By Vivian Ihechu
Thirty-two-year-old Chinedum was excited when she discovered she was pregnant. She was in a foreign land when the baby girl came. As a fresher, Chinedum was almost clueless on how to nurse the baby.

She relied on constant telephone calls from home, mostly from her mother and aunties telling her how to bathe, breastfeed and carry the baby, among other pieces of advice.

One piece of instruction was constant: use petroleum jelly on the baby’s clitoris and vulva, especially after bathing her. She consequently engaged in the practice. Chinedum was later to understand that the practice was a subtle form of Female Genital Mutilation (FGM), a cultural practice prevalent in Africa.

The practice, which has many forms, regrettably, has been established to have negative effects on the sexual, reproductive, and emotional health of females.

A media consultant, Mrs Voke Omoregie, who is in her early forties and married with three children, narrates her ordeal as a victim of FGM. Omoregie says her ordeal started on her 13th birthday and has remained a nightmare.

According to her, she, in company with her sister, father, and aunt, visited a relative in a Lagos suburb. On getting to their destination, some elderly women welcomed them with enthusiasm and ushered them into a room.

Omoregie was later taken to another room. There, she saw some small bowls of water, a white cloth, and a mat on the floor as well as a blade, towel, cotton wool, and some mixtures. In the room were three women, who told her to remove her clothes. She complied in confusion.

“I was told to lie on the floor, and two of the women firmly gripped my legs down. It was one of the most unimaginable and excruciatingly painful moments of my life. The eldest of the women cleaned a blade and a very small sharp knife. “They spread my legs wide and, in a twinkle of an eye, I felt this sharp, excruciating pain down my vagina; I let out piercing screams and the ground started moving around. After the procedure, I was told that I had just been circumcised and that I had become a woman. The women took turns to explain the reasons for the ‘ambush’.” According to Omoregie, the woman claimed that cutting off some parts of her clitoris was cultural and a rite of passage.

She recalls that the women said that it would also prevent her from being promiscuous. “However, they never told me some accompanying negative effects. Now, I quarrel with my husband over sex, I loathe having sex; it is not pleasurable and it is almost always a painful ‘duty’,’’ she regrets.

A banker, Miss Ibidun Gbolahan, also has a bitter experience. Gbolahan, who is in her mid-twenties, recounts how, as a teenager in secondary school, she discovered that her menstruation was not regular and she often had itching in her vagina.

She recalls that medical examinations showed that the scar she had as a result of FGM as a child was responsible for the condition. Gbolahan says she was unable to engage in sexual intercourse because of the scar as no penis could penetrate her vagina until shortly before her wedding, a team of doctors performed a surgical procedure on her to widen the opening of her vagina.

According to her, although she can now have and enjoy sex, she will only be able to give birth through Caesarean Section. Analysts believe that there are more bitter experiences of victims of FGM but many of the experiences are untold.

The World Health Organisation notes that female genital mutilation/cutting includes procedures that intentionally alter or cause injury to the female genital organs for non-medical reasons. It involves removal of a part or all of the female external genitalia; it can be done with knives, blades, or even by consistently rubbing the clitoris with lubricants such as Vaseline or shea butter known to many in Nigeria as ‘Ori’.

The practice is mostly carried out by traditional circumcisers, who often play other roles in communities such as attending to childbirths.

WHO describes the different types of female genital mutilation as a violation of the human rights of children, girls, and women.

This practice, which also violates a person’s rights to health, security, and physical integrity, is a procedure that has no health benefits, it says. According to UNICEF, FGM can lead to death.

Girls subjected to female genital mutilation are also at increased risk of child marriage and dropping out of school, and this threatens their abilities to build a better future for themselves, their families, and their communities.

FGM was outlawed by the United Nations in 2012. It is a punishable offence in Nigeria under the Violence Against Persons Act, 2015. Recognising the need to stop FGM, the International Day of Zero Tolerance for Female Genital Mutilation is commemorated annually on February 6.

The latest data by UNICEF on FGM shows that no fewer than 200 million girls and women alive have undergone female genital mutilation with an additional two million girls likely at risk by 2030 due to COVID-19.

