Chioma Umeha
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).