Female Genital Mutilation (FGM), popularly known as female circumcision, is the cultural practice of partial or total removal of the external female genitalia. It includes procedures that intentionally alter or cause injury to the female genital organs for non-medical reasons. The procedure has no health benefits for girls and women.
FGM is performed on infants, girls, and women of all ages, depending on where it is done. The age at which girls are cut can vary widely from country to country, and even within countries. Most often, it happens before a girl attains puberty. Sometimes, however, it is done just before marriage or during a woman’s first pregnancy.
In Egypt, about 90% of girls are cut between 5 and 14 years old. Research has shown that the average age at which a girl undergoes FGM is decreasing in some countries, such as Burkina Faso, Co’t d’ Ivoire, Kenya and Mali.
The reasoning is that with more awareness and legislation, more girls and women deliberately opt out of it, leaving only the ignorant and the under-age at the mercy of the practice.
Researchers also think it is possible that the average age of FGM is getting lower so that it can be more easily hidden from authorities in countries where there may be laws against it. It is also widely believed that FGM is performed on younger girls because they are less able to resist.
There are four notable types of FGM . They are: Type 1, called clitoridectomy. It is the partial or total removal of the clitoris and, in very rare cases, only the prepuce, the fold of skin surrounding the clitoris is left. This is also called Sunna Circumcision, it is the least mutilating of all.
In Type 2, known as excision, the clitoris and part of the labia are excised and then sewn together by sutures, thorns, or tying the girl’s legs together until the edges have united.
Type 3, called infibulations, or pharaonic, is the most extreme. In this case, the clitoris, labia minora are excised and incisions made in the labia majora to create raw surfaces that are then either stitched together or kept in close contact until they seal and form a cover for the urethrae meatus. A very small orifice is left for the passage of urine and menstrual flow.
Due to the fact that this type is the most mutilating, the medical, obstetrical and psychological complications are more profound. In many regions, it is the most common procedure performed.
Type 4, regarded as any other form, includes all other harmful procedures to the female genitalia for non-medical purposes. Examples are pricking , piercing, incising, scraping and cauterizing the genital area.
FGM is practiced in 30 countries in Western, Eastern, and North Eastern Africa, in parts of the middle East and Asia, and within some immigrant communities in Europe, North America and Australia.
A recent UNICEF report states that Egypt has the world’s highest total number with 27.2 million women having undergone FGM, while Somalia has the highest prevalence rate of FGM at 98%.
In July 2003, at its second summit, the African union adopted the Maputo protocol, which promoted women’s rights and called for an end to FGM. The agreement came into force in November 2005, and by December 2008, 25 member countries had ratified it.
According to UNICEF report made available to newsmen, 24 African countries have legislations or decrees against FGM practice. These countries are: Burkina Faso, Benin, Central African Republic, Chad, Cote d’Ivoire, Djibouti, Egypt, Ethiopia, Ghana and Guinea.
Others are Guinea-Bissan, Nigeria (some states), Senegal , Somalia, Sudan (some states), Tanzania, Togo, Uganda, Zambia and South Africa.
Findings across these countries have shown that beyond the institution of legislation, little has been done in terms of enforcement for various reasons, which mostly have to do with the belief system of the people involved. The result is that there have been inconsistencies in the rate of FGM. In most cases, there have, in fact, been an increase in FGM practices, and legislations have been of little or no use in checking the trend.
In Nigeria, a 2008 Demographic and Health survey revealed that 30% of the country’s women have been subjected to FGM. This contrasts with 25% reported by a 1999 survey, and 19% by 2003 survey. This suggests no trend unreliable past or most recent survey data in some regions, as well as the possibility that a number of women are increasingly willing to acknowledge having undergone FGM.
In some parts of Nigeria, the vagina walls are cut in new born girls or other traditional practices performed, such as the angurya and gishiri cuts, which fall under Type IV FGM classification of the World Health Organisation (WHO).
