Some candidates being prepared for the Female Genital Mutilation in Sebei Sun-region. The practice was outlawed in 2010. PHOTO/FILE
On a cold morning in December 1977, during the circumcision period in the Sebei sub-region, Zelida Chelogoi Musoobo was awoken at dawn to face the knife. The 18-year-old was ready. For months, Chelogoi and the girls in her age group had prepared for the day they would be initiated into womanhood. “We would visit relatives and sing some songs with them. Then, in the night, locked up in the house, elderly women would tell us about the tribe’s ritual and the dos and don’ts. They always cautioned us not to share the information with the public,” she says. Chelogoi recalls that no one held her down. However, her father stood over her with a machete (panga). Shaking was not an option. If a girl trembled, in fear, she would be ridiculed for the rest of her life. “As I was being cut, other girls stood in line, waiting their turn. I felt hot white pain. But I could not dare tremble. The entire process is painful but I was treated with herbs and within two months, I was healed,” she reminisces. Now 66, she is a single mother of six, living in Rwanda Cell, Kapchorwa Municipality, in Kapchorwa district. She is a casual labourer, working in people’s gardens to earn a living. She separated from her former husband.
An ancient tradition
Female Genital Mutilation (FGM) includes all procedures that involve the partial or complete removal of the external female genitalia or any other injury to the female genital organs for non-medical purposes. The practice offers no health benefits and can lead to serious complications such as excessive bleeding, difficulty with urination, infections, cysts, menstrual issues, complications during childbirth, and an increased risk of newborn mortality. Most often performed on minors, FGM also infringes on children’s rights. According to the World Health Organisation (WHO), FGM is widely recognised as a violation of the human rights of girls and women. Uganda has the lowest prevalence of Female Genital Mutilation in East Africa. In 2016, the national rate among girls and women aged 15 to 49 was recorded at 0.32 percent, down from 0.64 percent in 2006. Despite the overall low national figures, there are significant disparities in prevalence across different regions and ethnic communities. FGM has been a longstanding tradition in various cultures, notably the Karimojong, Pokot, and Sabiny communities of Uganda. Chelogoi explains that since FGM was part of the culture in her youth, she did not feel ashamed or affected by the practice. “My mother, aunts, and grandmother were all circumcised.
All the women were the same. It was a condition one had to fulfill before marriage. No husband would complain about a woman who had adhered to and upheld our traditions,” she explains. Chelogoi further believes that an uncircumcised woman was always referred to as a girl, adding that in every clan gathering, she would be insulted until she left. Every mistake or strange occurrence would be imputed on her refusal to follow tradition. “An uncircumcised woman was not allowed to climb the granary to pick food and could not attend cultural events. So, because of these insults, even if she is married and had children, she would go back to her parents’ home and get circumcised so that she can enjoy her marriage,” she adds. Anna Cheplito, a 75-year-old former cutter from Kakres Village in Amudat Town Council, Amudat District, transitioned from a practitioner of FGM to an advocate against the practice. This was after she began to understand its devastating impact on women and girls. “I learnt how to cut by watching other women in my village. That was during the Obote I regime in the 1960s. I would sit with them, closely observing how they cut, and as I sharpened my knife, I prepared myself for when the time came for me to start.
By the time (Idi) Amin took over, I had perfected my skill,” she recalls. Gradually, she began performing circumcisions regularly. Sometimes, at the season’s peak, she would cut 20 to 30 girls a day. The practice brought both a sense of mastery and material rewards. “On the days I performed circumcisions, my home would be full of food, gifts such as cows or goats from the girls’ families, and sometimes money. I never lacked,” she says. Cheplito reflects on the societal pressure to mutilate girls, particularly the belief that only circumcised girls were considered to be women. “No man would marry an uncircumcised girl. But once she was circumcised, no matter her age, suitors would come to see her parents,” she explains. However, the toll of the practice was not lost on Cheplito. There were close calls with girls who bled excessively, with one particular memory standing out.
“One time, two girls bled heavily, and nearly died. I rushed to get local herbs, and luckily, I saved them. Such cases were rare, but when they occurred, it was a reminder of how dangerous the practice could be.” Despite her success, Cheplito began to question the practice after a personal transformation. “When I started going to church, I heard sermons about the harm of FGM. The preachers talked about shedding innocent blood and how it would come back to curse us. It was hard to ignore. But even though I heard these, I continued circumcising for some time,” she shares. As Cheplito grappled with guilt, her transformation began at a meeting convened by a local non-governmental organisation. Here, she listened to women who had abandoned the practice share their painful experiences. “Their stories touched me. They openly shared their experiences. I realised that I had been part of something that was causing pain and suffering. I did not want to contribute to that anymore,” she reminisces. Despite the pressure from those around her, the former cutter remained resolute in her decision. “I remember people asking me, 'How are you surviving without the benefits of circumcision?' I told them God was providing whatever I needed,” she says.
