A: BACKGROUND:

FGM comprises all procedures that involve the partial or total removal of external genitalia or other injury to the female genital organs for non-medical reasons (World Health Organisation-WHO).  FGMis practiced in 30 countries in Africa and in a few countries in Asia and the Middle East.  The rise in international migration has also increased the number of girls and women living in the various diaspora populations, including in Australia, Europe, New Zealand and North America, and who have undergone or may undergo the practice.

The age at which girls experience FGM varies across countries and cultural groups. In some communities, FGM is performed before girls turn five years old, but in others, girls are cut when they are between the ages of five and 14 years, or prior to marriage (Care of girls and women living with female genital mutilation: a clinical handbook 2018).  It is estimated that over 200 million girls and women worldwide are living with the effects of FGM, and despite efforts to eradicate the practice, every year some 3 million girls and women are at risk of FGM and are therefore exposed to the potential negative health consequences of this harmful practice.

B: CLASSIFICATION OF FEMALE GENITAL MUTILATION (FGM)?

The WHO classifies FGM into four types, with subdivisions.  These are…

FGM Type I. Partial or total removal of the clitoris and/or the prepuce (Clitoridectomy). The subdivisions are: Type Ia. Removal of the clitoral hood or prepuce only and Type Ib. Removal of the clitoris with the prepuce.

FGM Type II. Partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora (excision). The subdivisions are: Type IIa. Removal of the labia minora only; Type IIb. Partial or total removal of the clitoris and the labia minora; and Type IIc. Partial or total removal of the clitoris, the labia minora, and the labia majora.

FGM Type III. Narrowing of the vaginal orifice with creation of a covering seal by cutting and appositioning the labia minora and/or the labia majora, with or without excision of the clitoris (infibulation).  The subdivisions are Type IIIa. Removal and apposition of the labia minora and Type IIIb. Removal and apposition of the labia majora.

FGM Type IV. All other harmful procedures to the female genitalia for nonmedical purposes, for example, pricking, piercing, incising, scraping, and cauterization. Type IV also includes introduction of corrosive substances and herbs in the vagina, and other forms. In some communities, in Nigeria, they try to push the clitoris back into the body or apply herbs, petroleum jelly, menthol ointments, or hot water to make the clitoris numb. This is called “MASSAGING or PRESSING”. 

C: WHY DO COMMUNITIES PRACTISE FGM?

FGM is practiced for a variety of sociocultural reasons, varying from one region and ethnic group to another.  Some of these reasons are to 1) Enhance Fertility: 2) Respect for Tradition: 3) Rite Of Passage; 4) Social Convention; 5) Marriageability; 6) Ensure Virginity, Chastity and Faithfulness; 7) Cleanliness and Beauty; 8) Femininity; and 9) Religion.

D: HEALTH RISKS FROM FGM

FGM has no known health benefits, and those girls and women who have undergone the procedure are at great risk of suffering from its complications throughout their lives. The procedure is painful and traumatic, and is often performed under unsterile conditions by a traditional practitioner who has little knowledge of female anatomy or how to manage possible adverse events. Moreover, the removal of or damage to healthy genital tissue interferes with the natural functioning of the body and may cause several immediate and long-term genitourinary health consequences.

According to the WHO Publication, “Care of women and girls living with FGM: a clinical handbook”, the health consequences are, broadly, grouped into Immediate & short-term physical complications as well as long-term complications (Gynaecological & urogynaecological, etc.). 

The “Immediate & Short term complications” of FGM (severe pain and injury to tissues; haemorrhage (bleeding); haemorrhagic shock; infection and septicaemia; genital tissue swelling; acute urine retention and fracture of bones.

The “long-term complications of FGM” are chronic vulvar pain; clitoral neuroma; reproductive tract infections; menstrual problems; urinary tract infections; painful or difficult urination; epidermal inclusion cysts and keloids.  

The Obstetric Risks: are 1) Caesarean section; 2) Postpartum haemorrhage (Postpartum blood loss of 500 ml or more); 3) Episiotomy; 4) Prolonged labour); 5) Obstetric tears/lacerations; 6) Instrumental delivery; 7) Difficult labour/dystocia; 8) Extended maternal hospital stay; 9) Stillbirth and early neonatal death; and 10) Infant resuscitation at delivery.

The Sexual Functioning Risks are1) Dyspareunia (pain during sexual intercourse); 2) Decreased sexual satisfaction; 3) Reduced sexual desire and arousal; 4) Decreased lubrication during sexual intercourse; 5) and Reduced frequency of orgasm or anorgasmia.  Finally, the Psychological Risks are: 1)Post-traumatic stress disorder (PTSD); 2) Anxiety disorders; and 3) Depression.

