By Saheed Ibrahim
Despite the global stance and legal prohibitions against Female Genital Mutilation (FGM) as a health-threatening practice for young girls, a recent investigation by The Hope exposes the continued involvement of professional nurses and traditional birth attendants in this perilous activity.
Similarly, known as ‘dida abe fun omo opinion’ or ‘female circumcision,’ we’ve uncovered that parents and grandparents continue to seek FGM for their newborns in both urban and rural areas.
Female genital mutilation (FGM) encompasses any procedure involving the partial or total removal of external female genitalia or other non-medically motivated harm to the female genital organs. Typically performed on girls just a few days old, FGM is driven by various factors, including cultural and religious beliefs.
The World Health Organization (WHO) estimates that approximately 200 million girls and women across Africa, the Middle East, and Asia have undergone FGM. It remains prevalent among immigrant populations worldwide, with an additional 3 million girls at risk of being cut annually, averaging 6,000 girls each day.
FGM, as per WHO, poses severe risks such as bleeding, infection, reproductive system damage, childbirth complications, sexual and reproductive health issues, and mental health challenges. Often conducted in unhygienic conditions using non-sterile instruments, the practice leads to further health complications.
Nigeria bears one of Africa’s highest rates of FGM, impacting around 23 million women and girls. Predominant in the northern and middle belt regions due to cultural and religious traditions, FGM correlates with harmful practises like child marriage and female seclusion. The Nigerian government has implemented measures to combat FGM, including legislation criminalising the practise.
WHO identifies cultural and religious beliefs as reasons for FGM persistence. Some view it as a rite of passage into womanhood, a safeguard for a girl’s virginity, a means to control women’s sexuality, or a method to preserve purity and chastity. FGM may also be perceived as ensuring social acceptance, marriage, and adherence to social norms and traditions.
The Legal Implications of FGM
Female Genital Mutilation (FGM) is unequivocally recognised as a violation of human rights. The Nigerian government has taken a strong stance by criminalising the practise and imposing legal consequences. The legislation deems it an offence to perform, assist, or encourage FGM, with provisions safeguarding the rights of girls and women who have undergone this practise.
Moreover, numerous African countries, such as Benin, Burkina Faso, Chad, Djibouti, Egypt, Guinea, Kenya, Liberia, Mauritania, Somalia, and Togo, have also criminalised FGM.
The Violence Against Persons (Prohibition) Act of 2015 in Nigeria is a pivotal instrument in combating FGM. Section 6 of the Act explicitly outlaws female genital mutilation, outlining penalties for offenders. These penalties range from imprisonment for up to four years, fines not exceeding N200,000.00, or a combination of both. Attempting or abetting FGM carries its own set of legal consequences, emphasising the severity with imprisonment up to two years or fines not exceeding N100,000.
Ondo State, recognising the urgency of addressing such issues, enacted the Violence Against Persons (Prohibition) bill in 2021. This legislation received endorsement from the First Lady, Chief Betty Anyanwu-Akeredolu, who foresaw its role in safeguarding girls and women from various forms of violence, including FGM.
The trigger
Residing in a burgeoning community characterised by a communal lifestyle, a knowledgeable neighbour with a child aged over a year ignited a conversation on health communication and female genital mutilation (FGM). As we engaged in this discourse, an observant woman in our midst interjected with a Yoruba phrase, ‘e maa tan ara yin,’ translating to ‘keep deceiving yourself.’ Upon further inquiry, she sceptically questioned the possibility of halting this age-old practise and promptly departed, possibly to evade further interrogation.
The Revelation
Motivated by this encounter, I dove deeper. The investigative team at The Hope conducted interviews with fifty parents who welcomed female children between 2022 and 2023. Our primary inquiries centred around whether they subjected their daughters to the practise of female genital mutilation (FGM) and who facilitated this procedure. Astonishingly, out of the fifty respondents, 37, constituting 74%, acknowledged having performed FGM on their daughters in the past two years, while only 24% affirmed abstaining from such practises. Among those who practiced FGM, 29 revealed their reliance on Traditional Birth Attendants (TBAs) and midwives at mission houses, while the remaining 8 disclosed assistance from nurses, both professional and auxiliary. It emerged that a significant majority, over 60%, conducted these procedures in semi-urban or rural settings.
