According to UNICEF coronavirus
disease (COVID-19) pandemic is of a scale most people alive today have never
seen. Worldwide, the outbreak is claiming lives and livelihoods as health
systems buckle, borders close and families struggle to stay afloat.
Communities across the globe are
rising to the challenge – from health workers risking their lives to fight the
virus, to young people deploying innovative ways to share public health
messages.
Yet, even as the spread of the
virus slows in some countries, its social toll will come fast and hard. And in
many places, it will come at the expense of the most vulnerable children.
Without urgent action, this
health crisis risks becoming a child-rights crisis. Disruptions to society have
a heavy impact on children: on their safety, their well-being, their future.
Only by working together can we keep millions of girls and boys – including
those who have been uprooted by conflict, children living with disabilities and
girls at risk of violence – healthy, safe and learning. Most especially Female
Genital Mutilation (FGM).
Female Genital Mutilation (FGM)
has affected the social and economic wellbeing of generations of Girls/Women.
Globally, many endFGM campaigns have been introduced to help end this harmful
traditional practice. Yet, even in the efforts to arrest these harmful cultural
practices, not all actors share in this vision.
In some FGM practicing
communities, disparate voices continue to champion continuation of harmful
cultures rather than advancing human rights of Girls/Women. These factions seem
to take advantage of emergency situations such as COVID-19 pandemic to
perpetuate such harmful practices.
In situations of conflicts and
disaster, FGM practices present a life-threatening, health and human rights
challenge. In cases of FGM, a survivor has no choice to refuse or pursue other
options without severe social, physical, or cultural consequences. In
emergencies, these consequences border on extreme intolerance or
ethno-terrorism. This includes social sanctions such as being ostracized or
suffering psychological abuse.
It includes invoking of cultural sanctions
that can border on, being cursed and excommunication. It also comes with
threats of physical harm such as death threats or risk of violence being
verbally communicated or actualized. All of these constitute a violation of
international human rights law and principles of gender equality as well as
State/National laws prohibiting the practice of FGM in Nigeria.
Measures have been taken by various Countries and states, going from
total lockdown to less restrictive measures depending on the local situation. We
can say that unfortunately the current situation may have an effect on the
Campaign to end FGM.
In particular, FGM support
services are not considered as a medical emergency and a lot of facilities are
closed and will remain so for at least several more weeks. Medical staff have
rightly been re-allocated to overcome the COVID-19 outbreak or encouraged to
avoid any non-urgent medical care for now. As a result, many FGM survivors and Girls/women
at risk in general are left without any access to needed medical care.
For many women and children, the
home is not a safe place. UNFPA released its paper on ‘COVID-19: a gender
lens’, explaining how women are specifically effected by this pandemic: “Pandemics
compound existing gender inequalities and vulnerabilities, increasing risks of
abuse. In times of crisis such as an outbreak, women and girls may be at higher
risk, for example, of intimate partner violence and other forms of domestic
violence due to heightened tensions in the household. https://www.unfpa.org/resources/covid-19-gender-lens
They also face increased risks of
other forms of gender based violence including sexual exploitation and abuse in
these situations. For example, the economic impacts of the 2013-2016 Ebola
outbreak in West Africa, placed women and children at greater risk of
exploitation and sexual violence. https://www.unfpa.org/resources/covid-19-gender-lens
In addition, life-saving care and
support to gender based violence survivors (i.e. clinical management of rape
and mental health and psycho-social support) may be cut off in the health care
response when health service providers are overburdened and preoccupied with
handling COVID-19 cases. https://www.unfpa.org/resources/covid-19-gender-lens
Systems must ensure that health
workers have the necessary skills and resources to deal with sensitive
gender-based violence related information, that any disclosure of gender based
violence be met with respect, sympathy and confidentiality and that services
are provided with a survivor centered approach. It is also critical to update
gender based violence referral pathways to reflect changes in available care
facilities and inform key communities and service providers about those updated
pathways. ”, in a moment when #stayathome has become the new general rule. https://www.unfpa.org/resources/covid-19-gender-lens
“Systems that protect women and
girls – including community structures – may weaken or break down, specific
measures should be implemented to protect women and girls from the risk of
intimate partner violence with the changing dynamics of risk imposed by
COVID-19”. https://www.unfpa.org/resources/covid-19-gender-lens
Before we close, we would like to share a brief overview of Female
Genital Mutilation (FGM) for the benefit of those joining our tweet conference
for the first time.
Female Genital Mutilation (FGM) includes all procedures that involve
the partial or total removal of external genitalia or other injury to the
female genital organs for non-medical reasons. @WHO
The
World Health Organization (WHO) classifies FGM into four types, and all four
types are all practiced in Nigeria.
Type I: partial or total removal of the clitoris
and/or the prepuce (Clitoridectomy). Subgroups of Type I FGM are: type Ia,
removal of the clitoral hood or prepuce only; type Ib, removal of the clitoris
with the prepuce.
a Type II: partial or total removal of the
clitoris and the labia minora, with or without excision of the labia majora
(excision). Subgroups of Type II FGM are: type IIa, removal of the labia minora
only; type IIb, partial or total removal of the clitoris and labia minora; type
IIc, partial or total removal of the clitoris, labia minora & labia majora.
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). Subgroups
of Type III FGM are: type IIIa, removal and apposition of the labia minora;
type IIIb, removal and apposition of the labia majora. Reinfibulation is
covered under this definition. This is a procedure to recreate an infibulation,
for example after childbirth when defibulation is necessary.
Type IV: unclassified – all other harmful
procedures to the female genitalia for nonmedical purposes, for example,
pricking, piercing, incising, scraping and cauterization. Type IV also includes the practice of
“massaging” or applying petroleum jelly, herbal concoctions or hot water to the
clitoris to desensitize it or pushing it back into the body, which is common in
many parts of Nigeria, especially Imo State.
FGM has no
known health benefit, and is harmful to girls and women. It involves altering,
removing and/or damaging otherwise healthy female genital tissue.
It is estimated that over 200 million girls and women worldwide are
living with the effects of FGM, and every year some 3 million girls and women
are at risk of FGM and are therefore exposed to its potential negative health
consequences (UNICEF 2016).
In Nigeria,
the Nigeria Demographic Health Survey (NDHS 2018) revealed that 20% of women
aged 15-49 years had undergone FGM, a decrease from 25% (NDHS 2013).
For more information about FGM you can visit http://www.who.int or watch
At this
point, I will stop the conversation so we can reflect on the key points
discussed as I entertain any questions.
Thanks for
being part of the conversations today. Visit our www.endcuttinggirls.org for
more info and updates on FGM, and kindly follow the handle “@Endcuttinggirls”
on all social media platforms.
Over the years, the campaign to end
female genital mutilation through the initiative of UNICEF #endcuttinggirls has
become one of the most successful campaign towards eliminating female genital
mutilation.
Let me re-emphasize that in the recent times, the discussion, campaign
and issues around harmful traditional practices especially FGM have become one
of the most talked-about topics.
However, despite the massive
interventions across FGM-practicing communities, with a lot of messages, there
is need to use multi-pronged approach to keep driving the change to end this
harmful practice.
Today, we will be
looking at the various ways young people are changing the norms to accelerate
the campaign to #endcuttinggirls
in Africa.
According to WHO, it is estimated that more than 200 million girls and
women alive today have undergone female genital mutilation in the countries
where the practice is concentrated and are living with the negative consequences
of the practice.
It is
also estimated that 3 million girls are at the risk of undergoing female
genital mutilation every year. So, what is Female
Genital Mutilation (FGM)!?
Female Genital
Mutilation (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. FGM is also widely called various local and traditional
names according to the community where it is practiced.
FGM is a form of
violence which is based on cultural beliefs and gender norms. This harmful
practice is performed on babies, girls and women depending on the community
In most communities,
FGM is seen as a protection of virginity, a beautification process, and in a
number of cultures is regarded as an essential precondition of marriage. There
are different forms of FGM, some of which involve more radical excisions in the
genital area than others.
The World Health
Organization (WHO) has classified FGM into four types, and they are all
practiced in Nigeria.
FGM
Type 1 is defined as the partial or total
removal of the clitoris and/or the prepuce (Clitoridectomy). The subgroups of
Type 1 FGM are: type 1a, removal of the clitoral hood or prepuce only; type 1b,
removal of the clitoris with the prepuce.
FGM
Type 2 entails the partial or total removal of
the clitoris and the labia minora, with or without excision of the labia majora
(excision). Subgroups of Type II FGM are: type 2a, removal of the labia minora
only; type 2b, partial or total removal of the clitoris and labia minora; type
2c, partial or total removal of the clitoris, labia minora and labia majora.
FGM
Type 3 involves the 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).
Subgroups of Type III
FGM are: type IIIa, removal and apposition of the labia minora; type IIIb,
removal and apposition of the labia majora.
FGM
Type 4 is also known as unclassified and involves all
other harmful procedures to the female genitalia for nonmedical purposes, for
example, pricking, piercing, incising, scraping and cauterization.
The FGM Type 4 also
includes the practice of “massaging” or applying petroleum jelly, herbal
concoctions or hot water to the clitoris to desensitize it or pushing it back
into the body, which is common in many parts of Africa including Nigeria.
FGM has so many
consequences including short and long terms consequences ranging from excessive
bleeding, trauma, Contraction of infections, etc.
Although the
elimination of FGM was originally regarded as a mere question of health
education and information, today FGM is recognized as a socio-cultural problem
that is deeply rooted within the societies in which it is practiced.
Thus social change is
indispensable if the practice is to be ended permanently. Commitment to ending
FGM is symbolic of the effort to strengthen the position of women and women’s
rights generally, because FGM is a serious violation of human rights, and its
elimination would serve to advance virtually every one of the UN Sustainable
Development Goals (SDGs).
In the last decade,
UNICEF under the UNFPA/UNICEF Joint Programme on Elimination of FGM, has
supported strategic stakeholders, advocates, government institutions and civil
society organizations (NGOs) to collectively and innovatively work together to
eliminate FGM.
So many approaches,
methodologies and various levels of advocacy have been deployed by various
stakeholders with the youth championing major aspect of the initiative.
Many girls and young women are still subjected
to genital mutilation in the name of ‘tradition.’ In the beginning, it was
difficult to talk to anyone about that issue, as this is an unnegotiable topic
and not ready for open discussion.
But against all odds, young people have
taken to the stage in the campaign and deploying all possible strategies to
combat the practice of FGM. I will be sharing about key
strategies that young people are using to change Traditions Fueling FGM In
Africa
Creating Awareness:
Young people are predominantly affected by the practice of FGM, they have been
helping to end this practice by engaging in aggressive awareness campaigns in
rural communities, where cultural beliefs and societal pressure to conform to
existing traditional practices force parents to let their girl children go
through this excruciatingly painful and medically unnecessary procedure.
Engaging
schools: The youth have been engaging with those
who can various stakeholders across communities. Additionally, most youth
advocates have directly engaged with various public and private schools to
sensitize the students, especially girls, about the dangers of FGM. Since it is
girls who are affected, such visits are led by fellow youths and in most cases,
a female survivor of FGM who shared their personal experiences.
Engaging
schools and religious leaders: The youth also engage
with religious leaders to speak out against FGM through the various religious
platforms. For example, Nigeria is made
up of highly developed and diversified religious groups, and the religious
leaders are given enormous respect and weight in Nigerian society. Based on the
respect they carry; youths have been engaging the religious leaders to convince
their parents and community leaders to stop the practice of FGM.
Seek
government support: One of the most effective
ways to record maximum result in the campaign to EndFGM is through government
support. As a result, young people are getting approvals for government’s
support, while their advocacy efforts have led to and strong political
commitment to enact strict penalties for those who still practice FGM. Young people have been leading the way in
tackling development, gender, and health issues, which are major components to
ending the practice of FGM. They just need to be given more opportunities.
Advocacy
to parents/traditional leaders: Young people have
been highlighting the harmful health implications of FGM to parents and
traditional leaders in communities where it is practiced, explaining that girl
children who do not undergo FGM grow up to be healthy women and are no less
female than girls who undergo FGM/C
Personal commitments: Youth, as future parents, are making
personal commitments not to allow themselves to be subjected to FGM, and they
are also promising not to subject their own children to FGM in the future.
Surveillance:
In Nigeria, the youth are members of the Community Based Child Protection Committee
(CBCPC), where they are monitoring the compliance to commitments made during
the public declaration of abandonment of FGM.
Organizing
school-level art contests has been a very strategic
initiative in the FGM campaign because it allows people from different cultures
and different times to communicate with each other via images, sounds and
stories. Young people have been using various Art contest as a vehicle for
social change especially in the campaign to #EndFGM
The
art contests have also given voice to the politically or socially
disenfranchised. And in most cases, a song, film or novel can rouse emotions in
those who encounter it, inspiring them to rally for change.
