More secrecy surrounds female circumcision in South West Nigeria despite war against practice

By Taiwo Oluwadare

THE World Health Organisation (WHO) describes Female Genital Mutilation (FGM) as all procedures which involve partial or total removal of the external female genitalia and/or injury to the female genital organs, whether for cultural or any other non-therapeutic reasons.

FGM has been described as a societal malaise militating against the sexuality of female folks, an act that is rooted especially in African traditions. The practice is documented in 28 countries in Africa, Asia and the Middle East and among these countries. The prevalence rate in Nigeria, according to the National Demographic Health Survey 2013, is 24 per cent.

Female circumcision is a cultural practice from time immemorial and the reason for practising it is borne out of the belief that unless it is done, a woman is incomplete. It is also seen as a means of preserving girls virginity,  believed to help increase a girl’s chances at marriage.

According to Waris Dirie, “female genital mutilation targets little girls, baby girls- fragile angels who are helpless, who cannot fight back. It’s a crime against a child, a crime against humanity. It’s absolutely criminal and we have to stop it”

Various advocacy groups have risen against the practice which some describe as “evil”. According to an anti-FGM campaigner, Dare Olagoke-Adaramoye, girls and women who have been mutilated have either died from the complications afterwards or lost the urge for sex and other negative consequences.

Tosin, a traditional nurse in Ise Ekiti.

Effects of FGM ranges from complications at birth, infections, excessive bleeding, delayed or incomplete healing. And because many traditional circumcisers do not use anaesthetics on their patients, there is the possibility of damage to adjacent organs like urinary tract, infections, cysts and even death. Anti-FGM activists also believe that the practice has no clinical medical benefits but rather causes irreparable dangers to female folks.

As a result of the aforementioned dangers, there is a law in place that criminalizes female circumcision in Nigeria. The law was signed by former President Goodluck Jonathan. However, violators continue with the practice secretly.

At the heart of the investigation, is how the practice affects women; the present prevalence rate and the secret practice in spite of the prohibition law.

Preliminary investigations reveal that Southwest Nigeria recorded the highest rate of Female Genital Mutilation in the country. This is in spite of the high literacy level in the region. Asides that, various religious organizations have condemned the act.

According to the NDHS, the female genital mutilation prevalence rate in the South West is the highest in the country. Although little progress has been made from a prevalence rate of about 57 per cent in 2003 to 48 per cent in 2013.

File photo sourced from google

The practice is based on myths and religion passed down for many generations. Some communities believe that the clitoris contains powers strong enough to cause harm to a man’s reproductive organ or to damage or kill a baby during childbirth.

Genital mutilation has assumed a frightening and worrisome dimension in Ekiti, Osun, Oyo and Lagos where this investigation covered. Findings show that until recently, rural, illiterate and unenlightened old men and women have remained in the cultural habit of mutilating the virginal part of female babies, and they have their reasons. Chief among those reasons is to prevent young women from becoming promiscuous as they assume teenage age. The cultural belief is that a female tends to become promiscuous if her virgina is not “tamed” through the severance of that virginal part believed to make her want men so much.

Unbelievably, the practice has gradually crept into the medical profession as you now have a situation whereby nurses, mostly auxiliary nurses who work with certified medical doctors in both public and private hospitals surreptitiously help parents “tame” the private part of both male and female children days after their birth. In Ise Ekiti, this reporter met with a lady named Tosin at a palm wine joint. She revealed how female circumcision is done in her hospital. She, however, refused to divulge the name of the hospital.

In some communities in the four Southwestern states, female genitals of uncircumcised women are considered ugly, unclean and unattractive.

This investigation started in Ekiti in communities like Emure, Eporo, Egbara-Odo, Ise Ekiti and other communities that are perceived to have a high prevalence for FGM/Cutting.

While in Emure, a priestess of a deity named Oloofin said female circumcision is rooted in the tradition of their town and Ekiti generally. The woman who is popularly called Iya Eku whose husband is from Aro lineage, the authentic circumciser in the town since time of immemorial, said people’s belief in female circumcision is so strong that even women who are in marriageable age are cut or get cut during childbirth because it is widely believed that the clitoris must not touch the head of the newborn baby because it could lead to death. Iya Eku also revealed that the cut part of the clitoris must not be thrown away anyhow. According to her, it must be carefully buried because if a dog eats it, the girl would become wayward and won’t able to control her sexual desire.

