Unsafe Traditional Health Practices Against Females in Nigeria | Taiwo Orimoloye | TEDxOsogbo
A speaker, drawing on personal experience and research, argues that harmful traditional practices like female genital mutilation (FGM) and child marriage are deeply entrenched human rights violations in Nigeria, causing severe health and psychological consequences. She highlights the high prevalence of FGM in specific Nigerian regions, detailing its barbaric types and justifications, and notes the slow progress in its decline despite legislation, advocating for a multidisciplinary grassroots approach to eradicate these practices. The strongest evidence presented are the detailed descriptions of FGM types, the devastating health consequences like fistulas, and the statistics on FGM prevalence in Nigeria. ## Speakers & Context - Unnamed speaker, with prior experience as a peer educator for the Society for Family Health and as a corps member involved in medical outreach. - The talk is delivered in Nigeria, with references to specific Nigerian states and cultural contexts. - The speaker draws on personal anecdotes and research from academics like Professor Blessing Onu and studies by UNICEF and the National Demographic Health Survey. ## Theses & Positions - Harmful traditional practices such as female genital mutilation (FGM) and child marriage have severe adverse health and psychological effects on individuals, particularly women and girls. - FGM and child marriage are human rights issues that violate the fundamental rights of women and girls. - These practices are deeply entrenched in Nigerian cultures and traditions, making them difficult to change. - Legislation alone is insufficient to combat these practices; a multidisciplinary, grassroots approach is necessary. - The medicalization of FGM is a way to cover up barbaric practices with a medical explanation. - There are no health benefits to FGM. ## Concepts & Definitions - **Unsafe health practices:** Traditional or cultural practices with adverse health effects. - **Female Genital Mutilation (FGM):** Defined by the WHO as procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reasons. - **Child marriage:** Giving girls away in marriage at very young ages, often before the stipulated age of independence (18 years). - **Fistula:** An abnormal communication between two internal surfaces; specifically, recto-vaginal fistula (anus and vagina) and vesico-vaginal fistula (bladder and vagina) are common complications of FGM and early childbirth. - **Medicalization of FGM:** Performing FGM procedures by health personnel to reduce bleeding or as a cover for barbaric practices. - **Rite of passage:** A ceremony or event marking an important stage in someone's life, often used as a justification for FGM. ## Mechanisms & Processes - **FGM Type 1:** Removal of the clitoris or part of the clitoris. - **FGM Type 2:** Removal of the entire clitoris and part or all of the labia minora. - **FGM Type 3 (Infibulation):** Removal of the clitoris, labia minora, and labia majora, followed by suturing of the vagina, leaving only a small opening for urine and menstruation. - **FGM Type 4:** All other harmful procedures to the female genitalia, including piercing, cutting, or nicking the clitoris or labia, and sometimes introducing corrosive substances. - **Child marriage justification:** Belief that a woman must be "mature" before entering a husband's house, or for socio-economic reasons (e.g., dowry, reducing financial burden). - **Consequences of FGM:** Immediate complications like pain, shock, bleeding, and fractures; long-term complications like urinary tract infections, difficult urination, and fistulas. - **Consequences of child marriage:** Sexual intercourse before physical maturity leading to lacerations, risk of fistula formation, pregnancy complications (anemia, pregnancy-induced hypertension), and psychological trauma. - **Legislation:** The Prohibition of Persons Act of 2015 criminalizes FGM, and the Marriage Act (1990) and Child Rights Act (2003) set minimum ages for marriage. ## Timeline & Sequence - **1985-2015 (30 years):** Slight percentage decline in FGM prevalence in Nigeria. - **2015:** The Prohibition of Persons Act was enacted, criminalizing FGM in Nigeria. - **1990:** The Marriage Act set the minimum age of marriage at 21. - **2003:** The Child Rights Act set the minimum age of marriage at 18. - **Ongoing:** Speaker's personal experiences as a peer educator and corps member, and academic research by Professor Blessing Onu and others. ## Named Entities - **Society for Family Health** - Organization that organized the peer education program. - **Professor Blessing Onu** - Professor at the African Population and Ultra Trust Research Center in Nairobi, Kenya, who shared a story about FGM. - **UNICEF** - Organization that provided statistics and highlighted FGM as a human rights issue. - **World Health Organization (WHO)** - Provided a definition for Female Genital Mutilation. - **National Demographic Health Survey (NDHS)** - Provided prevalence data for FGM in Nigeria. - **Yoruba race** - Identified as having the highest prevalence of FGM after the Yoruba race. - **Oyo State, Osun State** - States with high prevalence of FGM. - **South South, Southeast, Southwest** - Regions in Nigeria with high prevalence of FGM. - **Professor Ine Duzan and Abuo Chi Duzan** - Researchers who conducted a study on FGM prevalence in Nigeria. ## Numbers & Data - Age of girl accompanying her husband to his house: **12-13 years old**. - Age of girl in Professor Onu's story who underwent FGM: **19 years old**. - Gestational period of the 19-year-old girl: **four months pregnant**. - Prevalence of FGM in Southwest Nigeria: **41 percent**. - Percentage decline in FGM between 1985 and 2015: **very slight**. - FGM prevalence according to UNICEF (2016): **27 percent**. - FGM prevalence according to National Demographic Health Survey (2013): **25 percent**. - Prevalence in Yoruba race: **highest**. - Prevalence in Osun State: **76.something percent**. - Minimum age of marriage according to the Marriage Act: **21 years**. - Minimum age of marriage according to the Child Rights Act: **18 years**. - Age of girls given out in marriage: **12, 13, 