Yahya Jammeh peddled fake HIV cures complete with alleged human rights abuses. But he also banned female genital cutting, which can put women at risk of dangerous and lifelong complications.(Marco Longari, AFP, Getty Images)
Jakumba Ceesay was angry. In a far-away capital city, in dimly-lit government offices filled with men, lawmakers were trying to tell her what Gambian women like her could and couldn’t do with their own bodies.
What made them think, she wondered, that they knew better than her about her own traditions, her own religion, her own rights?
“I have successfully carried out circumcision on some 400 girls and many of them have given birth and become mothers. So all the talk that cutting causes this or that is nothing but lies,” she says. “I have been practising the profession for over a decade now and none of the girls that have been circumcised by me experienced any complication during and after the process.”
Three-quarters of Gambian women between the ages of 15 and 49 have undergone a form of female genital cutting (FGC), according to statistics from the country’s latest demographic health survey conducted in 2013. As part of the tradition, women undergo surgery on their genitals, for instance, to prick, pierce or remove either parts or the entirety of the labia and clitoris — the organ responsible for sexual pleasure in most women.
And according to advocates like Ceesay, the practice has helped young women in their communities to avoid pre-marital sex, and by extension, unwanted pregnancies. Whether this is true is debatable in a country where the average age of marriage is 18 and where 15% of women have sex for the first time before the age of 15, the survey shows.
Although research on the topic is scarce, about 12% of more than 6 000 women who had been cut in nearby Guinea also reported having sex before marriage, according to a study published in the journal Archives of Sexual Behaviour in 2009 that analysed decades’ old data. What was clear is that almost twice the proportion of women, as well as about 2 000 men included in the study, thought that the procedure did make women more “marriageable”.
Today, women like Ceesay are at the forefront of a blistering social debate in the Gambia. As in many countries in the region, it has pitted advocates of cutting like herself against activists and lawmakers who argue the practice is deeply harmful, physically and psychologically, to women here.
The procedure has no medical benefit and it can leave women with a lifetime of consequences. Women can face infections, a lack of sexual desire and difficulties in passing urine and faeces, studies have shown. In the long term, they often report chronic pain and are significantly more likely to face life-threatening complications during childbirth such as Caesarean sections and haemorrhaging after birth, according to a 2006 study conducted in six countries and published in The Lancet medical journal.
But in the Gambia, the FGC debate has an unusual twist. In November 2015, Gambia’s then-dictator Yahya Jammeh, banned FGC in the country, making the practice punishable by a hefty fine or a three-year jail term.
But then, just over a year later, Jammeh was unexpectedly ousted from office after 23 years in power, providing new and unexpected ammunition to those on both sides of the FGC fight.
For their part, practitioners of cutting began to argue that Jammeh’s anti-FGC law should be scrapped. After all, they lived in a democracy now, women like Ceesay argued, where “autocratic” laws governing women’s bodies had no place.
“We want to ensure that those Gambians who choose to do so enjoy their sociocultural rights as well as preserve the cultural and Islamic rights of our girls,” Ceesay says.
For anti-FGC activists, the advent of democracy meant, that for the first time, Gambians lived in a place where the law applied equally to everyone.
“Nobody, even the so-called ‘traditionalists’, is above the law in the new Gambia,” says Mariama John, an anti-FGC activist and senior officer of Network against Gender-Based Violence, a local NGO.
Women in Somaliland speak out about their experiences of female genital mutilation.
So who is winning?
So far, the new government of President Adama Barrow has been almost entirely silent on the issue, not advocating for the law to be undone, but not pushing for prosecutions of those who practise FGC either.
In fact, there have been no successful prosecutions under Jammeh’s ban. The closest anyone came was in the dying days of the regime, when two women were charged over the death of a five-month-old who died after undergoing FGC.
The case was eventually thrown out on procedural grounds and the charges dropped. Still, many activists see the law as a last resort. Arrests and prosecutions, after all, can have the unintended consequence of making practitioners dig in and reaffirm their efforts to keep cutting traditions alive.
“My community will continue to practise FGC even if it will mean we will go to jail,” one woman, Nyima Fofana, told local publication The Point after a community meeting on the subject in her village of Dasilami.
“You can jail us but we will not stop the practice. Let President Barrow concentrate on something else rather than this FGC issue.”
Pro-cutting activists also frequently point to donor support and funding for anti-FGC advocacy as proof that the idea of banning the practice is a Western import designed to kill off traditional African cultural values.
Anti-FGC activists are “a bunch of propagandists of the West,” Ceesay argues. These arguments have pushed many activists who want to stop FGC to try more conciliatory approaches.
The Gambia Committee on Traditional Practices Affecting the Health of Women and Children (Gamcotrap) was founded in 1984 and is widely considered to be the grandmother of anti-FGC advocacy groups. Since 2007, the organisation has been running “drop the knife” campaigns encouraging circumcisers like Ceesay to find alternate ways to welcome women into adulthood in their communities — and earn a living.
This campaign works, its organisers say, because it is locally rooted. Communities often trust their own elders far more than they do finger-wagging outsiders who burst in telling them that their traditions are wrong and harmful.
“To do this [work] you have to be part and parcel of that culture, to show that their experience is your experience too,” Mary Small, then acting executive director of Gamcotrap told the Christian Science Monitor in 2017.
“When people know you accept them, that you are not condemning them for how they live, they begin to listen.”
The kind of diversion programmes Gamcotrap runs are just one part of an array of approaches organisations across the world have used to tackle FGC in the past five decades — from working with religious leaders to change cultural norms to providing girls and communities alternative rites of passage. But rigorous studies on how well these kinds of programmes work remain few and far between, according to a 2013 research review published in the journal Obstetrics and Gynecology International.
A similar 2012 review found that only eight interventions had been evaluated well enough to be included in the study, which was published in the journal Studies in Family Planning. Only two had been peer-reviewed.
Five years later, only three high quality studies sought to understand how well reimagining girls transition into womanhood in communities worked to spare girls the knife, the international NGO Population Council found. Even less research had looked at the effectiveness of training healthcare workers to treat and prevent female genital cutting.
Authors of the 2013 study conceded that trying to convert traditional circumcisers such as Ceesay may help to garner media attention with what is, for example, public ceremonies in the case of Gamcotrap’s work, but they don’t necessarily reduce demand for the procedure.
In some cases, these types of programmes may not even decrease the number of traditional circumcisers as apprentices take over practices after experienced practitioners hang up their tools. And even offering people new ways to earn a living may not be enough to get them to leave the profession entirely, the study argues, citing 1998 research in Mali.
In Mali, traditional circumcisers — also called excisers — felt that new forms of income would not sufficiently compensate them for the loss of social status as a traditional leader after they gave up the practice. That study, conducted in part by Population Council, found that 70% of 41 traditional circumcisers who vowed to stop their work not only later reneged on their promises but also did not see anything wrong with the FGC, the review says.
In the Gambia, Gamcotrap has convinced more than 150 cutters to abandon the practice, according to their own figures, and given them money to start new businesses.
But even reformers admit the pace of change is slow.
“This was the law of a dictator, so when Jammeh left, people felt like the law should go too,” said Jaha Dukureh, another Gambian anti-FGC activist, in a 2017 interview. “It’s taking time to convince communities that they can have ownership over this law too.”