane. Stop and please stop those practicing it. More importantly, if you see something, say something.

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