14, some even 10, 11**. ## Examples & Cases - **Speaker's personal experience:** As an SES 1 student, participated in peer education on unsafe health practices. During a medical outreach in Kondo Gidon Dondo, observed a 12-13 year old girl being taken to her husband's house for marriage rites. - **Professor Blessing Onu's story:** A 19-year-old girl in Bonilla State, four months pregnant, was pressured by the community to undergo female circumcision. During delivery, complications arose due to scarring, requiring a Cesarean section. She later experienced severe pain during sexual intercourse due to the FGM. - **FGM Type 3 (Infibulation) description:** Involves removal of clitoris, labia minora, and majora, with the vagina sutured shut, leaving only a pin-sized opening. - **FGM Type 4 description:** Involves piercing, cutting, or nicking of the genitalia, sometimes with corrosive substances. - **Fistula case:** A woman with recto-vaginal fistula cannot control defecation, with feces coming out directly into her vagina. A woman with vesico-vaginal fistula cannot control urination, with urine coming out directly into her vagina. - **Child marriage case:** Girls as young as 10-11 years old are married off. ## Tools, Tech & Products - Not applicable. ## References Cited - **Society for Family Health** - Organized peer education. - **Professor Blessing Onu** - African Population and Ultra Trust Research Center, Nairobi, Kenya. - **UNICEF** - Reports and statistics on FGM. - **World Health Organization (WHO)** - Definition of FGM. - **Lady Mo and Arkansas (2002)** - Defined unsafe health practices. - **Professor Ine Duzan and Abuo Chi Duzan** - Researchers on FGM prevalence. - **National Demographic Health Survey (NDHS)** - Prevalence data. - **The Prohibition of Persons Act, 2015** - Legislation criminalizing FGM. - **The Marriage Act (1990)** - Minimum age of marriage. - **The Child Rights Act (2003)** - Minimum age of marriage. ## Trade-offs & Alternatives - **FGM vs. no FGM:** The "alternative" to FGM is to not perform the practice, which has no negative health consequences and upholds human rights. - **Child marriage vs. allowing girls to reach maturity:** The alternative to child marriage is to allow girls to reach the age of consent and independence before marriage, enabling them to make informed choices. - **Medicalization of FGM vs. eradication:** Medicalization is presented as a false alternative that merely masks the barbarity of FGM, rather than eradicating it. ## Counterarguments & Caveats - The speaker acknowledges that cultures and traditions are "very, very difficult to change." - The slow decline in FGM prevalence (slight over 30 years) indicates the difficulty in eradicating the practice. - The speaker notes that despite legislation, adherence is not universal across communities. - The "medicalization" of FGM is presented as a way to cover up barbaric practices, implying that some may argue it makes the practice safer, but the speaker refutes this. ## Conclusions & Recommendations - Harmful traditional practices like FGM and child marriage must stop. - Addressing these issues requires a multidisciplinary approach that goes beyond legislation and government regulations. - Efforts must be taken to the grassroots level, involving community education and awareness campaigns. - Voices must be joined in a campaign to say no to FGM and child marriage. - Communities should be engaged to find out about these practices and educate people about them. - Students should take this education back to their classes. - Collaboration with organizations fighting these practices is essential. - Legislators and law enforcement agencies must ensure laws are obeyed. - With grassroots decisions, options, and opinions, the tide of FGM and early forced child marriage can be stemmed in Nigeria. ## Implications & Consequences - **Health implications of FGM:** Severe pain, shock, bleeding, infections, urinary tract infections, difficult urination, and the formation of recto-vaginal and vesico-vaginal fistulas. - **Health implications of child marriage:** Sexual intercourse before maturity leading to lacerations, risk of fistula formation, pregnancy complications (anemia, pregnancy-induced hypertension), and psychological trauma. - **Social implications:** Violation of human rights, denial of aspirations and life ambitions for girls, perpetuation of harmful traditions. - **Legal implications:** Criminalization of FGM and setting minimum ages for marriage, though enforcement remains a challenge. - **Economic implications:** Some individuals profit from performing FGM procedures. ## Verbatim Moments - *"My first contact with unsafe health practices, someone to remain in an injury, I was as an SES one student."* - *"Don't forget Sophia's 13 years old. Questions popped up in my mind: What about the aspirations, the goals, the life ambitions, the desires of this girl? Have they perhaps gone down the drain?"* - *"The vagina was already very touched, the baby could not come out. They had to resort to zero section."* - *"Female genital mutilation is something very evil, something that has to stop."* - *"Type 3 which is called infibulation. Please listen very carefully here. It involves removal of the clitoris, the labia minora, the labia majora, then you go ahead to suture the entire length of the vagina together, leaving a small pin-size hole just for urine and menstruation. It's very, very barbaric."* - *"The prevalence was still put at 25 percent."* - *"The Yoruba race has the highest prevalence. After the Yoruba race, it was found that Osun State has the highest, building with seventy-six point something percent."* - *"There is no benefit at all, no health benefit at all for female genital mutilation."* - *"The issue of addressing these evil practices goes beyond legislation, rules, and government regulations. It is multidisciplinary."* - *"We must join our voices in the campaign, the crusade to say no against female genital mutilation in our country."* - *"I believe with these practices, now these grassroots decisions and options and their opinions, we are going to be able to stem the tide of female genital mutilation and early forced child marriage in our country, Nigeria."*