There is a case from Dr Morissanda Kouyaté’s career that stays with him.
In 1983, Kouyaté, then 32, was working at a village hospital in Guinea when 12-year-old twins, Hassantou and Housseynatou, were brought in. Through wails, their relatives told Kouyaté that earlier that day, the girls had been taken into the bush to be submitted to genital mutilation. Now, they were barely conscious and bleeding heavily.
For the next 48 hours, Kouyaté and his colleagues worked to try to save them; his own wife came and donated blood. But the girls died.
“We did everything,” he says. “I was very sad because at that time, I had my two daughters who were very young. I thought about the people who had lost their twins.”
Kouyaté wrote a letter to the Guinean ministry of health, recounting what had happened and that this practice must be controlled. His letter ended up at the headquarters of the World Health Organization and Kouyaté was invited to Geneva to learn more about female genital mutilation (FGM).
Since then, Kouyaté has dedicated much of his life to fighting FGM and was instrumental in founding the Inter-African Committee (IAC), which brought 16 countries together to focus on practices affecting the health of women and children. In 2003, the IAC organised a conference where several first ladies declared 6 February as a day to mark zero tolerance of FGM, something adopted by the UN in 2012. In 2020, Kouyaté, received the Mandela prize for his work.
Kouyaté, who last year became minister of foreign affairs for the Republic of Guinea, was one of the few male campaigners in the early 1980s. Now, he says many more men are involved, something he believes is essential if FGM is to be eradicated by the UN’s target date of 2030.
“If you consider FGM a female issue, that is minimising the effect of this practice,” he says. “It is a violation of human rights; men must be involved in the fight against that. Of course women and girls are direct physical victims but men are indirect victims – the consequences of the practice affect men.”
In Somalia, where an estimated 99% of women have been mutilated – the highest level anywhere in the world, activist Hassan Istiila, 30, is often asked why he, as a man, is so involved in the anti-FGM campaign. “People say to me, ‘You are male, why are you talking about a women’s issue?’” says Istiila. “In Somalia, culturally, men dominate the house. They are the decision makers. If they don’t agree, women can’t refuse.”
Istiila became aware of FGM and the resulting dangers to life and risks around childbirth while he was at university. As a campaigner he received training in 2017 from the anti-FGM Global Media Campaign and now works to change the narrative in a country where anti-FGM legislation does not exist. But there is a great deal of stigma around speaking about it.
Over the past five years, he has noticed a change in attitudes. “There is an increasing number of people, especially women, who are talking about the issue on the radio or on social media. It’s not a big number but it’s good when you look back to five or six years ago,” he says.
Istiila worked as a journalist, including on the story of Fartun Hassan Ahmed, 13, a girl who bled to death last year after being cut and whose loss was keenly felt by her blind father. “That story touched me. The girl was the right hand of her father,” he says. “I asked him why he submitted her to FGM and he told me his wife had decided and he accepted it. He said if he had refused, his daughter would still be alive.” A few months later, Fartun’s father joined the anti-FGM movement.
In Kenya, Jeremiah Kipainoi, 29, an award-winning journalist, thinks the time for raising awareness is over. “There’s no need to keep sensitising people,” he says. “I don’t think there’s anyone who doesn’t know FGM is wrong.”
He points to Kenya’s Female Genital Mutilation Act of 2011, which made FGM punishable by imprisonment or a hefty fine. President Uhuru Kenyatta has pledged to end FGM by 2022. In Kenya, 21% of girls and women aged 15 to 49 have had their genitals mutilated.
Kipainoi is now doing what he calls accountability activism. “FGM is happening,” he says. “I have to task those people who are supposed to prevent it from happening to do their job.”
When the pandemic hit, he started End FGM live, which broadcast over the internet, interviewing officials whose mandate it is to end the practice, and enabling people to directly address their questions and concerns to those in power.
In December, when he heard that hundreds of girls in south-west Kenya had been cut, he called the county commissioner, who was on holiday at the time. “It was a little bit confrontational,” he says, “but from that we were able to get them to act and arrest people.”
Q&A
Female genital mutilation: what does it involve and what are its consequences?
Show
Female genital mutilation (FGM) is the removal of part or all of the external genitalia for nonmedical reasons, as defined by the World Health Organization.
There are different types of cutting: removal of the clitoris and/or its hood; removing the clitoris and the inner fold of the vulva (labia minora); and the narrowing of the vaginal opening by cutting and repositioning the labia minora through stitching. Also known as infibulation, this has the worst health consequences. The fourth type of cutting includes other forms of injury to the genitalia such as incising, scraping or cauterising.
Since traditional practitioners use razor blades or knives, with no anaesthesia, girls experience excruciating pain and are at risk of severe bleeding and infections which can lead to sepsis. Some do not survive.
For the girls, who are often married off soon after genital cutting, sex is traumatic and painful, and enjoying sex will always be difficult unless they have surgical reconstruction.
In pregnancy, delivery is often risky due to obstructed and prolonged labour. Women are at risk of developing obstetric fistula (an abnormal opening between a woman’s genital tract and her urinary tract or rectum) which can cause incontinence – leading to shame, stigma and rejection from their partners.
- Dr Mercy Korir is a medical doctor and health and science editor at the Kenyan media organisation Standard Group
Prof Wilberforce Oti, a lecturer and pastor, is similarly determined to end FGM in his native Nigeria. The UN Population Fund estimates 25% of female Nigerians aged 15 to 49 have undergone FGM. The 2015 Violence against Persons (Prohibition) Act makes it a federal offence but it has not been passed in all 36 states and, according to Oti, implementation is low.
Oti’s resolve was sparked by a training session in 2016 for religious leaders. “That was the first time I got deep information about the adverse effects of FGM,” he says. “I began to imagine what my own mother must have gone through. She told me every time she gave birth they had to cut her open. She shared this with me and I found I was going to do everything in my power to not let anybody I know go through this and to stop it happening to as many people as possible.”
He uses his position to talk to traditional rulers, the “custodians of culture and tradition”, and hosts a radio programme, Brand New Me. He says he has seen a drop in support for FGM and in his own state of Ebonyi – statistics suggest prevalence has fallen from 74% in 2013 to 53.2% in 2018; nationwide, prevalence has dropped from 25% to 20%.
Oti is encouraged but doubtful over the UN’s 2030 goal. “If we are going at the pace we are going right now, we will minimise FGM, but this is not the same as eradicating it completely,” he says.
“We are doing our best, but I wish we could do more.”
Sign up for Her Stage to hear directly from incredible women in the developing world on the issues that matter to them, delivered to your inbox monthly:
Sign up for Her Stage – please check your spam folder for the confirmation email