February 6th is marked across the globe as International Day of Zero Tolerance for Female Genital Mutilation usually referred to as female circumcision.
In Nigeria, Female Genital Mutilation is still practiced in spite of the numerous health issues and complications.
In this chat with Lolo Ayaba, Dr Esther Oluwatosin, a Gender and Reproductive Health Analyst throws more light on FGM, its complications, and benefits of not being circumcised as a woman and other sundry issues.
In simplified terms what is FGM?
FGM is female genital mutilation ie female circumcision It is the partial or total removal of female external genitalia due to non medical reasons. There are four types
Type 2 : Type 1 and removal of labia Minora (external lip) with or without the majora
Type 3 : Narrowing of the external genitalia
Type 4: It includes all other forms including pickling, piercing and incising.
Nigeria is one of the countries that are still practicing it, what are the implication?
Nigeria is one of the seven countries which accounts for over 200 million girls and women who are mutilated.
Though the incidence is dropping, the practice still persists because of gender inequality, the belief that it can curb promiscuity, it must be part of the rite of passage, weak enforcements of laws and recently, medicalization.
Currently, five states account for the highest number of cases : Ekiti, Osun, Imo, Ebonyi and Oyo.
What is the prevalence rate in these state?
In Oyo=55.0%, Osun=67.8%, Ebonyi=43.2%, Imo=51.6% and Ekiti=62.6%.
What is the source of this data and does that mean we are winning the war against FGM in Nigeria?
Multiple indicator cluster survey 2016-2017 conducted in all states
Why is this so?
Osun accounts for a high number of cases due to deep seated cultural norms including prevetion of promiscuity, family ritual which must be done for all women to be clean and free of evil spirits, weak enforcement of laws amd medicalization of FGM.
Knowing that it is a cultural issue, UNFPA has sice 2014 engaged community, traditional and religous leaders to have a consensus to abandon FGM. Cureently, we have over 600 anti FGM champions conducting door to dooor counselling on the need to abandon FGM in the five states.
How true is the notion that women who go through Genital Mutilation do not enjoy sex?
Due to the complications of FGM, women find it difficult to enjoy sex because the external female organ, the clitoris which ensure lubrication during sex has been cut off. In some cases, the external organ have been sown up.
Apart from not enjoying sex, what other implications can this have on women?
Infertility, pelvic inflammatory infections, menstrual pains, keloids, obstructed labour are some of the implications of FGM. FGM can cause obstructed labour due to the narrowing of the external genitalia.
Is there a medication to aid lubrication in other to enjoy sex for such women?
Lubricants can be used but it will not totally resolve the pain. Depending on the type of FGM, corrective surgery can be done to open the external genitalia to allow for easy passage of the male external genitalia.
Is there surgery for all types of FGM and
is there age limit for such surgery?
Yes and there is no age limit.
Does FGM have any effect in Child delivery ?
Women with type 2 and 3 are most at risk during delivery.
As a medical doctor, what are the benefits of not being circumcised as a woman?
There are huge benefits both for short term and long term: There is no risk of gynaecological problems including, painful mensuration, repeated pelvic infections, infertility, urinary tract infections, and sexual intercourse will not be painful. There is also no risk of obstructed labour.
Apart from the huge success you recorded in Osun State, have you in any way impacted other states?
In other states collectively, over 1,500 communities have declared abandonment for FGM. All states have VAPP laws in place to prosecute perpetrators, and each state has a technical committee that ensures complaince. Three hundred heath care workers have also been trained to offer services to women with complication.
We also have champions in other states campaigning against FGM. We equallly engage youth social media advocates to create awreness among girls.
Last year, UNFPA supported Federal government to revise their National Policy and plan of action on FGM.
All five states now have adopted the Violence Against Person Prohibition Act which puts in place sanctions on perperatarors. All supported by UNFPA.
How will you rate Nigerian government in the campaign against FGM?
The government is putting in a lot to ensure it’s eradicated. But the government still needs to do more by creating more awareness and enlightment programmes to dispel myths.
It should also ensure all laws are enforced, provide essential services to surivors to allevaite the complications; involve young girls as advocates to fight against FGM practice, and engage with the traditional leaders and religious leaders to ensure the abandonment of FGM.