FGM Sierra Leon
Female Genital Mutilation in Sierra Leone has recently become a topic of conversation both nationally and internationally since it is one of the 28 African countries that still partake in the practice. The World Health Organization officially described female genital mutilation (FGM) as “procedures that intentionally alter or cause injury to the female genital organs for non-medical reasons.” The procedure usually involves some kind of cutting or removing of the genital flesh of a female as part of the initiation into womanhood. Several organizations are spreading awareness of the devastating results of this barbaric procedure and working to end this practice once and for all.

Why FGM Occurs?

The reasons for the procedure of FGM depend on the culture, they but usually fall into four categories: psychosexual, as a way to control female sexuality and maintain virginity; sociological and cultural, the practice is viewed as a vital tradition to the cultural heritage; hygiene and aesthetics, as some communities view the external female genitalia as unappealing and unclean; and finally, socio-economic factors since FGM is often a pre-requisite for marriage and the right to inherit.

The procedure is often performed with penknives, razors or even cut glass, and can result in severe pain, bleeding, cysts, infections, complications in childbirth, infertility and in extreme cases, death. The initiation can also often result in psychological issues from the trauma and pain of the event as well as from the inability to experience sexual pleasure thereafter. An estimated 200 million women and girls have undergone the procedure worldwide, with a staggering 90 percent in Sierra Leone.

Challenges in Stopping the Practice

The practice is ingrained into the culture and holds high social significance. In fact, 69 percent of women and 46 percent of men aged 15-49 believe in the continuation of the practice. FGM has been viewed as an initiation into womanhood and has been an important cultural touchstone for the people of Sierra Leone. This makes it difficult to stop the practice, as many see it as socially embarrassing and being unworthy of marriage if they have not received the initiation.

Another challenge faced to end FGM is that many Soweis, who usually perform the initiation, refuse to end the practice as they see it as a threat to the traditions of the Bondo society. They also receive large amounts of money for the initiations and do not want to lose this source of income.

Organizations Working to End FGM

The Amazonian Initiative Movement (AIM) is a non-governmental organization aiming to end the procedure. It was founded in 2002 by Rugiatu Turay, a victim of FGM herself, and many other women while living in a refugee camp in Guinea during the Sierra Leon’s civil war. AIM activists visit villages and speak with the women who perform this procedure and try to convince them to give it up. They have convinced 700 practitioners from 111 villages to stop practicing FGM.

AIM believes that one of the most efficient ways to begin the ending of practice is to teach women how to read and write since most of the procedures are performed by illiterate elder women. Providing them with the knowledge to read and write will open opportunities for them to pursue alternate means of income and reduce their interest in performing FGM.

Another non-governmental organization, AMNet, is fighting against the old fashioned initiation rite. AMNet works with Soweis, the senior female community members, to change the social stigmas surrounding women in regards to FGM in local communities. The group has high profile supporters like Sia Koroma, the first lady of Sierra Leone, which helps bring attention to their cause.

Legislation is Needed

Non-governmental organizations are working hard to provide knowledge on the issues surrounding FGM, but formal legislation against the practice will further help end the societal pressures and stigmas that encourage the continuance of the initiation rite. Several countries have banned the practice, including more than 20 countries in Africa and most Western European countries. Ending the practice has also become a part of the United Nations 2030 sustainable development agenda.

Female Genital Mutilation in Sierra Leone is not yet illegal, though progress is being made to eradicate the procedure. The country recently ratified the African Unions 2003 Maputo Protocol on Women’s Rights, stating in Article Five of the protocol that female genital mutilation should be prohibited by the government in order to finally end the procedure.

Female Genital Mutilation in Sierra Leone has been a huge cultural touchstone for many communities. The procedure, though, is highly dangerous for females in many areas of their mental and physical health. Many of the activists fighting to end the procedure recognize that immediate ending of the practice will not work, but could lead to underground practices, as the social and cultural significance of the initiation is far too important to many communities. Instead, they hope to use education to spread awareness about the harms of the practice, hopefully, changing opinions over time with respect to cultural significance.

Mary Spindler
Photo: Flickr

Maternal Healthcare in Belarus
Fewer than 30 years ago, maternal health care in Belarus was not treated as a top priority in the country and the numbers show it. In 1990, 33 out of every 100,000 live births resulted in the death of the mother. By 2015, that number had decreased to four out of every 100,000.

Reasons for Bad Maternal Health Care in Belarus

The reasons for this precipitous drop are numerous, but some stand out more than others. For a long time, public health in Belarus revolved around containing the fallout from two momentous events. One was the Chernobyl disaster in 1986 that directly affected more than 2.2 million people in Belarus, half a million of whom were children. Charities, nongovernmental organizations and United Nations system organizations focused on providing emergency care to those who had been exposed to dangerous amounts of radiation.

The other event was the breakup of the Soviet Union in 1991. According to the World Health Organization (WHO), health care in Soviet-era Belarus was centered on the Semashko system. In this system, industrial workers, believed to be the source of productivity and prosperity for the Soviet Union, were essentially considered more important than the rest of the population. This resulted in addressing their immediate health needs first while overlooking larger public health concerns and it also meant that health care professionals were not as highly regarded as industrial workers. Low pay and little respect for medical workers perpetuated a cycle of subpar health care in Belarus.

Government Initiatives

Independence from Russia brought economic decline for Belarus in the short-term, but it also created an opportunity to revamp the country’s approach to public health. Maternal health care in Belarus received some overdue attention. Between 2005 and 2010, several health resolutions were initiated under the new Government of the Republic of Belarus, including a greater focus on reducing maternal mortality rates.

One such initiative was to build health facilities in rural areas, so that expectant Belarusian mothers in agricultural townships would have the same access to care as their urban counterparts. Another was to create a multileveled perinatal care system, made possible with the support of the head of state who approved the allocation of funds to improve maternal health care in Belarus. This included employing almost 2,700 obstetrician-gynecologists to treat a population of roughly 4.8 million women of fertile age. This initiative was implemented in 2005.

The Progress of Maternal Health Care in Belarus

A doctor visit at the earliest point in a known pregnancy is optimal for the health of mother and child. To ensure that expectant mothers would adhere to this guideline, a monetary allowance was given to them as an incentive for seeing a doctor within the first 12 weeks of their pregnancy. As a result of this bold initiative, prenatal visits within the first trimester increased by approximately 93.5 percent.

Paid maternity leave in Belarus lasts between 126 and 140 days, depending on the difficulty of the labor. Fathers are encouraged to play an active role in the birthing process, with maternity wards made to accommodate families. Today, maternal health care in Belarus ranks 26th in the world. Belarus is a shining example of how a country can evolve over a matter of mere decades and transcend seemingly insurmountable difficulties.

With a maternal mortality rate among the lowest in the world and a compassionate and comprehensive maternal health care system, Belarus has defied expectations across the board. The aid provided to the country during the low points in Belarusian history following the Chernobyl disaster and the fall of the Soviet Union was an important stepping stone toward a healthier and more independent Belarus. The state of maternal health care in Belarus is a magnificent reflection of that.

– Raquel Ramos

Photo: Google