Peer education: Peer education aims to
influence young people’s attitudes and behaviour patterns for the better. In Nigeria young people that have
been trained on FGM inform other young people, their peers, about health and
gave them their support in coping with their problems and telling them where
they can seek for support.
Partnering with school clubs: Youth in school clubs
(Health, Press, Debating Society, etc.) are collaborating with UNICEF-partners
and are being trained to include ending FGM into their regular Club activities
in the school. These clubs are very
active in creating awareness about FGM in their schools.
Life
Building Skills training: UNICEF and
partners are training girls (in-and-out of school) on ‘Life Building Skills”
and FGM. This empowers them to talk to
their peers, family and community members about the need to end FGM.
Intergenerational dialogue: Years of experience have
shown that education and awareness work alone do not bring about behaviour change. Therefore, youth are engaging in the
intergenerational dialogue, which is based on the principle of listening and
questioning rather than instructing. It enables participants to reflect on
their values, customs, traditions and expectations and to consider
whether, when, how and under what
conditions change should take place.
There are so many other
ways youth are using to accelerate the campaign to end female genital
mutilation but the points mentioned above have formed some of the most
effective methods and ideas to engage various traditions and ending the
practice across all communities.
In conclusion,
youth are the key to change. It is essential that they become empowered through
education and various approaches to bring about behavioural change. It is equally
important to involve their social environment into the change process – the
decision-makers, that is, such as parents and traditional and religious
leaders.
This is where
we will end today’s segment of the conference and will gladly standby to take
your questions. Thank you for staying with us
To learn more
about the @endcuttinggirls Social Media Campaign, please visit
www.endcuttinggirls.org for information.
You may also follow our social media handles on Facebook, Twitter,
Instagram and YouTube, using @endcuttinggirls
At this point,
I will give room for questions and contributions from participants. Thank you
for joining us.
Conversations
around music, storytelling, film production and other forms of art as strategic
media for ending #FGM are very vital as the deliberate production of these art
forms tailored to pass the message on the Effects of FGM will help push the
cause farther. Considering a production force of approximately 50 movies weekly
with almost double that number of songs, and an audience that cuts across all
classes of people, the Nigerian film and music industry is undoubtedly an asset
that must be maximized in ending FGM.
In
Nigeria, “UNFPA-UNICEF Joint Programme on Eliminating FGM: Accelerating Change”
has adopted ARTs and Entertainment (Theatre, Music, Nollywood, etc) as tools
for the elimination of FGM.
Before
we go further with this conference, I’d like us to revisit what FGM is for the
sake of those that are joining us for the first time.
Female
Genital Mutilation (FGM) includes all procedures that involve the partial or
total removal of external genitalia or other injury to the female genital
organs for non-medical reasons. The World Health Organization (WHO) has
classified FGM into four types, and they are all practiced in Nigeria.
Type
I: partial or total removal of the clitoris and/or the prepuce
(Clitoridectomy). Subgroups of Type I FGM are: type Ia, removal of the clitoral
hood or prepuce only; type Ib, removal of the clitoris with the prepuce.
Type
II: partial or total removal of the clitoris and the labia minora, with or
without excision of the labia majora (excision). Subgroups of Type II FGM are:
type IIa, removal of the labia minora only; type IIb, partial or total removal
of the clitoris and labia minora; type IIc, partial or total removal of the
clitoris, labia minora and labia majora.
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). Subgroups of Type III FGM are:
type IIIa, removal and apposition of the labia minora; type IIIb, removal and
apposition of the labia majora.
Reinfibulation
is covered under this definition. This is a procedure to recreate an
infibulation, for example after childbirth when defibulation is necessary.
#endcuttingirls
Type
IV: unclassified – all other harmful procedures to the female genitalia for
nonmedical purposes, for example, pricking, piercing, incising, scraping and
cauterization.
Type
IV also includes the practice of “massaging” or applying petroleum jelly, herbal
concoctions or hot water to the clitoris to desensitize it or pushing it back
into the body, which is common in many parts of Nigeria, especially Imo State.
It
is estimated that over 200 million girls and women worldwide are living with
the effects of FGM, and every year some 3 million girls and women are at risk
of FGM and are therefore exposed to its potential negative health consequences
(UNICEF 2016).
In
Nigeria, the Multiple Indicator Cluster Survey (2016-17) revealed that 18.4% of
women aged 15-49 years had undergone FGM, a decrease from 27% (2011).
Conversely, the FGM prevalence among daughters (0-14 years) rose from 19.2%
(2011) to 25.3% (2016-17).
The
practice of #FGM has thrived in a culture of silence. In a lot of communities
where it is practiced there’s an unspoken lock on the lips of victims regarding
the negative effects of fgm. Years of
advocacy and research has shown that FGM is often treated with indifference and
sometimes feigned ignorance of its existence. This ignorance and indifference
is premiered by the culture of silence attached to the practice.
The
Nigerian film industry fondly called Nollywood is arguably the largest hub of
entertainment in Africa. With a work force of people from all regions, tribes,
and religions in Nigeria, Nollywood is undoubtedly an attractive partner in the
fight to End FGM. The industry is known to produce movies that carry vital
information and lessons for all who see them and so leveraging on this as well
as its popularity would help spark conversations about #FGM in all households,
communities, rural and urban settlements.
The
production of relative stories through films would encourage survivors in
practicing communities to talk more about the effects of the practice
especially in their lives and lives of loved ones. While some cutters may be ignorant of the
adverse and long term effects of #FGM movies that carry the message would serve
as a medium and tool of education and enlightenment.
Movies
on community declarations featuring the collective abandonment of FGM in rural
communities alike should also be promoted. Movies like this would not only
spark conversations in homes but in the community at large.
Further
familiarity with the message of the adverse effects of FGM, is a sure step towards mass reorientation and
education, which would prepare families to make better decisions regarding the
practice of FGM.
On
how music is can also be a powerful tool; Music has the power to infiltrate the
consciousness of an entire generation of people and influence their emotions
and eventually, their actions. Music can unite groups and help them stay strong
together to achieve a common goal.
The
use of music in communities for rituals such as coronation, naming ceremonies,
and rites of passage events including FGM predates literacy. It therefore can
also be used to promote positive changes in these communities. Music is so
powerful that one song, one right song, about FGM can reach and compel millions
of people in Nigeria and across the world, causing social actors to unite under
a common cause to End FGM.
Other
forms of art that can be beneficial to this initiative include:
Mouth to mouth storytelling: a good number of
us would remember stories that we were told as children and the morals that we
drew from them. Imagine a generation of people who have been told stories about
the harmful effect of FGM from their childhood?
Drawings/Paintings: Art works have been
known to evoke certain emotions without using words. Paintings can be made to
tell stories. Stories of the pain and struggles that come with FGM.
Creative competitions: Game shows and
competitions have over time become a source of entertainment for people.
Schools, churches, and even communities can come together to organise
competitions (singing, dancing, etc) that push the agenda of FGM abandonment.
Additionally, in our of our Tweet conference held Thursday, 17th October 2019 The anchor @_chzy in her tweets highlighted some of the importance of Music as a powerful tool for mobilizing Communities to end FGM, as follows:
The use of music in communities for rituals such as coronation, naming ceremonies, and rites of passage events including FGM predates literacy. Music therefore can also be used to promote positive changes in FGM practicing communities.
Song writing competition for in and out of school youths within the “UNFPA-UNICEF Joint Programme on Eliminating FGM: Accelerating Change” focal communities would help develop unique music for such communities.
Creating play songs for growing children with the message to end FGM will embed this message in the fabric of the DNA of the next generation. I know I still remember songs I played to as a child, the only definition I remember from my junior secondary school days are the ones I made into songs. ‘Social Studies’ was a bore for me so I added music to my notes.
Dance dramas with compelling wordless music can be created by community members. This kind of music has the power to make audience pay attention and get drawn into the message, owning the message as they have to put words to the drama and music themselves.
Music has always been a powerful educational tool. We have established in previous topics on this conference that education is a vital key in ending FGM in this generation. Here is a link to the transcript on the conferences edition on education.
Music as a tool of change is an inexhaustible topic, but we will have to stop here to give room for questions. While waiting for said questions, I will be posting examples of songs written and sung for the purpose of accelerating change across the globe.
In
conclusion, the role that Art and Entertainment have to play in the cause to
End Female Genital Mutilation cannot be overemphasised or undermined. It is our
hope that this industry puts in more effort to see that they play their part in
this campaign.
Thank
you for joining in this month. I would pause now to take your questions.
Female Genital Mutilation (FGM)
includes all procedures that involve the partial or total removal of external
genitalia or other injury to the female genital organs for non-medical reasons.
The World Health Organization (WHO) has classified FGM into four types,
and they are all practiced in Nigeria.
Type I: partial or total removal of
the clitoris and/or the prepuce (Clitoridectomy). Subgroups of Type I FGM are: type Ia, removal
of the clitoral hood or prepuce only; type Ib, removal of the clitoris with the
prepuce.
Type II: partial or total removal of
the clitoris and the labia minora, with or without excision of the labia majora
(excision). Subgroups of Type II FGM are: type IIa, removal of the labia minora
only; type IIb, partial or total removal of the clitoris and labia minora; type
IIc, partial or total removal of the clitoris, labia minora and labia majora.
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). Subgroups of Type III FGM are: type IIIa, removal and
apposition of the labia minora; type IIIb, removal and apposition of the labia
majora. Reinfibulation is covered under this definition. This is a procedure to
recreate an infibulation, for example after childbirth when defibulation is
necessary.
Type IV: unclassified – all other
harmful procedures to the female genitalia for nonmedical purposes, for
example, pricking, piercing, incising, scraping and cauterization. Type IV also
includes the practice of “massaging” or applying petroleum jelly, herbal
concoctions or hot water to the clitoris to desensitize it or pushing it back
into the body, which is common in many parts of Nigeria, especially Imo State.
FGM has short terms and long term
effects on the health and well-being of girls and women. Short term effects of
FGM include: severe pain, excessive bleeding, shock, genital tissue swelling,
infections, while the long term effects include chronic genital infections,
urinary tract infections, painful urination, keloids, perinatal risks, etc.
FGM is recognized
internationally as a violation of the human rights of girls and women. FGM practice violates women and girls’ rights to
health, security and physical integrity, rights to be free from torture and
cruel, inhuman or degrading treatment, and rights to life (when the procedure
results in death)
For more information about FGM you can visit http://www.who.int or watch
FGM
practice is strongly rooted in the people’s culture and so, it has not been an
easy task in getting people to abandon the practice despite the harmful effects
on girls and women.
It
is estimated that about 200 million girls/women have undergone FGM and about 3
million girls/women per year are at risk.
Unless action to end FGM is accelerated, another 68 million girls will
have been cut by 2030 (Antonio Guterres – UN Sec. Gen.)
The
Multiple Indicator Cluster Survey (2016-17) revealed that 18.4% of women aged
15-49 years had undergone FGM, a decrease from 27% (2011). Conversely, the FGM prevalence among
daughters (0-14 years) rose from 19.2% (2011) to 25.3% (2016-17).
In
the regard of FGM and education, the program advisor for USAID Somalia MaryBeth
McKeever said that advocacy should be focused on community education
communities (CECs), and these communities are composed of parents, students,
teachers, school administrators and traditional/religious leaders and each
school has one.
Community
education communities (CECs) have been instrumental in increasing girls’
education and can help these pupil and students make informed choices on
decisions that will impact their health, education and lives.
The
connection between FGM and education is twofold: education and awareness about
the practice and its risks and general educational attainment.
Teaching
pupil and students about the dangers of FGM is a powerful tool in changing
public opinion and reversing the trend. However, the importance of overall
education may seem less clear.
The
International Center for Research on Women published a report on FGM and education
that stated that, while more research needs to be done, “emerging evidence
illustrates that basic education can be an effective instrument for abandoning
the practice of FGM.” Several persons
are yet to come to terms with the significant relevance of educating these
students as a powerful tool to eradicating the practice of FGM.
This
was so evident in the research conducted on mothers by International Center for
Research. This research shows that women are less likely to have their
daughters cut as their level of education rises. Education exposes students,
male and female, to a variety of competing ideas and concepts and a broader
worldview. This allows them to make more informed decisions regarding their own
reproductive health and agency.
This
emphasizes on the need for school-based interventions and further highlights
the important role (s) that schools can play in ending this practice.
Educating
pupils can also give them the freedom to make decisions to improve their lives,
which has deep social implications.
By
imparting literacy, education also facilitates the pupil’s access to
information about social and legal rights and welfare services. Learning to
read and write can bring greater confidence and agency to identify and
challenge inequality throughout society.
For
instance, just as with FGM, low levels of education are a significant risk
factor in perpetuating and experiencing intimate partner violence so the
earlier these pupils are informed the better it is for the society.
To
further buttress this, the 2013 NDHS in Nigeria shows that women (which
includes female pupil/students) with higher levels of education are less likely
to have undergone female genital mutilation.