E: FGM & HUMAN RIGHTS

FGM violates a series of well-established human rights principles, which include 1) Principles of equality and non-discrimination on the basis of sex; 2) Right to life (when the procedure results in death); 3) Right to freedom from torture or cruel, inhuman or degrading treatment or punishment; and 4) Rights of the child.

F: MEDICALIZATION OF FGM:

The medicalization of FGM refers to “situations in which the procedure (including re-infibulation) is practised by any category of health-care provider, whether in a public or a private clinic, at home or elsewhere, at any point in time in a woman’s life”. This definition was first adopted by WHO in 1997, and reaffirmed in 2008 by 10 UN agencies in the interagency statement, Eliminating female genital mutilation. The interagency statement strongly emphasizes that regardless of whether FGM is carried out by traditional or medical personnel, it represents a harmful and unethical practice, with no benefits whatsoever, which should not be performed under any circumstances.

For more information about FGM you can visit http://www.who.int and www.endcuttinggirls.org or watch

PREVALENCE OF FGM IN NIGERIA:

FGM remains widespread in Nigeria with regional and ethnic variations in prevalence.  According to the Multiple Indicator Cluster Survey (MICS 2016 -2017), 18.4% of women aged 15-49 years had undergone FGM, a decrease from 27% in 2011.  Worrisomely, the prevalence among daughters aged 0-14 years increased from 19.2% (in 2011) to 25.3% (in 2016-2017).  In the UNJP intervention states, the overall FGM prevalence among women aged 15-49 years ranged from 43.2% in Ebonyi to 67.8% in Osun state.  Decreases in FGM prevalence among women aged 15-49 years was observed in the UNJP intervention States (Ebonyi: 62.3 % to 43.2%; Ekiti: 66.2% to 62.6%; Imo: 58.4% to 51.6%; Osun: 73.4% to 67.8 %; and Oyo: 71% to 55%).  The FGM prevalence among the girls 0-14 years decreased in Ebonyi: 6.4% to 5.2%, Imo (33.4% to 22.2%), and Oyo states (32.9% to 29.6%). A slight increase was seen in Ekiti (40.3% to 41.7%) and Osun (33.4 to 34.6%).  According to the MICS (2016-2017), 21.6% of women surveyed were in support of the continuation of FGM, a very slight decrease from 21.8% in 2011.  In the UNJP intervention states a decrease was observed in Ebonyi (11.8% to 3.8%) and Ekiti (50.2% to 31.4%); and increases in Imo (27.8% to 29.6%); Oyo: (21.2% to 30.3%; Osun: (34.8% to 38.5%).

GLOBAL EFFORT TO END FGM:

From 2014 to 2017, Phase II of the UNFPA/UNICEF Joint Programme on FGM Abandonment (UNJP) was implemented in Nigeria.  The goal was to contribute to the acceleration of the total abandonment of FGM within a generation in line with the United Nations General Assembly Resolution A/RES/67/146 to “intensify global efforts to eliminate female genital mutilations”.  To achieve this goal, the Government of Nigeria in collaboration with UNFPA, UNICEF and in partnership with Civil Society Organizations implemented a common coordinated national response to contribute to the elimination of FGM.  During the 4-years period, the UNJP supported policy formulation, institutional strengthening, service delivery and community-based activities in five focus states, namely, Ebonyi, Ekiti, Imo, Osun, and Oyo.  These states were selected because they had the highest prevalence based on the 2013 Nigeria Demographic Health Survey (NDHS).

In order to contribute to the elimination of harmful practices as proposed by Target 5.3 of the Sustainable Development Goals (SDGs), the UNJP has commenced Phase III (2018-2021).  The Joint Programme is taking place in 16 Countries (Burkina Faso, Djibouti, Egypt, Eritrea, Ethiopia, Gambia, Guinea, Guinea-Bissau, Kenya, Mali, Mauritania, Nigeria, Senegal, Somalia, Sudan, and Uganda).  The vision of Phase III is to “contribute to the elimination of FGM by 2030”.  The goal is “to accelerate efforts towards the reduction of FGM, fulfilling the rights of girls and women by realizing social and gender norms transformation by 2021”.  The launch of Phase III in January 2018 marks a critical juncture and opportunity to consolidate the considerable gains made by the UNJP in the last four years, in Nigeria, while also addressing the growing number of girls and women affected by and at risk of FGM.

The #endcuttinggirls WhatsApp Conference is a UNICEF-supported, under the Joint Programme.  It began in 2017.  At the last WhatsApp conference, 17^th December 2018, we discussed the topic “The Benefit of Community Public Declaration on the Abandonment of Female Genital Mutilation (FGM)”, a participant made a comment that “those who really need this training are not on social media”.  That is the reason behind this conference.  Today we would explain the reason behind the #endcuttinggirls social media campaign, and what we hope that you can do after participating in any of the #endcuttinggirls conferences (Twitter, Facebook and WhatsApp).

