By Babatunde Adeleke
IN Nigeria, it is estimated that 17% of girls aged 0-14 years and 25% of women aged 15-40 years have been subjected to female genital mutilation. While there has been a decline in the rate at which Female Genital Mutilation (FGM) is practised all over the world, UNICEF predicts that if female genital mutilation continues to be practiced at current levels, 68 million more girls would have undergone FGM by 2030.
Female genital mutilation is a broad term for a wide range of procedures, ranging from removal of part of the clitoris to procedures that reduce the vaginal opening, leaving a tiny opening for the passage of menstrual blood and other body fluids.
In many communities where FGM is practiced, it is assumed that the removal of the clitoris and/or the fear of pain from the sexual act through a narrowed passage would ensure sexual abstinence in young women. It’s important to highlight some reasons why this is such a harmful practice that has a long term, even lifelong impact on the girls and women who are subjected to this traumatic mutilation of their genitals.
6th of February is the international day for the zero tolerance of female genital mutilation. The day was set aside to expose the ills of the traditional vice that brings with it a lot of health complications. Dr J.A Famurewa of the Obafemi Awolowo University Teaching Hospital gave insight into how FGM could adversely affect female health in general and reproductive health in particular.
FGM impacts women’s health adversely in several ways which can be broadly classified into Immediate; Late; Obstetric; Psychological and Sexual complications.
Immediate complications occur within days to weeks of the mutilation. Debilitating pain is experienced by most women because the female genital tract is richly supplied with nerves that transmit sensation and these mutilations are mostly carried out without the aid of anaesthetic agents or pain medications. Other immediate complications include excessive bleeding and wound infection which in some cases result in death. Difficulty and pain in passing urine may also arise as a result of infection of the urinary tract or may be a complication of the genital cutting itself. Most of the mutilations are performed under unhygienic conditions with crude and unsterilised instruments with the attendant risk of transmission of HIV.
Late complications occur within weeks to years of the procedure. Excessive scar formation may occur leading to disfigurement of the genital region. In certain cases, chronic pelvic pain and infertility may occur.
Obstetric complications are those relating to pregnancy and child birth and as with most obstetric complications, it usually affects both the mother and her unborn child. They include prolonged obstructed labour and Post-partum haemorrhage. There is also an increase in the risk for Caesarean Section and assisted vaginal delivery. A baby is also at risk of dying while exiting the birth canal if its mother’s vagina has been made unnaturally narrow through FGM.
Psychological complications: Mutilation traumatises not just the body but the mind. Following the procedure, women report having nightmares and night terrors. Some spend the rest of their lives battling depression and anxiety disorders.
Sexual complications: Embedded at the root of FGM is the aim of making the sexual act as undesirable and unappealing as possible. Women who have been cut often derive no pleasure from and experience pain during sexual intercourse.
Although Nigeria’s Violence Against Persons (Prohibition) Act, was signed into law in 2015, it has been domesticated in only 3 states in the federation. Incoming governors and state legislators need to prioritise the domestication of this bill in order to bring an end to the horror of FGM.