PRESENTED TO THE NATIONAL ASSEMBLY JOINT COMMITTEE ON 8TH MAY 2024:
Introduction:
According to World Health Organizations definition, FGM/C refers to the partial or total removal of external female genitalia or other injury to the female genital organs for non-medical reasons. FGM/C is a harmful practice that violates the human rights and undermines the health and well-being of girls and women worldwide. WHO estimated that over 200 million girls and women worldwide have undergone FGM/C, and approximately 3 million girls are at risk of undergoing the practice.
Types of FGM in The Gambia
· Type I: Excision of the prepuce, with or without excision of part or all of the clitoris.
· Type II: Partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora.
· Type III: Infibulation of part or all of the external genitalia and stitching/narrowing of the vaginal opening, with or without the removal of the clitoris and labias.
In The Gambia, FGM/C is also referred to as female circumcision by the Women’s (Amendment) Act 2015 as commonly known in Gambian communities. According to the Demographic Health Survey (GBoS2019/2020), 73% of women aged15-49 are circumcised, a slight decrease from 2013 DHS (75%).Despite national efforts to eliminate the practice in The Gambia for almost four decades (since 1980s), FGM/C persists in many Gambian communities due to deep-rooted traditional, social, and religious beliefs. According to the Demographic Health Survey (DHS) 2019/2020, the most common type of FGM/C in The Gambia is Type II (some flesh removed), with 73% of circumcised women undergoing this procedure. Seventeen percent (17%) of women underwent Type III procedure (also known as infibulation or sealing). Only 1% of women underwent Type I procedure (clitoris nicked). Thus, the DHS 2019/2020 confirmed to us that what more than 90% of our women and girls who underwent FGM/C have been subjected to type II and III which both have serious health consequences on them.
FGM/C IMPACT ON THE HEALTH OF WOMEN AND GIRLS
FGM/C poses severe physical, psychological, and emotional consequences for affected individuals. Evidence from researches conducted in The Gambia and other parts of the world have showed that the practice violates women and girls’ sexual and reproductive health and rights including right to choose and dignity. Immediate risks include severe pain, bleeding, infections, and even death, while long-term complications encompass chronic pain, urinary problems, sexual dysfunction, obstetric complications and psychological trauma.
Honorable NAMs, in 2017 clinical research on the ‘Obstetric Outcome of FGM’ on pregnant women in The Gambia was commissioned by Network AgainstGender Based Violence (NGBV) and ActionAid International The Gambia in partnership with the Ministry of Health. The study was conducted in four major health facilities which include Edward Francis Small Teaching Hospital (EFSTH), JammehFoundation for Peace Hospital (JFPH), now call Bundung Maternal and Child Health Hospital, BrikamaDistrict Hospital, and Bansang General Hospital. The study was done by Gambian Doctors and Nurse Midwives working at the above-named hospitals. The on-site Investigators were Dr. Neneh Bah and Dr. Awa Jah of EFSTH, Dr. Dado Jabbi of Jammeh Foundation for Peace Hospital now known as Bundung Maternal and Child Health Hospital, Dr. Lukas Jatta of BrikamaDistrict Hospital and Dr. Momodou T. Nyassi of Bansang Hospital. They were supported by sixteen senior Nurse Midwives who were working at the labour wards of these hospitals. These Gambian doctors and midwives were trained and guided by Specialists including Dr. Patrick Idoko, a Gyneacologist and Dr. Mustapha Bittaye, a Gyneacologist and Research Clinician at EFSTH and Dr. Olubukola Idoko, a Paediatricians and Research Clinician at MRC amongst others. A total of 1,569 women participated in the study.
➢ 23% had no FGM/C
➢ 77% had FGM/C out of which:
1) 23.8% had undergone FGM/C type I
2) 44.8% had undergone FGM/C type II
3) 8.4% had undergone FGM/C type III/IV
➢ Only 6 cases of type IV FGM/C were recruited into the study.
➢ The age range of study participants were from 18to 46 years.
➢ 39.2% live in the rural areas while 60.8% lived in urban areas.
According to the report of this clinical study on FGM:
• Women with FGM/C are more likely to have blood loss of 500ml or more after delivery and the risk increases with the severity of the type of FGM/C.
• Women with FGM/C are more likely to have undergone operation during childbirth with the risk increasing based on the severity of the FGM/C type.