UNICEF says an alarming trend is emerging as even health personnel are helping to carry out the practice. “Around one in four girls and women, who have undergone female genital mutilation, or 52 million worldwide, are subjected to the practice at the hands of health personnel. This proportion is twice high among adolescents. “In about half of countries, female genital mutilation is increasingly performed at younger ages, narrowing the window of opportunity to intervene,” UNICEF warns.

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WHO, governments, and gender and health experts have continued to emphasise the dangers of FGM to health, adding that it is a violation of human rights.

Minister of Women Affairs, Paulen Tallen, says: “FGM is one of the most grievous and unacceptable practices against women and children. It is a violation of human rights, and it is most dehumanising because it destroys the pride of women. It gives them low esteem and reduces them to an object that can be manipulated and destroyed by society.”

Tallen spoke at the launch of the National Policy on FGM National Protocol on Management of Complications of FGM in Nigeria.

The UNFPA Country Representative, Nigeria, Ms Ulla Mueller, also describes FGM as a harmful practice with no health benefits, but with physical, mental, psychological, and social harm to the survivor.

A gynaecologist at the Nigerian Institute of Medical Research, Dr Oliver Ezechi, warns that infertility can occur as a result of an infection contracted during FGM, also known as female circumcision.

According to him, FGM is usually done with unsterilized equipment used for more than one person, thereby predisposing victims to infections. Ezechi adds that FGM can cause pain to women during labour and child delivery.

He explains that the vagina and vulva are made of soft tissues to reduce injury during delivery as they expand for the baby to pass through. “The scarred tissues can cause tear during childbirth with a lot of bleeding. Some of the tears may even go into the rectum. When this happens, you have to suture them, and the woman may have what we call rectovaginal fistula, also called obstructed labour,” Ezechi added.

He regrets that FGM is still common in Nigeria and that even educated parents still carry out this act on their children using modified methods. According to another gynaecologist, Dr Rotimi Adewale, FGM can lead to excessive bleeding, wound healing problems, fever, infections, shock, menstrual and urinary problems, cysts, sexual challenges as well as complications in childbirth.

A public health officer, Dr Taiwo Oguntoyin, is worried that FGM also predisposes women to contracting HIV/AIDS. Ogutoyin says: “Circumcision makes the vagina have scars after healing which can make it tighter and inelastic. During sex, the woman is likely to sustain injuries which can predispose her to HIV and other infections.’’

A Social and Education Counsellor, Ifeoma Ibe, says the process of FGM puts the female through pain and trauma with psychological consequences, such as post-traumatic stress disorder, low self-esteem, anxiety, and depression.

Ibe appeals to mothers to stop subjecting the girl-child to FGM because of the negative health and social effects.

On why FGM persists despite the associated dangers, Mrs Grace Osazee, a culture promoter, argues that FGM is part of cultural identity and improves the health and appearance of females.

The Permanent Secretary in the Federal Ministry of Health (FMoH), Malam Mahmuda Mamman, is worried that resource mobilisation is a major challenge in the campaign to end FGM.

He calls for support to the upscale campaign and accelerates the elimination of FGM.

To end FGM, the Federal Ministry of Health, recently launched the National Policy on Female Genital Mutilation National Protocol on Management of Complications of FGM.

At the launch, the Minister of Health, Dr Osagie Ehanire, also presented the Revised National Policy and National Protocol on Management of Survivors of FGM to the public.

According to Ehanire, both guidelines are expected to provide up-to-date evidence-based recommendations on the management of health complications from FGM.

Analysts are convinced that while strategies and policies play a huge role in the struggle to end FGM, getting women to key into the struggle is critical because they are the drivers and perpetrators.

Ending it also requires the cooperation of all stakeholders including policymakers, civil society organisation, women’s rights groups, and influencers such as teachers, health workers, religious leaders, and community leaders.

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More summits, community mobilisation, advocacies, and collaboration with religious and traditional leaders on ending FGM/C and harmful traditional practices against women, girls, and children should be done.

Ending FGM is so important that Sustainable Development Goal 5 emphasises it- elimination of all harmful practices such as early and forced marriage and FGM by 2030.