Are we doing enough to attain zero tolerance to FGM/C?

by Amref Health Africa

By Dr Tonny Kapsandui

So a good part of the world is currently abuzz with the FGM/C stories: the what, who, the how and everything there is to talk about FGM/C.

February 6 is the International Day of zero tolerance to FGM/C and indeed the hype is on around FGM/C.

While growing up deep in the steep cold slopes of mountain Elgon back then, the name I knew for this practice was “female circumcision”; the season of which was highly anticipated with excitement, expectations of celebrations and promotion from girl-hood to woman-hood.

Nowhere during the year did I ever observe tangible peer pressure at play for the candidates ear-marked for the ritual.

The community embraced it; each family with a candidate preparing early in the year as the excitement and anxiety piled leading up to the October to December period of every even year.

This was the moment of truth for the girls soon to be initiated to a moment of pride, woman-hood.

Worth noting is the fact that nobody therein saw anything wrong with it. That was my region of Sebei, whose people are the graceful Sabinys, the only Kalenjin group in Uganda (the rest being in Kenya).

To the north of Sebei, the Tepeth and the Kadam ethnic groups tacked up in the rugged mountains of Moroto and Nakapiripirit districts of Karamoja practice FGM/C every year timed for the harvest season. At the border district of Amudat, the Pokot do the same every year.

But what is FGM/C? The acronym stands for “Female Genital Mutilation/Cutting”. Do I have a problem with this description in itself and how I think it has impacted the fight against this practice? Maybe, but let us save that discussion for another day.

FGM/C is classified as a traditional harmful practice, and according to the World Health Organization (WHO), there are no health benefits to be derived from FGM/C, except only harm.

FGM/C is defined as any procedure that is intentionally undertaken with the capacity to alter or cause injury to the female genital organs for non-medical reasons.

Estimates put more than 200m girls and women currently alive in 30 countries having gone through FGM/C in a variety of the forms it is undertaken, and an annual 2m are at risk globally (WHO).

FGM/C has been studied and researched to detail over the years. A lot is documented for our reading and understanding.

It is also true that a lot of work has gone into interventions to eliminate the practice. WHO, in 1997, issued a joint statement against the practice of FGM/C together with the United Nations Children’s Fund (UNICEF) and the United Nations Population Fund (UNFPA).

Since then there have been reports of reducing prevalence and incidence of FGM/C. Research shows that, if practising communities themselves decide to abandon FGM/C, the practice can be eliminated very rapidly (WHO).

My question then is: “Are all anti-FGM/C programmers taking this firmly founded conclusion seriously?”

In Uganda, reduction in FGM/C prevalence has been reported thanks to the various stakeholders and government line ministries (of Health and Gender, Labor and Social Development), working with law enforcers (the police) in anti-FGM/C work.

The Uganda Demographic Health Survey (UDHS) shows the following trends: 1% national prevalence in 2006, 1.4% in 2011 shortly after the release of the Prohibition of FGM/C Act in 2010 by Parliament of Uganda, which criminalizes the FGM/C practice, persecutes and punishes the mutilators, and protects the girls and women from any discrimination resulting from the abandonment of the practice. Has the law been prohibitive enough as anticipated?

In 2016, UDHS reported FGM/C as low as 0.3%. Before we rest on our laurels, it is important to note that the regional/local prevalence is much higher, given that FGM/C practice is confined largely to tribes in the northeastern corner of the country.

The FGM/C Survey Report (UBOS, 2017) showed the regional prevalence at 27% (3 in every 10 women aged 15-49 years) and districts prevalence thus- Karamoja region has Moroto at 52%, Nakapiripirit at 49% and Amudat at 42%; Sebei region has Bukwo at 27.7%, Kween at 21% and Kapchorwa at 13%.

This is still a very high prevalence at the regional level and calls for more concerted multi-sector community-owned and community proposed interventions.

Can we do more and eliminate this harmful practice from these communities of Sebei, Pokot, Kadam, Tepeth and the migrant Somali and other communities in Uganda? The answer is an absolute “YES WE CAN”.

I invite all stakeholders to pledge to undertake this challenge as we remember FGM/C and its harmful effects on the health, dignity and rights of girls and women of Uganda and the world on the 6th of February, 2020.

The writer is a medical doctor, a public health specialist and women’s health advocate currently working as a programme manager at Amref Health Africa in Uganda.

Article first published on

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