“No child born with its mother’s clitoris intact will survive. Every girl born in this community must be circumcised so that they can have babies who will live. It is the culture and nobody can stop it” – Members of Ilawe community, Ekiti State, January 2018.
“We have finished the circumcisions we have on ground. But she can bring her daughter, we will do it and she can watch us while we circumcise her.”
This was the response of a ‘cutter’ in Idanre, a community in Ondo State, when enquiries were made about the female genital cutting procedure.
Mrs. Remi Ajogbeje, a traditional birth attendant in Idanre, is a mother of two girls. She firmly believes that “FGM is good, very healthy and can cause the body to react negatively if not done.”
Ajogbeje also believes that a woman’s sexual urge should be curbed except prompted by her husband’s. It is unacceptable for her to make the first sexual move. Without the circumcision, they could become promiscuous, and eventually become prostitutes. FGM puts a woman’s sexual urges in place.
FGM is female genital mutilation or cutting. The United Nations has set February 6 as International Day of Zero Tolerance to Female Genital Mutilation.
Adamant that her daughters must not be exposed to such, she ensured they were circumcised, thanks to the services of a trained nurse who secretly executed the task. The nurse is a staff in a hospital that had earlier turned Ajogbeje away advising her against the procedure.
Ajogbeje said, “If it [clitoris] is not cut, it can cause constant itching of the private part.”
Repeatedly referring to the procedure as “FGM” – oblivious of its full meaning, she said, “The nurse carried out the FGM for my two girls for free but I gave her N500 and bought all the materials needed. She used Dettol, small scissors, Jik, spirit and cotton wool.
“She cleaned the surface area to be cut and after cutting, the place was cleaned with spirit while the cut-off clitoris was given to me. I buried it. But I flushed that of my second daughter in the toilet.”
According to Ajogbeje, “It is because of HIV that government stopped it but if the needed materials are bought by the parents there won’t be need for any disease.”
Her belief and justification for FGM is not unique to her. Justifications for FGM ripple across Nigeria, from men and women alike.
According to a UNICEF report, female genital mutilation or cutting is “an extremely harmful traditional practice, documented in 28 countries in Africa, Asia and the Middle East.
“It comprises all procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reasons. It is widely practiced in Nigeria, where an estimated 19.9 million Nigerian women have undergone the procedure.”
The report said, “It exposes girls and women to severe and sometimes life-threatening health complications, including haemorrhage, tetanus, sepsis, urine retention, sexual dysfunction and infertility; women who have undergone FGM/C are twice as likely to die during childbirth, and their babies are more likely to during or just after birth.”
A research led by Dr. Tochukwu Okeke revealed that Nigeria 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 (77%) (among adult women), followed by the south-east (68%) and south-west (65%), but practiced on a smaller scale in the north, paradoxically tending to in a more extreme form. Nigeria has a population of 150 million people with the women population forming 52%. The national prevalence rate of FGM is 41% among adult women. Prevalence rates progressively decline in the young age groups and 37% of circumcised women do not want FGM to continue. Sixty-one percent of women who do not want FGM said it was a bad harmful tradition and 22% said it was against religion,” researchers wrote in their findings.
According to the Nigeria Demographics and Health Survey, one in every four Nigerian women aged between 15 and 49 has been circumcised, especially among Ibo and Yoruba.
The survey ranks Osun highest in prevalence of FGM at 76.6%, Ebonyi follows closely at 74% and Ekiti at 72.3%. Imo and Oyo states come fourth and fifth place with prevalence rates of 68% and 65.6%, respectively.
While most communities visited for this report do not attribute a specific age for when FGM should occur, the demographic report shows that 82% of the cutting takes place for most females before the age of five.
Ajogbeje, who has had her daughters cut, confirmed the age of cutting. It is corroborated by members of Ilawe community in Ekiti.
“There is no age specification but the earlier the better because it grows and can cause the body to react negatively. Some, if not cut can grow to look like the penis,” Ajogbeje said.
In Ilawe, females are circumcised as newborns within the first eight days of their birth.The reason is that it may be when the uncircumcised female wants to give birth to another child that her first child would die.
Circumcision ushers a female into womanhood and forms part of her marriage rites in Delta State. It is proudly paid for by her groom-to-be who brags about it as much as he does when he pays her bride price.
There, if she misses being circumcised at birth, adolescence or just before marriage, it most likely will be done when she is about seven months pregnant.
A visit to Ofagbe in Isoko North, Delta State revealed that male relatives of the groom are the ones who pin the woman to the ground during the circumcision process.
Responding to why it is the male in-laws who perform the role, Rev. Jonah Okriko, an elder in the community said with a half laugh, “That one, they are the ones who own her. She has become their property.”
Peer pressure is another reason women here are circumcised. “If you give birth with your clitoris still intact, you will be mocked in the community as being weak,”Princess, a member of the community, explained.
