The incursion of health professionals into female genital mutilation (FGM) is said to be hindering the harmful practice, reports VINCENT IKUOMOLA
In Nigeria, female genital mutilation (FGM) is as old as history. The practice, also known as female genital cutting (FGC), is a customary family tradition that many young women (age 0-15) experience as a rite of passage to adulthood.
It is a procedure that involves partial or complete removal of the external female’s genitalia or other cuts to the female genital organs. Yet, till date, there is no medical explanation or basis for the hurtful act.
Over 200 million women and girls globally are affected by FGM, with three million new cases recorded yearly. FGM has no religious basis; it has been condemned by both Christians and Muslims. Nigeria, it was also learnt, accounts for 20 million of the global record. Nationally, 27 per cent of women between 15 and 49 are estimated to be victims of FGM, making the country account for the most FGM cases worldwide.
In the communities that allow excision of female genitalia, FGM is associated with ethnicity, culture, prevailing social norms, and sometimes as religious obligations.
In the majority of the cases, however, it has been documented that their family members, such as parents – mainly mothers, grand-parents, and grandmothers of the girls – are the perpetrators of this act. Besides, in some cultures, ensuring a daughter’s virginity is a required task for them to arrange for her marriage, receive proper bride price, and for family honour.
But the practice is considered harmful to girls and women. It is also a violation of human rights. According to reports, FGM causes infertility, maternal death, infections, and the loss of sexual pleasure.
After years of advocacy against the practice, former President Goodluck Jonathan, shortly before leaving office in May 2015, signed into law a bill banning FGM. Thus, Nigeria became the first country in Africa to have a law in place to halt the practice. Yet, the dangerous practice has not stopped.
In the last 30 years, prevalence of the practice has decreased by half in some parts of Nigeria. While practice of FGM seems to be on the decline among older women, the case is opposite among the girl child. As the world struggles to find a solution to FGM, which is usually carried out by traditional circumcisers without proper knowledge of human anatomy and medicine, trained medical and health workers have also delved into the practice.
The involvement of medical personnel, otherwise called medicalisation of FGM, has thus become a stumbling block to eradicating the practice in the country. Though it is not particular to Nigeria alone, it is still being practised even in some developed countries.
However, series of surveys carried out have also revealed that medicalisation of FGM has increased in recent years in the country, with about one-third or more of girl-child having experienced FGM by a trained health professional.
Despite the open condemnation, the practice has been on the increase because of secrecy and personal benefits, which have been the driving forces behind the practice of FGM.
The implication is that the practice is on the rise, which thus calls for more serious actions to stop FGM. Also, the excuse that medicalisation will take care of sanitary concerns, thereby reducing the risks associated with FGM, has given room for medicalisation.
But it also needs to be stressed that monetary benefit is what has pushed many healthcare workers into the practice.
Consequently, the situation has forced stakeholders to call for adequate punishment for the erring medical personnel to eradicate the practice.
At an advocacy meeting on curbing medicalisation of FGM and sanctions for erring medical personnel held in Abuja, stakeholders agreed that the law on violence against persons may only have drawn attention to the practice, and not actually stopped the act.
Stakeholders argued that because of low numbers of report, it might be difficult to implement the law. Hence, attention should be on continuous advocacy to prevent the act as FGM is performed by healthcare providers, which is alarming.
Medicalisation of FGM, stakeholders said, is proposed by some health professionals to reduce the incidence of its complications.
However, medicalisation of FGM will not reduce the long- term complications of the practice, with stakeholders arguing that since it has no benefits, medicalisation of FGM thus violates the code of medical ethics.
Furthermore, it was agreed by the stakeholders that medicalisation would result in a setback in the global efforts to eradicate this illegal practice, and will give the green light to its performance by non-healthcare providers with subsequent increased incidence of complications.
Stakeholders, therefore, agreed that various regulatory bodies should apply the necessary punishment on any of their members caught in the act, as the continued involvement of the doctors legitimises surgery.
The Minister of Health, Prof. Isaac Adewole, described the involvement of medical personnel as shocking.
Speaking on the occasion, the minister said there was no reason for medical personnel to join the illegal act.
The minister, who was represented by Dr KayodeAfolabi, Head of Reproductive Health in the ministry, said the involvement of medical personnel in the promotion of FGM was unacceptable.
“The medicalisation of FGM in Nigeria is actually shocking. Nigeria bears at least 10 per cent of the burden of FGM globally. Out of 200 million woman with FGM, Nigeria accounts for 20million. Twenty-five per cent in Nigeria have FGM; that is really very shocking to hear. Therefore, FGM is a human right problem,” he said.
The minister also added: “I was also shocked to realise that 12.718 per cent of FGM is actually done by health professionals in Nigeria. To me, it is unacceptable that medical personnel are enticed to it because it helps their pocket, but that is not a justification.”
He noted that the government has been working with partners to address the issue by developing clinical protocols on how to manage and sensitise health professionals against medicalisation of FGM.
He said with the ongoing efforts, FGM would be eradicated in the year. ”The import of why we are here is for you to go back and talk to your workers, to create awareness, talk to the nurses, midwives, doctors, health professionals to be aware that the practice of medicalisation of FGM is not acceptable in the country.
“So, what we do is to ensure that we create awareness against FGM. We also conduct advocacy to different levels and different states just as we are doing here today at this national stakeholder’s advocacy meeting.We had different advocacy and we also provide enabling environment for states to adapt or adopt the law against gender violence.”
FGM is outlawed and should not be practised in any form or under any cover in the country, he stressed.
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