 Because of poor access to information, and because circumcisers downplay the causal connection, women may not associate the health consequences with the procedure.Lala Baldé, president of a women's association in Medina Cherif, a village in Senegal, told Mackie in 1998 that when girls fell ill or died, it was attributed to evil spirits.When informed of the causal relationship between FGM and ill health, Mackie wrote, the women broke down and wept.