This was one of the reasons the mother of two girls and a boy volunteered herself to be circumcised in her second trimester of pregnancy, a decision she now regrets.
She said, “As a newly married couple, our sex life was fantastic. Then I got pregnant and was told that I had to be fully circumcised so that I would have a healthy child and avoid being mocked.”
Princess was circumcised at seven months pregnant. “After that I noticed, my sex drive went to zero, even though the delivery was successful. It almost cost me my marriage but for my mother’s intervention. Also the campaigns that began in the community against FGM, helped my husband and I understand that what was happening to us may not be unconnected to the cutting,” she said.
In Ofagbe, some women have been lucky to escape the process, thanks to their claim of being Jehovah’s Witnesses.
To avoid the same fate befalling her girls, Princess became a Witness.
Beauty, a nurse from Arada, Delta State, who was circumcised in adolescence, counts herself lucky: only the ‘inner lips’ of her privates were cut off. She felt it was better to do it then than later as a seven-month pregnant married woman.
In the line of duty, she has had to recommend Caesarean sections for several circumcised women because the walls of their vagina had been so stretched or improperly healed, it would have been too risky for them to have normal deliveries. “Even episiotomy, was not an option in most of these cases,” she said.
Three elderly women, who seemed like custodians of the culture, spoke to our reporter at their neighbourhood market atop a hill looking down on the palace of their traditional ruler the Alawe of Ilawe-Ekiti, Oba Adebanji Ajibade Alabi.In some parts of Nigeria, deep-seated patriarchal normsfuel the continued existence of the practice; in other parts, the belief that no child should be born with a clitoris intact fans the FGM embers, as is the case in Ilawe.
The fact, it is said, that he has decreed that anybody found engaging in the practice will be banished from the community is not deterrent enough for the women who brag about the reasons why it is important to preserve their age-long culture.
They chorused, “In this community, no child born with its mother’s clitoris intact will survive. Every girl born in this village must be circumcised so that they can have babies that will live. It is the culture and nobody can stop it.”
On why they have such strong beliefs, they said, “It is something we were born into and have passed on to our children. It is also in the Bible for us to circumcise our daughters.”
The latter, a claim which Rev Fr. Anthony Akinwale refuted.The professor of Theology and Vice Chancellor Dominican University, Oyo State, said, “The Bible does not speak about circumcision of the female child. Circumcision of the male was a requirement of the Mosaic Law and required of the Jews but not of Christians. The Bible does not require women to be circumcised.”
Against the notion that FGM exists among the less educated and less privileged, Gina (not her real name) shared her experience with her Imo-born Howard University-trained fiancé.
“After he proposed, he came to visit me from the U.S. as we discussed wedding plans and things we wanted in our lives, the conversation drifted to FGM practice. When I expressed my disgust, he seemed surprised and said, ‘Oh, you are not circumcised?’ I said,‘how can you ask such a ridiculous question. Of course not.’ He said, ‘Ah, you have escaped it, then. But mind you, if we have daughters, they must all be circumcised. My mother and sisters were circumcised. It is a tradition in my family and I will not be the one to break it.’”
“I froze. Even now, as I narrate this, I’m in shock afresh. I fled from his hotel room that day and have never set eyes on him or spoken to him again. It’s been two years now but I’m still in shock as to how somebody who went to America’s Howard University and also has a Master’s from there, has such a mindset.”
The FGM scale tilts from bad to worse.
The Executive Director of the NGO, Kids & Teens Resource Centre, Mr. Martin-Mary Falana, said FGM practice has reduced in the open, but there is a surge in the number of procedures carried out secretly because there are more watchdogs.
The independent consultant who has advocated against FGM for about two decades, targets elderly women in communities.
“The elderly women are the ones who still hold strong beliefs about myths and misconception about female genital cutting. In one of the cases, a grandma who lived in Lagos brought her daughter back to Idanre to have her circumcised. They believe if the girl isn’t circumcised she won’t get married. If the cultural beliefs that are barriers can be broken, the scourge will be eradicated.”
In 1995, the World Health Organization(WHO) developed four broad categories for FGM operations.
- Type 1 – Excision (removal) of the clitoral hood with or without removal of part or all of the clitoris.
- Type 2 – Removal of the clitoris together with part or all of the labia minora.
- Type3 (infibulation): Removal of part or all of the external genitalia (clitoris, labia minora, and labia majora) and stitching and/or narrowing of the vaginal opening leaving a small hole for urine and menstrual flow.
- Type 4 (unclassified): All other operations on the female genitalia, including:
- • Pricking, piercing, stretching, or incision of the clitoris and/or labia;
- • Cauterization by burning the clitoris and surrounding tissues;
- • Incisions to the vaginal wall;
- • Scraping (angurya cuts) or cutting (gishiri cuts) of the vagina and surrounding tissues; and
- • Introduction of corrosive substances or herbs into the vagina.
