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Health implications of female genital mutilation

Female genital mutilation, also known as female circumcision, is the partial or total removal of the external genitalia of girls and young women for non-medical reasons.

According to the World Health Organisation (WHO), female genital mutilation (FGM) comprises all procedures that involve partial or total removal of the external female genitalia, or other injuries to the female genital organs for non-medical reasons.

Experts said the practice, which is mainly fueled by ignorance, has no benefits for women and girls and commonly leads to infection, infertility and even death.

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It causes ‘untold physical and emotional trauma’ for many survivors, many of whom refuse to talk about it for fear of stigmatisation and opt to suffer in silence.

Aside from immediate consequences of female genital mutilation such as bleeding, shock, difficulty passing urine, infection and death, FGM also has long-term psychological, physical and sexual effects.

Other effects include adverse effects on mother and newborn during childbirth, painful sexual intercourse, urinary and menstrual problems to mention a few.

The five states with the highest prevalence of female genital mutilation in the country are Osun, Oyo, Ekiti, Imo and Ebonyi.

Ajo, 50, who was circumcised as an infant, said she felt the negative impact of the practice when she gave birth to her first child and had to undergo surgery. She also said it had affected her marriage negatively as she observed some differences between her experience with her husband, and what her friends narrate to her.

“With counselling and treatment I have been able to gradually overcome it,’ she said.

Over the years, as the condemnation against female genital mutilation grew, some parents have abandoned going to traditional circumcisers or practitioners, and now seek the help of health workers, particularly doctors and nurses to perform the procedure on their babies.

Anu, 28, said her mother told her she met a nurse to perform the procedure for her (Anu) because she believed it was more hygienic and safer. The nurse used a blade and some powder. She bled for days after but luckily survived.

Experts said since the practice holds no benefits, healthcare providers should not be involved in it, adding that it was still not ‘safe’ even if performed by healthcare providers.

The United Nations Population Fund (UNFPA) UNFPA defines “Medicalization” of FGM to refer to situations in which FGM is practised by any category of health care providers, whether in a public or private clinic, at home or elsewhere. It also includes the procedure of reinfibulation at any point in time in a woman’s life.

It said FGM can never be “safe,” and there is no medical justification for the practice.

“Even when the procedure is performed in a sterile environment by a health care provider, there are health consequences immediately and later in life. Under any circumstance, FGM violates the right to health, the right to be free from violence, the right to life and physical integrity, the right to non-discrimination, and the right to be free from cruel, inhuman or degrading treatment.

“When performed in a clinical setting, FGM violates medical ethics as well and may confer a sense of legitimacy to FGM or give the impression that it is without health consequences, which can undermine efforts towards abandonment,” it said.

WHO strongly urges health professionals not to perform such procedures. “While the practice is mostly carried out by traditional circumcisers, in many settings, health care providers perform female genital mutilation due to the erroneous belief that the procedure is safer when medicalized,” it said.

Professor Oladosu Ojengbede, a professor of Gynaecology and Obstetrics, and Executive Director of the Centre for Population and Reproductive Health, the University of Ibadan in an interview with Daily Trust said female genital mutilation is a form of gender-based violence that violates the rights of women.

“It is a surgery performed without the consent of the person and prevalent in Asia and Africa. The long and short term consequences make it important to end the practice.

“Why cut at all? There is no reason why this part of the woman’s body should be cut. There is no justification for it. We need to put a surveillance system in place at the community level and health care level,” he said.

He said medicalization of female genital mutilation is a new and worrisome trend in the country, adding that it encourages traditional practitioners to continue in the trade, believing they were being cheated out of their trade.

As part of efforts to end FGM, a nonprofit organisation, Action Health Incorporated (AHI) in collaboration with the State Ministry of Health with the support of the United Nations Population Fund (UNFPA) organised a three-day capacity building training for health workers drawn from Ilesha West, Irepodun and Ede South Local Government Areas of Osun State.

AHI Programme Officer, Miss Abdulrasheed Nuriyat, described FGM as a harmful practice that involves altering or injuring the female genitalia for non-medical reasons. She noted that the practice is internationally recognised as a human rights violation.

Nuriyat said health workers have to be engaged to serve as advocates against FGM and to also provide services to meet the sexual and reproductive needs of women and girls who suffer from its consequences at the community level.

She said the objective of the training is to build the capacity of health workers to provide FGM related services to women and girls using FGM protocol, case management forms and referral pathway at the community level.

The Focal Point Person of the United Nations Population Fund on FGM in the state, Mrs Aduke Obelawo, also told health workers that medicalization of FGM is unethical to medical practice and urged them to shun it.

The Director of Public Health, Dr. Gbenga Adepoju, said the rate of FGM practice has reduced in the state but that more efforts were required by all stakeholders to ensure the eradication of the harmful practice.

He urged all health workers to ensure strict compliance to the principle of ‘do no harm’ and to utilize the training in providing adequate services to FGM survivors and women and girls who were at risk.

The trained health workers signed anti-FGM commitment document and vowed to champion the advocacy against FGM to ensure total eradication of the practice in the state.

They also pledged their commitment to end female genital mutilation in the state and to always protect women and girls from being mutilated.

 

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