The
importance of empowering pupils/students as FGM advocates is an important tool
that cannot be overemphasized. We will briefly discuss on strategies that can
work in empowering/ equipping these pupils.
Possession
of right education resources is the first pathway towards achieving our aim.
This implies that teachers should be taught and should be able to transfer
right knowledge to the pupils. These resources include; .
Lesson plans on citizenship and PSHE
teaching resources which have been carefully structured in order to ease
students into sensitive areas of discussion on FGM. Read more here Action
Aid: FGM Teaching Resources.
Lesson plan on raising awareness of the
practice of FGM and to educate the young about facts, issues and where to seek
help if at risk. Read more here Healthy
Schools: KS3 FGM Lesson.
Lesson plan to help students
distinguish between myth and fact. This is a great “ice breaker”, which
explores why FGM is perpetuated through such myths and engages pupils on the
importance of critical thinking. Read more here Orchid
Project – Challenging the Myths.
The use of the award-winning
drama-documentary, “Silent Scream” tells the story of a young Somali girl
living in Bristol. Read more here Documentary – “Silent Scream”.
Beyond
teaching them, we should endeavor to provide them with IEC materials which will
serve as a guide for them when educating their parents, peers or
communities. We should continually
increase pupils’ access to education, because educated pupils (boys or girls)
are less likely to allow their mothers cut them or subject their future
daughters to FGM.
If
EndFGM advocates are inducted amongst pupils, they should be well guided and
should also commit to some actions. These two actions are listed below…
Respectfully
educate parents, senior family members, religious leaders and health
professionals on the potential harmful effects of FGM.
Support
and engage in village/community campaigns (they should be guided by parents),
which aim to change social norms at the community level instead of only
individual attitudes.
Virtually
every school in Nigeria have school clubs and mainstreaming EndFGM into their
activities will help strengthen the campaign against FGM, it keeps reminding
the students on reasons why they shouldn’t support the act, what they should do
when they see anyone standing the risk of been cut.
Not
only that, a topic consistently discussed becomes a norm amidst them and
anything that looks like it becomes a taboo to them and that’s because it’s a
talk they hear every time, the teacher once taught on it, the club members
presented on it and the drama students once acted a drama on the subject
matter.
Last
year (2018) UNICEF Supported School based #endFGM activities in some selected
secondary schools in from the five project states (Osun, Ebonyi, Ekiti, Imo and
Oyo State). The project targeted young secondary school students.
It was
as a result of school based activities such as this that provided an
opportunity for a student to refuse to be cut, which initiated the events that
led to the first ever public declaration
of FGM in Nigeria by the people of Izzi Clan in Ebonyi State. https://www.youtube.com/watch?v=kevlo0KXJQE
.
Because
of the recent happenings in FGM practicing communities where Girls
travel outside their states to present themselves for FGM secretly due to peer
pressure, targeting school clubs can help reduce such pressure.
UNICEF is
still partnering with existing school clubs across the five project states to
build their capacity through life skill training for in and out of school
girls.
The Life
Building skill Progarmme will empower Students will 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 vision 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 four
expected outcomes of Phase III of the UNFPA/UNICEF Joint Programme on Elimination
of FGM are:
Outcome
1: Countries have an enabling environment for the elimination of FGM practices
at all levels and in line with human rights standards.
Outcome
2: Girls and women are empowered to exercise and express their rights by
transforming social and gender norms in communities to eliminate FGM.
Outcome
3: Girls and women access appropriate, quality and systemic services for FGM
prevention, protection and care.
Outcome
4: Countries have better capacity to generate and use evidence and data for
policymaking and improving programming.
When
the capacity of school clubs in are built on the area of ending FGM, Schools
with Press and Debate club can come up with inter class debate on topics on
FGM?
Also
the press clubs can organize a writing or speech or poem contest on the subject
matter, student tends to believe their own research more than what they were
ordinarily told. The school art club can
organize a poster competition which can be inter class or even interschool,
some people get communicated to more with images and music that writing or even
what they were told.
The
school newscasters can adopt a closing statement that they will always close
their news with, words like this that is always repeated every time they listen
to the school newscasters can help it become a norm faster.
Before I end the presentation, its good we Note
that FGM is treated as a harmful traditional practice under Physical and health
Education in the Junior Secondary School Curriculum in Nigeria.
At this point, I will step aside to
entertain your questions or comments or contributions. Thank you so much for
participating at this conference and we hope you had a great time learning our
platform. .
Female Genital
Mutilation (FGM) includes all procedures that involve the partial or total
removal of external genitalia or other injury to the female genital organs for
non-medical reasons.
The World Health Organization (WHO) has classified FGM into four types, and they are all practiced in Nigeria.
Type
I:
partial or total removal of the clitoris and/or the prepuce (Clitoridectomy). Subgroups of Type I FGM are: type Ia, removal
of the clitoral hood or prepuce only; type Ib, removal of the clitoris with the
prepuce.
Type
II:
partial or total removal of the clitoris and the labia minora, with or without
excision of the labia majora (excision). Subgroups of Type II FGM are: type
IIa, removal of the labia minora only; type IIb, partial or total removal of
the clitoris and labia minora; type IIc, partial or total removal of the
clitoris, labia minora and labia majora.
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). Subgroups of Type III FGM are: type
IIIa, removal and apposition of the labia minora; type IIIb, removal and apposition
of the labia majora. Reinfibulation is covered under this definition. This is a
procedure to recreate an infibulation, for example after childbirth when
defibulation is necessary.
Type
IV: unclassified – all other harmful procedures to the female genitalia
for nonmedical purposes, for example, pricking, piercing, incising, scraping
and cauterization. Type IV also includes the practice of “massaging” or
applying petroleum jelly, herbal concoctions or hot water to the clitoris to
desensitize it or pushing it back into the body, which is common in many parts
of Nigeria, especially Imo State.
FGM has short terms
and long term effects on the health and well-being of girls and women. Short term
effects of FGM include: severe pain, excessive bleeding, shock, genital tissue
swelling, infections, while the long term effects include chronic genital
infections, urinary tract infections, painful urination, keloids, perinatal
risks, etc.
FGM
is recognized internationally as a violation of the human rights of girls and
women.
FGM practice violates women and girls’
rights to health, security and physical integrity, rights to be free from
torture and cruel, inhuman or degrading treatment, and rights to life (when the
procedure results in death)
For more information about FGM you can visit http://www.who.int or watch
FGM practice is strongly rooted in the people’s culture and
so, it has not been an easy task in getting people to abandon the practice
despite the harmful effects on girls and women. It is estimated that about 200 million girls/women have
undergone FGM and about 3 million girls/women per year are at risk. Unless action to end FGM is accelerated,
another 68 million girls will have been cut by 2030 (Antonio Guterres – UN Sec.
Gen.)
The Multiple Indicator Cluster Survey (2016-17) revealed
that 18.4% of women aged 15-49 years had undergone FGM, a decrease from 27%
(2011). Conversely, the FGM prevalence
among daughters (0-14 years) rose from 19.2% (2011) to 25.3% (2016-17).
Girls and women
living with have experienced a harmful practice and should be provided quality
health care, while those at risk should be protected from being subjected to
this harmful procedure.
The “UNFPA-UNICEF Joint Programme on Elimination of FGM:
Accelerating Change” is being implemented to end FGM in 16 countries including
Nigeria. It commenced in 2008, while
Nigeria joined in 2014. Phase III began in Jan. 2018 and will end by Dec. 2021.
The UNFPA-UNICEF Joint Programme on Elimination of FGM is
playing a mammoth role in achieving Target 5.3 of the Sustainable Development
Goal, which calls for the elimination of all harmful practices by 2030, under
Goal 5 of the SDGs.
In Nigeria, one of the strategies adopted by the
“UNFPA-UNICEF Joint Programme on Eliminating FGM: Accelerating Change” is partnering
with Community based Associations to end Female Genital Mutilation (FGM).
Community Based
Association is a public or private non-profit organization that is
representative of a community or a significant segment of a community and works
to meet community needs. Examples are Community Women Associations, Youth
Associations, Age Grade Associations, Association of Custodian of Cultures and
traditions and Market Women Associations etc.
Different Community Based Associations usually meet on
specific occasions or at least monthly or weekly to discuss developmental
issues affecting their communities.
These groups are referred to as Community Based
Associations.
Community Based
Associations are typically, and almost necessarily, staffed by local members
-community members who experience firsthand needs within their neighborhoods.
Community Based
Associations is representative of a community or a significant segment of a
community and works to meet community needs.
Since they are so
localized, Community Based Associations they will understand the issues
surrounding FGM in the community they operate.
One of the best
features of a Community Based Associations, due to their localized focus, is
that it is they will have wealth of information regarding the issues like FGM.
Community Based
Associations can engage communities in multiple ways, this include “having an open dialogue with the
community, will increase awareness on the effects and consequences of Female
Genital Mutilation”.
Community Based
Associations can collaborate with community
partners and local organizations easily because they understand the structure
of their environment.
Community Based Associations
positively affect the process of rural change through increase in income,
improvement of health, health education of the people.
Communities
therefore seek solace in Community Based Associations which pressurize
government for attention to development problems in their communities and/or
undertake development programmes and projects that they observe that are very
much needed in their immediate communities.
The Community Based
Associations are associated with self-help. They constitute the media for
resource mobilization to confront local challenges. Such associations are not
money driven but purpose driven.
These include
stopping dangerous social norms, holding government to finance programs at
rural level and press their needs and developing human resources against future
development needs of immediate communities.
In communities where FGM is not discussed in the open,
partnership with CBYA will help in making FGM an open topic for discussion
during community gathering.
Community Based Associations
can help at community levels to identify the root cause of Female Genital
Mutilation in their community and why it still persist.
This can be found
out through survey of residents and discussion with community leaders, health
workers and parents, Results of this survey would reflect the personal beliefs,
viewpoints, and judgments of community members.
This can be used
for intervention because People who respond to such surveys will give valuable
information about knowledge, attitudes, and their beliefs concerning Female
Genital Mutilation. This
type of survey would include detailed information about the perception of the
community members about FGM, what should be done to remedy the situation, the
resources available, and the effects it’s having on the community.
Because
Community
Based Associations are made up of Youth, Women,
Men and Custodians of Culture and traditions serving in different capacities:
the justice system, the public health department, health Institutions, mental
health agencies, the Division of Social Services, and Age grade groups e.t.c.
they will be a strong force in ending Female Genital mutilation because they
are made up of diverse people who are strong willed.
The history and
importance of community based- Youth association in grassroots communities is a
long one. They have been deeply involved in activities that have impacted on
the livelihood of members of their communities and have gained there trust.
Partnership
with Community
Based Associations will not only build capacity
and show commitment, it will also create an environment in which sustainability
of FGM Campaign could thrive.
To partner with Community
Based Associations, they need to be educated first about the harmful effect,
consequences and the norms surrounding Female Genital Mutilation, this enable
them function well, High level advocacy should be paid to the Custodians of
Culture and tradition, Leaders of the different groups such as the Iyaloja in
southwest Nigeria (Ekiti, Lagos, Ogun Ondo,
Osun, and Oyo States). etc.
The Iyaloja which
means the leader of the market women Association, and because of the word
‘Iya’, which means woman or mama or mother, it is natural that Iyaloja is a
woman and it is one of the powerful policy making structures in southwest
Nigeria.
Across various
Yoruba markets and the states they belong to, an Iyaloja is usually
democratically chosen she has an enormous decision-making power both in
political affairs (because of her closeness to, and recognition by traditional
rulers and policy makers), and in family matters.
Going by the power
and influence of the Iyaloja, and their groups, working with Market Owen Associations
in Southwest Nigeria will facilitate FGM abandonment process. This training
will also enable them identify the problems surrounding this culture clearly
and how to provide solutions.
Partnership with Community
Based Associations will also allow the community take ownership of the #endFGM
campaign and give room for open discussion on the issue during their regular
meetings especially in places where FGM is not allowed to be discussed in the
public.
In southeast
Nigeria (Abia, Anambra, Ebonyi, Enugu and Imo State),
Community Women Associations will also deliberate the on the issue of FGM
during their annual Women’s Meeting. This meeting is
called the “Annual Home and Abroad meeting” or popularly known as “August
Meeting”
This “August
meeting” brings together all the women married into the community from
different parts of the worlds. It is
mandatory for members to attend this meeting, which usually takes place in
August each year.
The “August
Meeting” helps foster bonding, unity, and a sense of belonging between the
women and other women who have married into their community.
Apart from
intervening to resolve family or community conflicts, women also engage in
community development projects, contribute to scholarship funds to support the
education of indigent members of the communities, and combat violence against
women.
During the Annual
“August Meeting”, the women uses this opportunity to remind community members
both home and abroad about the dangers of FGM and the need to abandon the
practice.
