My first contact with a female who had been circumcised was as a house officer in Pediatrics in Africa. A baby, no older than 10 days, had been circumcised and was brought into the pediatric emergency room bleeding profusely. I had to draw her blood for blood group identification & cross matching as the child was pale and symptomatic and in need of an urgent blood transfusion. To make matters worse, the parents were of a religious sect that did not believe in receiving blood. The Chief Medical Director stood in loco parentis before this baby received the treatment needed to save her life.
Female circumcision is also known as female genital cutting and female mutilation [FGM]. In some communities where this ritual is practiced, it is backed up by highly entrenched customs so much so that girls who are not circumcised are stigmatized and may not be able to get married. Some communities in Africa and the Middle East believe that circumcision prevents the girls from being sexual wayward.
There are three procedures that are typically performed. The procedures differ according to each ethnic group and include:
- The removal of the clitoral hood and clitoral glans (the visible part of the clitoris);
- The removal of the inner labia and, in the most severe form;
- Infibulation, which is the removal of the inner and outer labia and closure of the vulva.
A small hole is left for the passage of urine and menstrual fluid, and the vagina is opened for intercourse and opened further for childbirth. The adverse effects depend on the type of procedure and include recurrent infections, chronic pain, cysts formation, an inability to get pregnant, complications during childbirth and fatal bleeding. In spite of this painful process, there are no known health benefits. In fact, it can cause severe pain, shock, haemorrhage (bleeding), tetanus or sepsis (bacterial infection), urine retention, open sores in the genital region and injury to nearby genital tissue. As circumcised young girls grow into young women of child bearing age, they become at a heightened risk for infertility and complications associated with childbirth. It also decreases sexual satisfaction. Nothing good can ever come out of this practice.
It is time for FGM to join the league of procedures that should be retired such as bloodletting, leeching a.k.a hirudotherapy [using leeches for blood letting ]; using mercury for the treatment of gonorrhea & syphilis, and using radioactive radium suppository to improve well being. Nigeria recently made history by becoming the first African country to sign into law, a ban on female genital mutilation. Somalia, a country which has one of the highest rates of female genital mutilation in the world, is moving towards placing a ban on this practice as well.
While a radical, but gradual cultural paradigm shift will be necessary to actively engage established traditions and perceptions, these actions by countries and their leadership sets a very powerful precedent that will change the lives of women, their families and economic development in the regions that have been affected by this scourge.
Frontline Research and Training in Reproductive and Family Health is a non-governmental organization with a goal to promote the reproductive health of individuals, families, communities and the general population. For more information, visit: Frontline Research and Training