Type I and Type II operations account for 85 percent of all FGM. Type III (infibulation) is common in Djibouti, Somalia and Sudan and in parts of Egypt, Ethiopia, Kenya, Mali, Mauritania, Niger, Nigeria, and Senegal.
According to the WHO, the type of procedure performed also varies, mainly with ethnicity. “Current estimates (from surveys of women older than 15 years old) indicate that around 90% of female genital mutilation cases include either Types I (mainly clitoridectomy), II (excision) or IV (“nicking” without flesh removed), and about 10% (over 8 million women) are Type III (infibulation). Infibulation, which is the most severe form of FGM, is mostly practiced in East Africa. In West-Africa, the tendency is to remove flesh (clitoridectomy and/or excision) without sewing the labia minora and/or majora together.
Victor Erumewa, a father of two daughters, in an interview shared on YouTube by the nongovernment organisation, Media Initiative Against Human Trafficking Women Rights Abuse, revealed a fifth – pressing the clitoris away.
Erumewa, a Lagos-based trader, said, “When my wife gives them a bath, she has a way of doing it so that the thing that is usually cut off goes back inside. When the baby is young, you use your hand to press it until it goes back inside. If you leave it, it will disturb the woman later in life and cause her to be misbehaving. It won’t allow her stay in her marriage.”
Sexual health is considered a component of general wellbeing with studies revealing that hormones secreted by the body during the sexual process enhance sleep, emotional wellbeing, keep depression at bay and aids relaxation among others.
Against this backdrop, a psychiatrist at the Federal Medical Centre, Makurdi, Dr. Michael Amedu, explained the psychological dangers of FGM on the victim.
“Mental health manifestations from FGM could be post-traumatic stress disorder, anxiety disorder, depression/mood disorder and sexual disorder, which are of different types,” said Amedu.
“In the PSTD which follows an exposure to trauma, the female may have flashes of the experience of being cut. The symptoms include reliving the experience which keeps coming back. It comes with all the experiences which one has during the real experience. Sometimes it has symptoms of anxiety and depression.”
Amedu said, “Patients would usually not directly complain of a sexual disorder. These disorders have different physical symptoms like headaches, body aches, fear, pounding hearts, internal heat, not sleeping well. These symptoms are what they tell the doctor.
“They undergo all sorts of investigations trying to arrive at a conclusion. But then the completeness of a total medical history involves the sexual history too. Since it is a delicate issue, some doctors may not want to ask their patients about it. But if done in a considerate way, the patient could open up and talk about it. If the patient isn’t prompted, it may never be resolved.
“When it comes to emotional pain, first of all identification of the problem is a problem because it may not even be seen as an emotional problem. What lay people understand as psychiatric symptom is when one goes on the street. That is when it is recognized. But symptoms of depression can come as withdrawal from people, feelings of sadness, unnecessary guilt. Sometimes people have suicidal thoughts. Some of these people may eventually reach the medical practitioners.”
He added, “There is need for cultural reorientation and getting those cultures practising it to understand the physical, social and psychological impact it has on people. So that they will begin to consider the possibility of ending the practice completely.”
Shedding more light on the issue, Dr. Zulaiha Pawa, a consultant gynaecologist at the Ahmadu Bello University Teaching Hospital, Zaria, said, FGM has no medical benefits and the consequences include bleeding, long-term defects.
Pawa said, “The practice is mostly carried out without anaesthesia by quacks who sometimes use crude instruments.
“Even the way they hold the victims down can predispose them to fracture or dislocations of their joints especially when the girl is struggling against restraint. The victims can sometimes go into shock, get urinary retention, infection, fever and even HIV. There can be delay in the wound healing due to the wound infection, malnutrition or anaemia, keloids scar, fistula and many more like long term complication including menstrual problems or sexual dysfunction and difficulty in labour/delivery.”
Responding to Erumewa’s claim, she said, “Pressing or massaging the clitoris is not going to make it disappear or stunt its growth. The clitoris is a very sensitive organ that adds to sexual pleasure. These women are being denied this.”
Although the journey to ending the practice is still a long one, FGM has been described globally as a violation of the rights of women and girls. In Nigeria it was criminalized in May 2015 when the Senate passed the Violence Against Persons Prohibition (VAPP) bill.
The law says “a person who performs female circumcision or genital mutilation or engages another to carry out such circumcision or mutilation commits an offence and is liable on conviction to a term of imprisonment not exceeding four years or to a fine not exceeding N200,000 or both.”
To bring an end to FGM, Pawa said, “We need to educate everybody on the risks. We have to ensure that the law passed is implemented and will serve as deterrent to others who practise it or are accomplices. Whilst she admitted that cultural practices are some of the most difficult to change, she urges, “We should start somewhere.”
Martin-Mary Falan facilitated access to communities in Ondo and Ekiti states, while Martha Onose facilitated access to communities in Delta State.
This story was done with the support of Code for Africa