A traditionalist in the town, Alh. Lasisi Kareem Kayode, revealed that, the people in Aro lineage are legitimate circumcisers and that they pass the “trade” to their offsprings. He said it is disheartening that most women circumcisers were dying off while quacks were taking over.

Alhaji Lasisi

He noted that culturally, they so believe in the saying of the town’s appraisal which says: ‘Alakomola lojeremi julo’ meaning that Aro house is the deliverer of children from untimely death and the most benefactor from the town’s deity”. Alhaji Lasisi said this means that it is a must for females to be circumcised to avoid the untimely death of their children.

This reporter was also referred to one Iyamola Elekuru (Ekuru seller) whom many inhabitants of the town said circumcised their daughters. All efforts to see her at home were to no avail. After many tries, she was seen in the market. The reporter who disguised as a student with an ID card of the College of Health Technology, Ilesa, Osun State told her he was researching how circumcision is carried out, as part of the requirement for his final year project.

The old woman said: “I’m not from Aro house or lineage neither a medical practitioner, but I learnt and mastered it. There’s no available child now to show you the procedure of cutting the clitoris. But it is simple. And besides, we usually cut it in the morning before sunset to avoid complications. The reason for cutting it in the morning is to avoid uncontrollable bleeding and dangers that associate with it.”

She said, “There are types of cuttings, we can just cut the tip and leave it but cutting of the tip without pilling it can cause the wound not to heal fast. So, the best option is to finger dress the flesh down the clitoris and peel the flesh before cutting the tip of the clitoris. And after cutting it, tomato leaf is used to stop the bleeding and make it heal fast.”

When asked how they sterilise their cutting tools, she said there is a herbal liquid used to sterilise the tools to avoid infections.

This reporter through the assistance of a native of Emure travelled to Eporo Ekiti,  a neighbouring town. The reporter spoke with a circumciser after introducing himself as a student. The circumciser named Iya Ajebidan, also a wife of all occultic initiates in the town, said she was no longer into circumcision of females noting that she did it before because of the belief that the female child that doesn’t do it will experience mortality during childbirth.

She said, “Today, it shows that it is a mere belief. Although people truly experience mortality during childbirth due to uncircumcision, it is witches that turn it to reality. We have female children outside the town who are not circumcised and they don’t experience mortality during childbirth.”

She said leaving female children uncircumcised would not make her sexually wayward, “but cutting them and not carefully keeping or burying the severed part of the clitoris would make the child unable to control her sexual urge. especially if a dog or any other animal ate it. But we must circumcise male children otherwise he will become impotent and that is why we only do male circumcision especially now that the government has prohibited female circumcision.”

But as this practice holds sway in many parts of Nigeria especially in Southwest states, there are pathetic tales of traumatised victims. According to sources in communities where this practice is common, many victims have died because of complications arising from genital mutilation while others who live are subjected to a life of pain and frustration. The story of one Nneka from Ibadan, was cited as one of the most pathetic cases.

A married woman,  Nneka died as a result of the genital mutilation procedure she underwent as a baby in South East Nigeria some three decades ago. As part of cultural demands and traditional beliefs of that community, Nneka along with other girls was made to go through the process. As a way of preventing her from becoming promiscuous, Nneka’s parents made her undergo type 3 genital mutilation and cutting called infibulation, that is, the removal of all external female genitalia which leaves a small opening for the blood and urine. The procedure like this is usually performed by elderly women under unsanitary conditions, with scissors, razor blade or knives and no anaesthetics were used.

After Nneka got married, a surgical procedure was performed to correct the damage caused to her genitals when she was infibulated as a child. Her genitalia had to be opened up for the passage of penis and baby. Four years after marriage, she was unable to conceive and had to battle with infection traceable to genital mutilation. For her, sex with her husband was always painful experience as a result of the mutilation and as a result, she lost urge for sex because her clitoris and both the labia majora and minora had been cut.

