Some 230 million girls in more than 90 countries – predominantly in Africa and Asia – have undergone female genital mutilation (FGM) and can suffer lifelong physical, emotional and psychological scars, an issue that the UN’s sexual and reproductive health agency has been tackling with the support of the international community including the United States.
Zeinaba Mahr Aouad, a 24-year-old woman from Djibouti, remembers the day when, as a ten-year-old, an unexpected visitor came to her house: “She had a syringe, a razor blade and bandages.”
The woman was there to carry out a brutal, unnecessary and – since 1995 in the Horn of Africa country – illegal operation known as female genital mutilation, which involves sewing up a girl’s vagina and cutting out her clitoris.
Even as Zeinaba’s traumatic experience has clouded her memories of that day, she still remembers the sensation of intense pain once the effects of the anaesthetic had worn off.
Difficult to walk
“I had trouble walking and when I urinated, it burned,” she said.
Her mother told her it was nothing to worry about and spoke of the degrading procedure in terms of the importance of tradition.
Like many victims of FGM, Zeinaba came from a vulnerable and poor background, living in a single room with her mother and two sisters in a rundown neighbourhood of Djibouti City.
“There was just a TV, suitcases where we stored our clothes and mattresses on which we slept,” she remembered.
Her mother sold flatbread to passersby, while Zeinaba played with a skipping rope with friends. “We also just played in the dirt.”
230 million mutilations
Some 230 million women and girls worldwide have undergone mutilations according to data released by the UN’s sexual and reproductive health agency, UNFPA, and it is on the increase as ever younger children, sometimes below five years old, go under the knife.
“A baby doesn’t talk,” explained Dr. Wisal Ahmed, an FGM specialist at UNFPA.
It’s often thought of as a one-time procedure, but in reality, it involves a lifetime of painful procedures that continue into adulthood.
“The woman is cut again to have sex, then sewn back together, then reopened for childbirth and closed again to narrow the orifice once more,” said Dr. Ahmed.
Tackling harmful traditions
UNFPA and its international partners have worked to put a definitive end to FGM and although these efforts have contributed to a steady decline in the rates at which the procedure is performed over the past 30 years, the global increase in population means the number of women affected is actually growing.
UNFPA continues to work with communities that still engage in the practice about the short and long-term effects.
The agency’s work has been supported across the world over a number of years by the US Government, which has recognized FGM as a human rights violation.
It is not a problem which affects just developing countries. According to US State Department figures, in the US itself, approximately 513,000 women and girls have undergone or are at risk of FGM.
Support from men
In Djibouti, in 2023, the US provided around $44 million in foreign assistance.
UNFPA confirmed that FGM programmes supported by the United States have not yet been impacted by the current stop work orders, adding that “US support to UNFPA over the last four years resulted in an estimated 80,000 girls avoiding female genital mutilation.”
Local networks
Zeinaba Mahr Aouad now works as a volunteer for a local network launched by UNFPA in 2021, which numbers over 60 women and provides support to local women’s health and rights activists.
She also visits underprivileged areas of Djibouti to raise awareness among young people and future parents, both women and men, of the harmful effects of FGM.
“Because it’s not just the woman who participates in these practices: without the agreement of the man by her side, it couldn’t be done”, she said.