Here are the Advantages of using the Social Media to Campaign for the

1. Increased Campaign Awareness: Social media is one of the most cost-efficient digital marketing methods used to syndicate content and increase your business’ visibility. Implementing a social media strategy will greatly increase your campaign recognition since you will be engaging with a broad audience. Making a Post on social media and getting friends and followers to share the post helps the campaign to reach more people which helps the campaign to spread.

• More Inbound Traffic: Social media is a melting pot of different types of people with varying backgrounds and behaviors. With different people come different needs and different ways of thinking. Syndicating your content on as many platforms as possible allows these individuals to organically reach your campaign.

• Faster means of connection:  Social media is a networking and communication platform. Creating a voice for your campaign through these platforms is important in humanizing your campaign. Survivors, or someone who wants to make a report, appreciate the fact that when they post comments on your pages, they will receive a personalized response rather than an automated message. Being reachable on social media gives them a level of assurance that their identity is protected and that due process will be taken without them been on anybody’s black book.

• Improved Campaign Loyalty: One of the main goals of almost all campaigns is developing a loyal Followers base. Considering that Survivor and Reporters satisfaction and campaign loyalty typically go hand in hand. Social media is not just limited to introducing your brand’s products and promotional campaigns. Survivors/reporters see these platforms as a service channel where they can communicate directly with the business.

• Cost-Effectiveness:  Social media marketing is possibly the most cost-efficient part of an advertising strategy. Signing up and creating a profile is free for almost all social networking platforms, and any paid promotions you decide to invest in are a relatively low cost compared to other marketing tactics.

But just like the participant at the last conference right said, the campaign won’t be effective if all the knowledge gained from WhatsApp, and other social media platforms, are not stepped down in our community. If we keep the information to ourselves, then the primary aim of the conference would be defeated.  The question now is how do we step down the training in our communities?

The questions are 1) How can we now step down the training? 2) How can we take what we have learnt from WhatsApp to the Street?

The following are part of what we can move the campaign to end Female Genital Mutilation (FGM) from the social media users to our communities.

1. Open Declaration: some people believe that FGM has no medical advantage. They accept the fact that the act should be stopped, but the fear of speaking out is a major challenge. So we need to speak out.

• Become an End FGM advocate: without waiting for anyone, you can decide to talk to those around you, so that no one is left behind.  FGM is the concern for everyone both young and old. Visit hospitals, churches, etc., and utilize every opportunity, don’t stop making those around you know the reason why FGM should be stopped.

• Speak for the Girls who are about to the cut: as an advocate against FGM, when you get to know about any female child been born around you. Paying a congratulatory visit won’t be a bad idea, and in the process of the visit, initiate talk on FGM and why that girl should not be cut. After the visit, don’t go too far, ensure you keep yourself informed on the child so that they don’t get to cut the child after the discussion.

• Be an Intermediary: Not everyone knows who to call when FGM occurs but as an informed person who is knowledgeable about FGM and who knows the right agency to call on when there is an emergency; you automatically become the middleman between the people and the agencies.

• Speak their language: the social media reach out to a lot of people but some still won’t get the message, because the social media doesn’t communicate in their language. Some people only understand the language of music; some won’t believe until its announced on radio, while some won’t accept until they see their religious leader comes to speak to them on it. You know your community better, you know the language they understand better, if you can’t do it on your own, reach out to agency that can pick it up, tell them the language they love and you can be sure due process will be taken.

• Road and Wall Signs (Wall Murals): this method was used in the campaign against rape in a particular area of Ikorodu (Lagos State) some years ago, a group of boys bought paints and were writing on the street, “we say no to rape”.  This sent a signal to everyone on the street, including visitors that this community frowns at rape, at with that the cases of rape in that community drastically reduced. Employing this method can also send a great signal to those who can read but are not just social media freaked that the campaign against FGM is on in their street also.

• Don’t stop learning: to remain on top of your game, to conquer FGM, you need to constantly learn about the subject matter.  This is because you might meet someone who would be ready to engage you and once you are not knowledgeable, you will lose that opportunity. That’s why we have a Twitter Conference every Thursday (5-7pm) using the #endcuttinggirls hashtag, and we have a monthly Facebook Conference too.  You can also join us on YouTube and Instagram.  For videos and materials on FGM, just search for #endcuttinggirls.  We also have a website where you can get to learn extensively on the subject matter, visit www.endcuttinggirls.org.

Thanks so much for joining the first WhatsApp conference for 2019.  We do hope that after today we would have foot soldiers who would go to become #endcuttinggirls advocates in their community. Till we come your way again, the Moderator has been Ademola Adex, while the Facilitator was Mr. Ola Moses.  Please let questions and contributions start rolling in.