• Women with FGM/C are more likely to have perineal laceration (tears) or episiotomy (a cut through the area between the vaginal opening and anus to aid childbirth) with the risk increasing based on the severity of the FGM/C type.
• Most women suffer in silence as they hesitate to express pain related to childbirth and to FGM/C, noting that open discussion of sexual and reproductive health is hindered by norms related to privacy and projecting strength.
• Women are not the primary decision makers on matters Concerning their own sexual and reproductive rights.
OUR POSITION
The position of NBGV, and larger CSOs in The Gambia is for the ban on FGM/C to remain. Based on the evidence presented above and the ‘Do No Harm’ principle of the medical profession, FGM/C should not be medicalized. The National Assembly should listen to the voices of reason, and consider the health implication highlighted by professional health workers, and reject the Women’s (Amendment) Bill 2024. This will empower affected individuals and communities, strengthen the health rights and dignity of survivors and facilitate the eradication of the practice.
Honourable NAMs, various justifications, both socially and religiously have been attached to the practice of FGM. However, the reasons given cannot be justified considering the evidence that has been presented to you which showed the practice violates women’s sexual and reproductive health and rights.
As a human rights network, NGBV promotes and defend right to religious practice. The campaign to not lift the ban on FGM/C is not anti-islamic, rather based on the Islamic teaching of Do No Harm. Furthermore, from an Islamic point of view, Islam prioritizes health. This is why, Muslims who are not healthy enough to fast or to perform Hajj are exempted from these religious obligations based on professional medical doctor’s advice. Based on this Islamic Do No Harm principle, the practice of FGM/C should be banned in The Gambia.
OUR CALL:
In our quest to address the FGM/C problem, NGBV and the CSO Coalition call on the National Assembly and the Executive to:
• Ensure The Women’s (Amendment) Act 2015 banning FGM/C remains as a law in The Gambia to protect Gambian Women and Girls from FGM/C.
• Amplify community engagements and awareness raising on the health consequences of FGM/C to empower communities/ constituencies to abandon the practice.
• Strengthen police and other law enforcement agencies to maintain and implement the Women’s (Amendment) Act 2015 to deter communities from practicing FGM/C and protect women and girls from the harmful effects of FGM/C.
In that regard, it is imperative on Government of The Gambia in general and the National Assembly to be precise, as lawmakers and representatives of people including women and girls to protect their fundamental right to health. Over the past few months, The Gambia has been tested on the FGM/C issue as we were tested in the past during the impasse after the 2016 Presidential election and as a peace-loving people we passed the test. Today we are tested again and as the primary duty bearer, the National Assembly, we urge you to look at the best interest of our women and daughters by critically considering the plight and rights of innocent souls, our little girls, who are vulnerable and could not protect themselves or make a choice for themselves in this matter. We appeal to you to selflessly think of them while you make a decision to ensure that you are guided by the “Best Interest Principle” as enshrined in the Children’s Act 2005.
CONCLUSION:
Understandably, The National Assembly has a tough responsibility. A responsibility that includes shaping society, its culture, and behaviour. FGM/C is a deeply-rooted cultural practice, and many also argued it’s a religious one. However, the decision National Assembly Members should take in this matter has been made by the 5th legislature – banning FGM/C. Today, the 6th legislature has responsibility to maintain the ban in order to protect women and girls in this country.
Mr. Fallu Sowe
National Coordinator
Network against Gender Based Violence
8th May 2024.
Reference:
WHO Website: https://www.who.int/health-topics/female-genital-mutilation#tab=tab_1
Demographic and Health Survey (GBoS2019/2020): https://dhsprogram.com/pubs/pdf/FR369/FR369.pdf
Obstetric Outcome of Female Genital Mutilation 2017: https://gambia.actionaid.org/sites/gambia/files/publications/Obstetric%20outcome%20of%20FGM_final.pdf
TELEPHONE WEBSITE TWITTERFACEBBOOK
(+220)4398122 WWW.NETWORKGBV.ORG @NGBVTHEGAMBIA NETWORK AGAINST GENDER BASED
VIOLENCE THE GAMBIA
NO TO SEXUAL AND GENDER BASED VIOLENCE
NETWORK AGAINST GENDER-BASED VIOLENCE – THE GAMBIA
CHAIRPERSON: MUSUBAKOTO SAWO: (+220)3934389
NATIONAL COORDINATOR: FALLU SOWE: (+220) 9933491/7638129/3453525