From a witness
Local advocacy efforts against FGM are significantly strengthened by the involvement of community leaders and elders, who are now denouncing the practice in public. One such leader is Thomas Aremok, a 70-year-old elder from Lochengenge village in Amudat Town Council. Initially, Aremok viewed the practice as a regular part of life. However, as he grew older and witnessed the effects it had on women, he realised just how harmful the practice truly was. “I have seen how difficult it is for a circumcised woman to give birth because the birth canal is too narrow. Sometimes, the midwife has to cut her again to create space for the baby to pass. It is painful,” he shares. Now, he is an advocate in the fight against FGM, using his voice and influence to challenge outdated beliefs and push for change within his community.
Aremok recalls how he and other community elders took a decisive decision against FGM by warning traditional cutters that if they ever cut another girl, the elders would be the first to report them to the police. This was a turning point in his community. “None of my younger daughters is circumcised. And I am proud of that. As an elder, I feel I must guide others, especially the youth and fellow elders in Uganda and across the border, in Kenya, that I may have misled,” he asserts. Other key factors in the shifting narrative against FGM have been the enactment of Uganda's Anti-FGM Act of 2010 and educating the girl child. Schools play a crucial role in protecting girls from the harmful practices of forced and early marriages, denial of education, and FGM. The support they receive from educational institutions helps the girls build resilience and self-confidence. They return to their communities as mentors and role models, furthering the fight against harmful practices.
Chelogoi’s life today
Some studies have implicated FGM in women’s sexual complications, such as low libido. However, Chelogoi rubbishes these claims. “It depends on how some women are created. Several women in the Sebei community are circumcised but they have high sexual desire compared to uncircumcised women from different communities,” she asserts. Chelogoi adds that sexual intercourse with her former husband was normal, without pain, asking that if it was painful, how would she then safely deliver six children? “Unless one has an underlying problem, I have never seen women develop complications while giving birth because they have undergone FGM. Instead, we have more caesarean section deliveries nowadays, from young uncircumcised women,” she reveals. Several challenges persist, though, such as societal pressure in the rural areas and along the border with Kenya, which forces girls to seek traditional cutters. Girls are often taken across the border for circumcision.
The way forward
When Monitor asked Chelogoi if she would permit her grandchildren to be cut, in response, she advised that if girls are educated, there is no way anyone can force a harmful practice onto them. “If I were educated, I would not have allowed the cutter near me. I am now sensitising people on the vices of FGM. It is unfortunate that in some remote areas, people practice FGM. For instance, a woman in labour can be mutilated after she has pushed the child,” she explains. In Amudat District, the fight against FGM serves as more than just a battle against a harmful tradition; it is a movement towards gender equality and the empowerment of women and girls.
Long-term health complications from FGM
Female genital mutilation (FGM) affects almost all dimensions of the health of women and girls, according to a new study published today from the World Health Organisation (WHO) together with the United Nations’ Human Reproduction Programme (HRP). Health complications of the practice can be severe and life-long, causing both mental and physical health risks.
Published in BMC Public Health, the publication analyses evidence from more than 75 studies in around 30 countries to paint a comprehensive picture of the ways that FGM impacts survivors’ health at different life stages.
It shows that women with FGM are significantly more likely to experience a wide range of complications during childbirth compared to those without, for instance. They have more than double the risk of enduring prolonged or obstructed labour or haemorrhage, while being significantly more likely to require emergency caesarean sections or forceps delivery.
In addition, women with FGM have an almost three-times greater risk of depression or anxiety, and a 4.4 times higher likelihood of experiencing post-traumatic stress disorder.
“This study paints a devastating picture of the manifold health implications of female genital mutilation, spanning mental and physical health and undermining emotional well-being,” said Dr Pascale Allotey, Director of Sexual and Reproductive Health and Research at WHO and head of HRP. “There is a critical need to ensure timely, high-quality health care for survivors, to engage communities for prevention and ensure families are aware of FGM’s harmful effects, alongside serious political commitment to stop the practice and educate and empower women and girls.”
FGM’s immediate risks can be life-threatening and include severe infections, heavy blood loss, as well as extreme pain and emotional trauma. Longer-term consequences for survivors include, as well as those described above, menstrual difficulties; urological complications, including urinary tract infections and difficulty urinating; and painful sexual intercourse.
In addition to various obstetric risks for women, the paper highlights that FGM can also have impacts on babies during or following childbirth. Babies born to women who had FGM are more likely to experience birth complications such as faetal distress or asphyxia, resulting in lower newborn survival rates.
Recognising FGM’s devastating health impacts, the World Health Organisation (WHO) supports efforts to strengthen prevention efforts within the health sector, engaging health workers to educate communities and family members, while providing clinical guidance on effective care for survivours.
Source: www.who.int