It is very important to note that in communities around the world where people have openly declared to #endFGM, it has been led by the custodians of custom/traditional rulers due to partnership with their association.
Partnering
with Community
Based Associations will help the success
experienced in some states like Osun, Ekiti, Ebonyi, Imo and Oyo state to be
sustained in the long-term and
transferred to the next generation.
It’s important to
note that ending Norms like Female Genital Mutilation in a community that has
accepted such over years requires input from the entire community and community
base Associations is an important
platform to help reach the entire community.
In conclusion, if
End FGM campaigners can identify the different community based associations
around them and fully engaged them in the campaign to end FGM, FGM will be
eliminated in the this generation.
At this point, I
will step aside to entertain your questions or comments or contributions. Thank
you so much for participating at this conference and we hope you had a great
time learning our platform.
Female Genital Mutilation (FGM) is defined, by the
World Health Organization (WHO), as “all procedures that involve partial or
total removal of the external female genitalia, or other injury to the female
genital organs for nonmedical reasons”. The term FGM is preferred by WHO and
United Nations in order to convey the irreparable physical and psychological
damage done to girls and women.
In 1997, World Health Organization (WHO) classified FGM
into four types, namely, Type I (Clitoridectomy); Type II (Excision); Type III
(Infibulation); and Type IV (Unclassified).
These types, which were further subdivided in 2008 by WHO, are all
practiced in Nigeria. The four Types of
FGM and their subtypes are described in 7a-d.
FGM Type I: partial or total removal of the clitoris
and/or the prepuce (Clitoridectomy).
Subdivisions of FGM Type I are: FGM Type Ia, removal of
the clitoral hood or prepuce only and FGM 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).
Subdivisions of FGM Type II are: IIa, removal of the labia minora only; IIb,
partial or total removal of the clitoris and labia minora; and IIc, partial or
total removal of the clitoris, labia minora and 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).
Subdivisions of FGM Type III are: FGM Type IIIa,
removal and apposition of the labia minora; and FGM Type IIIb, removal and
apposition of the labia majora.
Reinfibulation is covered under this definition. This
is a procedure to recreate an infibulation, for example after childbirth when
defibulation is necessary.
Type IV: unclassified – All other harmful procedures to
the female genitalia for non-medical purposes.
It includes:
Piercing or incision of clitoris and/or labia.
Cauterisation by burning of clitoris and surrounding
tissues;
Scraping (angurya cuts) of the vaginal orifice or
Cutting (gishiri cuts) of the vagina;
Introduction of corrosive substances into the vagina to
cause bleeding or Herbs into the vagina with the aim of tightening or narrowing
the vagina.
FGM Type IV also includes the practice of “massaging”
or applying petroleum jelly, herbal concoctions or hot water to the clitoris to
desensitize it or pushing it back into the body, which is common in many parts
of Nigeria, especially Imo State.
It is estimated that over 200 million girls and women
worldwide are living with or at risk of suffering the associated negative
health consequences of FGM.
Every year 3 million girls and women are at risk of FGM
and are therefore exposed to the potential negative health consequences of this
harmful practice. The procedure of FGM 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.
FGM has no known health benefits. Moreover, the removal
of or damage to healthy genital tissue interferes with the natural functioning
of the body and may cause immediate and long-term health consequences.
The “Immediate & Short term complications” of FGM
are 1) severe pain and injury to tissues; 2) haemorrhage (bleeding); 3)
haemorrhagic shock; 4) infection and septicaemia; 5) genital tissue swelling;
6) acute urine retention; and 7) fracture of bones.
The “long-term complications of FGM” are 1) chronic
vulvar pain; 2) clitoral neuroma; 3) reproductive tract infections; 4)
menstrual problems; 5) urinary tract infections; 6) painful or difficult
urination; 7) epidermal inclusion cysts; and 8) keloids.
In 2006, WHO study group analysed the obstetric risks
associated with FGM and concluded that women living with FGM are significantly
more likely than those who have not had FGM to have adverse obstetric outcomes
such as 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.
Given that some types of FGM involve the removal of
sexually sensitive structures, including the clitoral glans and part of the
labia minora, some women may experience the following 1) 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.
For many girls and women, undergoing FGM can be a traumatic
experience that may leave a lasting psychological mark and cause a number of
mental health problems, which include 1) Post-traumatic stress disorder (PTSD);
2) Anxiety disorders; and 3) Depression.
The practice of FGM is prevalent in 30 countries in
Africa and in a few countries in Asia and the Middle East, but also present
across the globe due to international migration
FGM is practiced for a variety of sociocultural
reasons, varying from one region and ethnic group to another. The primary
reason is that it is part of the history and cultural tradition of the
community.
In many cultures, FGM constitutes a rite of passage to
adulthood and is also performed in order to confer a sense of ethnic and gender
identity within the community. In many contexts, social acceptance is a primary
reason for continuing the practice.
Other reasons for practicing FGM include safeguarding
virginity before marriage, promoting marriageability (i.e. increasing a girl’s
chances of finding a husband), ensuring fidelity after marriage, preventing
rape, providing a source of income for circumcisers, as well as aesthetic
reasons (cleanliness and beauty).
Some communities believe that FGM is a religious
requirement, although it is not mentioned in major religious texts such as the
Koran or the Bible, rather FGM practice is deeply rooted in a strong
cultural/social framework. It is endorsed by the practicing community &
supported by loving parents who believe that undergoing FGM is in the best
interest of their daughter.
FGM is supported by both men and women, usually without
question. Yet the reasons for the practice are often rooted in gender
inequality.
In some communities, it is carried out to control
women’s and girls’ sexuality. It is sometimes a prerequisite for marriage – and
is closely linked to child marriage.
Some societies perform FGM because of myths about
female genitalia, for example, that an uncut clitoris will grow to the size of
a penis, or that FGM will enhance fertility. Others view the external female
genitalia as dirty and ugly.
Whatever the reason behind it, FGM violates the human
rights of women and girls and deprives them of the opportunity to make
critical, informed decisions about their bodies and lives.
The truth is that Men, Boys, Girls and Women can be
empowered as change agents to end FGM in their various communities.
Empowering young girls with adequate information will
help to shape their attitudes and influence their future behaviour towards the
abandonment of FGM. The empowerment of girls and Women begins with education.
Topics around FGM should be integrated into
formal/non-formal education. The inclusion of this topic would make it less of
a taboo and young girls can receive accurate information and this would in turn
help break the culture of silence around FGM and other harmful traditional
practices (HTPs).
Young girls should be trained intensively to make sure
they have the necessary information needed to be an End FGM change agent.
When young girls are trained on what they believe and
understand the impact of their voices, they can represent their families and
communities with pride, courage and ability.
Proof of this can be seen in Ebonyi state when a
teenager, Njideka and two other girls, stood their ground on not undergoing FGM
because of the information she had received in in School and the Church.
Njideka’s stance led to a public declaration of the abandonment of FGM by some
communities in the Izzi Clan of Ebonyi State.
As part of the efforts to empower young Girls as
#endFGM change agents in Nigeria, The Output 2 of the joint programme result
framework is to “Strengthened girls’ and women’s assets and capabilities to
exercise their rights”
The UNJP supports capacity building skills for
girls–educated or not–based on competencies, and through comprehensive sexual
education programs, professional development and programs of “Girl Club’s”
The aim of the capacity building is to integrate FGM in
the life skills of girls with the objective of making them agents of change in
their families and their communities.
Currently these capacity building workshop has taken
place in most of the UNJP pilot communities.
Additionally, Men can provide critical leadership
through their roles as decision makers, public figures and opinion makers by
speaking out against FGM and ensuring that priority attention is given to the
issue. Men can be role models for male adolescents and boys. Men have an essential
role to play as community leaders in speaking out, standing together,
mobilizing communities and taking action to end FGM and other violence against
women.
Engaging Men who are community leaders, including
religious and cultural leaders, has proved to be a successful strategy in
improving the response of communal justice mechanisms to end violence against
women and prevent trafficking of women and girls. The participation of positive
male role models in campaigns that condemn violence against women has also
shown promising results.
Under the UNFPA-UNICEF Joint Programme for elimination
of FGM in Nigeria has adopted a strategy known as MALE ENGAGEMENT ALLIANCE IN
THE ELIMINATION OF FGM.
This
strategy is vital because many interventions on FGM elimination do not engage
men or male groups as strategic partners and advocates in leading the campaign
to end FGM. In most cases the men, and
male groups, participate in community dialogues and similar social mobilisation
interventions but are rarely engaged as advocates due to the belief that FGM is
a “woman’s issue”.
This
situation has limited the ability of men to contribute to the campaign beyond
these initial engagements. Men in their
diverse roles (fathers, husbands, relatives, community leaders, religious
leaders, etc.) have been perpetuating the practice of FGM either by omission or
commission.
While
some men have openly supported the practice by paying for the procedure or
served as traditional cutters, others aid the practice through their
silence. Men hold very prominent
positions in the community and have a lot of influence within and outside the
home, especially in a patriarchal society like Nigeria.
Men
also belong to groups (religious, social, traditional, etc.) that address
social issues and contribute to the development of their communities. These Men and their groups have the potential
to contribute to the elimination of FGM.
Unfortunately,
the potential of men to use their different platforms and positions to develop
their communities, have not been well explored.
Engaging men as endFGM advocates will bridge this gap by engaging
community-based male groups as strategic partners in promoting women’s health
by advocating for the elimination of FGM.
The
expectation is that if men become involved in the campaign to eliminate FGM,
there is a greater likelihood that they will motivate their families and
community’s to end FGM.
In
2018, the UNJP trained representatives of male groups from selected communities
in the intervention LGA (Ekiti, Ebonyi, Osun and Oyo States) and supported them
to form a coalition called “Male Engage Alliance to end FGM”. This strategy has
been successful.
In
conclusion, Collective abandonment, in which an entire community chooses to no
longer engage in FGM, is an effective way to end the practice. It ensures that
no single girl or family will be disadvantaged by the decision and can be
achieved with the collective efforts of Men, Boys, Girls and Women.
At
this point, I will step aside to entertain your questions or comments or
contributions. Thank you so much for participating at this conference and we
hope you had a great time learning our platform.
Today, 25th
June 2019, the UNICEF Nigeria supported Facebook
conference will discuss the topic on “Ending
FGM through Strategic partnership with key sectors such as Health, Education,
and Law Enforcement”. This Facebook
conference is part of a multidisciplinary approach to eliminate the harmful
practice of Female Genital Mutilation (FGM) in this generation in line with the
global goals.
This Facebook Event will last from 5pm-7pm
Nigerian time (GMT +1). I will attend to
your questions and contributions from 6:31 to 7:00pm. Please feel free to share the
event or tag your friends to participate.
For the sake of
those joining us for the first time, I shall present a brief overview of Female
Genital Mutilation (FGM).
Female Genital Mutilation (FGM) is defined, by the World Health
Organization (WHO), as “all procedures
that involve partial or total removal of the external female genitalia, or
other injury to the female genital organs for nonmedical reasons”. The term FGM
is preferred by WHO and United Nations in order to convey the irreparable
physical and psychological damage done to girls and women.
In 1997, World Health Organization (WHO) classified FGM into four types,
namely, Type I (Clitoridectomy); Type II (Excision); Type III (Infibulation);
and Type IV (Unclassified). These types,
which were further subdivided in 2008 by WHO, are all practiced in
Nigeria. The four Types of FGM and their
subtypes are described in 7a-d.
FGM Type I: partial or total removal of the clitoris and/or the prepuce
(Clitoridectomy).
Subdivisions of FGM Type I are: FGM Type Ia, removal of the clitoral
hood or prepuce only and FGM 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).
Subdivisions of FGM Type II are:
IIa, removal of the labia minora only; IIb, partial or total removal of
the clitoris and labia minora; and IIc, partial or total removal of the
clitoris, labia minora and 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).
Subdivisions of FGM Type III are: FGM Type IIIa, removal and apposition
of the labia minora; and FGM Type IIIb, removal and apposition of the labia
majora.
Reinfibulation is covered under this definition. This is a procedure to
recreate an infibulation, for example after childbirth when defibulation is
necessary.
Type IV: unclassified – All other harmful procedures to the female
genitalia for non-medical purposes. It
includes:
Piercing or incision of
clitoris and/or labia.
Cauterisation by burning
of clitoris and surrounding tissues;
Scraping (angurya cuts)
of the vaginal orifice or Cutting (gishiri cuts) of the vagina;
Introduction of corrosive
substances into the vagina to cause bleeding or Herbs into the vagina with the
aim of tightening or narrowing the vagina.
FGM Type IV also includes the practice of “massaging” or applying
petroleum jelly, herbal concoctions or hot water to the clitoris to desensitize
it or pushing it back into the body, which is common in many parts of Nigeria,
especially Imo State.
