Table of Contents
Objectives of the seminar paper.
Reasons for focusing on south-west region of Nigeria
Countries where FGM are practiced
Consequences of female genital mutilation on women
CLASSIFICATION OF FEMALE GENITAL MUTILATION BY WORLD HEALTH ORGANIZATION
Widespread of secrete FGM practices in south-west of Nigeria
Effectiveness of criminalization of FGM in Nigeria.
Effect of formal education on FGM practices in south-west of Nigeria
Effectiveness of public awareness on FGM practices in south-west region of Nigeria
Does living in Urban areas have effect on FGM practice in south-west region of Nigeria?
Effect of family pressure on FGM practice in south west of Nigeria
Religion influence on FGM practice in south-west of Nigeria
Cultural influence on FGM practices in south west region of Nigeria
Strong government support and more political commitment toward FGM eradication
Aggressive medial campaign to target re-orientation and behavioural change
Mobilization of women leaders and traditional rulers as advocates and ambassadors against FGM.
Skill acquisitions and empowerment
Compensation for local circumcisers
Collaboration with education sector
Aggressive government enforcement of existing laws against FGM
Table of figures
Figure 2: Prevalence of FGM by state in Nigeria
Figure 3: Percentage of women age 15-49 years circumcised by selected ethnic groups
Figure 4: Percentage distribution of FGM according to type for women aged 15 to 49 in Nigeria
Figure 6: Picture showing performance of FGM by traditional circumciser
Figure 7: Picture showing normal virginal structure
Figure 8: Picture showing FGM type I (Clitoridectomy)
Figure 9: Picture showing FGM type II (Clitoridectomy and/or labial excision)
Figure 10: Picture showing FGM type III (Infibulation)
Figure 11: Picture showing FGM type IV (Stretching of labia)
Female genital mutilation is a menace ravaging southern Nigerian states. It is an age-long cultural practice that is imposed and enforced by community expectation from generation to generation among Yoruba people in south-west zone of Nigeria. It evolves as a complex chain of events which reinforce itself through a feedback loop, with a sequence of reciprocal cause and effect in a culturally glued society where ancient values and practices still have a grip on its people. Secrete female genital mutilation is a major public health challenge in south-west of Nigeria. Despite their high level of education and awareness rate, their mutilation prevalence was unfortunately the highest in the country. Extensive medial awareness has been employed to stop the practice in the past. Government also banned it nationwide, but people still go secretly to have the procedure done despite health consequences associated with the practice. The aim of this paper is to identify factors that are responsible for continuous secret performance of female genital mutilation in south-west region of Nigeria, evaluate the challenges facing its eradication and proffer the way forward. Cultural influence, societal expectation, family pressure and religion attachment have been identified as the motivators that perpetuate the practice. The most effective way of achieving behavioural change is active engagement of community members in participatory community mobilization to control and shape their own future, destiny and development, using communication as a means of empowering people with the right information. Actions that are necessary to change community way of life, like collective action, public declaration and organized diffusion would definitely go a long way in eradicating the menace.
Female genital mutilation (FGM) is an age-long cultural practices that is imposed and enforced by community expectation from generation to generation among Yoruba people in south-west geo-political zone of Nigeria. Female genital mutilation evolves as a complex chain of events which reinforce itself through a feedback loop with a sequence of reciprocal cause and effect in a culturally glued society like south-west of Nigeria, where ancient values and practices still have a grip on its people. Female genital mutilation could be defined as all practices involving total or partial removal of a female genital organ, or any form of injury to the external female genitalia for non-medical purpose (World Health Organization, 2017). If Nigeria is to achieve the relevant United Nation sustainable development goal number three (Good health and well-being) and five (Gender equality) with a view to advance the right of women and girls, we need to be part of actively moving international ambition which tagged 2017 FGM awareness day theme as “Building a solid and interactive bridge between Africa and the world to accelerate ending female genital mutilation by 2030”.
