Nzeribe Emmanuella                                                                                         

Contact Person for Ghana Pharmaceutical Students’ Association (GPSA, Ghana).                           

5th year PharmD student in Kwame Nkrumah University, Ghana; with interests in Research and Global Health.

Female Genital Mutilation or Cutting (FGM/C) is a traditional practice that involves the total or partial alteration or removal of girls’ or women’s genitalia. It is the violation of a girl’s and women’s human rights. The World Health Organization (WHO) estimates that 130 million women worldwide had undergone FGM. FGM is usually practised in over 25 countries in Africa which also spread in some areas of Europe, North and South America, New Zealand and Australia. As at 2005, FGM was nearly universal in Africa with prevalence ranging from 89-98% in Egypt, Eritrea, Guinea, Mali and North Sudan. It was 77% in Burkina Faso, 80% in Ethiopia and at moderate levels in Benin (17%), Nigeria ((19%)), Tanzania (18%) and Niger (5%). While FGM prevalence is higher in rural than in urban areas for most countries, some countries like Eritrea, Guinea, Mali- the urban and rural either have the same prevalence or differ slightly.

FGM was classified into three types by WHO in the 1950s and they include Clitoridectomy; which is the removal of the prepuce with or without the removal of the clitoris. The second type is Excision, which is the removal of the clitoris with part or all of the labia minora. And the Infibulation is the removal of part or all of the external genitalia. Infibulation has been the commonest type practised most. It is being on record that the rationale behind FGM by the upholders include but not restricted to religious practices of purity, the personal belief of female genitalia in their natural form is ugly and that cutting which is infibulation is presentable and beautiful. Some are of the beliefs of upholding the traditions and it is a way of preventing girls’ promiscuity and preserving virginity.

FGM is mostly performed on girls between the ages of 4-12 years by traditional birth attendants, local specialists, traditional healers, experienced grandmothers and in some countries, it is practised by medical experts. Medicalization has been a trend which seeks to improve the conditions under which FGM is performed (like better hygiene, use of anaesthesia, in combination with anti-tetanus vaccination. It violates the principles of professional health ethics and does not address the potential long term medical psychological and psychosexual complications as well as the violation of human rights. Meanwhile, efforts to eradicate this practice in Africa can be traced back to the beginning of the 20th century coupled with the ban by UN General Assembly yet the prevalence of FGM still remains high in Africa ranging from 98% in Somalia all through Uganda and Cameroon (1%). Without any doubt, we all can agree to the fact that FGM has caused more harm than good. Asides the pain associated with the practice, this practice poses a lot of health risk to the individual such as shock, HIV, infections, obstetrics problems not to mention the psychological problems the church

Therefore, what is the way forward?

The first step would involve the conducting of specific researches to gather baseline community information, good human resources that are available for the control of FGM and determine the best intervention methods in the community. Data on the distribution of FGM and how it is practised are important because it would help policymakers as well as guide the development of strategies and promote FGM abandonment.

The next step would be to train health workers to become change agents. This should be carried out by providing care to women who have undergone FGM, counselling women and couples, and influencing key opinion leaders in communities. However, the content of the training should depend on the local needs, therefore, will vary for different localities or countries. Health education strategies which include behaviour change, community sensitization, and awareness raised about human rights and gender roles are ways we can intervene as young pharmacists in eradicating FGM practice.

Interventions must take place to support gender equality and the empowerment of women and girls including an effort that enhances women’s ability to make decisions about their bodies. Let us say no to Female Genital Mutilation.