By Saheed Ibrahim

Despite the universal declaration against Female Genital Mutilation (FGM) as a health-risky practice for young girls and its criminalization, professional nurses and traditional birth attendants have been found to still engage in this dangerous practice, as revealed by The Hope investigation.

Equally, commonly referred to as ‘dida abe fun omo obinrin’ or ‘female circumcision,’ we have also discovered that parents and grandparents still request FGM for their newborns in urban and rural areas.

Female Genital Mutilation (FGM) is any procedure involving the partial or total removal of external female genitalia or other injury to the female genital organs for non-medical reasons. It is usually performed on young girls only a few days old. Various reasons underpin the practice of FGM, including cultural and religious beliefs.

According to the World Health Organization (WHO), an estimated 200 million girls and women alive today have undergone FGM in 31 countries across Africa, the Middle East, and Asia. FGM is also prevalent among immigrant populations in other parts of the world. The WHO also estimates that three million girls are at risk of being cut yearly, equating to about 6,000 girls a day.

According to WHO, FGM can cause severe bleeding, infection, and damage to the reproductive system. It can also lead to problems during childbirth, sexual and reproductive health issues, and mental health challenges. FGM is also associated with an increased risk of HIV and other sexually transmitted infections. The practice is often carried out in unhygienic conditions, using unsterilized instruments, which can lead to further health complications.

Nigeria has one of the highest rates of FGM in Africa, affecting an estimated 23 million women and girls. It is more prevalent in the country’s northern and middle belt regions, where it is practised as a cultural and religious tradition. FGM is also linked to other harmful practices, such as child marriage and female seclusion. The Nigerian government has taken steps to eradicate FGM, including passing a law criminalizing the practice.

The WHO identifies several reasons why FGM persists, including cultural and religious beliefs. In some communities, FGM is viewed as a rite of passage into womanhood or a means to ensure a girl’s virginity. It may also be seen as a way to control women’s sexuality or to maintain their purity and chastity. FGM may be perceived as ensuring social acceptance, marriage, or upholding social norms and traditions.

THE LEGAL STATUS OF FGM

FGM is regarded as a violation of human rights. The Nigerian government has criminalized the practice of FGM, and it is punishable by law. The law makes it an offence to perform, aid, or abet FGM, and it also provides for the protection of girls and women who have been subjected to the practice. In addition, several other African countries have also criminalized FGM, including Benin, Burkina Faso, Chad, Djibouti, Egypt, Guinea, Kenya, Liberia, Mauritania, Somalia, and Togo.

The Violence Against Persons (Prohibition) Act 2015 seeks to eliminate violence in private and public life in Nigeria. Section 6 of the Violence Against Persons (Prohibition) Act 2015 prohibits Female Genital Mutilation, specifying that: (2) A person who performs female circumcision or genital mutilation or engages another to carry out such circumcision or mutilation commits an offence and is liable to conviction to a term of imprisonment not exceeding four years or to a fine not exceeding N200,000.00 or both. (3) A person who attempts to carry out the offence of female circumcision or genital mutilation also commits an offence and is liable on conviction to a term of imprisonment not exceeding two years or to a fine not exceeding N100,000.00 or both. (4) A person who incites, aids, or abets or counsels another to commit the offence of female circumcision or mutilation also commits an offence and is liable on conviction to a term of imprisonment not exceeding two years or to a fine not exceeding N100,000.00 or both.

In Ondo State, the Violence Against Persons (Prohibition) bill was signed into law in 2021. The First Lady, Chief Betty Anyanwu-Akeredolu, believed that the law would protect the girl child and women against all forms of violence, including FGM.

THE TRIGGER

I live in a developing community with the usual communal way of life. A learned neighbour of mine has a child over a year old. We were talking about health communication and FGM. One of the women who came around overheard us and commented, ‘e maa tan ara yin,’ which in Yoruba means ‘keep deceiving yourself.’ When probed, she asked, ‘do you think this can be stopped?’ She went her way afterwards, perhaps to prevent further questioning.

THE DISCOVERY

With this, I decided to probe further. The Hope team interviewed fifty parents who gave birth to female children between 2022 and 2023. Our main questions were whether they cut their female children and who assisted them. Shockingly, of the fifty, 37 of them, representing 74%, admitted cutting their girl child in the last two years, while only 26% said they did not. Of those who did, 29 admitted patronizing Traditional Birth Attendants and midwives at mission houses, while the remaining 8 said they were assisted by nurses (professional and auxiliary). We found that over 60% of those who cut their daughters did so in semi-urban or rural areas.

INVOLVEMENT OF THE TBAS AND MISSION HOUSES

Mrs Adeshile Folashade was delivered of her baby by a TBA. She did female genital mutilation for her daughter because her husband asked the midwives to do it, and the midwives did it for her daughter. She says nowadays, not every parent will do it for their daughters, but in her husband’s house, you must do it for your daughter.

Mrs. Mercy Adegboye was delivered of her daughter by a TBA. She said she agreed to do it for her daughter on the advice of the TBA, who said it would prevent the child from ‘sleeping around with men’ when she is grown. In addition, she admitted that every girl child in her husband’s family must undergo FGM.

Mrs. Rofiat Yusuf gave birth to her daughter at a mission house. She admitted not doing it for the baby because the government forbids parents from doing it. Still, she returned to the mission house to have her daughter cut after a week on the advice that “it is good for every girl child, and boys undergo circumcision too.”

When contacted, the President of Traditional Birth Attendants in Ondo State, Prophetess Ruth Oluwatosin Arisoyin, said they had been warned and trained to desist from the practice. She said she was unaware of her members still engaging in female genital mutilation.