Engagement of TBAs and Mission Houses
Mrs. Adeshile Folashade, who underwent childbirth assisted by a Traditional Birth Attendant (TBA), proceeded to subject her daughter to female genital mutilation (FGM) based on her husband’s request. The midwives, complying with the husband’s directive, performed the procedure on her daughter. While acknowledging that not every parent now endorses this practice, Mrs. Folashade emphasized its obligatory nature in her husband’s household.
Similarly, Mrs. Mercy Adegboye, delivered by a TBA, chose to undergo FGM for her daughter guided by the TBA’s counsel. The TBA asserted that such a procedure would deter the child from engaging in relationships with men as she grows. Mrs. Adegboye further revealed the mandatory imposition of FGM on every girl child in her husband’s family.
Mrs. Rofiat Yusuf, who gave birth at a mission house, initially refrained from subjecting her daughter to FGM due to governmental prohibitions. However, she later returned to the mission house, influenced by the belief that the practice is beneficial for both girls and boys. In response to the situation, Prophetess Ruth Oluwatosin Arisoyin, the President of Traditional Birth Attendants in Ondo State, expressed unawareness of her members’ continued involvement in female genital mutilation. She emphasised the association’s commitment to eradicating the practice through warnings, training, and government-led campaigns against it.
Involvement of Nurses
Mrs. Mary Augustine, who delivered her last child at a clinic in Ondo town, disclosed to The Hope that a nurse at the clinic recommended female genital mutilation (FGM) for her daughter. Yielding to the nurse’s advice, Mrs. Augustine opted for the procedure.
Sharing a similar experience, Mrs. Olalekan, upon refusing the hospital’s initial request to perform FGM on her daughter, had a nurse assure her not to worry. Subsequently, the nurse visited Mrs. Olalekan at home to carry out the circumcision on her daughter.
Our investigation aligns with a recent report from the United Nations Population Fund (UNFPA), indicating that approximately one in four girls and women aged 15 to 49 who underwent FGM (52 million individuals) were subjected to the practice by health personnel. According to demographic and health surveys, as well as multiple indicator cluster surveys, Nigeria stands among the countries where health workers contribute to 13% of FGM cases.
Although we were unable to interview the State Commissioner for Health, Dr. Banji Awolowo Ajaka during this report filing, Mrs. Olayinka Ogunleye, the Chief Nursing Officer at Insinkan Primary Health Care, affirmed that FGM is illegal and punishable by law. She emphasized that individuals caught engaging in the practice would face legal consequences, and there are designated personnel for this purpose. Mrs. Ogunleye also mentioned that seminars are organized to educate health workers, including traditional birth attendants (Agbebis), about refraining from FGM.
Adding historical context, a retired matron, Abidakun, acknowledged that FGM was once prevalent in hospitals. However, advancements in research and modern knowledge led to its cessation, with laws enacted to prevent medical practitioners and others from participating in the practice.
Husbands and Family Dynamics
Mrs. Abdulsalam Quadrat, after giving birth to her daughter at a government hospital in Idanre, faced resistance to her request for female genital mutilation (FGM). Upon returning home, her mother-in-law insisted on performing FGM for her granddaughter, and Mrs. Quadrat’s husband supported his mother’s decision. Consequently, the baby underwent circumcision at the hands of ‘Iya Agbebi.’ When asked about the mother-in-law’s insistence on FGM, Quadrat explained, “My mother-in-law said FGM must be done for her child so that when she grows up, she won’t flirt around with men.”
