There is no doubt that Female Genital Mutilation (FGM) is one of the major negative cultural practices that affect the dignity and violate the fundamental human rights of women. It must be emphasized that the practice does not only affect the dignity and pride of women but it also has serious health implications for them. FGM is the practice that involves the complete removal or partial removal or alteration of the gentile for non-medical reasons. Types of FGM There are four types of FGM. The first one is termed as Clitorisdectomy, which involve the partial or total removal of the clitoris. Excision, which is the second, involves the removal of the clitoris and the labia minora. Here the labia majora are left intact and the vagina left unclosed. The amount of tissues removed depends on the individual communities. The third termed as infibulations involve the complete removal of the clitoris and labia as well as the inner surface of the labia majora. The two sides of the vulva are then stitched together with thorns or by silk of catgut sutures so that when the remaining skin of the labia majora heals, it forms a bridge of gaps of scar tissues over the vagina. A small opening is preserved to allow for the passage of urine and menstrual flow. Unclassified FGM, which is the fourth type, involves pricking, piecing or incision of the clitoris and or labia, burning of the clitoris and surrounding tissues, scrapping or cutting of the vagina or surrounding tissues and with the introduction of corrosive substances or herbs into the vagina. It also includes the pulling of the labia minora or smaller lips to make them long. Practitioners of FGM An elderly woman in the village, who is designated as the practitioner, usually performs the FGM. She may also be a traditional birth attendant and sometimes a village barber. The Practitioner of FGM uses tools such as special knives, scissors, razors, or a piece of broken glass. On other occasions sharp and burning stones are used in the exercise. The age at which FGM is performed differs and depends on the ethnic groups or geographical location. In some ethnic groups it is performed at the age of four and 10 years. It could also be performed at puberty, during pregnancy or during childbirth or at death. In some parts of the Kusasi traditional areas and some Muslim communities in Bawku the exercise is performed as soon as a baby is born. The girl or woman is held down tightly by a number of women including relatives. The small lips are pulled longer by using sticks. The legs are pulled apart and part of the genital is cut. The wounds are then dubbed with alcohol or lemon juice, or sheabutter or cocoa nut oil or ash or herbal mixtures, porridge or cow dung. The victim’s legs are bound together until the wounds heal. The actual operation sometimes last from 10 minutes to 15 minutes. Male circumcision is performed to remove the foreskin covering of the penis by way of preventing it from trapping filth and germs and to help in the passage of urine. However, in contrast to FGM the parts of the genital that are cut off are very important to the woman as sexual and reproductive activities are concerned. With male circumcision it makes them enjoy sex but that of women inhibits their ability to enjoy sex. FGM is a tradition that is practiced in many other African countries. An estimated 100 million to 140 million girls and women in the world today have undergone some forms of FGM and two million are at risk of the practice each year. Areas where FGM is practised In Ghana FGM is still perpetrated in the three Northern Regions. Some ethnic groups including the Kusasis; Frafras; Kassenas; Busangas; Wallas; Dagarbas; Builsas and Sisalas practise it. Some ethnic groups in the Brong Ahafo and Volta Region also practice FGM. A research conducted by the Navrongo Research Institute in 1998 for instance indicated a prevalence rate of 77 per cent in the Kassena-Nankana East District. Another research conducted by Dr K. Odoi Agyekum of Rural Help Integrated in the Bawku District in 2003 indicated a prevalence rate of 85 per cent. There are many general community enforcement mechanisms that allow the practice to continue. In the Upper East Region for instance it is performed as part of puberty rites. It was considered sacrilegious for a young girl to marry without being mutilated. It was a test of virginity. Females were expected to be virgins before marriage and to ensure that FGM was carried out immediately before marriage to discover those who could not observe sexual purity. A non-virgin woman was considered as disgrace to the family and circumcisers charge extra fees. To the Frafras, Kassenas, Nankanas and Builsas, an uncircumcised woman was not entitled to traditional funeral rites and without these rites their souls would not go to the ancestors. Reasons assigned for the practice of FGM It was also practised on the ground of aesthetic reason when leaves were worn in the olden days. Teenagers before puberty and before circumcision wore leaves only at the back and it would have been psychological uncomfortable for grown up females with enlarged clitoris projecting to the leaves above the labia majora going without cover at the front overlying the pubis. There was also the trauma effect of the leaves rubbing on the clitoris. Circumcision was therefore done at puberty to prevent undesirable effects. Other reasons assigned to the practice is that they argued that