It is estimated that over
200 million girls and women worldwide are living with or at risk of suffering
the associated negative health consequences of FGM. Every year 3 million girls
and women are at risk of FGM and are therefore exposed to the potential
negative health consequences of this harmful practice. The procedure of FGM 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. FGM has no known health benefits. Moreover, the
removal of or damage to healthy genital tissue interferes with the natural
functioning of the body and may cause immediate and long-term health
consequences.
The “Immediate & Short term complications” of FGM are 1) severe pain
and injury to tissues; 2) haemorrhage (bleeding); 3) haemorrhagic shock; 4)
infection and septicaemia; 5) genital tissue swelling; 6) acute urine
retention; and 7) fracture of bones.
The “long-term complications of FGM” are 1) chronic vulvar pain; 2) clitoral
neuroma; 3) reproductive tract infections; 4) menstrual problems; 5) urinary
tract infections; 6) painful or difficult urination; 7) epidermal inclusion
cysts; and 8) keloids.
In 2006, WHO study group
analysed the obstetric risks associated with FGM and concluded that women
living with FGM are significantly more likely than those who have not had FGM
to have adverse obstetric outcomes such as 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.
Given that some types of
FGM involve the removal of sexually sensitive structures, including the
clitoral glans and part of the labia minora, some women may experience the
following 1) 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.
For many girls and women,
undergoing FGM can be a traumatic experience that may leave a lasting
psychological mark and cause a number of mental health problems, which include
1) Post-traumatic stress disorder (PTSD); 2) Anxiety disorders; and 3)
Depression.
The practice of FGM is
prevalent in 30 countries in Africa and in a few countries in Asia and the
Middle East, but also present across the globe due to international migration
FGM is practiced for a variety of sociocultural reasons, varying from
one region and ethnic group to another. The primary reason is that it is part
of the history and cultural tradition of the community.
In many cultures, FGM constitutes a rite of passage to adulthood and is
also performed in order to confer a sense of ethnic and gender identity within
the community. In many contexts, social acceptance is a primary reason for
continuing the practice.
Other reasons for practicing FGM include safeguarding virginity before
marriage, promoting marriageability (i.e. increasing a girl’s chances of
finding a husband), ensuring fidelity after marriage, preventing rape,
providing a source of income for circumcisers, as well as aesthetic reasons
(cleanliness and beauty).
Some communities believe that FGM is a religious requirement, although
it is not mentioned in major religious texts such as the Koran or the Bible.
FGM practice is deeply
rooted in a strong cultural/social framework. It is endorsed by the practicing
community & supported by loving parents who believe that undergoing FGM is
in the best interest of their daughter.
Despite its cultural
importance, we need to acknowledge the fact that FGM is a harmful traditional
practice that violates the rights or girls and women. These 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. Therefore, FGM has to be eliminated.
When FGM is conducted by
healthcare providers this is also known as the “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”.
Healthcare providers who
agree to perform FGM are violating the fundamental medical ethical principle or
duty of non-maleficence (“do no harm”) and the fundamental principle of
providing the highest quality health care possible.
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.
The decrease was also observed in the five states where the UNFPA-UNICEF
Joint Programme on FGM Elimination (UNJP) is working, namely, 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%).
According to the MICS
(2016-2017), the FGM prevalence among daughters aged 0-14 years increased from
19.2% (in 2011) to 25.3% (in 2016-2017).
In the five UNJP intervention states, FGM prevalence decreased in three
States, namely, Ebonyi (6.4% to 5.2%), Imo (33.4% to 22.2%), and Oyo states
(32.9% to 29.6%). While, 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 five UNJP intervention states a decrease was observed in Ebonyi
(11.8% to 3.8%) and Ekiti (50.2% to 31.4%); while an increase was seen in Imo
(27.8% to 29.6%); Oyo: (21.2% to 30.3%); Osun: (34.8% to 38.5%).
Now let us talk about “Ending FGM through
Strategic partnership with key sectors such as Health, Education, and Law
Enforcement”
FIRST LET US DISCUSS PARTNERSHIP WITH THE HEALTH SECTOR:
Research suggests that there are several ways to win health care
professionals’ support as allies in FGM abandonment efforts having in mind
their programmes and organizational structures.
First, training programs for these professionals, particularly those
living in areas where FGM is widely practiced, should focus on what FGM is, why
it is practiced, its health impacts, and ways to prevent it.
Trainings must also sensitize health care practitioners to the fact
that FGM is a violation of girls’ and women’s rights to health and conflicts
with the “do no harm” principle of medical practice.
Second, these professionals, as a focus of FGM abandonment programs,
should be given the opportunity to reflect on their own beliefs and think
critically about how these views may fuel the continuation of the practice.
Health professionals’ associations and health regulatory agencies
should have clear guidelines and standards for providers that outline the
sanctions on those who perform FGM.
These organizations should also offer opportunities for health care
professionals to contribute to community efforts to promote the abandonment of
the practice.
Community health outreaches should include sensitization of the people
on the dangers of Female Genital mutilation on the health of girls and
women.
Health-care providers should be equipped with the reasons why FGM
should not be performed by health-care providers and how to resist requests to
do so from parents;
Health-care providers should be equipped with how to recognize and
manage complications of FGM, including suitable obstetric care; and how to
counsel women and families on FGM-related issues.
Guidelines should be in place, including medical, ethical and legal
information, such as how to counsel and care for girls and women who have
undergone FGM, including counselling against reinfibulation.
Deeply rooted discriminatory norms and practices that underlie FGM,
including sexual concerns and eventual religious underpinnings, should be
addressed, where relevant, when designing training programmes and developing
protocols.
Necessary actions in this area are: appropriate national authorities
should develop national guidelines for various health-care providers on how to
deal with issues related to FGM, including how to care for complications and on
how to resist pressure to perform any form of FGM, including reinfibulation.
Training modules on FGM for inclusion in pre-and in-service curricula
and training, including refresher courses and updates for all health-care
providers, should be developed including nurses, midwives, medical doctors and
other health outreach workers.
Training of health-care providers should be integrated at the
community level with other community-based activities promoting the abandonment
of FGM.
Health-care providers should be informed without delay about human
rights and ethical perspectives as well as the harmful consequences of FGM, and
that performing FGM, including reinfibulation, would give rise to civil and
criminal liability.
Appropriate ethical guidelines on FGM should be incorporated into the
training curricula of health-care providers.
The Ministry of Health and professional regulatory bodies should issue
a joint policy statement against FGM.
The application of existing laws and policies should address the role
health-care providers play in the elimination of FGM and forbid the performance
of any type of FGM, including reinfibulation.
Licensed health-care practitioners must be subject to the maximum
available criminal penalties that apply to anyone performing FGM. Offending
practitioners may be suspended or their licences withdrawn if they perform FGM.
Strengthen monitoring, evaluation and accountability Monitoring and
evaluation are essential for improving health-care providers’ approaches to FGM
and for refining plans to promote abandonment of the practice.
SECOND, LET US REVIEW HOW TO PARTNER WITH THE EDUCATION SECTOR
Addressing a complex issue such as FGM in a way that will bring about
sustainable change requires a comprehensive and context-sensitive response
involving many and varied education organizational structures .
Coordination across all levels is needed to understand the
perspectives of these different structures, what constrains and enables them to
act, and what support, training and resources they need.
It is clear from previous research undertaken by @28TooMany that the
inclusion of FGM education in schools is an essential element in addressing the
issue.
This view is also reflected in other studies; for instance, a survey
of secondary-school teachers in North Central Nigeria (2015) put forward the
opinion of the participating teachers that awareness of FGM and its
implications should be taught in schools (Adeniran et al, 2015).
In the education sector, there are also different union and
associations that sees to the overall development of teachers. Some of these unions and association includes:
Teachers Union, International School Educators of Nigeria, and Association of
Christian Schools International.
Teachers’ union is one important structure to partner with in the
education sector to end FGM in Nigeria.
Teachers’ union represent the collective of teachers as employees. As
such, they have strong legitimacy among teachers and play a key role in setting
the standards, codes of conduct and practice, and employment terms of teachers.
As teachers play a key role in preventing and responding to FGM,
teaching unions can support their members to access appropriate training and
support on FGM, raise awareness about FGM and advocate at a national policy
level.
Teachers’ unions are therefore key partners in both changing teachers’
behaviours and experiences and in looking at the wider system of education to
strengthen support, capacity and readiness to address FGM.
With growing pressure on teachers worldwide to measure progress in
more limited ways, such as enrolment, attendance or learning outcomes, teacher
report that the well-being and wider development of learners can be sacrificed
(UNAIDS IATT, 2015).
Working with teachers’ unions can help education systems to give
teachers the mandate to better promote students’ social and emotional well-being
and create safer learning environments to this end.
Teachers’ unions should be involved in raising awareness of FGM among
their members, producing tools and materials and training teachers.
The Federal and State Ministries of Education could do more to support
teachers to address FGM by reviewing the school curriculum to accommodate FGM
and other harmful practices affecting the wellbeing of children.
The Federal and State Ministries of Education (F/SMOE) could, for
example, provide better and more training, professional guidance, stronger
teacher resources, as well as clear written codes of conduct and ethics on FGM
and harmful practices.
Work is also being done by various NGOs in Nigeria to ensure that FGM
education is included in school curricula. The Girls’ Power Initiative provides
information for adolescent girls both in their centres and by conducting
lessons in selected schools. This outreach programme aims to educate girls on
gender and reproductive-health issues, including issues around Gender Based Violence
and FGM, and aims to train teachers to further this work by continuing lessons
and running GPI clubs in their schools (GPI, 2016).
The Centre for Healthcare and Economic Empowerment for Women and Youth
(CHCEEWY) also attempts to advance FGM education in the school curriculum in
Plateau, Benue and Enugu States, where it operates. In partnership with others,
it trains teachers to deliver the Family Life and HIV Education and Family Life
and Emerging Health Issues programmes, which are approved by the Federal
Government. @28Toomany
The formation of clubs in schools to continue this education is
proving successful and being supported by a number of international donors such
as Oxfam (CHCEEWY, 2016). @28Toomany
The Child Health Advocacy Initiative (CHAI) advocates for more FGM
education in schools and through clubs in Lagos, Osun, Ekiti, and Ogun States,
where it works. @28Toomany
The Center for Social Value and Early Childhood Development (CESVED)
also raises awareness in schools and holds workshops for school head-teachers
in Cross River State (Augustine, 2016).
@28Toomany
Currently, The UNCEF-UNFPA Joint Programme is building the capacity of
in and out of school girls with life skills that will enable them resist any
form of FGM and educate their peers and family members on the consequences of
the practice.
In Nigeria, FGM has, finally being included being included in the
Junior Secondary School (JSS 3) Curriculum. It is under Social Studies
(Sub-Theme Culture and Social Values), and the topic on FGM is treated under
the harmful traditional practices.
In Nigeria, FGM has also being included being included in the
Curriculum for Out of School Boys and Girls. FGM is treated under the harmful
traditional practices.
THIRD, LET US REVIEW HOW TO PARTNER WITH THE LAW ENFORCEMENT AGENCIES
To best address the
issue of FGM, the law enforcement (@PoliceNGR) should work as part of a broader
multi-sectoral approach.
As part of this
interagency approach, law enforcement (@PoliceNGR should “be educated about
violence against women and girls and be trained on how to appropriately
intervene in cases of violence against women and girls.”
@PoliceNGR and other
Law enforcement agencies such as Nigeria Security and Civil Defence Corps
(NSCDC) should include FGM as part of their in service training programmes for
officers.
The @PoliceNGR
should ensure that their officers at different organizational structures are
well equipped with information on how best to handle FGM cases when brought to
their table. Establishing gender desks alone are insufficient; there should be
routine technical/training support to designated officers on enforcing the law without
compromising the safety of informants, or undermining the cultural
sensitivities of the people.
Nigeria’s Violence
Against Persons (Prohibition) (VAPP) Bill was signed into Law on 28th
May 2015 as the VAPP Act. The legislation contains provisions banning various
forms of gender-based violence, including FGM. The VAPP Act 2015 law
criminalizes “harmful traditional practices,” a term defined broadly to include
FGM. This includes “all traditional behaviour, attitudes and/or practices,
which negatively affect the fundamental rights of girls and women (VAPP Act
2015). Any person who performs FGM, engages, incites or abets another person to
carry out FGM is on conviction, subject to a punishment of 4 years imprisonment
or a fine of NGN200,000 (VAPP Act 2015). An attempt to commit any form of FGM
on conviction be liable to a punishment of 2 years imprisonment or a fine
NGN100,000 (VAPP Act 2015).
Various states in
Nigeria has domesticated the VAPP Act 2015 and in states where the it is yet to
be domesticated, the Child Rights Law (CRL) and other anti-FGM laws still
prohibits the practice of FGM. The VAPP Act 2015 and other laws against FGM
empower the Law enforcement Agencies in Nigeria (Police, NSCDC, etc.) to arrest
any individual involved in the practice of FGM.