Prophetess Arisoyin told The Hope that her association had put much effort into stopping the practice among the members. She added that the government used to engage them in training and campaign programmes to dissuade people from engaging in the practice.

NURSES ARE NOT LEFT OUT

Mrs Mary Augustine gave birth to her last child, Gift, at a clinic in Ondo town on the 3rd of February 2022. She revealed to The Hope that one of the nurses at the clinic advised her to cut her daughter. She yielded to the nurse’s advice.

“The nursing sister there advised me to do it for her daughter. She said if I did not do it for her, she will not enjoy sex. So, it is better to do it for a female child. That was why I did it for my last girl.”

She was not the only one. Mrs Olalekan said that after she gave birth at the hospital and her request to cut her daughter was turned down, one of the nurses told her not to worry and visited her at home to carry out the cutting on her daughter.

Our findings corroborated a recent report from the United Nations Population Fund, UNFPA, showing that around one in four girls and women between the ages of 15 and 49 who have undergone FGM (or 52 million) were cut by health personnel. Estimates from demographic and health surveys and multiple indicator cluster surveys also showed that Nigeria is one of the countries where FGM cases (13%) are performed by health workers.

When filing this report, we could not speak with the State Commissioner for Health, Dr. Banji Awolowo Ajaka. However, the Chief Nursing Officer at Isinkan Primary Health Care, Mrs. Olayinka Ogunleye, stated that “it (FGM) is against the law. Anybody that is found doing it will be taken to court; there are people sent for that assignment. If they use Agbebi and it is detected, the women’s affairs will charge them to court. In the medical line, it has been wiped off.”

A retired matron, Mrs Abidakun, confirmed that FGM was a practice in hospitals at the time, but with research and modern knowledge, the practice was stopped and declared unhealthy. Hence, laws were made to prevent medical practitioners and others from doing it.

HUSBANDS AND FAMILY INFLUENCE PRACTICE

Among the women who cut their daughters, Mrs Abdulsalam Quadrat had her request for FGM turned down when she gave birth to her daughter at a government hospital in Idanre. On getting home, her mother-in-law said she must do it for her granddaughter, and her husband also supported his mother. Hence, the baby was taken to one ‘Iya Agbebi’ for circumcision. When asked why the mother-in-law insisted on FGM, she said, “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.”

However, just like my friend fought his wife and her mother not to cut his daughter, Mrs Yemi’s husband also prevented her from cutting her daughter. However, she was not satisfied. She said her mother did it for her, and she wished to do it for her daughter. The role of the husband in decision-making by women is very significant. Mrs Yemi’s husband and Mr Adegboye have underscored the need not to direct campaigns against FGM to women, TBA, and health workers alone. Men also have more significant roles to play.

EARLIER IN ONDO STATE

Our findings confirmed a 2015 Safe World for Women in Ondo State report that FGM thrives in secrecy in the state. The report also showed that professional nurses, auxiliary nurses, TBAs, and Mission Houses engaged in the illegal practice despite prohibition. A recent study by Taiwo Monisola Olufunke, published in the American Journal of Physical Education and Health Science (AJPEHS) in 2023, revealed that 73% of those sampled in Ondo State said FGM is good, 75% said that the rate of the FGM practice among adult women is still rampant, and 69% said they would encourage FGM on their female children. Significantly, 68% of the respondents said that the awareness campaigns and sensitization programs on FGM did not affect the high prevalence of risky practices in the Sunshine State. Our investigation corroborated these findings.

According to the Chairperson, Ondo State International Federation of Women Lawyers (FIDA), Jumoke Ogunjebi, Nigeria is yet to win the war against FGM. Noting that from the events witnessed at the commemoration this year, it is obvious that even at urban centres, more people practise FGM, saying “most always keeping it discreet.”

Maternal and Newborn Child Health Programme Officer, Ondo State Primary Health Care Development Agency, Mrs Olabisi Dare – Owolabi while speaking with The Hope noted that a lot of people still practice the act. According to her, people go all the way to get those who will help in circumcising their girls.

SOME GOOD NEWS

However, despite the troubling findings, there is good news. Our results showed that not only parents and hospitals reject carrying out FGM, but auxiliary nurses also do. As Mrs. Esther Akinjo, an auxiliary nurse, said, “I will never do it, and my hospital is rejecting it. In the last six months, I have seen several female babies without the cutting. “I did not cut my daughter, and many people also condemn it because it is not in any way good.” She narrated a story of a severely cut girl, and the wall between her vagina and anus was damaged.

ENDING THE ILLEGAL PRACTICE

According to WHO, some of the strategies to prevent the practice are raising awareness and educating communities about the harmful effects of FGM, engaging with traditional and religious leaders to advocate against the practice, providing support to girls and women who have been subjected to FGM, providing access to safe, confidential health care for girls and women who have been affected, and training health workers to provide services for girls and women who have been subjected to FGM.

Mrs. Dare – Owolabi noted the need for consistent sensitisation of the people. While also admitting that FGM is more prevalent in rural areas without ruling out the prevalence in cities, the Ondo State Project Coordinator for IGRHD Initiative for Girls’ Rights and Health Development, Mrs Moninkan Ogidan, said, “Most of the rural areas still practice cutting the girl child. The reason is not far-fetched from the fact that FGM is rooted in culture and tradition, and we know how much our people revere custom and tradition. She advocated intensified efforts against the health-risk practice, such as partnering with traditional rulers to spread anti-FGM campaigns involving TBAs and everyone in society.

“If you see something, say something. To cap it all, we’ve got to engage the media, especially in reaching those at the grassroots,” she stated.

There is a need to integrate campaigns against FGM into the school curriculum and set up local task forces to arrest those doing or patronizing the illegal and unhealthy act.