During the last decade, government in Nigeria had recognized female genital mutilation as a major public health challenge and had deployed extensive public medial campaign to combat the menace. Despite the educative media campaign of the government, the practice still largely continues in south-west of Nigeria. Some non-governmental organizations are also making tireless effort to stop the practice. Many international advocacy groups have claimed that FGM is a discrimination against women (Rhoodie, 1989) while human right groups have also claimed that it is a pure form of human right violation (Human Rights Watch, 2010 ), especially as concerned he right violation of women and girls (Yoder et al., 2013). Many of the south-west state of Nigeria also enacted laws that banned the practice in order to dissuade people from carrying out the procedure. The practice actually reduced, but still went on largely been practiced secretly away from the government’s camera lens at the hospitals, but shifted base to the villages in the hands of untrained traditional birth attendants. Many exploited the loophole that not all the states that banned the practice in Nigeria and transported their girls away from the state where it was banned to where it was not banned. In year 2015, in an effort to stop FGM practice across the country, federal government of Nigeria banned it all over the country. Banning the practice nationwide was actually a step forward in the fight against FGM. The law curbed the practice openly but failed to curb it secretly. People still largely performed FGM secretly in various communities, compounded with family pressure.
The aim of the seminar paper is to evaluate the challenges facing female genital mutilation eradication in south-west of Nigeria, and to proffer the way forward.
Female genital mutilation practice is widespread in southern Nigerian states, but more alarming in south-west geo-political zone of the country. Demographic and Health Survey (2013) showed that the prevalence of female genital mutilation among Yoruba girls and women between 15 to 49 years of age living in south-west region of the country was 55%. This was the highest in the country. Most of the procedures are secretly done with traditional birth attendants and traditional circumcisers under unhygienic conditions that carries high health risk with serious health complications. Eradicating this practice will significantly reduce the health risk and complications arising from female genital mutilation, thereby improving maternal and child morbidity and mortality arising from the practice.
Adopted from The Nigerian Observer news 2015
Figure 1: A picture showing painful condition a girl go through and unhygienic condition where FGM is performed.
Demographically, Nigeria is Africa’s most populous country. It is located in Sub-Sahara African region. According to the Nigerian National Population Commission (2017), It has an estimated population of 182 million with about half of the population women. More than half of its population are under 30 years of age. This put a strain on a country with dwindling economy and declining revenue to improve health and other social services. Nigeria is an African country in the Gulf of Guinea which shares border with Cameroon, Benin republic, Chad and Niger. Nigeria is the most populous country in that region and unfortunately, it has the lowest life expectancy in Africa, lower than many poorer nations in west Africa sub-region. Life expectancy in Nigeria was put at 54.46 years and ranked 176 in the world while life expectancy for Nigerian women went down to number 178 in the world. Issues concerning women like FGM should be of great concern and should not be overlooked. Since the Nigeria population has been growing for the past five decades, the health burden that could arise from the adverse effect and complications from FGM in the next decade could be difficult for the country to cope with in the face of other pressing issues that are competing for her scarce resources. Therefore, it would be economically viable to eradicate FGM practice in order to stop the health burden that could arise from its complications.
It was estimated by World Health Organization (2017) that female genital mutilation affect over 200 million women around the world in countries where FGM is concentrated. The vast majority of these women are from Africa, Middle East and Asian Countries. Due to immigration, many migrants also took this practice to some developed countries they migrated to, thereby making it a global phenomenal today. In 2009, European parliament estimated that over half a million women in Europe have been subjected to FGM, with over 180,000 more at risk (Leye and Sabbe, 2009).
According to United Nations Population Fund (2015), female genital mutilation is practices in different countries around the world. It is known to be practiced in the following countries:
Nigeria, Kenya, Zambia, Tanzania, Uganda, Togo, Sudan, Somalia, Senegal, Sierra Lone, Niger, Liberia, Mauritania, Mali, Guinea, Gambia, Ghana, Guinea-Bissau, Eritrea, Egypt, Djibouti, Ethiopia, Democratic Republic of Congo, Chad, Cote d’Ivoire, Cameroon, Benin, Central African Republic, Burkina Faso.
