1. Hello. Welcome to this week’s edition of the #endcuttinggirls tweet conference.
2. We are glad to have you join us. The conference is one of the activities of UNICEF-UNFPA joint programme to #endcuttinggirls.
3. Every Thursday, UNICEF trained social media advocates discuss issues around FGMC in order to educate, enlighten and collate opinions that will help to #endcuttinggirls
4. Before we go into the main activity, I am Abayomi Sarumi. Titilade DaCosta (@oloridaco1) and Anthony Ayeni (@thonyayeni) are here with me. #endcuttinggirls
5. Today, our topic; COUNTING THE COST OF FGMC will look in details, the socio-economic aspect of FGMC. It will not be limited to the survivors but to the entire society. #endcuttinggirls
6. FGMC, as Female Genital Mutilation and Cutting would be referred to in this conversation was defined in 1997 by the World Health Organisation (WHO). #endcuttinggirls
7. FGM/C is defined as any procedure that involves the partial or total removal of the external female genitalia or any other injury to the female genital organ for nonmedical reasons (World Health Organisation-WHO).#endcuttinggirls
8. FGMC which has grandmothers, and mothers-in-law as drivers, based on the 2015 UNICEF/UNFPA Joint Programme Baseline Survey in Nigeria, is shrouded in communal belief(s) and is regarded as a social norm in many practising communities. #endcuttinggirls
9. While FGMC predates civilisation and Pre Islamic era, the varying ways/processes of mutilation/cutting from community to community have no base in any religion around the world. (https://tinyurl.com/y9a6yb7b) #endcuttinggirls
10. To read more on definition, types and general facts about FGMC, kindly visit www.endcuttinggirls.org #endcuttinggirls.

Sarumi would stop at 10 and Olori Daco continues from 11

11. It is on record that more than 200 million girls and women have gone through at least one of the four types of FGM/C around the world (World Health Organisation). #endcuttinggirls
12. With the number of survivors quoted in 11 above, it must be noted that the cost of FGMC is not limited to instant monetary value of mutilation but includes cost of social exclusion, psychological trauma and post mutilation expenses #endcuttinggirls
13. Knowing that the impacts of FGM/C are felt physically, socially, psychologically and health-wise and that they are numerous helps to give a glimpse into the many factors to be considered in counting the cost of FGMC. #endcuttinggirls
14. When discussing the cost of FGM/C, people mostly concern themselves with economic losses attributable to FGM/C rather than the money spent trying to ameliorate it- partly because there isn’t data available to calculate the total money spent on protecting or helping children. #endcuttinggirls
15. The cost of FGM/C depends on a number of factors including the type performed, the expertise of the practitioner, the hygienic conditions under which it is performed, the amount of resistance and the general health condition of the girl/ woman undergoing the procedure. #endcuttinggirls
16. The cost also depends and reflects on the service delivery system which survivors are exposed to – this would include peer support system, legal system and ultimately, the health care services available #endcuttinggirls
17. Attempts to quantify the monetary cost of violence against children and women have over the years led to some attention-grabbing figures but never to the creation of an equation of hurt. #endcuttinggirls
18. The global cost of violence against children could be anywhere from 2 to 8 percent of the GDP of the world – potentially as high as $7 trillion dollars per year. (Source: https://tinyurl.com/ychc9o76 ) #endcuttinggirls
19. However, no one has determined the monetary (socio-economic) implication of FGM/C through research or any related work. Literatures available focus on types and effects of FGM/C (https://tinyurl.com/y7othruh) #endcuttinggirls
20. In Nigeria, the most negligible cost of cutting/mutilation would be the service charge of circumcisers/cutters because from field survey, it’s valued within N2,000 (6 USD ) to N3,000 (9 USD   ). #endcuttinggirls
21. With economic factor as one of the reasons FGM/C is prevalent, it supposes that to #endcuttinggirls, the cutters/circumcisers must find/be provided with alternative means of livelihood.
22. The above also suggests that the reason for cutting and type of cutting would ultimately reflect in the cost (challenges faced before, during and after) of cutting. #endcuttinggirls
23. FGM/C which has some long-lasting effect on women and girls who undergo it means that the survivor would live with its effect for long and would affect their finances as explained in tweet 21 and 22 #endcuttinggirls
24. For instance, girls who have contracted HIV /AIDS through any of the processes of FGMC would go through the stigmatisation the society subjects PLWHA to and incur the cost of their medication. #endcuttinggirls
25. FGMC imposes significant cost on the girl-child and the world as a whole but these costs can be difficult to quantify as much as the burden of FGM/C results from intangible concerns about permanent injury and/or death. #endcuttinggirls
26. Children who experience FGMC are likely to have higher rate of mortality, chronic absenteeism from school and physical injury.(https://tinyurl.com/y6ufmktt) #endcuttinggirls
27. Such girls who are cut as teenagers during school breaks tend to lose steam and play catch up when school resumes due to both physical and psychological pains they are going through from cutting #endcuttinggirls
28. It is made worse because these girls would likely suffer the effects in silence with no one to explain what happened (and what they are currently going through) to #endcuttinggirls
29. Through on-field interaction, we have seen that the teachers of these girls are not equipped to handle such cases if eventually, one shares. With the probability of sharing the experience at 0, the education of the girl child suffers a dip. #endcuttinggirls
30. However, there’s light at the end of the tunnel as @UNICEF_Nigeria has empowered her Social Media Advocates to take the FGM/C abandonment campaign to secondary schools in 5 project states under the UNICEF-UNFPA joint programme to #endcuttinggirls
31. Also, there is the possibility of premature death of children due to mutilation and unintended outcomes from cutting and poor management of post-cutting effects #endcuttinggirls
32. For girls and women, there are the short and long term effects and serious implications on sexual and reproductive health resulting from FGMC. Also, its severity depends largely on type and ‘expertise’ of the cutter. #endcuttinggirls

