From the Editor’s Keyboard

Why open old wounds?

4 October 2016 at 03:23 | 2206 views


By Dr. Nanah Sheriff Fofanah-Sesay, Special Contributor on Health and Gender Issues, Virginia, USA.

Female genital mutilation (FGM) comprises of all procedures involving partial or total removal of the female external genitalia such as the labia majora, labia minora, clitoris and other injuries to the female genitalia for non-medical reasons as defined by the World Health Organization (WHO).

Proponents of this act often engage in these behaviors to adhere to and preserve an ongoing cultural tradition that failed to take into consideration the dignity, physical trauma, emotional trauma, and human rights of young girls and women.

In a recent article titled SALWACE’s “imitated not mutilated” Campaign, the author/s referred to Bondo (a society for the performance of FGM) as “the recognition of adult women to choose what they want to do with their own bodies.” The author/s further describes the act of FGM as “labiaplasty” and “clitoroplexy” and other forms of “so-called female genital cosmetic surgeries.”

The purpose of this article is to respond with an opposite view to the above article and to shed some light on the adverse effects of FGM from a personal point of view.

In areas where FGM is practiced, the act is most often done on very young girls whose parents verbally consented to the procedure as a rite of passage. The people doing the circumcision or Soweis ( in Sierra Leone) are usually the lead providers of the act and are often oblivious to adverse effects of surgical procedures nor do they have strategies in place to respond to possible complications.

These procedures, even though invasive, does not require pre-operative preparations such as laboratory work-up to evaluate for anemia, clotting factor, ongoing infections, status of electrolytes, the ability of the heart to withstand the procedure, or anesthesia. The processes of these procedures and possible complications are hidden from girls and women prior to the actual act as revealing this information is considered a violation of the rules of engagement.

Equipment utilized for these procedures are not sterilized and are likely used from one individual to the next, increasing the transmission of diseases such as HIV and Hepatitis.

In situations where complications such as severe bleeding occurs, the Soweis are not equipped with antidotes such as Vitamin K injections to counteract bleeding nor do they provide pre and post-operative antibiotics to prevent or minimize infections from surgical wounds. Keep in mind that pains associated with procedures that involve excisions of healthy tissues are excruciating; however, the only analgesics administered to these girls and women are plain Tylenols if they are very lucky.

The question now becomes how does this desire to respect our ancestral traditions translate to universal human rights to quality, dignity, and self-determination for young girls and women?

Let us now turn our focus to the author/s descriptions of the procedures as labiaplasty and clitoroplexy. In medicine, the suffixes “plasty” indicate molding, formation, or surgical repair as in plastic surgeries whereas “plexy” indicates a surgical procedure that adjust the sizes and positions of tissues or organs.

Any procedure that involves excision such as in FGM requires the suffixes “ectomy” as in labiaectomy and clitoridectomy.

According to (2015), the adverse effects of FGM are multifaceted and include but not limited to hypovolemic shock from persistent and profuse bleeding, urinary retention from obstructions of the urethra caused by swelling, excruciating pain caused by excision of raw and healthy tissues, septicemia caused by wide-spread infections in the blood stream, transmission of infectious diseases caused by utilization of unsterilized instruments to perform the procedures, damage to the urethra and bladder from inexperienced Soweis and death.

On a personal note, my experience with FGM is not different from those experienced by most of the 200 million girls and women worldwide who have undergone these procedures as the act almost resulted to my demise.

Today, I’m able to write this this article because one of the women became uncomfortable with my deteriorating condition and reported the issues to my father who in turn collaborated with a male dispenser and another male Good Samaritan to save my life.

It amazes me how all my fellow women decided to watch a thirteen-year old girl at the time (my humble self) sink in and out of consciousness from massive loss of blood for 12 to 13 hours without carrying out appropriate interventions to correct the issues all in the name of upholding ancestral traditions and the rules of engagement.

African girls and women are already facing multiple disadvantages such as early marriages, death from childbirths, child abuse, high rate of illiteracy and being considered less of a priority when compared to their male counterparts. The act of FGM and its associated complications is one disadvantage they could forgo. We all need to work collaboratively to put an end to this act as girls and women around the world deserve better.

This article is dedicated to my late father (Pa Sheku Santigie Fofanah), late dispenser Victor Cole and late Mr. Ibrahim Kargbo aka Teacher Kargbo whose collective efforts saved my life from the claws of FGM. May their souls continue to rest in profound peace. Amen. Ameen.