Female Genital Mutilation/Cutting in the Gambia: From Medical Evidence to Knowledge Transfer

“Female Genital Mutilation/Cutting” (FGM/C) refers to all procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reasons and it is recognized internationally as a violation of the human rights of girls and women. WHO calculates that between 100-140 million women and girls in the world have been victims of some kind of FGM/C, essentially in 28 countries in sub-Saharan Africa. The three types of FGM/C defined by WHO present severe health consequences, both immediate and long term.

In The Gambia, the prevalence of FGM/C is 78,3% and it is carried out in girls aged between birth (7 days) up to pre-adolescence, always before the first menstruation and marriage. Despite this high prevalence, knowledge about the extent of health consequences of FGM/C in The Gambia is scarce.

The present study focuses on the analysis of two clinical surveys done in the country in 2008/2009 and in 2011 to know the types practices and the consequences of each type.

The first survey shows that FGM/C is still practiced in all the six regions of The Gambia, the most common form being type I, followed by type II. All forms of FGM/C, including type I, produce significantly high percentages of complications, especially infections.

The second survey focuses on the consequences of FGM/C during delivery and foetal suffering and revealed a strong correlation between these factors.

These results allowed the implementation of a national training workplan for the health professionals and students regarding the issue of FGM/C, directly based on knowledge transfer as the training contents include the observed health consequences in The Gambia.

The results have been transferred to the religious leaders bringing evidence based information and as a result a Fatwa has been released against the practice of FGM/C.