@PoliceNGR should
make it easy for community members and other stakeholders to report suspected
cases of FGM, and ensure that the reporter’s identity is not revealed to the
public.
Having in mind the
organizational structure of the @PoliceNGR, the Community stakeholders should
have a good working relationship with the closest police station in other to
report cases of FGM.
During community
dialogue sessions, @PoliceNGR can be invited too to speak about the laws
prohibiting the practice of FGM, its provisions and how cases can be reported
to them.
FGM Community
surveillance team should also work closely with law enforcement agencies
(Police, NSCDC, etc.) at the community or village level to effectively track
down new cases of FGM.
Often times, FGM
survivors, those at risk and witnesses cannot report to the police directly for
fear of social backlash. Anti-FGM
Advocates should be available to provide the cloak of anonymity by receiving
the information and sharing with law enforcement. For advocates to be able to
do this, they must be committed, trustworthy and reliable. Law enforcement will
take advocates serious if their information is credible and devoid of malice.
So they must ensure the credibility of the information received. Also, the
members of the community must trust us to keep their confidentiality, and trust
that we will take prompt steps to when aware of a threat. Advocates and
Community stakeholders must also follow up on cases and reports that the law
enforcement agencies are handling.
We must appreciate
the fact that the work of policing is an onerous one. The officers can get overwhelmed
by a heavy workload. Following up
constantly helps to ensure that cases don’t fall through the cracks. When a FGM
case is taken to court, advocates and community stakeholders need to be there
too to provide both moral and technical support to the prosecutors and the FGM
survivors.
In conclusions, partnership with key sectors such as Health, Education
and law Enforcement is required to accelerate the elimination of FGM given the
structure, system and personal available within these sectors to provide FGM
prevention, protection and care services to women and girls in Nigeria.
Good evening everyone, we welcome you
to today’s edition of the UNICEF Nigeria supported Facebook conference designed
to Female Genital Mutilation. This Facebook conference is part of a
multidisciplinary approach to eliminate the harmful practice of Female Genital
Mutilation (FGM) in this generation in line with the global goals
#endcuttinggirls.
This conference is a unique one as
it marks the Global celebration of Children’s Day. It will last for an hour
where we will discuss practical ways to end FGM by enhancing the roles of
children and young people and we will give room for questions at the end of the
conference. Please feel free to share the event or tag your friends to
participate. #endcuttinggirls
In 1997, World Health Organisation
(WHO) defined Female Genital Mutilation (FGM) as all procedures that involve
partial or total removal of the external female genitalia, or other injury to
the female genital organs for non-medical reasons. #endcuttinggirls. The
process is classified into four (4) types. They are (i). Clitoridectomy, (ii)
Excision, (iii) Infibulation and (iv) Unclassified.
Type 1: partial or total removal of the clitoris and/or the prepuce (clitoridectomy).
Type 2: partial or total removal of & clitoris and & labia minora, with or without excision of & labia majora (excision).
Type 3: narrowing of & vaginal orifice with creation of a covering seal by cutting and appositioning of labia minora and/or & labia majora, with or without excision of & clitoris (infibulation).
Type 4: unclassified – all other harmful procedures to the female genitalia for non-medical purposes, for example, pricking, piercing, incising, scraping and cauterization. For more on types, myths, facts and what we are doing to #endcuttinggirls, please visit www.endcuttinggirls.org
W.H.O puts the number of girls and
women who have undergone one form of FGM or more at 200 Million and another 2
million at annual risk of undergoing the process. This staggering number is not
only a cause for concern but a call to action #endcuttinggirls. It is then
advantageous that efforts are synergised, strategies reviewed and approaches
redefined to not only prevent new incidences but to also provide succour to
survivors. #endcuttinggirls
To ensure that all approaches
adopted do not set the people against one another, there’s a need for an
all-encompassing strategy to eliminate female genital mutilation. Identification
and eventual adoption of such strategy will be a product of a no-holds-barred
discussion that will break mythical barriers around the practice
#endcuttinggirls
To thoroughly deal with a problem
at hand, all parts contributing to the cause must be identified and responded
to accordingly; and for FGM, the culture of silence has been its greatest
trick. Culture of silence refers to the behavior of a selected group of people
by unspoken rules to not mention, acknowledge enough to discuss a subject, for
either positive reasons, or in avoidance of negative outcomes #endcuttinggirls
The Culture of Silence is the
unseen gag, the invisible mask and the untold tales surrounding acts like FGM
in our society. It’s usually formed on norms, cultural beliefs and myths to
ward people off an issue. As such, the issue is left unattended in public and
becomes accepted as a part of the people’s culture, grows steadily and becomes
a sin to ask questions about it. #endcuttinggirls
To break such culture and set the
people affected by such free, there is a need to identify the sets of people
affected by this culture of silence and identify unique ways to engage, renew
their mindsets and ensure they speak when such occurrences take place. Various
groups of persons have been identified such as women, children, teenagers,
youths etc some of who are directly or indirectly affected.
Following our topic today, we will
be discussing on practical ways and strategies to enhance the role of children
and young people to ensure this culture of silence is broken. This will further
strengthen them and make them understand their roles we look forward to making
FGM history soonest. #endcuttinggirls
To enhance the role of these children, we should;
1. Create awareness by highlighting
the harmful health implications of FGM to children nd young people in
communities where it is practiced, and explaining that girl children who do not
undergo FGM grow up to be healthy women and no less female than girls who
undergo FGM, would go a long way is changing the mind-set of these set of
individuals and enable speak up against such practice.
2. Engaging schools and religious
leaders: To end FGM in Nigeria, we would need to engage the right set of people
who frequently speak to these children. Engaging with schools and religious
leaders in communities where this practice is on the increase will disseminate
the information of the harmful effect of this practice and enable them speak up
when necessary. This is because Nigeria is made up of highly developed and
diversified religious groups and much religious leaders are given enormous
respect and weight by the children or young persons in general.
3. Training of Trainers: There are
different age ranges of children and young persons, the mature young people who
have been trained can go directly into schools and talk to students, especially
girls, about the dangers of FGM. Since it is girls who are affected, such
visits should be led by a young female, or perhaps even a female victim of FGM who
could share her personal experience.
Experiences like that of a young
girl like Chituru (not real name), a 19-year-old girl from Imo state, Nigeria,
can connect on an interpersonal level with other female girls/teenagers.
Here is Chituru’s story:
When I was 9 years old, I went to
stay with my grandmother in the village for the holidays. On the third night of
my stay, she took me to an elderly woman’s house where I was asked to remove my
underwear, lie down and spread my legs. I was afraid but grandma assured me
that it was going to be fine. Grandma held my hands and the other woman brought
out a razor blade and started cutting. I shouted in pain but grandma held me
firmly so I couldn’t break free. I was crying and bleeding but grandma held me
still. When the other woman was done, grandma carried me home. I could not walk
for days and when I asked her why I was made to go through such painful
process, she replied that it was a necessary cultural practice to make me a
woman and prevent me from being promiscuous.
4. With adequate training, these
young persons need to seek government support in other to champion this cause.
They need the government’s support and strong political commitment to enact
strict penalties for those who still practice FGM. This has already begun. Goal
3 of the post 2015 sustainable development goals (SDGs) says that government at
all levels must ensure healthy lives and wellbeing for their citizens,
including any practice that negatively affects the health of her citizens, such
as FGM. SDG goal 5 also seeks to achieve gender equality and empower all women
and girls, an ending FGM is a critical starting point. Young people can lead
the way in tackling development, gender, and health issues, and they can lead
the way to ending the practice of FGM.
Generally, children and young
people have an important role to play in the FGM Elimination campaign. Their
roles can be categorized as Peer
Educators, Advocates, Change Agents, Educators, Reporters, etc.
This unique 27th May
(Children’s Day) is a day to engage, enlighten, educate, encourage and enhance
the roles of children and young people to ensure FGM becomes obsolete in no
distance time.
Thank you all for joining our
conference, to learn more about the EndCuttingGirls Social Media Campaign, and
other discussions around FGM, follow our social media handles on Facebook,
Twitter, Instagram and YouTube, using @endcuttinggirls. #endcuttinggirls
Female Genital Mutilation (FGM) is defined, by
the World Health Organization (WHO), as “all
procedures that involve partial or total removal of the external female
genitalia, or other injury to the female genital organs for nonmedical reasons”.
The term FGM is preferred by WHO and United Nations in order to convey the
irreparable physical and psychological damage done to girls and women.
In 1997, World Health Organization (WHO)
classified FGM into four types, namely, Type I (Clitoridectomy); Type II (Excision);
Type III (Infibulation); and Type IV (Unclassified). These types, which were further subdivided in
2008 by WHO, are all practiced in Nigeria. The four Types of FGM and their subtypes are
described below;
FGM
Type I: partial or total removal of the clitoris and/or
the prepuce (Clitoridectomy).
Subdivisions of FGM
Type I are: FGM Type Ia, removal of the clitoral hood or prepuce only and FGM
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).
Subdivisions of FGM
Type II are: IIa, removal of the labia
minora only; IIb, partial or total removal of the clitoris and labia minora;
and IIc, partial or total removal of the clitoris, labia minora and 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).
Subdivisions of FGM
Type III are: FGM Type IIIa, removal and apposition of the labia minora; and
FGM Type IIIb, removal and apposition of the labia majora.
Reinfibulation is
covered under this definition. This is a procedure to recreate an infibulation,
for example after childbirth when defibulation is necessary.
Type
IV: unclassified – All other harmful procedures to the female
genitalia for non-medical purposes. It
includes:
Piercing or
incision of clitoris and/or labia.
Cauterisation by
burning of clitoris and surrounding tissues;
Scraping (angurya
cuts) of the vaginal orifice or Cutting (gishiri cuts) of the vagina;
Introduction of
corrosive substances into the vagina to cause bleeding or Herbs into the vagina
with the aim of tightening or narrowing the vagina.
FGM Type IV also
includes the practice of “massaging” or applying petroleum jelly, herbal
concoctions or hot water to the clitoris to desensitize it or pushing it back
into the body, which is common in many parts of Nigeria, especially Imo State.
It is estimated
that over 200 million girls and women worldwide are living with or at risk of
suffering the associated negative health consequences of FGM
Every year 3
million girls and women are at risk of FGM and are therefore exposed to the
potential negative health consequences of this harmful practice.
The procedure of
FGM 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.
FGM has no known
health benefits. Moreover, the removal of or damage to healthy genital tissue
interferes with the natural functioning of the body and may cause immediate and
long-term health consequences, which are listed in 11a and b.
The “Immediate & Short term complications” of
FGM are 1) severe pain and injury to tissues; 2) haemorrhage (bleeding); 3) haemorrhagic
shock; 4) infection and septicaemia; 5) genital tissue swelling; 6) acute urine
retention; and 7) fracture of bones.
The “long-term complications of FGM” are 1) chronic
vulvar pain; 2) clitoral neuroma; 3) reproductive tract infections; 4) menstrual
problems; 5) urinary tract infections; 6) painful or difficult urination; 7) epidermal
inclusion cysts; and 8) keloids.
In 2006, WHO study
group analysed the obstetric risks associated with FGM and concluded that women
living with FGM are significantly more likely than those who have not had FGM
to have adverse obstetric outcomes such as 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.
Given that some
types of FGM involve the removal of sexually sensitive structures, including
the clitoral glans and part of the labia minora, some women may experience the
following 1) 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.
For many girls and
women, undergoing FGM can be a traumatic experience that may leave a lasting
psychological mark and cause a number of mental health problems, which include
1) Post-traumatic stress disorder (PTSD); 2) Anxiety disorders; and 3)
Depression.
The practice of FGM
is prevalent in 30 countries in Africa and in a few countries in Asia and the
Middle East, but also present across the globe due to international migration
FGM is practiced for a variety of sociocultural
reasons, varying from one region and ethnic group to another. The primary
reason is that it is part of the history and cultural tradition of the
community.
In many cultures, FGM constitutes a rite of
passage to adulthood and is also performed in order to confer a sense of ethnic
and gender identity within the community. In many contexts, social acceptance
is a primary reason for continuing the practice.
Other reasons for practicing FGM include
safeguarding virginity before marriage, promoting marriageability (i.e.
increasing a girl’s chances of finding a husband), ensuring fidelity after
marriage, preventing rape, providing a source of income for circumcisers, as
well as aesthetic reasons (cleanliness and beauty).
Some communities believe that FGM is a religious
requirement, although it is not mentioned in major religious texts such as the
Koran or the Bible.
FGM practice is
deeply rooted in a strong cultural/social framework. It is endorsed by the
practicing community & supported by loving parents who believe that
undergoing FGM is in the best interest of their daughter.
The beliefs
sustaining the practice of FGM vary greatly from one community to another,
although there are many common themes such as ending promiscuity or the
maintaining culture tradition of the community.
