Ann-Marie Wilson reports on the global incidence of FGM and its toll on women.

Meeting Manha (1) was my first experience of the horrors of Female Genital Mutilation (FGM). I was working in North Sudan. Manha was just ten years old and pregnant as a result of rape. She had undergone FGM and was unable to give birth naturally. Her terrible suffering spurred me on to devote myself to ending the practice. After studying FGM, working on anti-FGM projects and gaining birth attendant and fistula experience, I founded 28 Too Many.

This name reflects the 28 or so African countries where FGM is practised – that's 28 too many. Our focus is on research that enables local initiatives to end FGM. As well as working closely with other charities to stop violence against women (VAW) and other harmful traditional practices (HTPs).

My dream is that if one woman does not cut her daughter, then (as a mother herself) she will choose not to cut her daughter and then that daughter in turn will choose not to cut her own daughter. This breaks the cycle of FGM, and over the course of five generations I believe that FGM could be permanently eliminated.

Global statistics

FGM has been making headlines in Britain but the problem goes much wider and deeper. Recent reports have shown that at least 125 million girls and women have experienced FGM in Africa and the Middle East, As many as 30 million girls under the age of 15 may still be at risk over the next decade. (2)

Shockingly, this equates to one women or girl undergoing FGM every ten seconds. (3) FGM is also carried out amongst diaspora communities within Europe, North America, the Middle East and Australia. Estimates show that 66,000 women and girls have undergone FGM in England and Wales, while 24,000 girls under the age of eleven are at risk of undergoing it. (4)

In Africa, the highest prevalence of FGM occurs in Somalia where an estimated 96.7% of girls aged 15-19, and an estimated 98.9% of women aged 35-39 have been cut. (5) More positively, change is being made in other African countries like Kenya where the prevalence rate for FGM in 15-19 year olds has dropped from 37.6% (1998) to 27.1% (2008-9). Although measurable progress is now being seen in a number of countries, the existence of the practice itself still shows that much work needs to be done to eliminate it worldwide. (6)

Health implications

There are harmful physical and psychological effects that women and girls suffer following FGM. The most severe immediate consequence can be death caused by haemorrhaging and/or shock after the procedure. Women and girls are also at risk of contracting tetanus because of the unsanitary conditions in which FGM is often carried out. The situation is made worse where the appropriate medical treatment is not available or there is insufficient medical knowledge to correlate it with the contraction of infection.

Women who have undergone FGM are at risk of shock, open sores, cysts and cheloid scarring and have an increased risk of contracting HIV/AIDS. Infibulated girls commonly suffer from bladder and urinary tract infections. Pelvic inflammation, painful abdominal cramps and internal infections are commonly experienced by girls once they have started their menses.

FGM can also cause infertility for women due to womb infection, (7) caused by stagnation of menstrual blood within the vagina. FGM also causes severe complications for both women and babies during childbirth. Postpartum haemorrhage, obstructed labour, prolonged hospitalisation following the birth of the child and increased need for caesarean deliveries are all common complications that occur for women giving birth. In Africa, FGM causes an extra ten to twenty deaths per 1,000 deliveries. (8) Girls who have undergone FGM also experience psychological trauma including feelings of betrayal, shame, hopelessness, post-traumatic shock and depression. (9)

Religion and FGM

It is important to note that FGM is not a requirement within any religion. Some Islamic scholars claim that it is allowed by the teachings of the prophet Muhammad, but others, including the leading scholars of Al Azhar in Cairo and the Chairman of the Shari'ah Islamic Council in the UK, say that it is not allowed. In both Christianity and Islam there is emphasis on the fact that the human body has been created by God, and that we are encouraged to look after the body and not mutilate it in any way. (10)

Through work carried out by the church and religious authorities, myths surrounding FGM can be challenged and dispelled. The evangelical tradition draws upon Scripture in order to support taking action against harmful acts such as FGM:

'Learn to do right; seek justice. Defend the oppressed. Take up the cause of the fatherless; plead the case of the widow.' (11)

This scriptural perspective is empowering people to use 'charity from the mission of God on earth… to proclaim a gospel of grace, forgiveness and love', (12) so that the suffering of women and girls who have undergone FGM does not go ignored. The role of the church then is to teach and discipline people so that they can learn about FGM and challenge those who support the practice.

The Bible's account of creation story states that once God had created the world 'God saw all that he had made, and it was very good.' (13) This highlights the perfection of God's creation, and so by implication women's bodies are not to be harmed or mutilated through HTPs as it denies them of their natural rights as mothers, wives and humans. (14)