it promoted social cohesion in the sense that it was obligatory for one to go through the exercise before being accepted to become a full member of the group of a society that practised it. It is also agued that FGM signified the bravery of womanhood and if a woman was able to stand it then it implied that she would be able to bear the pains during childbirth. Some group of people also believed that the clitoris had the power to kill a baby if it came into contact with the clitoris during childbirth. The secretion from the clitoris they believed could also kill the sperms of a man. It is also stated that the secretion produced by the glands in the clitoris is unhygienic and could even contaminate food. Others have the belief that an un-circumcised girl has an overactive and uncontrollable sex drive and that the uncut clitoris could arouse intense sexual desire. The supporters of this theory also believe that FGM enhances male sexual pleasure where the vaginal opening is made very small by suturing. They argued that male sexual satisfaction was very important as the woman was expected to provide that service to the man. Effects of FGM on victims There are so many dangers associated with FGM. Most of the victims of FGM become barren and could not deliver. Some have also died as a result of profuse bleeding after undergoing FGM. Victims of FGM are also likely to be affected with tetanus, HIV and hepatitis B due to the use of un-sterilised tools and the application of local dressing such as herbal concoctions; ashes; cow dung among other preparations. The infecting organisms may ascend through the short urethra into the bladder and then to the kidneys to cause kidney problems. Difficulty in passing urine may arise as a result of damage caused to the urethra. Other victims also experience difficulties in menstrual flows and pains during sexual intercourse. Pelvic infection leading to infertility, prolonged and obstructed labour due to tough unyielding scar may occur. Other obstetrical consequences such as difficulty in performing virginal examination and brain damaged and mentally handicapped babies may be delivered as a result of prolonged labour. From the above analysis it is crystal clear that the practice of FGM is very cruel, inhuman and degrading. It is an abuse of the physical and psychological state of the victims. It is also a form of discrimination against girls and women and also promotes gender inequalities that all must condemn and the necessary mechanism put in place to deal with the practice. One may ask whether there were laws against FGM in Ghana. The Law provides that anybody found practising FGM or collaborating with it is liable on summary conviction to imprisonment for a term of not less than five years and not more than 10 years. There are also a lot of international conventions against FGM including the Universal Declaration of Human Rights of 1948; the International Convention on Civil and Political Rights; the International Convention on Economic, Social and Cultural Rights of 1966; the Convention of the Elimination of all Forms of Discrimination Against Women of 1979; the Convention of the Rights of the Child of 1990; the Declaration on Violence Against Women of 1993 and the Platform for Action of the Fourth World Conference on Women of 1995 among other conventions. Notwithstanding, all these efforts being put in place to address FGM, the practice still goes on in hideouts in some parts of the communities in Ghana and this calls for extra measures to combat the menace. New ways to combat FGM There is the need for activists against FGM to identify influential and key individual leaders and groups in the communities and collaborate with them in the effort to uproot the practice from the society. There is also the need to assist people to think and reflect on the dangers and health implications associated with FGM. This could be done through community sensitization programmes. Formation of watchdog committees to oversee and report those involved in the practice to the appropriate authorities is also important. There is the need to involve school children in the exercise by forming clubs in schools to speak against the practice. Education and counselling on FGM should be integrated into the day-to-day work of Nurses and Midwives and behavioural communication materials developed to facilitate the campaign against FGM. The Media, Religious Leaders, Law Enforcement Agencies, Social Workers, Health Workers, Women Activists and all stakeholders need to collaborate to fight to nip this social canker in the bud. Whilst commending the Ghanaian Association for Women Welfare (GAWW) for leading the crusade against FGM, there is the need for other stakeholders to support it with more resources and logistics to undertake intensive educational programmes to fight the menace. GAWW is the National Committee of the Inter-African Committee which has carried out a number of researches and activities aimed at sensitizing the general public, disseminating information and helping in the training of traditional birth attendants and others on the harmful effects of certain traditional practices. The recent workshop organized for the Media personnel in the Upper East Region on how to report on FGM issues was quite refreshing and it had equipped media personnel enough. The Media should join in the fight against FGM. It is a fight that must be won. Source: Samuel Adadi Akapule/GNA