Warning: the topic of this blog is rather graphic and disturbing. Feel free to skip this one and move onto the next one, or do your own research about Female Genital Mutilation (FGM) and its effects worldwide.
An ancient tribal ritual, FGM has been around for centuries. Prevalence rates among women in The Gambia are around 80%, among the highest in Africa but not the highest. Formerly called female circumcision, it is the act of cutting (and/or sewing) a woman’s genitalia to prevent sex before marriage. It was performed in Gambia before the introduction of Islam, but has been compounded by Islamic interpretations (or misinterpretations, this is not really my area of expertise). In modern times, the international community has denounced the practice as a violation of human rights and organizations like the UN have encouraged legal measures to be taken in countries in which the practice is prevalent. The Gambia was one of the last countries to hold out on legislation, finally declaring the practice illegal in 2015. Since then, offenders have been jailed but it is also the fear that others have continued their practice in secrecy. There are 4 different classifications of the practice, ranging from Type 1 – cutting of the clitoris, to Type 4 – cutting and then stitching the organ shut. FGM is performed by female elders, and differs based on tribes and customs. My village, predominately Wolof, does not perform the practice. However minority tribes in the village may seek the practice elsewhere. FGM is a tricky area where we as Peace Corps see the collision of health and culture. The practice has numerous negative health outcomes, but as outsiders some community members may not be receptive to our opinions. We partnered with a local NGO GAMCOTRAP to hold a regional Day of Action, to bring PCVs together with female counterparts to work together to increase awareness. The day was complex. Members of the Mandinka tribe flat out rejected our ideas and said they would continue the practice. Some Fulas were surprised by the negative health effects, as they had experienced them but didn’t know the root cause. Some counterparts wanted to go home and host a community meeting about the issue, others just wanted to come and be informed. As Peace Corps we have to meet people where they are, not force our ideas onto them. I led a session on medical impacts of FGM (short term: infection, hemorrhage, urine retention; long term: complications during sex, pregnancy, and childbirth – the leading cause of maternal mortality, post-partum hemorrhage) with a Community Health Nurse and a Nurse Assistant/Midwife (who is also my host sister). Then we had time to discuss, ask questions, action plan for further activities, and act out skits regarding the topic.Culture is important. But when cultural practices harm people, they must be evaluated. We should grow, change and evolve, not just continue on doing as we did before.