FGM functions as a self-enforcing social
convention or social norm. In societies where it is practiced, it is a socially
upheld behavioural rule. Families and
individuals continue to perform FGM because they believe that their community
expects them to do so.
While FGM is de facto violent, although it is not
intended as an act of violence. It is considered to be a necessary step to
enable girls to become women and to be accepted, together with the rest of the
family, by the social group of which they are part.
Despite its
cultural importance, we need to acknowledge the fact that FGM is a harmful
traditional practice that violates the rights or girls and women. These 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. Therefore, FGM has to be eliminated.
When FGM is
conducted by healthcare providers this is also known as the “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”.
Healthcare
providers who agree to perform FGM are violating the fundamental medical
ethical principle or duty of non-maleficence (“do no harm”) and the fundamental
principle of providing the highest quality health care possible.
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. The decrease was also observed in the five
states where the UNFPA-UNICEF Joint Programme on FGM Elimination (UNJP) is
working, namely, 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%).
According to the
MICS (2016-2017), the FGM prevalence among daughters aged 0-14 years increased
from 19.2% (in 2011) to 25.3% (in 2016-2017).
In the five UNJP intervention states, FGM prevalence decreased in three
States, namely, Ebonyi (6.4% to 5.2%), Imo (33.4% to 22.2%), and Oyo states
(32.9% to 29.6%). While, 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 five UNJP intervention states a
decrease was observed in Ebonyi (11.8% to 3.8%) and Ekiti (50.2% to 31.4%); while
an increase was seen in Imo (27.8% to 29.6%); Oyo: (21.2% to 30.3%); Osun:
(34.8% to 38.5%).
Now let us talk about “Ending FGM through provision
and accessibility of social and legal services.”
FGM is a form of extreme harm against women and
girls and leads to severe short and long term physical and psychological
consequences and may require access to quality services to address their heath,
legal and social needs. .
FGM may lead to psychological and mental health
problems because it is an extremely traumatic experience for girls and women,
which stays with them for the rest of their lives. In some cases these FGM
survivors may not have spoken about their experience for many years, and while receiving
psychological counselling many have reported feelings of betrayal by parents,
incompleteness, regret and anger.
Now there is increasing awareness of the severe
psychological consequences of FGM for girls and women, which can become evident
in mental health problems. The results from research in practicing African
communities show that women who have had FGM have the same levels of
Post-Traumatic Stress Disorder (PTSD) as adults who have been subjected to
early childhood abuse, and that the majority of the women (80%) suffer from
affective (mood) or anxiety disorders.
The fact that FGM is ‘culturally embedded’ in a
girl’s or woman’s community does not protect her against the development of
PTSD and other psychiatric disorders. Therefore, there is a need to ensure that
mental health support is made available to assist girls and women who have
undergone FGM, as well as treatment for any physical symptoms or complications.
It is therefore important to ensure that that the
provision of these services, especially social and legal services are integral
parts of the campaign to end FGM in Nigeria.
However, since no single agency or statutory body can meet the multiple
needs of someone affected by FGM, a multi-agency response is required.
In Nigeria, some of the main social services
required by women and girls living with FGM, or at risk of FGM, include
referral to social services for psychosocial counseling, counseling, and
shelter. The provision of these services
are the responsibilities of the Ministry of Health (MOH), Ministry of Women
Affairs and Social Development (MWASD), and other related agencies.
In Nigeria, some of the main social services
required by women and girls living with FGM, or at risk of FGM, include main
legal services include judicial counseling and assistance. These The provision of these services are the
responsibilities of Ministry of Justice, law enforcement agencies (Nigeria
Police Force, Nigeria Security and Civil Defence Corps), the judiciary and
other related agencies.
In Nigeria, the
legal and policy framework has created a conducive environment at national
level and state levels to support the campaign to end FGM in Nigeria, as can be
show as follows
The
Constitution of the Federal Republic of Nigeria (1999) does not specifically
refer to violence against women and girls, harmful traditional practices or
FGM; however, Articles 15(2) and 17(2) prohibit discrimination and set out
equality of rights respectively, and Article 34(1) provides that every
individual is entitled to respect for the dignity of their person and,
accordingly, no one ‘shall be subject to torture, or to inhuman or degrading
treatment.’
Although
the Child Rights Act (CRA-2003) does not specifically refer to FGM, section
11(B) states that “No child shall be subjected to any form of torture, inhuman
or degrading treatment”. . The CRA 2013,
as a federal law, is only effective in the Federal Capital Territory of Abuja,
and, as such, the remaining states must pass mirroring legislation to prohibit
FGM across the country. Currently, 24
States of Nigeria have passed their Child Rights Laws, and in some cases the
prohibition of FGM is clearly stated.
The
Violence Against Persons (Prohibition) Act, 2015 (the VAPP Act), aims to
eliminate gender-based violence in private and public life by criminalizing and
setting out the punishment for acts including rape (but not spousal rape),
incest, domestic violence, stalking, harmful traditional practices and
FGM. The VAPP Act 2015 states that ”a
person who performs female circumcision or genital mutilation or engages
another to carry out such, commits an offence punishable by 4 years
imprisonment or to a fine of N200,000 or both.
The VAPP Act, as a federal law, is only effective in the Federal Capital
Territory of Abuja, and, as such, the remaining states must pass mirroring
legislation to prohibit FGM across the country.
In addition to the National Laws, we also State laws that prohibit the
practice of FGM in Nigeria. In this
presentation, we want to highlight the laws in the five states where the UNFPA-UNICEF
Joint Programme on Eliminating FGM is taking place such follows…
Osun State
Female Circumcision and Genital Mutilation (Prohibition) Law 2004;
Violence
Against Women Law, 2016 (Oyo State);
Imo state
FGM (Prohibition) Law (2017); and
Ebonyi
State Violence Against Persons (Prohibition) Law, 2018;
In addition to the above laws, the existence of “Medical and Dental
Practitioners (Disciplinary Tribunal) Rules” and “National Health Act 2014”
also protects the girls and women from being subjected to FGM by medical practitioners
as described in 33a and b.
Regarding medical malpractice, the Medical and Dental Practitioners
(Disciplinary Tribunal) Rules, 2004 (the Medical Act), sets out in Section 16
under ‘Penalties for Professional Misconduct’ that, where a registered person
(i.e. a medical practitioner) is found guilty of professional misconduct by the
medical Disciplinary Tribunal or is convicted by any court of law or tribunal
for an offence considered incompatible with the status of a medical practitioner,
they may be subject to penalties. Although this does not explicitly refer to
FGM, if such an action is considered as medical malpractice, it would thus fall
under the scope of this law.
In addition, the National Health Act 2014 under Section 48(1)
addresses the removal of tissue, blood or blood product from the body of
another living person. The action is liable to prosecution unless it is done
with the informed consent of that person, for medical investigations and treatment
in emergency cases (where the consent clause may be waived) and in accordance
with prescribed protocols by the appropriate authority. Section 48(2) also
states, ‘A person shall not remove tissue which is not replaceable by natural
processes from a person younger than eighteen years.’
The availability of FGM-related social and legal services essential in
ensuring the accessibility of services to persons subjected to FGM and/or those
at risk of undergoing the practice. However, there are some challenges that
prevent them from accessing these services.
in Nigeria where the culture of silence still surrounds FGM, in many
quarters, a lot needs to be done to encourage women/girls to speak out when
subjected or of threatened with this harmful practice. Therefore, the public
needs to be aware that a survivor has the freedom and the right to disclose an
incident to service providers.
In Nigeria many women and girls who need FGM-related services may not
have the financial willpower to access such services. Therefore there is a need to ensure that some
of these services are provided free-of-charge, or subsidized as the case may
be. The people also need to become aware
of the existence of these services.
To address these challenges, there is also a need to harmonize the
process involved of providing FGM-related legal services, by all government and
non-government stakeholders at various levels, by establishing a Standard
Operating Procedures (SOP) & Referral Pathway for service provision.
These referral pathways, with Standard Operating Procedures (SOPs), will
serve for case management and by extension make easier for FGM survivors to access
FGM-related legal services
The provision of these FGM-related services must focus on two linked
aspects of care: (a) Provision of sensitive and appropriate services for
survivors of FGM; and (b) Safeguarding girls at risk of FGM. The nature of FGM services will vary
depending on local prevalence of FGM, and in each case there must be clear
referral pathways to FGM services.
These organizations providing FGM-related services must thereafter
commit to disseminate the SOPs and referral pathways in communities where they
operate to ensure knowledge and improve access of FGM survivors to services (health,
social and legal) and support.
At the bottom of the referral pathway, an FGM survivor may disclose
her experience or threat of FGM to a trusted family member or friend. She may
also seek help from a trusted individuals or organization.
Anyone the survivor tells about her experience has a responsibility to
give honest and complete information about services (including legal) available
and encourage her to seek help where available.
As earlier mentioned above, the survivor has the freedom to report the
incident/event to anyone. She may seek help from community leaders, social
workers, health workers or friends.
For each FGM case, the provider need to ensure that a written consent
form is completed by the survivor describing the incident in her own words.
If the survivor is trying to escape FGM, she would still provide
information on the event and provide her consent before protection or any other
services are offered. Also, if the survivor is illiterate, her exact words
should be written and read loudly to him/her to understand before he/she can
indicate signature with a thumbprint.
Referrals should be made among the various government and
non-government actors from those who first got the report to the actual legal
service providers.
Where legal services are needed, the consent of the survivor has to be
gotten and then referred to appropriate agency to provide security, protection
and legal services, complete the incident form and document incident.
In each case where a referral is made, a follow up is necessary to
ensure that services are provided, and also to ensure client satisfaction and
safety.
All members of the organizations that receive the referrals must also
be properly oriented on the guiding principles in the SOP for service
provision.
Upon receiving initial report of a girl-child or woman who is
threatened with FGM, the person who has this information should contact and
make referrals to relevant agencies and organization for child protection. Amongst
these relevant agencies and organization for child protection are the key
actors will be Ministry of Health, Ministry of Women Affairs and Social
Development (SMWASD), Ministry of Justice, National Human Rights Commission, International
Federation of Women Lawyers (FIDA), Child Protection Network (CPN), Legal Aids
Council, and others agencies providing similar services, especially Civil
Society Organizations. These agencies
will make sure to abide by the procedures for caring for child survivors and
should also utilize the applicable laws in the state to ensure protection of
the child.
In the case of a child facing the complications of FGM, the service
provider should also follow the steps and guide in the SOP and referral pathway
to ensure access to urgent medical intervention.
On documentation, reporting and information management the SOP should
adopt a format that will ensure that information on incident is systematically
recorded and stored in a safe place.
Organizations who are signed on to this SOP should ensure that their
staff members are oriented on how to complete the forms and interact with the
survivor in line with the guiding principles.
Actors for this SOP must attend a Quarterly Review Forum to be to
review successes, discuss challenges, share lessons learnt and work out the way
forward.
There should be Annual or Biennial review of the SOPs. However, the
referral pathways will continue to be reviewed as necessary by the actors as
necessary to maintain relevance and focus.
In Nigeria, traditional and community leaders are major decision
makers whose positions and opinions influence community behavior. Therefore,
FGM response and legal services must integrate the actions and perceptions of
this social group. Efforts will be made to educate, sensitize and include
community and religious leaders who are FGM champions in the overall FGM
response in the state as active actors in the referral pathways.
The Federal and State Governments should ensure that adequate funding
is available for anti FGM programmes to disseminate clear and accurate
information around the law, as well as the services available for FGM survivors
and those at risk.
The Nigeria Police Force, Nigeria Security and Civil Defence Corps
(NSCDC) and the judiciary need adequate support and training around the law and
should be encouraged to apply sentences provided for by the legislation.
The Ministry of Justice and Judiciary should be encouraged to use
Mobile Courts in fast-tracking the prosecuting of offenders. After serving their sentences, the convicted offenders and families are counseled to become change
agents. This system has been found to be very effective in Burkina Faso.
The Judiciary could be encouraged to make sure any prosecutions
relating to FGM are clearly reported, including by local media such as
community radio, and made available in local languages.
The increased involvement of Community and religious leaders in
education around the law, including their responsibilities and the importance
of the law in protecting women and girls in their communities, should be
encouraged.
Effective monitoring and collection of data around enforcement and
cases of FGM would help to inform strategies and programmes.
Mandatory reporting of instances of FGM by medical staff in hospitals
and health centers is recommended to ensure that now girl/women is left behind.
Where they are currently unavailable and a need is identified,
appropriate protection measures (for example, emergency telephone lines or safe
spaces, including temporary shelters) should be put in place for girls and
women at risk of FGM.
Laws could be printed and widely distributed in local languages, to
make them more widely available to the public, including in forms that can be
used in areas of low literacy.
Local community radio and other media channels, including mobile phone
technology and social media platforms, should also be considered for
dissemination of information on the law and social services available in
Nigeria.
