Bolgatanga, May 26, GNA – “I bled more than one week, and it took more than a month for the pain to subside. It is more than three months now and the wound is not completely healed.”
“I could not wear a pant at the beginning, even now every three days, I always boil water and sit on it for the steam to cool down the itches I experience around my genital region.”
This is the ordeal Rahinatu Ayamba (not real name), a 15-year junior high school pupil, who hails from the Pusiga District of the Upper East Region, is currently going through.
She is not suffering from any natural ailments or results of any accident but a dehumanising act; Female Genital Mutilation (FGM). She and 14 other girls from her community were compelled by their parents to undergo that act in December 2021.
She told the Ghana News Agency (GNA) that her parents forced her into it against her will.
“After the cutting of my clitoris, they used some herbs to prepare a black concoction and used a rag to apply it on the sore. They also used hot water to clean the place twice a day; morning and evening, but it was painful anytime I had to urinate, I suffered as the pain was so severe,” she said.
Sahadatu Akudugu (not real name), a 20-year-old survivor of FGM from Pusiga, told the GNA that she could not write her end of term examination in primary two, 11 years ago, because she was circumcised and could not walk to the school.
“When they cut my clitoris, I could no more attend school and I could not write the end of term exams and as a result I was not promoted to primary three. My relatives and friends used to mock me when I had not done it and that was why my parents sent me for it to be done,” she said with tears rolling down her cheeks.
Amid global efforts towards achieving the Sustainable Development Goal (SDGs), many young women in rural northern Ghana are still locked up in FGM.
Ghana’s situation
The GNA gathered that girls between ages nine and 15 suffer this cruelty in many rural communities in northern Ghana.
The United Nations Children Emergency Fund (UNICEF) revealed that four per cent of Ghanaian girls and women, aged 15 to 49, have undergone FGM, with the Multiple Indicator Cluster Surveys also indicating a 2.4 per cent rate among the same age group.
Furthermore, available data has shown that FGM is practiced in all the regions across the country with Upper West Region (41.1 per cent) and Upper East (27.8 per cent) being the highest, followed by Bono and Bono East regions.
Aisha Seidu, 35, a survivor of FGM from the Wa Municipality of the Upper West Region and a mother of two, said she was circumcised in 2002 when she was 15 years and since then she had been having complications after childbirth, with pain anytime she had sex with her husband.
She said had it not been for the understanding and support of her husband, their daughter of six years would have been circumcised too.
“When I gave birth to my first baby, I bled for two months due to the cutting. After the circumcision they blended ginger and cola and added some herbs to prepare a concoction and applied on it and after three days I still could not walk. I was finally sent to hospital where we spent over GH₵1,500.00, in 2017 but I didn’t get immediate relief.”
“One of the two girls who were circumcised with me cannot have normal delivery unless through caesarean section. I am lucky I had two of my babies through normal delivery.”
Health implications
Dr Aiden Saanwie, a Gynaecologist, Upper East Regional Hospital, Bolgatanga, disclosed that FGM could have both short and long-term effects on the victims including severe pain, shock, haemorrhage, tetanus, urine retention, ulceration of the genital region and injury to adjacent tissue, wound infection, urinary infection, fever, and septicemia.
He said if the bleeding was excessive, coupled with infection, it could cause death.
“Long-term consequences include complications during childbirth, anaemia, formation of cysts, keloid scar, damage to the urethra resulting in urinary incontinence, dyspareunia (painful sexual intercourse), sexual dysfunction, hypersensitivity of the genital area and increased risk of HIV transmission as well as psychological effects.”
Ms Dorah Kulariba, a Midwife and the Upper East Regional Adolescent Coordinator, said many women who had undergone excision suffered prolonged labour due to obstetric fistula, posing risk to the mother and baby.
She said apart from maternal health problems to be experienced later in life, mental and psychological trauma was considered the most serious complication.
According to UNICEF, treatment of health complications in about 27 prevalent countries is estimated to cost about $1.4 billion annually and projected to rise to $2.3 billion by 2047 if action is not taken to end the practice.