She finally conceived five years after marriage. Again, her female genitalia had to be cut open to allow the passage of foetal head while she remained in serious pain. She was discharged from the hospital after some weeks, but disaster soon struck.

One day while her husband was away at work, the suture of the surgery tore open and she began to bleed. There was no one at home to help her to the hospital. by the time the help finally came, it was too late. She had lost so much blood and she died.

According to Adaramoye, one of the anti-FGM campaigners, there was also the story of Bolade, a nine-year-old girl, who had undergone Type 3 infibulation. The wound healed but it left a huge scar and a keloid in her genitalia. As she grew older and bigger, the keloid kept growing.

“At nine, it was already the size of a big apple,” Adaramoye said. “Her family and friends of the parents had to contribute money to make the girl undergo a specialised surgery to remove the keloid and hopefully still retain the genitalia to be intact for childbirth in future.”

Another anti-FGM campaigner, Gift Abu, told the story of another woman, who died, following the insistence of her family that she must go through the procedure. Gift, in whose arms the woman died, said the victim’s late husband had been the one shielding his wife from the razor of the circumcisers, who eventually had their chance after the man died.

Gift said: “She had been living a normal life without circumcision until she became pregnant for the second time and was due for delivery. While she struggled on her due date, community leaders insisted that it would be a taboo for their daughter to give birth uncircumcised. But as healthcare officers, we refused to allow that. During the melee, there was some delay in giving medical attention to the poor woman. She died in the process.

“Emmanuel, her five-year-old son then became an orphan, as he had lost his father two months earlier. Emmanuel’s father was protecting his wife from being cut, but after he died, the cutters found their chance. They tried to force her to undergo circumcision during labour and told me that I was to blame for her death because I told them not to cut her,” Gift, a midwife at the time, said.

Gift added that since the demise of the woman, the community abandoned Emmanuel, having declared him an outcast for being born by an unclean and uncircumcised woman.

Gift took Emmanuel and found him a safe home with a family friend, Grace, alongside two other girls, Chinwe, seven, and Faith, nine, who had also been rescued from undergoing the female genital mutilation procedure.

Gift said Chinwe and Faith’s mothers refused to have them cut but feared that if the girls stayed with them, they would be snatched and forced to undergo the procedure.

This and many other stories show the plight of women and girls in Nigeria, who have suffered the ordeal of undergoing the age-long cultural practice of female circumcision.

Speaking on behalf of the Oyo State government through Ministry of Health, the state Reproductive Health Officer, Mrs Bilikisu Olawoyin noted that parts of the state government’s activities to eradicate or reduce this barbaric culture to the barest minimum is an Enactment of Violence Against Persons’ law in 2015 that penalized anybody that engages or coerced another person in the act.

Bilikisu Olawoyin

She added that the state government is collaborating with UNFPA-UNICEF joint programme on eradication of FGM through carrying out the following as Training of judiciary, Training of law enforcement agents, Training of Community Champions, Constitution and inauguration of State and  Local Technical Committees, Dialogues with different stakeholder at the community level, Consensus meetings with the community gatekeepers, Male engagement, Sensitization of different actors, Public enthronement via the media and during special occasions.

According to her, nobody has been arrested, arraigned nor convicted in Oyo State as there has not been any report yet.

She hinted that the psychological problem or consequences to FGM victims includes: Reduced  or no sexual satisfaction, no desire for sex, fear and suppression of feelings, feeling of low esteem, Mental and Psychosomatic disorder, Constant feeling of betrayal,  bitterness and anger, Poor interpersonal relationship, Depression, Puerperial, and Psychosis/maternity blues due to trauma during delivery.

On what may be the likely remedies for the victims of FGM to get over their predicament, she said: “We need to note that the part(s) removed cannot be replaced and their natural or physiological functions are gone with them.  However, there is special health management to alleviate some of these effects which can be accessed in the healthcare centres.

And on the aftermath problems of each of these type of FGM to circumcised females, Olawoyin said: “because of Scar formation in all the types which vary according to the type,  the following can occur during childbirth like prolonged / Obstructed labour, Perineal tear, primary  and secondary paturm haemorrhage,

Ceasarian Sections, prolonged hospitalisation and for a problem with sexual life, includes above psychological problems and menstrual disorder, Dysmenorrheoa, Chronic Pelvic Pains

Pelvic Infections / Pelvic Inflammatory Disease, Accumulation of blood in the vaginal Infertility.

