A random search online for images of women who practise female genital mutilation/cutting (FGM/C), also known as cutters, shows them in traditional attire displaying the tools they work with either on a tattered piece of cloth or on their bare hands.

These tools are razors, local knives, scissors, scalpels, and pieces of glass, which they use for the partial or total removal of the external female genitalia (most times the clitoris) for non-medical reasons. This is mostly carried out on girls between infancy and age 15, according to the World Health Organisation (WHO).

Now, these tools once used to carry out FGM as part of inherent cultural beliefs are no longer part of the identity of some cutters in Nigeria.

This is the case of Charity Aforkwalam whose grandmother taught her at 15 how to circumcise a newborn girl, a knowledge that was also passed to the grandmother by Mrs Aforkwalam’s great-grandmother. It was how the culture was passed to many girls born in Warri in Nigeria’s Delta State.

While the WHO sees female genital mutilation as a violation of the human rights of girls and women, Mrs Aforkwalam was taught that “when a woman is circumcised, it stops her from being a harlot.”

This perception that she was ‘saving girls’ by controlling their sexuality, made her decide to follow her grandmother, a known cutter in Warri, for every circumcision. Making money from the practice was a bonus. Her grandmother collected between one and five kobos for each circumcision.

The process would start with unwrapping the blade from a piece of cloth. The blade would only be rinsed with water after a previous cut while the mother of the newborn would struggle to keep her crying baby still.

In the corner, there would be a boiling pot of water mixed with herbs used to stop bleeding. Using the razorblade, her grandmother would slowly slice through the clitoris of the newborn from top to bottom, then administer the now warm herbs to the wound.

For any 15-year-old, this would not be a thrilling sight, but for Mrs Aforkwalam who trusted her grandmother and the purpose of the practice, she patiently watched each process because she felt it was the right thing.

After every cut, Mrs Aforkwalam’s grandmother would spit into her palms, place them on her granddaughter’s palms and tell her that when she dies, she must continue the practice. For this reason, Ms Aforkwalam felt she had been bestowed ancestral powers that could not be foregone.

There are several reasons why women practise FGM, which include psychosexual (to control women’s sexuality), sociology and culture (initiation into womanhood), hygiene and aesthetic appeal, religious doctrine and socio-economic factors (a prerequisite for marriage).

L ike Mrs Aforkwalam, Funmilayo Ajayi, 68, learnt the practice from her grandmother but practised hers medically as the head of midwives and traditional birth attendants in Ikere Local Government Area of Nigeria’s south-west state, Ekiti.

Women who patronised her felt comfortable with her because, being a health practitioner, she would perform the act with better hygiene. Beyond her health background, it was a way to uphold an intergenerational practice while she also made some money from it.

FGM/C is not only perpetuated by traditionalists but also by health workers. But even when medicalised, UNICEF says it is still not safe and “there is no medical justification for the practice.”

The global body estimated that at least 200 million women and girls have undergone FGM, out of which over 20 million of them were mutilated by a health care provider.

The national prevalence of medicalised FGM is above 10 per cent in eight countries, including Nigeria. Mrs Ajayi, who is part of the 12 per cent of health practitioners that have conducted medicalised FGM in Nigeria, has lost count of the number of girls she cut.

T he death of her grandmother in 1977 launched Mrs Aforkwalam into personal practice, charging N100 per cut. This was her only source of income until she left Warri with her family in 1983 for Oforola, a community in Nigeria’s south-east state of Imo where she combined trading, farming and cutting.

She went about the usual business of cutting until the ‘gospel’ of #EndFGM got to her one day while seeking medical attention at a community health centre in 2018.

While waiting for her turn to see the doctor, she heard someone saying, “Stop female circumcision; it is harmful to our girls”. Wondering what the message was about, she stepped out and saw community residents known as the ‘Opi committee’ lecture nursing mothers who had come to immunise their children.

‘Opi’ means trumpet blower in Igbo. Opi Committee are selected community residents who campaign against the practice.

The committee was birthed from an awareness programme on gender-based violence carried out by a non-governmental organisation, Honourbirth Foundation in two Imo communities — Oforola and Olaukwu in Owerri West Local Government.

They were later trained on how to respond to GBV by international bodies like ActionAid and the United Nations Population Fund (UNFPA) alongside local authorities like the National Human Rights Commission.

After several encounters with the committee at the marketplace and in her church, Mrs Aforkwalam bought a document that contained the by-laws produced to guide the residents on gender-based violence. From there, she further learned the health complications linked to the practice.