Middle East
In Middle East, countries where FGM is practice are, Yemen, Iran, United Arab Emirate, Iraq, Israel, Omar, Palestine
Asia
In Asia, some communities in Malaysia, Sri Lanka, India, Pakistan and Indonesia practice female genital mutilation.
South America
In Southern American countries, certain communities in the following countries practice female genital mutilation. Peru, Ecuador, Colombia and Panama.
Eastern Europe
Recently in Eastern Europe, certain communities in Russian Federation and Georgia are known to be practicing female genital mutilation.
Other western countries
Due to immigration in some western countries like United Kingdom, Australia, New Zealand, Canada, United states of America, and several European countries, immigrant population who migrated from regions where FGM practice is endemic still continue the practice in their host countries.
Out of the six largest ethnic groups, the Yoruba, Hausa, Fulani, Ibo, Ijaw and Kanuri, only the Fulani do not practice any form. The Yoruba practice mainly Type II and Type I. The Hausa and Kanuri practice Type III. The Ibo and Ijaw, depending upon the local community, they practice any one of the three forms (International Women’s Issues, 2009). Women from Ijaw ethnic group have the highest rate of type III 18.8% (Demographic and Health Survey, 2013).
Adopted from 28toomany (2017)
Figure 2: Prevalence of FGM by state in Nigeria
Adapted from Demographic and Health Survey (2013)
Figure 3: Percentage of women age 15-49 years circumcised by selected ethnic groups
Nigeria and Inter-African Committee (1997) showed the following prevalence and type of female genital mutilation in the following Yoruba states in Nigeria. Kwara (60-70 percent, Types I and II); Lagos (20-30 percent, Type I); Ogun (35-45 percent, Types I and II); Ondo (90-98 percent, Type II); Osun (80-90 percent, Type I); Oyo (60-70 percent, Type I)
Types of genital cutting in Nigeria
Adopted from: Demographic and Health Survey (2013, as cited in 28toomany, p 349-350)
Figure 4: Percentage distribution of FGM according to type for women aged 15 to 49 in Nigeria
In a qualitative and quantitative study on Intergenerational attitude change regarding female genital cutting in Yoruba speaking ethnic group of South-west Nigeria. The prevalence rate of female genital cutting among daughters and mothers in each of the 6 states (Alo and Gbadebo, 2011) revealed that Oyo state had the highest prevalence rate of 88% for daughters and 91% for mothers followed by Ondo State of 76% for daughters and 79% for mothers while Lagos had the least prevalence rate of 56% and 64% for daughters and mothers respectively. It is sufficient to note that Lagos state fared better regarding all the indices of modernization than any other state in the country being the former federal capital territory. Lagos state, however, had the highest intergenerational difference of 8%; this is followed closely by Ekiti State with an intergenerational difference of 5%.
FGM is a celebrated event in some communities. They viewed it as a transition from childhood to adulthood (Leonard, 1996). It is also erroneously viewed as a practice which brings dignity and make the woman clean, thereby make her marriageable and prevent promiscuity in marriage. Some also believed that if a baby’s head touches uncut clitoris during childbirth that the baby would die prematurely. Under this unjust social control of sexuality and fertility, traumatic and psychological burden of this gruesome act lies on women and girls. This brings varying decree of complications raging from excessive bleeding (which may lead to loss of life in children with bleeding disorder), infectious disease (including HIV), dermatological and obstetrical problems and complications (Ledger et al., 2015).
Adopted from thedailybeast.com
Figure 5: A Pokot woman holding a razor blade after performing a circumcision on 4 girls despite a government ban in Kenya.
The devastating effect of female genital mutilation on women is globally recognized. This practice is common with people with common historic background and similar socio economic strata, but there are variations within countries, regions and communities. South-West Nigeria is the most educated region in Nigeria, ironically, it is also one of the regions that have highest prevalence of Female genital mutilation in Nigeria. From this clue, education seems to play minimal role in curbing FGM practice in this region, but mother’s education have impact on their decision not to circumcise their daughters (Kandala et al., 2009). It also shows that community have significant impact on the practice with individual factor explaining little on FGM distribution.
