female genital mutilationFemale genital mutilation (FGM) is an act that involves all procedures partial or whole removal of the external genitalia or injury to the female sexual organs. This could either be for religious, cultural or other no-therapeutic reasons. Many women suffer permanent and irreversible damages to their health and well being with 2 million girls being subjected to it annually.

There are several types of FGM;

a) Type 1; excision of the prepuce, with or without excision of all or part of the clitoris.

b) Type 2; excision of the clitoris with partial or all excision of labia minora.

c) Type 3; excision of part or all of the external genitalia and stitching or narrowing of the vaginal opening.

d) Type 4: Infibulations this involves; pricking, piercing or incising the clitoris and or labia, cauterization by burning the clitoris and the surrounding tissues, introducing corrosive substances into the vagina or herbs to cause bleeding and for the purposes of narrowing it.

FGM qualification age in Africa vary from one state to another. From infancy in Ethiopia, Eritrea and Mali to seven-month pregnant females in Nigeria. In Somalia 'Horn of Africa', it was traditionally performed on adolescence as an initiation right to womanhood. it leads in the continent with 98% of women in the nation who have undergone the cut. Unlike other countries, in Somalia it's no longer practiced as a rite of passage, girls nowadays are circumcised between the ages of five and eight at the privacy of their homes. In most parts of the country traditional circumcisers, gudday, carry out the operation. With complications arising from the traditional methods, a lot of health professionals have started circumcising girls whom people are now turning to, there are even trained nurses who perform any type of FGM parents desire.

It's believed that a Lebanese medical practitioner introduced medicalisation of FGM at the dawn of independence in Martini Hospital in Mogadishu. He circumcised girls under sterilized and anesthetic conditions claiming to minimize the danger and damage associated with it. He was emulated by other health providers in Mogadishu providing their services to Mogadishu elite.

Long term health consequences are a result of FGM; infibulations cysts, keloid scar formation, damage to the urethra resulting in urinary incontinence, pain during sexual intercourse, sexual dysfunction, difficult child birth and difficult menstrual periods. If the operation is conducted in unhygienic surroundings or shared instruments, the victim is exposed to deadly virus like tetanus and HIV/AIDS. Some have even lost their lives due to excessive bleeding and pain.

Both rural and nomadic communities have recorded the most drastic forms of FGM, lack of access to health facilities worsens its complications. Somali women undergo 'three feminine pains' circumcision, wedding and labor which must be endured as an integral part of womanhood.

Although the origins of FGM remain blurred, communities practicing share the same perceptions. They have compelling reasons for eliminating with the clitoris and external female genitalia. The reasons ranging from, spiritual to religious, sociological to hygienic, aesthetic to sexual. The clitoris and female genitalia are considered as ugly, dirty and capable of growing to unsightly proportions and making women spiritually unclean. They are also deemed to prevent women from maturing and rightfully identifying with age mates, ancestors and the human races.

Every community member is bound by the culture, men, women, young, old, powerful, powerless are influenced by it unquestioningly. There are complicated beliefs associated with not eliminating the female genitalia and the dangers that may befall the girl, her family, future husband and society. A young woman's sexuality is therefore to be controlled to prevent her from being oversexed, losing her virginity, disgracing families or failing to get married. A woman is also a cause of mistrust to a potential husband and a threat to the existence of the entire community.

There are community enforcement mechanisms that compel communities to continue with the practice of FGM. For example, in Somalia uninfibulated women are easily divorced, while Somali's in Kenya, there's sworn secrecy among FGM candidates to bar disclosure of its pain and agony. They also require those marrying in the communities be circumcised and songs and poems are recited during marriages to deride the uncircumcised.

Religion, custom and tradition, preservation of virginity, hygienic reasons and pleasure for husband are the reasons given to promote FGM. Although some victims wanted to undergo the cut, some were forced to by their parents and society. There are other ways in which these results can be achieved without inflicting so much pain on the women, leaving lifetime consequences, losing a lot of blood or their lives.

These are some of the traditional practices that have suppressed the African woman denying her the right to decide for herself what is right or wrong since the society has already prescribed for her. This greatly affects her esteem, imagine a circumcised girl visiting a gynecologist or being married to a man from a community that doesn't practice it, how will she explain the permanent scar that was left by the cut.

By Oscar Otindo, Kenya
