There are about 115 million people in Ethiopia—that is about a tenth of the total population of Africa. Half of the people in Ethiopia are females, and half of the female population are circumcised. Female genital mutilation (FGM) or female circumcision, a tradition that is over 5000 years old, still maims girls at a young age. Female circumcision is the partial or complete removal of the external female genitalia. Sometimes, female circumcision involves infibulation, which is the stitching of the labia majora. This stitching aims to protect the virginity of the girl child.

In 2018, after three years of implementing our program to combat female circumcision with UNICEF, we met with gynecologists collaborating with the Espoir Foundation to evaluate the effectiveness of the work we have done and to brainstorm on possible options to further develop our charity program.

Our focus was mainly in the regions of Afar and Somali, where over 90 percent of the female population is subjected to some form of circumcision and in constant need of medical care. Before our Foundation’s intervention, these regions had only two gynecologists per five million people; but after our involvement, the number of gynecologists per five million people increased to five.Local doctors found it difficult to give us an exact answer when we asked them about the statistics of FGM in the regions. The regions have a lousy birth registration system, with only three children out of 100 receiving a birth certificate before age 5. In this system, it is impossible to know with certainty the number of girls that are subjected to mutilation.  On this account, the number of girls that die as a result of short-term consequences of mutilation is unknown. 

The procedure of FGM is brutal, crude, and unhygienic because it is usually done outside the hospitals and often without anesthesia and aseptic precautions. Considering the dysfunctional system of birth registration in these regions, the extent of disparity between the official FGM statistics and the real numbers can only be imagined. 

Grassroots Campaign

The real work to be done is at the grassroots level, and medical professionals—doctors, nurses, and other people with at least basic medical training—are the forerunners. Medical practitioners are best positioned to sensitize religious and community leaders about the enormous risks associated with female circumcision and infibulation. We believe that incessant sensitization on FGM can effectively attenuate the strength of female circumcision, or at the very best result in the practice of less mutilating practices such as the “Sunnah circumcision,” which only cuts the clitoris or its hood. The Roadblocks Female circumcision is commonly performed by traditional circumcisers. Although FGM is officially illegal in Ethiopia and strongly disapproved by religious leaders, traditional circumcisers still perform FGM because it is their only source of income. This explains why it is difficult to dissuade circumcisers from performing this procedure.

In Search of Allies

The fight against FGM is a formidable one that needs the cooperation of all stakeholders. This fight needs the corporation of traditional circumcisers since they perform circumcision. The local men are also instrumental in the fight against FGM because of their role as guardians of tribal traditions. According to local doctors, many men bring their wives to the clinics for the treatment of the consequences of female circumcision. However, the sad reality is that many men still believe that female circumcision ensures women’s virginity before marriage and also protects them from rape, which unfortunately is rampant in the remote regions of Ethiopia.  Traditional circumcisers and local men are therefore indispensable allies in the anti-FGM fight.

While women should be natural allies in the anti-FGM fight, the reality is that many of them, directly or indirectly, support this harmful practice. Even some women, especially grandmothers, put pressure on reluctant men to circumcise their daughters because they believe circumcision increases the chances of these girls finding husbands. Another erroneous belief is that female circumcision promotes fidelity and makes sexual intercourse more fun. Our gynecologists have observed that many female patients dread and avoid surgical procedures because of FGM-related post-traumatic stress syndrome (PTSD). What is even more intriguing is that these patients don’t often believe that their illnesses are related to circumcision. If FGM would become a thing of the past, women must join in the fight against it.

An Integrated Approach 

The Ethiopian government’s hope to completely solve the FGM problem by 2025 is very commendable but ambitious. It is hard to believe that a 5000-years-old practice will go into oblivion in less than a decade. It will take more than advocacy campaigns to tackle FGM. Through the work of our Foundation, there are now six gynecologists per five million people in the regions. Our imminent plan is to increase the number of qualified specialists in the regions, launch a network of mobile clinics, and provide not only treatment for consequences of mutilation but also eliminate FGM practices using long-term educational campaigns and community mobilization. It is only through such an integrated approach that the first positive changes can be achieved by 2025.