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A fate worse than death

Written for the Medical Women Association of Nigeria (Kano Branch), with permission of the patient.

As humans, we are taught to be grateful for the gift of life. Whether you are among those who hold lavish thanksgiving ceremonies and testimonies of survival or fall into the category of those who silently give alms to the poor in gratitude to God for sparing your life, the common denominator remains the same; we are thankful to the Almighty for being alive. But is it not true that one may suffer a fate worse than death itself? Do we not fathom that one may be better off dead than to continue living in some situations?

When the officials of the Medical Women Association of Nigeria (MWAN), Kano State chapter, called me on that Sunday morning, with the news, my heart sank. Not again, I thought. It is too early in the morning for this type of gruesome news. And for the umpteenth time, I cursed this profession that exposes us to terrible ailments and societal ills.

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The patient is a six-year-old girl referred from FMC Azare, Bauchi State. She lay on the hospital bed, naked except for bandages covering her genitals and upper thighs. Her face had this sullen expression, and I imagined her already tired of being confined to a hospital bed. The child’s mother, merely a girl herself, sat by her side, fiddling with her phone, watching Hausa home videos. The girl’s paternal aunt, also her guardian, was present in the room. Together they narrated Hauwa’s story.

On the 30th of December, 2020, while many were making preparations for the New Year, little Hauwa went outside to play with her peers in a small village in Jama’are LG in Bauchi. She lived with her paternal aunt as her parents had divorced and since re-married. The children were approached by two men, who wanted to send them on an errand. Some of the children ran away, while others pretended not to hear them and continued running around playing hide and seek. Little Hauwa volunteered and she was sent to call one popular ‘mallam’ in another street. Innocently, she ran to the house and was told by his wife that he was not home. She returned to tell the men who were standing near an abandoned building about her findings, but was grabbed by them instead.

What followed next is something I never want to ever hear narrated again. I watched Hauwa’s mother’s face as she narrated how her child was gagged and restrained by the younger man, while the older man proceeded to remove the girl’s entire genitalia. The man had scraped away everything with a knife, from one thigh to the other. All that was left was muscular tissue. I had heard the story from my colleagues but nothing prepared me for the brazen way in which the mother and aunt described Hauwa’s condition. Their voices were flat, nonchalant, as if one was discussing the price of tomatoes in the market. Ignorance is bliss, they say.

The men eventually released the child and ran off, leaving her screaming and soaked in blood. Her aunt was immediately alerted and they rushed to the General Hospital, from which they were referred to the Federal Medical Centre. There, little Hauwa was transfused and stabilised before the decision to refer her to a teaching hospital was taken. A diagnosis was made: Unclassified Female Genital Mutilation (FGM)- and a team of Gynaecologists, Urologists and Plastic surgeons were immediately set up. As expected after such a traumatic injury, her complications started almost immediately: inability to pass urine i.e urinary retention. A catheter was passed with difficulty and a protocol for her management was outlined. None of the doctors had ever seen this type of butchery in their lives.

If anything, Hauwa’s family history was even worse off. Her case highlighted all the societal ills that have plagued Northern Nigeria since time immemorial.  Her story is reminiscent of the typical, rural Arewa lifestyle. Our high rate of divorce: already, at age 21, Hauwa’s mother is in her third order of marriage. The cause of divorce? A trivial quarrel about the woman going out without her husband’s permission. Teenage pregnancy and marriage: Her mother was 15 years old when she gave birth to Hauwa.  Poverty and illiteracy: Unable to care for her two children, she dumped them with their aunt and immediately married another man. Insecurity and moral decadence: the men who cruelly cut out her privates for ritual purposes.

While listening to their narration and watching little Hauwa with her sullen expression, I was suddenly overcome with guilt. The truth is simple: We failed her. Her parents failed. Her society failed her. Nigeria failed her. How terrible can a society be that an innocent little girl cannot play with her peers in the streets? How heartless can parents be such as to abandon their primary responsibility; the safety of their child? How desperate can we be to get rich that we would cruelly butcher a young girl for financial purposes?

What about the culprits you ask? The young man was allegedly captured the day it happened after the local vigilante group saw him running with blood stained clothes, while the older man was caught five days later in Mararaban Jos. They have since been detained in police custody and are awaiting trial. However, the most dangerous of them all, the ‘mallam’ that requested they obtain ‘mafitsaran karamar mace’ loosely translated to mean ‘the urinary opening of a young virgin girl’ is still at large. The older man confessed that he contracted the young man to help him procure the part, promising him N500,000 when he eventually ‘hammered’.

The horrific manner of Hauwa’s mutilation has made sensational headlines no doubt. The Bauchi State government immediately donated a million naira for her medical treatment. Kudos to them! The Kano State chapter of MWAN was also quick to take up her case, supporting her financially, legally and medically; and for this I am immensely proud. The management of Aminu Kano Teaching Hospital (AKTH) has also approved a hefty sum towards her medical bills, all in a bid to curtail the tragedy.

However, It is not enough to get goose pimples after reading this. It is not enough for us to wipe away our tears and drop the newspaper only for our minds to return to other frivolous things. It is also not enough for us to express anger; curse the society we live in and continue to carry on as if all is well. All is NOT well! Hauwa’s treatment has just started. She will require multiple reconstructive surgeries if she is to ever have the semblance of a normal life.  Complications we are yet to fathom may emerge as she grows older and she may just have to live with this scar for the rest of her life. What scares me the most is that we may have many more like her in the near future. Many more battered and physically traumatised people who have had various body parts removed because of stupid get-rich-quick-ritual- schemes.

Therefore, it is for people like Hauwa that we will continue to talk until our voices are hoarse. That societal ills, hiding under the pillars of culture and religion be addressed and ultimately reformed so that we may halt this evil spreading in our land. So that our children may have a chance.

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