She also added that VVF is one of the complications of FGM especially type 3. According to her, Type 3 is total removal of the clitoris, labia manorial and majoral.  In the process of performing it and other types, the circumciser can mistakenly cut the urethra, therefore, link urethra to the vaginal and make urine to be leaking uncontrollably into the vaginal. Secondly, if the wound is infected and not promptly or effectively treated it can also lead to VVF”, she explained.

There are four types of female circumcision. The first type is clitoridectomy, where the clitoris, which is the top part of the private part has been removed completely or by half. The second type is sunna, when the clitoris and inner lip is removed which is also known as Labia minora. The third type is infibulation when the clitoris, inner lip and the big lip, labia majora are removed. In this situation, the edges are stitched together leaving a tiny opening for the passage of menstrual flow as well as urine. The fourth type refers to the unclassified forms of female genital mutilation, which may involve pricking, stretching, cauterisation, or inserting herbs into the vagina.”

Immediate complications include excessive bleeding when the clitoris is removed, whether with scissors or blade.

Women with genital mutilation are exposed to recurrent urinary tract infection and vaginal infections that can prevent them from getting pregnant.

Other complications include pain during sexual intercourse and during the menstrual period and victims like this also stand the risk of contracting HIV. If the patient has Type 3 mutilation, she would have to be cut open again, as she wouldn’t be able to get normal penetration during sexual intercourse.

However, the investigation revealed that the prevalence rate of FGM in South West Nigeria is reducing. 2013 National Demographic Health Survey (NDHS) on National prevalence rate of FGM in Nigeria suggests that Osun was rated 77℅, Ebonyi 74℅, Ekiti 72℅, Imo 68℅, Oyo 66℅ and Lagos State 35℅. But according to 2016/2017 Multiple Indicators Cluster Survey (MICS) report, Osun State recorded 67℅ as highest prevalence rate following Ekiti with 62.6℅, Oyo with 55.0℅, Imo with 51.6℅ and Ebonyi with 43.2℅.

The report further suggests that children between age 0 and 4 years old who are cut in Ekiti are 41.7℅ followed by Osun with 34.6℅, Oyo with 29.6℅, Imo with 22.2℅ and Ebonyi with 5.2℅.

Personal study carried out in Ibarapa area of Oyo State suggests that the prevalence rate in the area is 66.7℅ compared to survey carried out by UNICEF-UNFPA Joint programme on FGM abandonment in 2013 which rated Ibarapa at 84.2 which was ranked 5th above Ibadan North, Akinyele, Ogbomoso and below Oyo West and Kajola local governments in the state.

This reporter carried out a survey with questions to mothers in the communities on whether their daughters are circumcised and if yes, whether it was in the hospital or from traditionalists and what prompted the parents to circumcise their children whether it’s belief on promiscuity or cultural belief.

The report revealed that 66.7 per cent of the parents have circumcised their children which is interpreted as a prevalent rate of FGM in the area. 88.9 per cent of the mothers said the children were circumcised in the hospital while other 11.1 per cent of the mothers said the circumcision was carried out by the traditionalists. 33 per cent of the mothers believes in promiscuity as the reason for circumcising their daughters while other 33.3 per cent of the mothers had cultural belief.

The survey suggests that Ibarapa North which consists of Ayete and Tapa communities has the highest prevalence rate of the FGM with 90 per cent followed by Ibarapa Central with 30℅ and Ibarapa East with 20 per cent prevalent rates.

The above statistical analysis shows that cultural belief on the need to continue with FGM in Ibarapa North is very high and there’s little or no awareness against the practice in this area followed by Ibarapa Central and Ibarapa East. In order to carry out a successful survey in this area, this reporter disguised again as a student.