In contrast, Yemi’s husband took a different stance, preventing her from subjecting their daughter to FGM, despite Yemi’s desire to continue the tradition. Mrs. Yemi recalled that her mother had performed FGM on her, and she wished to continue the practice for her daughter. Highlighting the significant role husbands play in decision-making, Yemi’s husband, along with Adegboye, emphasized that anti-FGM campaigns should not solely target women, traditional birth attendants (TBAs), and health workers. Men, they asserted, have a crucial role in advocating against the practice.
Challenges Persist in Ondo State
Our investigation aligns with a 2015 Safe World for Women report on FGM in Ondo State, indicating that the practice thrives in secrecy. Despite legal prohibitions, our findings reveal the involvement of professional nurses, auxiliary nurses, traditional birth attendants (TBAs), and Mission Houses in the illegal practice. A recent study by Taiwo Monisola Olufunke, published in the American Journal of Physical Education and Health Science (AJPEHS) in 2023, reinforces these concerns. The study disclosed that 73% of respondents in Ondo State view FGM as acceptable, with 75% acknowledging a high prevalence of the practice among adult women. Furthermore, 69% expressed willingness to endorse FGM for their female children. Notably, 68% of respondents believed that awareness campaigns and sensitization programs had little impact on reducing the risky practices in the Sunshine State.
Jumoke Ogunjebi, the Chairperson of the Ondo State International Federation of Women Lawyers (FIDA), emphasized that the battle against FGM in Nigeria is far from won. She observed that, even in urban centers, the discreet nature of the practice persists, as evidenced by recent events.
Olabisi Dare-Owolabi, the Maternal and Newborn Child Health Programme Officer at the Ondo State Primary Health Care Development Agency, echoed concerns about the ongoing prevalence of FGM. According to her, individuals go to great lengths to find practitioners willing to perform circumcisions on their girls. The persistence of these challenges underscores the need for continued efforts to combat FGM and protect the well-being of women and girls in Ondo State.
Silver Lining Amidst the Challenges
Amidst the disconcerting revelations, a ray of hope emerges. Our findings highlight a positive trend where not only parents and hospitals are refraining from practicing FGM, but auxiliary nurses are also staunchly opposing it. Esther Akinjo, an auxiliary nurse, adamantly stated, “I will never do it, and my hospital is rejecting it.” Over the past six months, she has encountered several female infants untouched by the practice. Akinjo, who personally chose not to subject her daughter to FGM, emphasized that many individuals condemn the practice due to its inherent harm. She shared a poignant account of a severely cut girl, illustrating the damaging consequences that can result from such procedures. This glimmer of progress within the healthcare community signifies a step toward safeguarding the well-being of young girls and challenging the perpetuation of harmful cultural practices.
Eradicating the Harmful Practice: A Multi-Faceted Approach
To combat the illegal practice of Female Genital Mutilation (FGM), a comprehensive strategy is imperative. The World Health Organization (WHO) outlines key measures, including raising awareness and educating communities about the detrimental effects of FGM. Engaging traditional and religious leaders to advocate against the practice is vital, along with providing support to affected girls and women. Ensuring access to safe and confidential healthcare for those impacted is crucial, emphasizing the need for trained health workers to deliver appropriate services.
Dare–Owolabi underscores the necessity for consistent sensitization efforts, acknowledging the higher prevalence of FGM in rural areas. Moninkan Ogidan, the Ondo State Project Coordinator for IGRHD Initiative for Girls’ Rights and Health Development, emphasizes the deeply rooted nature of FGM in culture and tradition, calling for intensified efforts. Collaboration with traditional rulers is proposed to spearhead anti-FGM campaigns involving Traditional Birth Attendants (TBAs) and the broader community.
A proactive stance is encouraged — Ogidan advocates for community members to speak out when witnessing potential FGM cases. Media engagement, particularly targeting grassroots communities, is deemed essential. Furthermore, integrating anti-FGM campaigns into school curricula and establishing local task forces are proposed to apprehend those involved in illegal and harmful practices. This multifaceted approach aims to create a comprehensive and sustained effort to eradicate FGM, safeguarding the well-being of girls and women.