The WHO associates several health risks with FGM/C. They include complications like excessive bleeding, urinary problems, fever, infections, death and long-term effects like sexual problems (painful intercourse, decreased satisfaction), childbirth complications, psychological problems (depression and anxiety), and vaginal and menstrual problems.

Before she abandoned the practice, Mrs Aforkwalam had cut about 30 girls, a low number because there were a lot of cutters in her community. The girls are part of the 19.9 million FGM survivors in Nigeria, the third-highest number of girls and women who have undergone FGM worldwide, according to UNICEF.

Once she stopped performing FGM, Mrs Aforkwalam said she prayed to God to forgive her because “it was done out of ignorance.”

For Mrs Ajayi, the criminalisation of gender-based violence and constant sensitisation from GBV responders, made her stop. Now, she urges other health practitioners to shun the practice.

“I now know that it is bad and we were just harming the young girls. I threaten to hand them (circumcised,” Mrs Ajayi, fondly called ‘Iya Nurse’, told PREMIUM TIMES over the phone.

To further curb the practice, in April 2022 the Ekiti State government introduced stiffer punishment for erring health and local practitioners in its reviewed Gender-Based Violence (GBV) Provision Law. Such officials risk losing their license, a two-year jail term and a fine of N200,000 ($480) but no one has been punished yet.

Also, the Chairman of the International Federation of Women Lawyers (FIDA) in Ekiti, Oyin Olatunbosun, promised to engage relevant bodies in the country’s health sector to stop the act among them.

“It will be easy for us to stop it, especially when they know people are now watching,” she said.

A fter learning a lot from the by-laws and as a way to atone for her past deeds, Mrs Aforkwalam approached the secretary of the Opi Committee to become a member in August 2021. Since then, she serves as an advocate against the harmful practice.

“Whenever I hear that a woman has delivered a baby at the health centre, I visit the mother at her home to sensitise her about the dangers of FGM on her newborn and how to resist pressure from her mother-in-law. I follow-up several times too,” the 62-year-old told PREMIUM TIMES.

Mrs Aforkwalam is among the 15 men and women who make up the Opi Committee. In this committee, there are traditional leaders, health workers, women leaders, local security and youth representatives. She is the only repentant cutter on the committee.

Besides constant sensitisation, they track and respond to cases of violence against women and girls, refer cases to the NGO and criminal matters to the state’s Human Rights Commission.

In responding to civil cases, the committee set up a local court where proceedings are held every Thursday. They have not handled any FGM cases because the numbers have dropped.

Their by-laws also warn residents to shun FGM and stipulate that offenders will be reported to the authorities.

The health workers who are part of this committee routinely check the babies brought to the health centre for immunisation and during postnatal days to monitor the prevalence of the practice which they said has dropped drastically.

“Before 2021, we would see between 12 and 13 baby girls cut weekly but now, you will see one and that is for those stubborn people. Sometimes you won’t see any,” said Achonwa Isabella, the focal person in charge of female genital mutilation in Owerri West Local Government.

With the interventions of the Opi Committee in the communities, the Executive Director of Honourbirth Foundation, Elizabeth Onyemaechi, believes despite their financial constraints, they will be sustained because they are working on becoming an autonomous unit.

In addition to the Opi Committee’s work, the traditional ruler of Olaukwu community, Apollo Ekeocha, placed female spies in the community who monitor the progress of every newborn girl and report any wrongdoing to him.

S everal approaches have been adopted for the abandonment of FGM/C practice in Africa, such as human rights frameworks, a health risk approach, training health workers as change agents, and the use of comprehensive social development initiatives.

In Nigeria, empowering selected residents like Mrs Ajayi and Mrs Aforkwalam in states where the practice is prevalent to serve as responders in tackling GBV issues has helped with the reduction.

The Nigeria Demographic and Health Survey (NDHS) states that FGM/C reduced in Nigeria from 25 per cent in 2013 to 20 per cent in 2018 for women aged 15-49. This was restated by the UNFPA resident representative in Nigeria, Ulla Mueller, in 2021. The next NDHS in 2023 is expected to give more accurate data on the current state of the practice.

Quoting the NDHS 2013/2018 statistics, Ms Mueller said in Osun State, the prevalence reduced from 78 per cent to 45.9 per cent; Ebonyi: 74 per cent to 53.2 per cent; Ekiti: 72 per cent to 57.9 per cent; Imo: 68 per cent to 61.7 per cent, and Oyo: 66 per cent to 31.1 per cent.

