FEMALE GENITAL MUTILATION

Female genital mutilation (FGM) includes procedures that intentionally alter or cause injury to the female genital organs for non-medical reasons. It comprises all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons which has no health benefits for girls and women. It, also known as female genital cutting and female circumcision, is the ritual cutting or removal of some or all of the external female genitalia. 

Procedures can cause severe bleeding and problems urinating, and later cysts, infections, as well as complications in childbirth and increased risk of newborn deaths. There are four procedures involved. They are as follows; 

The first is referred to as clitoridectomy. It involves the partial or total removal of the clitoris (a small, sensitive and erectile part of the female genitals), and in very rare cases, only the prepuce (the fold of skin surrounding the clitoris). Second procedure is referred to as excision which is the partial or total removal of the clitoris and the labia minora (the inner folds of the vulva), with or without excision of the labia majora (the outer folds of skin of the vulva ).  Infibulation is the third stage. It is the narrowing of the vaginal opening through the creation of a covering seal. The seal is formed by cutting and repositioning the labia minora, or labia majora, sometimes through stitching, with or without removal of the clitoris (clitoridectomy). While the last stage includes all other harmful procedures to the female genitalia for non-medical purposes, e.g. pricking, piercing, incising, scraping and cauterising the genital area.

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. This act is mostly carried out on young girls between infancy and age 15 (WHO, 2018). Some African countries where this harmful act is seen are 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. 

In the past 30 years, there has been a decline in the rate of FGM in countries like Nigeria. However, Global Citizen states that there are eight countries where over 80% of women and girls aged 15 to 49 have undergone FGM, according to a 2016 report by UNICEF. These countries range from Somalia, Guinea, Djibouti, Egypt, Sierra Leone, Mali, Sudan to Eritrea.  

Female cutting causes no good but harm to the girls involved, family or society. It is a violation of their human rights and a threat to their sexuality. Short term effects range from severe pain, excessive bleeding (haemorrhage) which is as a result of the clitoral artery or other blood vessel to shock caused by pain, infection and/or haemorrhage. Genital tissue swelling due to inflammatory response or local infection is also an effect. Urination problems are not an exception. They may include urinary retention and pain passing urine. This may be due to tissue swelling, pain or injury to the urethra. It also leads to death caused by infections including tetanus and excessive bleeding. 

The long term effects are detrimental. Examples are pain which is as a result of tissue damage and scarring that may result in trapped or unprotected nerve endings. Infections like chronic genital infections with consequent chronic pain, and vaginal discharge and itching; cysts, abscesses and genital ulcers may also appear. Chronic reproductive tract infections; urinary tract infections and painful urination are not an exception. 

Menstrual problem, keloids, obstetric complications such as increased risk of Caesarean section, post-partum haemorrhage, recourse to episiotomy, difficult labour, obstetric tears/lacerations, instrumental delivery, prolonged labour, and extended maternal hospital stay  increase with the severity of FGM. It might also result to obstetric fistula. 

The tradition of female genital mutilation must stop. It benefits nobody. It only brings more health problems to the people involved. Do change the stories today. 

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