In Nigeria, intensive mass media campaign and advocacy has been going on (Ikediego, 2017, International Women’s Peace Group, 2017) for so many year, although significant gain has been made in reducing FGM, but eradicating this menace still remains a mirage. In an effort to tame FGM’s silent wildfire, Nigeria which is the most populous African country took a bold step and banned FGM (Shoaff, 2015), but advocates argued that there is still more work to be done (Goldberg, 2015).
Sexual health – Different women experience varying degree of sexual difficulty but a study suggested that woman who had female genital mutilation are likely to experience reduced satisfaction, pain during sexual intercourse and reduced sexual desire (Berg et al., 2010).
Immediate problems that could arise from FGM include excessive bleeding, severe pain, shock, infections, difficulty in passing urine, injury to surrounding genital tissue, fever, septicemia and death due to excess bleeding and infection. Complication and risk increase with FGM type, but are more severe with infibulation (Nowak, 2010). Long-term effects are severe pain for several weeks after the performance of FGM, psychological consequences, physical and sexual effect, chronic pelvic infection, infection of the reproductive system, chronic pain, genital ulcer, abscesses, development of cyst, excess scar tissue formation, decreased sexual enjoyment and post-traumatic stress disorder.
Adopted from Vanguard news website 2015
Figure 6: Picture showing performance of FGM by traditional circumciser
Other complications
Other complication and risk associated with infibulation are, menstrual and urinary problems, infertility, painful sexual intercourse, defibulation and reinfibilation surgery. Sexual intercourse could only be possible after opening the infibulation through surgery or traumatic penetrative sexual intercourse. Sex is usually painful for the woman in the first few weeks following the first sexual intercourse.
Problems during childbirth
During childbirth, the scar tissue may tear and cause significant blood loss. It could also cause post-partum haemorrhage, extended hospital stay and it could necessitate the performance of episiotomy. FGM have significant negative effect on the woman during childbirth. A meta-analysis study result (Berg and Underland, 2013) also showed that obstetric laceration, prolonged labour, difficult delivery, obstetric hemorrhage, instrumental delivery and increased risk of delivery complication were associated with FGM. A study from World Health Organization also showed that 1 to 2 babies per 100 birth die as a result of female genital mutilation (Banks et al., 2006).
Psychological effect
The psychological effect of traumatic FGM may linger long on the girls and women who undergone the procedure, since anaesthetic agent are not usually used. Behavioural disturbance may be triggered by the psychological stress the woman encountered during the procedure. Children could develop loss of trust and confidence in their caregivers. Women may develop depression and feelings of anxiety in the long term. The woman may encounter marital problem and divorce with her husband due to sexual dysfunction in marriage (United Nations Population Fund, 2015).
Normal Virginal
Adapted from Shockey (2017) Adapted from Swiss women’s clinic (2014)
Figure 7: Picture showing normal virginal structure
Adapted from Shockey (2017)
Figure 8: Picture showing FGM type I (Clitoridectomy)
TYPE II
Clitoridectomy and/or labial excision
Partial or total removal of the clitoris and/or the labia minora, with or without the removal of the labia majora
Adapted from Shockey (2017)
Figure 9: Picture showing FGM type II (Clitoridectomy and/or labial excision)
TYPE III
Removal of the external female genitalia and sealing or narrowing of the vaginal opening by joining opposing cut parts of the labia, using stitches. The clitoris may or may not be removed. A small opening is left for urination and menstruation
Adapted from Shockey (2017)
Figure 10: Picture showing FGM type III (Infibulation)
TYPE IV
All other harmful procedures to the female genitalia for nonmedical purposes
These include, pricking, piercing, incising and stretching the clitoris or labia, burning the clitoris, scraping the vestibule and cauterizing the vaginal vault with corrosive substances or herbs
Adapted from Swiss women’s clinic (2014)
Figure 11: Picture showing FGM type IV (Stretching of labia)
| CLASSIFICATION | ANATOMICAL INVOLVEMENT | SUBCATEGORIES |
| TYPE I | Clitoridectomy: partial or total removal of the clitoris and/or the clitoral hood (prepuce) | Type Ia: removal of the clitoral hood or prepuce only |
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