Olori Daco stops at 32 and introduces Tony to continue from 33

33. Physical implication of FGM/C has been well documented and can include reproductive tract infections, urinary tract infections, dysmenorrhea (painful menstruation), infertility and difficulties during pregnancy and delivery amongst other issues. #endcuttinggirls
34. At a workshop organised for couples in Aramoko Ekiti on Female Gemital Mutilation and Cutting, a participant commented on anorgasm due to FGM/C and its effect. #endcuttinggirls
35. “For women who suffer anorgasm (the medical term for regular difficulty reaching orgasm after ample sexual stimulation which can cause personal distress) due to FGM/C, the husbands are forced to go extra miles to satisfy them. The extra mile is not pocket friendly and has no health benefit.” #endcuttinggirls
36. His opinion was not a one off opinion has many other participants at various community dialogues and workshops on FGM/C have alluded to same #endcuttinggirls
37. The participant continued that the proliferation of “alcohol based herbal mixtures” amongst young husbands cannot be separated from their partners’ anorgasm. #endcuttinggirls
38. FGMC type III (infibulations, Deinfubalation and Reinfibulation) may cause complete vaginal obstruction resulting in the accumulation of menstrual flow in the vagina and uterus. (https://tinyurl.com/y9a6yb7b) #endcuttinggirls
39. An Infibulated woman, therefore, has to undergo gradual dilation of the vaginal opening before sexual intercourse can take place. #endcuttinggirls
40. The process of dilation is not only time consuming, it strains the relationship of the woman and her husband thereby creating cracks that can cause mental and emotional weariness in a marriage (https://tinyurl.com/y9a6yb7b) #endcuttinggirls
41. The detrimental effect of FGM/C on women’s sexual functioning for instance, less sexual arousal, and desire, less satisfaction and lower frequency of orgasm, have been widely reported and documented (https://tinyurl.com/yaascb79 ) #endcuttinggirls
42. Reports have also shown that there is a high prevalence of traumatic related and other psychiatric symptom such as anxiety and depression on FGMC survivor.( https://tinyurl.com/yaascb79 ) #endcuttinggirls
43. This psychiatric effect (as mentioned above) impacts on mental ability at the home front, work, personal engagements and social interactions #endcuttinggirls
44. The chronic absenteeism of survivors from work which might get the survivor sacked from work is an important cost of FGMC. #endcuttinggirls
45. In cases where the woman is not affected physically but mentally, her work ethics and productivity level might be affected. Hence, a loss for the woman and her employer. #endcuttinggirls
46. Nearly 80% of circumcised women do undergo depression bipolar disorder and anxiety disorder and a lot of women are presented with post – traumatic stress disorder. (https://tinyurl.com/y8hy9obh) #endcuttinggirls
47. Research on FGM/C as shown that a lot of people who have undergone FGMC have feelings of intense fear, helplessness, horror and a lot of people continue to suffer intrusive re- experience of their cutting. (https://tinyurl.com/yaascb79) #endcuttinggirls
48. In situations when survivors seek redress for undergoing FGMC, one of two things is possible in the Nigerian context. And, it’s not unlikely that the two possibilities would be the end result #endcuttinggirls
49. The cost of the legal battle; of filling processes and adjournment of FGMC cases which might take time because of our judiciary system. #endcuttinggirls
50. 48 above would not only take its economic toll on the survivor, the process would have psychological mark that can trigger memories of FGMC procedure the survivor underwent https://tinyurl.com/yaascb79 #endcuttinggirls
51. Also, seeking redress might be hindered by the inability of the survivors to “calmly” narrate their experiences convincingly in a law court due to the flashes of pain that come with the recollection of such events #endcuttinggirls
52. Researches also show that the reluctance to speak out can be related to the fact that thinking or talking about the mutilation may cause the pain experience at the time of the ritual to reappear. Chronic pain and traumatization can have a mutually reinforcing effect. #endcuttinggirls
53. The inability of survivors to narrate their experiences and the possible traumatisation when it’s done reinforces why FGM/C thrives on the culture of silence #endcuttinggirls
54. To #endcuttinggirls, it is imperative that we count the cost, make data available to government agencies, policy makers, civil societies and all stakeholders so that the battle against FGMC is not ruined on the altar of cultural sentiments and religious-based emotions
55. This task, actual determination of cost, socio-economic implications of FGM/C in a bid to abandon female genital mutilation and cutting might be daunting but it is not impossible to #endcuttinggirls

55a.        And when we begin to estimate the impacts of FGMC as the ability of children, who were lost to mutilation, Children who will contribute to the economy later in life and also the cost of hospital resources on mutilated children #endcuttinggirls

55b.       Then we will realise that the effect of FGMC on one girl child/or woman would be felt beyond her family; that it would impact on nation building and development #endcuttinggirls

56. Given the substantial burden of FGM/C; physically, socially, mentally and economically, the benefits of prevention outweighs the cost of cutting on our girls and implications on the nation #endcuttinggirls
57. Do join us on the 6^th of February for a special tweet conference to mark the International Day of Zero Tolerance for FGM/C from 2pm to 4pm #endcuttinggirls
58. As you ask your questions, we hope that you’d take a decision to join us to #endcuttinggirls in this generation. Thank you!