Over 80% of all FGMs are performed on girls under one year of age. The prevalence varies with religion in Nigeria: it is prevalent in 31% of Catholics, 27% of protestant and 7% of Muslim women. There is currently no federal law banning the practice of FGM in Nigeria.
Opponents of these practices have hitherto relied on section 34 (1) (a) of the 1999 constitution of the Federal Republic of Nigeria that states “no person shall be subjected to torture or Inhuman or degrading treatment” as the basis for banning the practice nationwide.
Consequently, Nigeria ratified the Maputo protocol in 2005. By 2010, 13 states of Nigeria had enacted laws against FGM practice. These states which include Abia, Bayelsa, Cross River, Delta, Ogun, Osun and Rivers, are being mocked by those who conduct FGMs and who dare any law enforcement agent to arrest them.
There is however an improvement in the legal backing to the quest to abolish FGM in Nigeria with the passage of the violence Against persons’ prohibition (VAPP) Bill by the Nigerian Senate on May 6, 2015.
There are various reasons behind FGM practice, all of which could be categorized under social, economic, and political. For instance, some of those who support it believe that it will empower their daughters not to be promiscuous and ensure that the girls get married and protect the family’s good name.
In some groups, FGM is performed to show a girls growth into womanhood and, in other cases, it marks the start of a girls sexual debut. It is also performed to keep a woman’s virginity by limiting her sexual behaviour.
In some groups, women who are not cut are viewed as dirty and are stigmatized, discriminated upon, or ostracized. There are also other superstitions beliefs attached to the practice.
In Abu/Odual Local Government Area of Rivers State, Nigeria, for instance, the act is carried out seven months of a woman’s first pregnancy. The belief is that if it is not done, the woman and her child would die during delivery.
Others are that the clitoris will continue to grow as a girl gets older and so it must be removed, as well as the one that views external genitalia as being unclean and capable of causing the death of an infant during delivery.
Complications associated with FGM are numerous and could be short-term or long-term. A research carried out by Network of Reproductive Health Journalists in Nigeria (NRHJN), Rivers State chapter, on sixty women and girls in the South-South zone of Nigeria, who have undergone FGM, revealed that about 70% of them were infibulated. Ten percent of them under-went excision, while 20% experienced clitoridectomy.
A particular case of infiblation in the research, which falls under long-term complication, revealed that the woman who was “circumcised” as an infant, currently in her mid-forties, has a growth covering her vagina, making it difficult for her to have sex.
“I first realized the abnormality in my private part when I was in secondary school, about twelve years old. When I enquired from my mother, she explained that it was normal and was in accordance with the belief of our people.
“Years into marriage as a teenager, I noticed a growth gradually covering my vagina, which I must shift before having sexual intercourse. I’ve not been able to get pregnant after over twelve years of marriage”, the woman lamented.
Other common long-term complications include: urinary incontinence, cysts, urogenital track infections, infertility, pelvic inflammatory disease, and obstetrical problems such as delayed or obstructed second stage labour, trauma, and hemorrhage.
The major immediate complications include hemorrhage from the dorsalartery, shock and then infection, urinary retention and tetanus, which can lead to mortality.
Research has also shown that FGM is a key contributor to HIV infection. This is because in most cases the same instruments are used on several girls and women without being sterilized.
In order to check the trend of FGM, much have been postulated, with virtually all relying on specific legislation.
Developments have, howver, shown that there is the need to go beyond coming up with legislation against FGM practice. This is because while legislation is important, the actual willingness to check the practice lies in the conviction of those practicing it to stop it. This can only be achieved when groups, communities , etc practicing FGM own the process.
One way for them to own the process is for key stakeholders, such as traditional rulers, women groups, opinion leaders, etc getting involved in the process of disabusing the minds of their populace about beliefs attached to FGM. By so doing, strict compliance to legislation can be achieved. This is the challenge of truly institutionalising the fight against FGM.
Group Wants RSG To Establish Cancer Treatment Centres
In the face of growing cancer cases in Rivers State, the state chapter of Civil Society Organisation on health has called on the state government to establish cancer treatment centres in the state.