During an interview with an Anti-FGM campaigner, Mrs. Aduke Obelawo in Osun State, she revealed that FGM in the state is a social norm which embedded in cultural practice just as it was gathered in other states. According to her, the forebearers that bequeathed the culture were oblivious of the dangers inherent in it and therefore see it as a cultural heritage that must be sustained from one generation to the other. But complications the patients suffer afterwards suggest that the practice must be abandoned.

Aduke Obelawo talking to the locals about dangers of FGM

She said, “The reason for stoppage is owed to the fact of complications during childbirth, infections and other problems that can lead to psychological disorder while some die by the complications.”

She added that the narrative is changing, now as more people are now more interested in stopping the practice saying before now, everybody sees female circumcision as a must but now, many people are refraining from it. ” Even the traditional leaders like Kabiyesi and others are interested in putting stop to it while communities are now making public declarations of stopping FGM”.

While revealing how they carried out the sensitization which has recorded success story, Mrs. Obelawo said: “We don’t ask direct questions, because direct questions will give us direct answers. Rather, we start by asking after the well-being of their children and gradually drifted to asking questions bordered on Female Genital Mutilation in the communities. We then continue to ask questions like why they do FGM and they start baring their minds to us.

“The common answers we get are that ‘because we don’t want our children to be promiscuous’, some will say the child’s head must not touch the clitoris, some will say the female child that is not circumcised will be having hitches and some will say the clitoris will be growing like penis and will be dangling the female thigh and therefore competing with male’s penis. Therefore, they see clitoris as an offensive organ that must be cut away.

“And after we have gotten a situational report of FGM in the communities through the questions, we would now start to sensitize them. We will start to make them understand the importance of every human organ God has created. And we will let them understand that as the eyes, leg, nose and other human organs are important also the clitoris they are cutting away is important especially during childbirth”.

According to Obelawo, research has shown that the rate women are dying is alarming. She said they make people in the communities understand that World Health Organisation, WHO as an authority in health sector globally has come up with findings that FGM is mostly responsible for the mortality rate.

Obelawo added that the people in the communities are made to understand that women whose genitalia has been mutilated won’t be able to give birth with ease because the stitched genitalia will inhibit the vulva to expand to allow baby to come out freely and this can cause tear and bleeding. She added that situation like this can lead to both mother and child mortality.

She continued, “In the time past, women were dying but there were no records to demystify the problem. But rather they traced the cause to witches and wizards. But research today has made us understand that practices like FGM are responsible for it.

Meanwhile, the reason for female circumcision and the need for the stoppage is ironical. According to the traditionalists, the essence of circumcision for female folks is to avoid children’s death at birth and to avoid females’ promiscuity. But according to Mrs. Obelawo, a survey which was conducted in Ojuelegba in Lagos among the sex workers revealed that more than 90℅ of them were circumcised.

She said this phenomenon can help to affirm that female circumcision is the cause for promiscuity because the study shows that the cut clitoris doesn’t make circumcised women get satisfied on time sexually.

“The way God created our sex organ is fashioned in such a way that men and women should enjoy themselves. But when a man has affair with a circumcised woman, by the time the man has reached orgasm, the woman is just having the feeling of sexual pleasure. By that time, the man is finished but the woman is just beginning to get aroused and not satisfied. As a result, a woman like this if she doesn’t have self control, will be looking for different men to seek sexual satisfaction from them.

“So, female circumcision is encouraging promiscuity compared to those that are not circumcised. But presently with the rate Anti-FGM sensitization has gone in the communities, they are now teaching themselves on the need to refrain from the practice”, Mrs. Obelawo said.

In his own submission, Dr. Wilson Imongan, Executive Director, Women’s Health and Action Research Centre, Benin City, maintained that promiscuity or prostitution is not determined by whether the clitoris is cut or not.

Dr Wilson Imongan

According to him, finding reveals that many girls who travelled to Europe for prostitution or in Nigerian brothels are circumcised. He said: “circumcision does not prevent girls or women from promiscuity or prostitution. To suffice my point, cutting clitoris has no value and that is the reason it is called mutilation.

One of the essences of circumcision is to reduce promiscuity but it is learnt that cutting clitoris to reduce the sexual drive is of no importance because the sexual drive is not only driven by the clitoris alone. There are other erotic points on the body.