Reacting to this development, an FGM survivor and activist, Abimbola Aladejare-Salako, said it gives her “strength to know that all the work as a grassroots campaigner and survivor is not a waste.” But “the target is zero”.

However, a UNICEF report released in February warned that FGM is on the rise among Nigerian girls aged 0-14.

“While the national prevalence of FGM among women in Nigeria aged 15-49 dropped from 25 per cent in 2013 to 20 per cent in 2018, prevalence among girls aged 0-14 increased from 16.9 per cent to 19.2 per cent in the same period, according to NDHS figures,” UNICEF said in the report.

A factor that could have caused the increase is the non-acceptance of awareness programmes by some people who still cherish the tradition.

For instance, Alice Uchenna, a mother the reporter met at Obinze Health Centre in Owerri West Local Government, said she still believes in the practice, but her mother, who supports the advocacy, stopped her from circumcising her daughter,

Nevertheless, the Director of Gender in the Ekiti State Ministry of Health, Olukemi Akinleye, told PREMIUM TIMES she is confident that with the level of awareness and popularisation of the law against FGM, the next NDHS report will indicate a reduction.

Also, new initiatives introduced by the Nigerian government, like the Movement For Good where critical actors mobilise local action using the #Act2endFGM to stop the practice, are expected to show progress in the coming year.

A ccording to Mrs Aforkwalam and Mrs Ajayi, the reason for practising FGM is to limit sexual urges, but in some parts of Nigeria and some African countries like Kenya and Sierra Leone, it is to observe the rite of passage from childhood into womanhood and to guarantee a girl’s marriageability.

The process starts with a ceremony to train the girls on family and women’s social roles and a public declaration stating the community’s recognition of the girls’ initiation to womanhood and ends with the genital cutting.

In these places, girls who do not undergo such a ceremony are usually stigmatised because it is seen as a thing of pride.

Now, Alternative Rites of Passage have been introduced by NGOs and international bodies. The alternative ceremonies keep and respect the tradition, but exclude the cut. During these ceremonies, the girls are made aware of the dangers of FGM and provided with sexual and reproductive health education. Girls’ education is also promoted.

After the historical ceremony and the cut, the girls are given a red scarf as a symbol of their initiation, but to show acceptance of the new ritual they replaced the red scarf with a yellow one.

Consequently, the Demographic Health Survey in Kenya showed that the overall prevalence of FGM decreased from 38 per cent in 1998, to 21 per cent in 2014 as restated by Jean Lokenga, UNICEF Kenya deputy representative.

I t was not easy for Mrs Aforkwalam to forgo the practice because she earned as much as N1000 per cut by the time she stopped the practice. But she eventually could, due to the other businesses she runs. Mrs Ajayi, on the other hand, is still struggling.

She was part of the beneficiaries of former circumcisers who were given N250,000 by the Ekiti State Government in 2021 at the ‘Drop the Blade Initiative’ to discourage the practice and to enable them to use the funds as capital to start up a business.

However, Mrs Ajayi still pleads for more financial support because she said she used the money to offset the economic difficulties caused by the global pandemic.

The FGM survivor, Mrs Aladejare-Salako, condemned the recurring requests from the former cutters because it feels as though they have not “internalised the fact that FGM is harmful”.

UNFPA Gender/GBV Specialist, Zubaida Abubakar, agreed that financial support for previous circumcisers is not sustainable because they will keep requesting more.

A public health specialist, Laz Eze, proposed that the cutters be trained on other skills of their choice, and be given start-up tools and grants to begin their businesses.

But if they continue, he said they should be prosecuted in line with the Violence Against Prohibition Act 2015 which stipulates a four-year jail term or N200,000 ($482) or both to serve as a deterrent.

In Sierra Leone, empowerment with livelihood skills was adopted and accepted by the previous cutters.

Mrs Aforkwalam and Mrs Ajayi want cutters who are still practising in secret to stop, mostly because of its harmful effects on girls and women.

TEXT AD: Call Willie - +2348098788999

Titilope Fadare is a Multimedia journalist with Premium Times and has practised Journalism for five years. Her interests range from women, children, politics to Internally Displaced Persons and Persons living with Disability She was one of the winners of the 2021 Facebook Africa Video Storytellers Programme. She obtained a degree in English Language from Obafemi Awolowo University, Ile-Ife, Osun state. She can be reached on Twitter @tittyfady

All content is Copyrighted © 2022 The Premium Times, Nigeria

All content is Copyrighted © 2022 The Premium Times, Nigeria