Married at the age of 17, Hadassah Isah had no idea of what future had in store for her until she tied the nuptial knots and became pregnant.
Like every newly wedded young lady, Hadassah was happy. But, her joy was cut short by dyspareunia – pain during sexual intercourse.
Also, Hadassah suddenly began to experience virginal itching, painful urination and menstrual problems. Next, she was diagnosed with genital tissue damage, reproductive tract and chronic genital infections. The diagnosis further showed keloids and cyst.
Her new marriage was threatened with failure. Hadassah’s joy was therefore unimaginable when it became confirmed that she was pregnant. But, her joy was short-lived. She developed Fistula after struggling with prolonged labour for three days, despite undergoing Caesarean section.
According to her doctor, Hadassah’s health crisis ranging from haemorrhage, excessive bleeding, pain, shock, genital tissue swelling, infections, pro-longed labour, caesarean section and postpartum haemorrhage are some of the risks of Female Genital Mutilation (FGM).
Her parents had ignorantly allowed her to be cut because they reportedly wanted to prevent her from being promiscuous. They wanted her virginity to be preserved so that her bride price would be huge. What Haddasah had was Type 3 female genital mutilation, which is called infibulation. That is the removal of all external genitalia, which leave a small opening for blood and urine.
This procedure is usually performed by elderly women under unsanitary conditions, with Scissors, razor blade or knives; no anaesthetics were used.
Her doctor had performed surgery on her to correct the damage done to her female genitalia after she was infibulated as a child before the pregnancy occurred. Her genitalia had to be opened for the passage of penis and baby.
Also, her female genitalia were further cut open to allow passage of foetal head while she remained in serious pains.
The World Health Organisation (WHO) reports that Female genital mutilation include all procedures which involve partial or total removal of the external female genitalia or injury to the female genital organs, whether for cultural or any other non-therapeutic reasons.
The world health body further classifies FGM into four major types, namely; Type I (Clitoridectomy), Type II (Excision), Type III (Infibulation) and Type IV.
Hadassah represent millions of girls who go through torture under the knives of genital mutilators worldwide.
The United Nations (UN) health body in its 2018 reported that young girls between zero and 15 years even women are subjected to female genital mutilation in worldwide.
Of the 200 million girls and women globally living with the consequences of FGM, 44 million are aged less than 15 years, the report further said.
According to the report, three million girls are at risk of the practice every year.
Nigeria is among four countries where two thirds of all women who have undergone FGM/C live; the other three countries are Egypt, Ethiopia, and Sudan.
Specifically, Nigeria has shares 25 per cent of the burden of e female genital mutilation which occur in Africa.
“Nigeria 10 to 25 per cent cases of female genital mutilation of the African countries where the practice is till rife,” the report said.
Analysts are therefore are worried that Nigeria is home to millions of those who survived female genital mutilation (FGM) despite its dangers. More worrisome is the high level of ignorance concerning the practice of FGM.
Most recent estimates from UNFPA-UNICEF Joint Programme On FGM/C Abandonment: Accelerating Change Phase II report from 2014 to 2017 show that Nigeria has zero to 28 per cent prevalence along with Yemen.
In 2016, UNICEF estimated that at least 200 million women and girls in 30 countries have been subjected to FGM.
While earlier focus in Nigeria has generally been on three major types of FGM/C practiced -Type I, Type II, and Type III – recent evidence shows that different forms of Type IV are as prevalent as the other types, especially in the northern regions, where little attention has been paid over the years.
The procedures for FGM can take place anytime from a few days after a child’s birth to a few days after a woman’s death.
Although FGM is known to be widespread in Nigeria and is an important issue in international discourse, nationally representative data on its prevalence in Nigeria is comparatively rare.
Speaking during two-day review meeting with media – radio – partners on ending FGM in Nigeria which was organised by National Orientation Agency (NOA), Oyo State with support from UNICEF, Benjamin Mbakwem, FGM/C Consultant for Ebonyi & Imo State, UNICEF Enugu Field Office, said it is an out-dated practice and tradition that threatening the rights of girls and women to development, protection and ultimately survival.
He stressed that no form of female genital mutilation is safe as it endangers women’s life.