Speaking in an exclusive interview yesterday, chairman of the organisation, Mr Dennis Otobo said the state needs the centres, going by its status in the community of states in the country.
“Going by the position of Rivers State among states in Nigeria, we are overdue to have cancer treatment centres, especially considering the State Government’s focus of the health of her people”, he said.
He continued that “taking all our cancer patients to Ibadan or other neighbouring states does not tell well of our health services, no matter how we look at it.
“Government should establish cancer treatment centres in the state, at least a one hub treatment centre in each local government area”, he said.
According to him, for now about 90% of treatments of cancer services are provided by donor agencies and taking patients outside the state for treatment requires a lot of funds, which is mostly not available.
“If the government can provide cancer treatment centres in the state, it will not only lessen the impact of the ailment in the state, but will also alleviate the suffering of patients who are unable to afford going for treatment outside the state”, Otobo said.
Meanwhile, the Coordinator of Reproductive Health, Rivers State Ministry of Health (RSMOH), Dr. Iroro Smith said the State currently has mammographic machine at RSUTH. The machine is used to diagnose breast cancer, while the University of Port Harcourt has a cancer treatment centre, but it’s not enough for the State.
She, however, noted that the establishment of cancer treatment centres will go a long way to check the incidence of cancer cases in the state.
Lassa Fever: Academy Urges More Actions, Funding
The Nigerian Academy of Science (NAS), has called for more actions and funding to tackle the outbreak of Lassa fever in the country.
Prof. Mosto Onuoha, President of the Academy, made the call on Tuesday in Lagos.
Onuoha also urged the Federal Government to declare Lassa fever a public health event of national concern.
He said in a statement that an interdisciplinary One-Health Committee, comprising medical and veterinary specialists, epidemiologists, social scientists, media practitioners, community representatives, should be set up to tackle the scourge.
According to him, the committee will advise and assist the National Centre for Disease Control (NCDC) in investigating and managing Lassa fever outbreaks.
“Government should provide adequate funds for a sensitive disease surveillance system back by a reliable network of diagnostic laboratories.
“Given that only about 20 per cent of suspected Lassa fever cases are usually confirmed, there is need to improve the capability and enhance the capacity of national laboratory network.
“This is for reliable and efficient definitive diagnosis of suspected cases.
“The Federal and State Governments need to mount an extensive and sustained public Lassa fever prevention and control awareness programme.
“Each state should establish a functional isolation ward for the treatment of Lassa fever patients.
Expert Tasks FG On Permanent Cure For Epilepsy
A renowned Neurologist, Dr Ibrahim Wakama, yesterday, called on the Federal Government to make funds available for researchers to find permanent cure on epilepsy.
Wakama made the call in an interview with newsmen in Abuja on the occasion of the International Epilepsy Day, celebrated annually on the second Monday of February.
The day is an opportunity to raise awareness on epilepsy, what it is, how it can be treated, and what is needed to bring treatment to people who need it.
Wakama, who said that finding permanent cure for epilepsy would help to save lives of those suffering from the ailment, urged government to recognise the strength, resilience, and accomplishments of Nigerians living with the health challenge.
He, however, added that “government cannot do it alone.
“This is where religious leaders, well-meaning Nigerians and philanthropists need to come together.
“It is not an everlasting illness. “It is curable,” he said.
Commending Nigerians suffering from the illness for striving to overcome the challenges they faced daily, Wakama said that epilepsy challenges were beyond seizures.
He said that depression, anxiety and difficulty with memory were some of the struggles people living with epilepsy faced.
The neurologist said that government should put in place self-management programmes that would teach those living with epilepsy to improve their ability to manage their health.
Wakama added that it was important for anyone who interact with the public to be properly trained on seizure safety, so that those who needed help would get appropriate care.
World Health Organisation (WHO) estimates that 50 million people around the world have epilepsy, and that one in 26 persons would develop epilepsy at some point in their lives.
The first-ever global report on epilepsy, recently published by WHO, calls this condition a public health imperative.
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