Whatever the reason
provided, FGM reflects deep-rooted inequality between the sexes. This aspect,
and the fact that FGM is an embedded sociocultural practice, has made its
complete elimination extremely challenging. As such, efforts to prevent and
thus eventually eradicate FGM worldwide must continue, in addition to
acknowledging and assisting the existing population of girls and women already
living with its consequences whose health, social and legal needs are currently not fully met.
At this juncture, I will like to stop and I will welcome questions and
contributions.
To learn more about the @endcuttinggirls Social Media Campaign to end
FGM, please visit endcuttinggirls.org and follow our social media handles on Facebook,
Twitter, Instagram and YouTube, using @endcuttinggirls
Good evening all.
Welcome to Facebook conference of the UNFPA/UNICEF Joint Programme on
Eliminating Female Genital Mutilation: Accelerating Change (Phase III).
Today 26th
March, 2019 the series of our Facebook conference continues as we look at the roles
community stakeholders can help to endcuttinggirls
We will spend some
minutes to take you through the discussion before we respond to your questions.
Before we move into
our major discussion for today, let’s quickly review some basic information
about Female Genital Mutilation (FGM).
Female Genital
Mutilation (FGM) is defined by the World Health Organization (WHO) as “all procedures that involve partial or
total removal of the external female genitalia, or other injury to the female
genital organs for nonmedical reasons”.
The World Health Organization
(WHO), classifies FGM into four broad types, and subgroups, based on the
anatomical extent of the procedure, and they are all practices in Nigeria: …
Type I:
partial or total removal of the clitoris and/or the prepuce (Clitoridectomy).
Subgroups
of Type I FGM are: type Ia, removal of the clitoral hood or prepuce only; type
Ib, removal of the clitoris with the prepuce.
Type II:
partial or total removal of the clitoris and the labia minora, with or without
excision of the labia majora (excision).
Subgroups
of Type II FGM are: type IIa, removal of the labia minora only; type IIb,
partial or total removal of the clitoris and labia minora; type IIc, partial or
total removal of the clitoris, labia minora and labia majora.
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).
Subgroups
of Type III FGM are: type IIIa, removal and apposition of the labia minora;
type IIIb, removal and apposition of the labia majora.
Reinfibulation
is covered under this definition. This is a procedure to recreate an
infibulation, for example after childbirth when defibulation is necessary.
Type IV:
unclassified – all other harmful procedures to the female genitalia for
nonmedical purposes, for example, pricking, piercing, incising, scraping and
cauterization.
Type IV
also includes the practice of “massaging” or applying petroleum jelly, herbal
concoctions or hot water to the clitoris to desensitize it or pushing it back
into the body, which is common in many parts of Nigeria, especially Imo State.
All types of FGM were
documented to occur according to the high rate of FGM is driven by deeply
entrenched cultural traditions, values and social norms. Local leaders,
government institutions, international and local agencies, religious scholars
and grassroots activists have attempted to promote the elimination of FGM with
varying degrees of success.
FGM functions as a
self-enforcing social convention or social norm. In societies where it is
practiced, it is a socially upheld behavioural rule.
Families and
individuals continue to perform FGM because they believe that their community
expects them to do so.
Families further
expect that if they do not respect the social rule, they will suffer social
consequences such as derision, marginalization and loss of status.
While FGM is de facto
violent, although it is not intended as an act of violence. It is considered to
be a necessary step to enable girls to become women and to be accepted,
together with the rest of the family, by the social group of which they are
part.
Moreover, the removal
of or damage to healthy genital tissue interferes with the natural functioning
of the body and may cause severe immediate and long-term negative health
consequences.
The risks girls and
women might likely encounter through FGM could be immediate and short term or
long term and permanent.
The roles of community
stakeholders can’t be over emphasized. There are many community stakeholders in
the campaign to end FGM, but we shall focus on Traditional Rulers, Religious
leaders, Health Care Practitioners and Teachers.
For us to #endcuttinggirls
in this generation, there must be synergy between these groups in our different
communities.
The first categories
of community stakeholders are the Traditional
Rulers and they remain a very significant element in the society that
cannot be ignored. Their influence varies enormously across the different
cultures and localities of the country.
Their influence even
becomes more relevant in this campaign to stamp out a practice which is
embedded in tradition. As custodians of tradition, it becomes imperative to
have their buy-in if we must succeed. Traditional rulers are the custodian of
culture and traditions while in some other part of Nigeria, there are other
groups who are seen as the custodian of cultures.
The Traditional rulers
and village heads exerts much power and influence when it comes to issues
related to culture and Tradition like FGM. The village heads are the leaders of
the villages which is one of the smallest units that makes up a community.
Most villages in
Nigeria meets monthly, Quarterly or Yearly to discuss some key issues affecting
the lives of their people then seek ways to address them if brought to the
table of the village leaders and issues like FGM can be discuss at such
meetings.
Therefore, the first
major point of call to Stop FGM will be, carrying along the rulers and decision
makers such as the Kings and regional heads to key into the general effort to Endcuttinggirls.
It is equally
important to suggest and promote alternative rites of passage for communities
where FGM is carried out as a rite of passage and this can be done with the
help of the community leaders.
The community leaders
can also help to fast track public declaration in their respective communities. One of the important roles of these community
stakeholders is Public declaration of FGM abandonment is a “formal public ceremonies involving one or more communities-typically
villages but increasingly also districts and ethnic groups that take part in an
event where they manifest through their representatives, the specific
commitment to abandon FGM”.
This is the result of years
of awareness creation/sensitization, education/training, and Community
Dialogues, Consensus Building and series of activities in the communities.
Public Declaration of FGM abandonment reflects the courage of the communities
to speak out against almost 2,000 year old practice.
Various activities can
be used for focused group (intergenerational discussion) dialogues on #FGM as
part of educational partnership to endcuttinggirls
You can watch Videos
of Public Declaration of FGM in
different communities via the Following links:
EP 30: FGM Public Declaration in Ekiti State
EP 31: FGM Public Declaration in Oyo State
EP 32: FGM Public Declaration in Osun State
Community stakeholders
can also help to strengthen the community systems to monitor FGM and ensure
that communities do not return to the practice after declaration.
The second category of
community stakeholders are Religious
Leaders, because globally, FGM is practiced among some adherents of the
Muslim and Christian faith.
The UNF{A/UNICEF Joint
Programme on eliminating FGM has been working to enhance the capacity of Religious
Leaders (Christian And Muslim) to lead the campaign to end FGM in religious
settings in Nigeria.
Religion organizations
employ a sophisticated means to pass a message across to different associations
under the umbrella of the organization. Also, we cannot underestimate the
importance of religion in the society of today.
C.A.N (Christian
Association of Nigeria) and J.N.I (Jama’tu Nasril Islam) are two religious
umbrella organizations in Nigeria, C.A.N for the Christian religion while J.N.I
for the Islamic religion can help in eradicating FGM and these bodies bring
together different religious leaders.
Religious leaders
(Christian and Muslim) are highly influential persons’ in the community and,
therefore, their involvement will help to fast-track FGM total abandonment in
Nigeria.
However, FGM is
erroneously linked to religion. FGM is not particular to any religious faith,
and predates Christianity and Islam. At the community level, those who carry
out FGM offer a mix of cultural and religious reasons for the practice.
Christians and Muslims
alike erroneously believe that circumcision of girls prevents them from
promiscuity and makes them more attractive for future husbands; mothers fear
that their daughters cannot get married if they’re uncut.
Female Genital
Mutilation (FGM) is not mentioned at all in the Bible and is rejected by
Christianity for this reason. Moreover, whereas male circumcision does not mutilate
the male sex organ, FGM damages the healthy female sex organ and deforms what
God has created.
Christianity
also repudiates FGM because of its immediate and long-term adverse health
effects and refutes claims that female circumcision protects a girl’s chastity
before marriage. You can learn more
about Christianity and FGM by watching https://www.youtube.com/watch?v=hhwzcmdi2gU
Also, the
association of FGM with Islam has been refuted by many Muslim scholars, who say
that FGM contradicts the “Do no Harm” principle of Islam. FGM is not prescribed
in the Quran and is contradictory to the teachings of Islam. You can learn more
about Islam and FGM by watching https://www.youtube.com/watch?v=27ENTiMkCu4
Because of
this flawed linking of FGM to various religions, especially Christianity and
Islam, religious leaders have an important role to play in eradicating FGM in their
communities.
One of the
most importantly roles of Religious leaders should focus on de-linking FGM from
religion among their congregations. Based on their influence, it would be
easier for religious leaders to drum support from religious faiths against FGM
The third category of
community stakeholders are Health Care
Practitioners (HCP). They are also important stakeholders also play a vital
role in the prevention of FGM by providing health education to patients and/or parents
during consultations as their educational background and social status give
extra credit to their messages
First,
training programs for these professionals, particularly those living in areas
where FGM is widely practiced, should focus on what FGM is, why it is
practiced, its health impacts, and ways to prevent it. Such trainings must also
sensitize health care practitioners to the fact that FGM is a violation of
girls’ and women’s rights to health and conflicts with the “Do No Harm”
principle of medical practice.
It is
striking to see that the preventive role of HCP is highly underused. Several
studies have identified numerous challenges to the involvement of HCP, particularly
in Nigeria, some HCP support FGM or consider it as a sensitive issue and
consequently resist working against the practice.
Another challenge
is the involvement of HCP in the “Medicalization of FGM”, which is a situation
“where the procedure is performed by any category of health professional in any
location (hospital, home, etc.)” People
are increasingly turning to health professionals to perform FGM, with the hope
that it will reduce the risk of complications. However, “medicalized FGM” does
not prevent the long-term health, sexual, psychological and obstetrical
complications of FGM.
According
to the 2013 Nigeria Demographic Health Survey (NDHS), the number of girls and
women who were subjected to FGM by health care professionals were 11.9% and
12.7%, respectively. In Nigeria,
Medicalization of FGM is done mostly by Nurse/midwife; Girls (10.4%) &
Women (9.9%) (NDHS 2013)
World
Health Organization (WHO) advises that, under no circumstances, should FGM be
performed by health professionals. In
addition, International and National Professional and Regulatory bodies of
Doctors and Nurses are opposed to FGM.
Medicalization
of FGM violates the ethical code governing health practice that requires that
health professional should “do no harm”. Medicalization of FGM contributes to
upholding the practice, and legitimizes a procedure that is harmful to the
health of girls/women.
Whether
FGM is performed in hospital or bush, it is still a deliberate damage of
healthy organs for non-medical. Health professionals that perform FGM violate
girls’ and women’s right to health, life, and physical integrity.
To prevent
Medicalization of FGM, we must educate health professionals & remind them
of their pledge to “do no harm”. To
prevent Medicalization of FGM, health professionals should resist the pressure
from families to carry out FGM. To prevent Medicalization of FGM, health
professionals who perform FGM should face professional & legal action.”
UNFPA/UNICEF
Joint Programme on Eliminating FGM is empowering health professionals to become
role models and advocates in Nigeria. The Joint Programme is partnering with the underlisted
professional and regulatory bodies to end Medicalization of FGM in Nigeria
Medical
and Dental Council of Nigeria (MDCN),
Nursing
and Midwifery Council of Nigeria (NMCN)
Community
Health Practitioners Regulatory Board of Nigeria (CHPRBN)
Society of
Gynecologist and Obstetrics of Nigeria (SOGON)
Paediatric
Association of Nigeria (PAN)
National
Postgraduate Medical College of Nigeria (NPMCN – Obstetrics & Gynaecology
faculties)
National
Association of Community Health Practitioners (NACHP)
Society of
Public Health Practitioners of Nigeria (SPHPN)
Association
of Public Health Physicians of Nigeria (APHPN)
Association
of Medical Officers of Health in Nigeria (AMOHN)
National
Association of Nigerian Nurses and Midwives (NANNM
The fourth category of
community stakeholders are Teachers.
They are also important stakeholders in different communities because of their
vast knowledge on different issues, they are well respected and they have
direct contact with the children from the communities.
Teachers
can help to educate and model the communities on why FGM should be stopped.
Teachers
can use their position as teachers and their influence on the curricula of
schools to help the campaign to reach a wider audience.
As we champion this
campaign to end FGM, let us also remember that we have a duty to protect the
girl-child and woman from harmful traditional practices. Therefore, you and I
need to become advocates to #endcuttinggirls in this generation.
In conclusion, the
community stakeholders have important roles in putting an end to FGM in this
generation and it’s important that they become advocates in the #endFGM
campaign.
At this juncture, I
will welcome questions and contributions.
To learn more about
the @endcuttinggirls Social Media Campaign to end FGM, please visit https://endcuttinggirls.org and follow our social media handles on
Facebook, Twitter, Instagram and YouTube, using @endcuttinggirls
#Endcuttinggirls.