Describing the structure of the normal female external genitalia, he said this include; Skene’s and Batholins glands, vaginal orifice, urethral meatus, clitoris, perineum, labia minora and labia majora.
The functions of the normal female external genitalia are; lubrication of the vagina, it allows the escape of the menstrual flow, sexual intercourse and delivery of the baby, it allows emptying of the bladder within a few minutes, it assists women to achieve sexual satisfaction, it supports the pelvic organs and separates vagina from anus, it protects structures and orifices and protects the inner structures and orifices.
The unaltered female genitalia are the prepuce, labia minora, labia majora, Bartholin glands, clitoris, urethra, vaginal Introitus, perineum and anus.
The female genital mutilation is classified by the world health organisation-WHO into four types.
In the first type we have the Clitoridectomy which is the partial or total removal of the clitoris ( a small, sensitive and erectile part of the female genitals) and in very rare cases, only the Prepuce ( the fold of the skin surrounding the clitoris).
Under the first type of the female genital mutilation there are two other parts which is the removal of the prepuce/ clitoral hood (circumcision ) and the removal of the clitoris with the prepuce ( clitoridectomy).
The prepuce, labia minora, labia majora, Bartholin glands, clitoris, urethra, vaginal Introitus, perineum and anus are organs that make up the two parts above.
In the second type we have the Excision which is the partial or total removal of the clitoris and the labia minora, with or without excision of the Majora – the labia are “ the lips” that surround the vagina.
There are three other parts that make up the second type which is the removal of the labia minora only, this is made up of the prepuce, labia minora, labia majora, Bartholin glands, clitoris, urethra, vaginal Introitus, Perineum and anus.
In the second part we have the partial or total removal of the clitoris and the labia minora and it is also made up of the prepuce, labia minora, labia majora, Bartholin glands, clitoris, urethra, vaginal Introitus, perineum and anus but in this case the prepuce may be affected.
In the third part it is the partial or total removal of the clitoris, the labia minora and the labia majora in addition with the prepuce, labia minora, labia majora, Bartholin glands, clitoris, urethra, vaginal Introitus, perineum and anus.
The last type is the Infibulation which is the narrowing of the vaginal opening through the creation of a covering seal. The seal is formed by cutting and repositioning the inner, or outer, labia, with or without removal of the clitoris.
We have two parts under this type and first is the removal and positioning the labia minora with or without excision of the clitoris and in this an infibulation can occur which may be as a result of the healing and not necessarily of the stitching.
The prepuce, labia minora, labia majora, Bartholin glands, clitoris, urethra, vaginal Introitus, perineum and anus are organs that make up the first but the prepuce and clitoris may be affected in this case.
The second part is the removal and positioning the labia majora with or without excision of the clitoris in this also an infibulation can occur which may be as a result of the healing and not necessarily of the stitching.
The prepuce, labia minora, labia majora, bartholin glands, clitoris, urethra, vaginal introltus, perineum and anus are organs that make up the first but the prepuce, labia minora and clitoris may be affected in this case.
The final type is the unclassified which is the use of all other harmful procedures to the female genitalia for non-medical purposes, for example; pricking, pulling, piercing, incising, scrapping and cauterization.
This is an unbridled contravention of the international Child Rights Act adopted by Nigeria in 2003 to domesticate the convention on the Rights of the child. Despite the fact that some states have passed it into law, it is still a daunting task fighting FGM in the Southwest, Mbakwem insisted.
According to WHO, the practice of FGM enables the victims to be automatically open to various risks which may be immediate, long term, psychological, sexual functioning, or obstetric. The immediate risks the victims are exposed to include: excessive bleeding, pain, shock, genital tissue swelling, infections, wound healing problems, as well as death. The victims are still exposed to long term risks which may include: genital tissue damage, vaginal discharge and itching, menstrual problems, chronic genital infections, reproductive tract infections, urinary tract infections, keloids and cyst.
These victims are not exempted from the risks in childbirth which may include: prolonged labour, post-partum haemorrhage, still birth and early neonatal death, caesarean section, extended maternal stay, episiotomy, etc.
Apart from the physical risks the victims are exposed to, they can also be affected psychologically. They can be depressed, have anxiety disorder, or post-traumatic stress disorder (PTSD).