But speaking on why tampering labia area can be more injurious to female folks during FGM procedure, Dr. Wilson said the role of labia is to play mobility role during intercourse but once it is cut, it bears scar and thus inhibits contraction during child labour.

“Even during sexual intercourse, a woman whose labia has been tampered will be feeling pain instead of feeling pleasure during intercourse. Labia that suppose to produce liquid for lubricant will dry and woman like this will suffer dryness during intercourse. The type 4 of female circumcision is the worst of all but what we are saying is that there is no need to do anyone because they have no benefit “, Wilson advised.

A personal survey was conducted on nursing mothers in communities in Osun State by this reporter, it seeks to know the age the mothers were circumcised the aftermath complications and other facts about female circumcision. Among the respondents, 52.1 per cent were circumcised while other 42.9 per cent were not circumcised.

The survey showed that 48 per cent of the mother were circumcised at age of 0-2 years. 4.8 per cent of them were circumcised at age of 3-10 years, 4.8 per cent were circumcised at age of 11-20 years while 42.9 per cent were recorded as nil. The following is the age demography of the respondents: 4.8℅ of the mothers are between age 10-20 years, 38℅ are between age 20-30 years, 29 per cent are between the age of 30-40 years, 10per cent are between the age of 40-50 years while 19 per cent of the women didn’t respond. And lastly, 89per cent of the women had a safe delivery without caesarian section procedure while 4.8℅ of the mothers delivered their baby through Caesarian section procedure. However, 19℅ of the women didn’t respond. The major setback in this survey despite explanation on its need is that the respondents feel inferiority complex for going through caesarian section because it is a popular belief that a woman gives birth through caesarian section are no longer medically fit. As a result, the reporter learnt the respondents gave a false response on whether they delivered their babies through a caesarian section or themselves.

But while reacting to whether female circumcision can lead to a caesarian section or not, Mrs. Osungbade Idowu, a nursing sister said some are not circumcised but delivered their babies through caesarian section. For example, she said: “if the position of the baby is not correct and other complications that have nothing to do with FGM, a woman can give birth through caesarian section. But most women that went through CS procedure are circumcised women whose stitched genitalia doesn’t allow them normal opening of the vulva to allow baby to come out.

Osungbade Idowu

“Our common experience is that the baby’s head causes a tear and leads to bleeding and a reason we refer them to the state hospital because this place is a primary healthcare centre. As a result, women like this will need to go through CS to have other children and we advise them that they stop childbirth early for their good health. Because we discover that circumcised women from age 20 years downwards don’t go through CS but from 25 years upwards has a tendency of going through caesarian section. Remember there are types of female circumcisions. Type 1 rarely go through CS because it doesn’t affect the contraction of vulva during childbirth but for type 3 and 4 which is rare, we don’t even advise them to go through labour at all but caesarian section.

Now that the practice is criminalized, it is a veritable mean to reduce FGM to the barest minimum but presently there haven’t been any recorded cases of arrest, arraignment or conviction. According to Dr. Wilson, though there are some cases of arrests, prosecutions and convictions have not been recorded.

    He maintained that the reason for this is that it usually a family affair where for instance a grandmother who believes so much in the cultural practice takes her granddaughter to the circumciser, would you arrest your mother or mother in law? It is not possible. During a training organized for policemen in Edo State, it showed that most policemen are not aware that female circumcision has been criminalised. As a result of these above reasons, we have not seen one litigation even in Edo State where we started the anti-FGM campaign. The most important thing is that the concerned persons should continue with awareness and sensitization for people on reasons they should stop female circumcision.

    During this investigation, this reporter encountered many challenges in unravelling the perpetrators of this practice. The circumcisers are very defensive especially the traditional circumcisers are ready to fight anyone who they suspect wants to reveal their secret practice of cutting girls with voodoo power.

    Adaramoye said while in Ijeru community of Ogbomoso South Local Government of Oyo State, some people confessed that some circumcisers do sell the cut clitoris from the mutilated female to ritualists for a ritual purpose called ‘Awure’ otherwise known as a ritual procedure to attract fortunes.

    This investigation is supported by the Ford Foundation and the International Centre for Investigative Reporting (ICIR).

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