Cross border activity
The practice is a cross border phenomenon, particularly among communities bordering Burkina Faso and Togo, with Burkina Faso having prevalence rate of 76 per cent.
Places including the Kassena-Nankana West, Pusiga, Bawku, Garu and Tempane in the Upper East Region, Wa Municipal and Wa West in the Upper West Region, and Sawla-Tuna-Kalba in the Savannah Region have been identified as major places for FGM practice.
Many Ghanaian women along these areas have undergone the practice and many more are at risk. Most of the incisors are said to come from Burkina Faso.
For instance, in 2018, the Ministry of Gender, Children and Social Protection lamented the resurgence of FGM in the Upper East Region with an alarming average of 27 per cent rise in prevalence and the practice widespread in Pusiga and Bawku, having 61 per cent prevalence.
Threat to SDGs
As the world continues to fight towards gender parity to achieving the Sustainable Development Goals by 2030, FGM remains a bane to such efforts, especially the SDGs Three and Five, and Ghana risks losing out on the target if pragmatic measures are not taken to ensure the practice is eliminated.
The SDG-Three is “To ensure healthy lives and promote well-being for all at all ages,” while the Five focuses on “Gender Equality.”
Mr Tenii Mammah, a Programme Specialist and Head of Decentralised Office of the United Nations Population Fund (UNFPA), Tamale, says FGM is not only a human right abuse and a sexual and reproductive health issue but also gender-based violence, adversely affecting the growth and development of women and girls.
He says although the UNFPA has launched a campaign against the practice where it is collaborating with various stakeholders, including the Ghana Health Service, Ghana Education Service, Department of Gender, Civil Society Organisations, and traditional authorities to develop communication messages to educate the public, collective effort was needed to tackle the canker.
What is FGM
The World Health Organisation (WHO) says FGM is a practice in traditional cultures that involves the partial or total removal of the external genitalia (clitoris) of girls and young women for non-medical reasons.
While there are varying traditional reasons for the practice, including reducing the sexual edge of girls to prevent promiscuity, placing high economic value on circumcised women among others, the practice is recognized, internationally, as a human right violation with long term complications to women’s physical, mental, sexual health and wellbeing.
Ms Charity Batuure, the Upper West Regional Director, Department of Gender, said there was a new trend to the practice where concocted herbs mixed with shea butter was applied on the clitoris of a newborn within one month of birth.
“The child then grows up without the clitoris,” she lamented.
Global concern
The WHO notes that at least 200 million women and girls, globally, have undergone FGM and about three million girls are at risk of experiencing FGM annually with the prevalence in Africa, the Middle East, and Asia.
The UNICEF and UNFPA revealed in 2019 that an estimated 4.1 million girls, globally, were at risk of FGM each year.
Despite numerous international and local laws criminalising the practice, with global efforts to end violence against women and girls, many girls are still subjected to FGM in Ghana.
Legal Regime
The Children’s Act of 1998, Act 560, and the Criminal Code Amendment Act of 2007, FGM Act 741, have criminalised the practice in Ghana but the lack of political support has affected their effective implementation.
Also, FGM was outlawed in 1994 while Article 39 of the 1992 Constitution stipulates, in part, that traditional practices that are injurious to a person’s health and wellbeing are abolished.
Way forward
There must be zero tolerance and an end to FGM and all dehumanising cultural practices if the country is to make headway in achieving the SDGs, particularly goals Three and Five, to ensure good health and wellbeing, and gender equality by 2030.
Apart from the need for government to prioritise and increase allocations to fund FGM programmes, all anti-FGM interventions must be decentralised and involve the local authorities, gender and human rights groups and the communities engaged in the practice, especially the traditional leaders, in the planning and implementation processes.
“This practice is an entrenched one, which has been done for several years, so it needs sustained sensitisation and enforcement of the law to be able to eradicate it,” Mr Mammah, the UNFPA Programme Specialist (Tamale), said.
This negative age-old tradition needs to be addressed from the cultural and gender perspectives. As such all strategies and interventions through a well-coordinated manner, from all stakeholders, must be channeled through the cultural and gender context to help address the canker.
