Dr Abubacarr Jah Says FGM Cannot be Medicalised

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Gambian consultant urologist and reconstructive surgeon Dr. Abubacrr Jah Wednesday informed lawmakers that Female Genital Mutilation/Cutting (FGM/C) cannot be medicalised because doctors are not allowed to do anything that is harmful to a patient in medicine.

 “And therefore, no medical person would do it if they are doing the right thing. Except you have some rogue doctors that are doing it,” he said during a consultative meeting with the National Assembly Joint Committee of Health and Gender on the proposed Women’s (Amendment) Bill.  

As medical practitioners, he said they should campaign against FGM and that no serious medical person will campaign for the practice to be upheld. 

“So I’m campaigning against it. We are not involved in performing it. So nobody can legalise it for us and say, medicalise it. We can treat the complications like you have seen. We have treated some of those complications. We should try to prevent the long-term effects of FGM,” he said. 

Like Dr. Babanding Daffeh, who recently presented to lawmakers 11 Gambian cases of FGM he dealt with and the anatomy of the female genitalia, Dr. Jah also presented pictures of the practice in the country to the members of the committee. Again, some lawmakers weren’t at ease with the pictures portrayed.

Unlike male circumcision which has been found to have health benefits, Dr. Jah said there are no known health benefits of FGM/C and the practice’s side effects are well documented. For the males, he said only the removal of some skin (also known as the hood) is done and not the glans penis which is similar to the female clitoris.

“There is no form of female genital mutilation that is being practiced throughout the world that does not remove the clitoris. So there is no form of cutting that should be referred to as circumcision. It is not circumcision because circumcision is just removal of skin. But all the forms that you can see, type 1, type 2, type 3, the clitoris goes out.

“Another thing that should be clear also is that the clitoris is equivalent to the glans. But the clitoris is much smaller than the glans. The hood that we are talking about is equivalent to the prepuce of the male which is removed during circumcision. But it is much thinner and much smaller and therefore, removing the skin alone, which according to some people who defend this, say that there was a Hadith by the prophet that said that if you are removing, remove only a small part.

“If you are actually removing, just remove the skin, not the clitoris. But nobody is doing that because it is very difficult. You will need a lot of training to be able to remove the skin alone. You need a lot of training for that to happen because it is very small and it is very difficult to remove that alone. Except if you are going to be in a theatre condition with microscopes so that you can increase the magnification. And that is what would have been called hoodectomy, not clitoridectomy.  Removing the clitoris is different. Removing the hood alone is different,” Dr. Jah explained. 

A few years ago, Dr. Jah said he dealt with an FGM case of a girl between 18 or 20 years old. He said the girl was brought to his clinic in lots of pain. He showed the lawmakers the picture of the girl’s genitalia where her clitoris and the opening of the urinary tract were removed.

“Everything was cut down. So this girl could not pass urine for almost 24 hours. And they ran to my clinic [saying] that this girl had this procedure and cannot pass urine now. Her bladder was full up to the brim. She was in lots of pain and I had to take her to the theatre. With all the lighting in the theatre, it took me about 2-3 hours before I could identify where the urinary opening is. And put a catheter there and do some reconstruction for her later on. 

“But this is just one case that we have come across. There are lots of other cases where you could come across. But this is considered to be type 2 female genital mutilation and we should call it what it is. It is female genital mutilation. It’s not circumcision. Circumcision is only removal of skin. And if you are going to do circumcision in a female, it’s a hoodectomy. Nothing else,” he said.  

Dr. Jah also showed a male’s genitalia whose glans has been removed because he had cancer in the glans penis.

“Now, let us imagine that we are being told that there is a law saying that you cannot do this to men. And now we are being told that people are fighting against that law because Islam said that there should be circumcision. It doesn’t make sense to me. No man will agree that this has to be done to you. 

“So we had to remove the whole glands penis to make him alive. That is why this man (referring to a picture of the man’s genitalia shown on the powerpoint presentation), it was done.  But I’m saying as a routine to tell somebody that you have to do this because it’s circumcision, because your religion says it. I don’t think anybody would go well with that,” he said.

Dr. Jah concluded that FGM has no medical benefit and no religious basis.

“It is a serious crime and dishonorable to human life. It should be differentiated from a female circumcision or a hoodectomy. And FGM should be stopped and should remain stopped in The Gambia,” he said.