Addressing Female Genital Mutilation/Cutting: A Neglected Component of RMNCAH programming

In honour of International Day of Zero Tolerance for Female Genital Mutilation (February 6th) I am reminded of the words of a woman in Nigeria who experienced being cut as a young girl: “I have three dreadful days: the day I was mutilated, the day I was married, and the day I gave birth.”

Female Genital Mutilation/Cutting is difficult to discuss, and complex in that it reflects deep rooted gender inequality, community power dynamics, traditional practices, livelihoods, and misinformation about the risks involved. Through Cuso International’s partnership with UNFPA in Nigeria, I have come to learn more about the prevalence of this practice, the lasting negative impact it has on girls and women, and the role that we can play to support local organizations and anti-FGM/C champions to support communities to abandon this harmful practice.

But first — a few facts:

• Female Genital Mutilations (FGM/C) refers to all procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical purposes;
• An estimated 200 million girls and women alive today have been subjected to FGM/C;
• FGM/C is an extreme form of violence against women and girls, recognized as such by many human rights treaties and internationally agreed documents. Those include: the 1994 ICPD Plan of Action, the Beijing Declaration and Platform for Action (1995), the Convention on the Rights of the Child (CRC), the Convention for the Elimination of Discrimination against Women (CEDAW).
• If nothing changes, UNFPA projects that by 2030, 20.7 million more girls aged 15–19 will have experienced some form of FGM/C.

In Nigeria, six states have particularly high rates of FGM/C, ranging from 44.8% to 76.3%. In Ebonyi State, where Cuso International is supporting an FGM/C-abandonment campaign, prevalence in some areas is as high as 72.6%.

Many of the myths that are used to maintain or perpetuate the practice of FGM/C in Nigeria reflect misinformation and gender inequality and discrimination. Myths include perceptions that the practice makes childbirth and conception easier, prevents promiscuity, maintains virginity and marriageability, reduces harm to male reproductive organs, and is an important rite of passage.

In reality, the practice claims women’s and girls’ lives due to bleeding and infection, makes childbirth and pregnancy much more difficult and potentially life-threatening, and can leave lasting physical and emotional scars resulting in a range of negative health outcomes for women and their babies. In Ebonyi state, the majority of girls are cut before their first birthday. In other communities, most cutting occurs between age five and 18 years of age. The majority of the cutting is by traditional FGM/C practitioners and skilled health workers (medicalizing and therefore somewhat legitimizing this practice).

Given the scale and scope of this issue, and the impact this practice has on women and girls’ sexual and reproductive health and rights, this issue needs to be addressed more broadly by the global health community.

Eradicating FGM/C requires sustained efforts over the long term, and sometimes takes us outside of our comfort zone. It requires strong local partners and champions to do the difficult community engagement and education work. Ensuring we engage communities, health workers, and educators to understand the very real health risks to women and girls is crucial if we are to meet the targets under Sustainable Development Goal 3 — Improved Health and Well-Being for All — and Sustainable Development Goal 5 — Gender Equality and Empowered Girls and Women.

In our work with UNFPA, Cuso International is supporting community education, awareness and abandonment campaigns, working with traditional FGM/C practitioners and political leaders, and getting the message out that communities must abandon this practice for the health and safety of their next generation of girls. As part of our ongoing efforts here in Canada, we are working with diaspora organizations, and community champions who are advocating for the abandonment of FGM/C.

Moving forward we are hopeful that more and more communities will continue to replace this practice with a symbolic one that does not include physical harm to young girls. And we hope that more organizations will address this issue in their Reproductive, Maternal, Newborn, Child & Adolescent Health work reflecting the complex gender and power dynamics impacting girls and women’s health within the communities in which we work.

You play an important role in eradicating female genital mutilation. Nigerian women need our voices and our investment in their fight to end this practice. Show your solidarity with a donation today. Together, we are all made stronger!