Health, Justice Ministries Oppose Pro-FGM/C Bill

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By Momodu Jarju

The Gambia’s health and justice ministries Thursday spoke against the proposition of the Women’s (Amendment) Bill which seeks to lift the ban on the practice of Female Genital Mutilation/Cutting (FGM/C) during a consultative meeting with the National Assembly Joint Committee of Health and Gender. Officials from both ministries said the practice causes more harm than proffer benefits to the victims and thus asked for the august body to maintain the ban on the practice.

“The position from health is that we think that this is harmful. And the best course of action is to educate people, ensure that this is stopped, and we don’t continue this injurious practice to our girls and our women,” said Dr. Mustapha Bittaye, the director of health service who conveyed the health ministry’s position on the bill.  

Dr. Bittaye told the joint committee that FGM/C causes a lot of complications—both for long and short term. The complications include psychological trauma, loss of motivation, anxiety, depression, and unpleasant sexual intercourse. He held that the sexual rights of all individuals must be respected and fulfilled. Ultimately, he said if the complications are not taken care of, it could lead to death.

“Early complications include acute pain. You could have hemorrhage, necrosis, systemic local infection. You can have hepatitis and other viruses. You may have an inability to pass urine; damage to neighboring organs like the urethra, botulinum ducts, skin, glands, even the bladder,” he explained.

“Long-term complications include chronic vaginal or low-abdominal infections; menstrual irregularity is painful, obstruction of the menstrual flow, difficulty with urination, urinary incontinence, injuries to the reproductive system and possible infertility depending on how it was done. It can lead to abscess, scars, and cyst formation.”

The mover of the pro-FGM/C bill Hon. Almameh Gibba and other lawmakers who support its amendment have been clamouring for the ant-FGM/C supporters and/or establishments to provide them with local (“Gambianised”) data that show the harmful nature of the practice. Though the government officials admitted that getting data is difficult in the country Dr. Bittaye did provide some to the joint committee.  

In 2010, Bittaye said a study was done among Gambian women of reproductive age and it puts the prevalence rate of female genital cutting at 73.6%. Also, he said a multi-center observational study was done to assess the obstetric and neonatal outcomes of mothers who are going to delivery—with and without FGM/C—in four health centers in The Gambia.

“The primary outcome was to look at postpartum hemorrhage, that is women who bleed during delivery, whether it was higher among those who are cut or those who are not cut. And secondary outcomes were cesarean section, where the women who had CS, whether they were higher among those who were cut or those who were not cut,” he said.

Dr. Bittaye said the study also aims to affirm where the perineal tear (which is an injury to the skin or muscle between the vagina and anus) occurs more.

 “So this study was big, of the 1,569 participants recruited into the study, 23% had no female genital mutilation or cutting, while 77% had varying severity. So the risk of postpartum hemorrhage was doubled, was two times for women with FGM type 1. Those who had type 1 FGM, the risk of all these complications were twice. And it was tripled in those who have type 2, and it was increased by up to five times for those with type 3 and type 4 combined.

“Cesarean section and perinatal tears were also increased. FGM/C was associated with increased risk of neonatal resuscitation and perinatal death. FGM/C is associated with poor obstetric and neonatal outcomes in the Gambia, with the degree of risk correlated with severity of FGM/C,” Bittaye revealed, adding that the study was done by consultants and experts within the health sector in The Gambia.

“The Gambia Demographic Health Survey 2019-2020 shows that women who believe FGM/C should continue decreased from 65% in 2013 to 46% in 2019-2020. This decrease was largest among women who have undergone FGM/C.

“According to the 2019-2020 Gambia Demographic Health Survey, nearly 5 in 10 girls age 0 to 14 in the Gambia have undergone female genital mutilation or cutting. More than 6 in 10 women who have undergone FGM/C were cut before the age 5. So the FGM/C range is from Banjul about 25% in girls to about 79% of girls in Basse. So geographically there is some maldistribution,” Bittaye said.

An official from the Justice Ministry Saffiatou Nyang agreed on the difficult nature of getting data in the country, but she said relying on the argument that local data are needed to believe whether FGM/C practice is harmful or not is unsettling.

She said as far as the justice ministry is concerned, the Act is valid and repealing it will go against the Children’s Act, the Gambian Constitution, and the Maputo Protocol.

“So at the level of the ministry, we’re saying that the national policy still remains that we’re not in favour of the repeal and we’re advocating for the law to be maintained,” she said.

Madam Nyang further said the country has legislation, including the Constitution, which has certain fundamental rights and principles that it guarantees to all Gambians, women included.

“And when we talk about women, it includes children, you know, protecting their right to life. There’ve been instances where we would ask for figures on how many people died. Whenever that argument is made, I get shivers. Do women have to die for us to say that it is serious? Does it have to get to death? Can we talk about the other complications that are happening? We all need to know and understand our context. We live in a country where sometimes women even need permission to go to the market to cook for the family. So do you think women can openly talk about it?” she quizzed.