Dakar, Senegal - Now in her 50s, Madina Bocoum Daff still cannot get over the agony and shame of her teenage years.

Madina - barely into adolescence - was subjected to one of the most severe forms of female genital mutilation (FGM) - a practice long carried out in many African countries.

She was too young to understand what was happening to her. Like all other young girls in her ethnic Fulani community in Mali, she was required to go through the rite of passage before the onset of puberty.

The practice involves "cutting" a girl's vagina to create a seal that narrows the opening, just wide enough to allow the passing of urine and menstrual blood. Infibulated girls often have their legs bound together for up to four weeks to allow the freshly fused tissue to heal.

"All I know is that I had severe problems immediately after being excised. I remember going through a very agonising cycle of puberty. I remained covered in pain and humiliation," says Madina.

"I don't see any harm from this practice. It has been our tradition for centuries." - Abdoul, father of two girls



On the International Day of the African Child, the suffering caused by female genital mutilation is under the spotlight with the controversial practice widely condemned by rights and health organisations.

According to the World Health Organisation , there are about 140 million girls and women around the world currently living with the consequences of the practice. The majority of these females are in Africa, where it is routinely done in 28 countries.

An estimated 101 million girls 10 years old and above have undergone varying forms of genital mutilation in Africa. A study by child rights and development organisation Plan International in Mali in 2010 found more than half of all fathers and one-third of mothers wanted their girls excised.

"I don't see any harm from this practice. It has been our tradition for centuries," Abdoul, a father of two young girls, told researchers.

Dangerous operation

For families it is a seal of guarantee that secures girls against any sexual encounter prior to marriage, and protects the family honour.

For infibulated girls, mutilation does not end with the childhood operation. On the day of their wedding, brides undergo another painful surgery to reverse it. This involves cutting open the connecting tissue and restoring the vaginal opening to enable sexual intercourse with their husbands.

"I cannot even explain the feeling of terror that runs through infibulated girls' minds thinking of marriage," says Madina.

In most cases cutting is done by a traditional practitioner without any anaesthesia and little care for hygiene. Razors, knives or scissors are used and they are rarely sterilised. The surgery takes place wherever it is convenient - from out in the open to a bathroom floor.

"It is only after completing this procedure an excised bride is considered 'free'. She usually has her first sexual experience the very same night after cutting," says Madina.

Cutting tools on display in a room in Lunsar, Sierra Leone [Grace Harmon/Plan International]

In most places where it is practised, FGM is considered an essential part of raising a girl and preparing her for womanhood and marriage. With its direct link to beliefs about premarital virginity and marital fidelity, the social pressure to adhere to the practice is intense.

Thousands of girls every year suffer health complications including severe vaginal pain, shock, bleeding and infection. Life-long consequences include infertility, childbirth complications and new-born deaths.

Recently 13-year-old Soheir al-Batea died in a clinic in Egypt when a doctor was performing the procedure. The girl's death has caused an uproar in the country where FGM is legally banned but still widely practised, affecting more than two-thirds of women there.

From verbal threats and physical force, all kinds of methods are used to coerce unwilling girls into submission.

"I will never forget that day. My mother woke me up very early in the morning and told me firmly to get ready for circumcision," says 13-year-old Ahlam, her surname withheld to protect her identity.

"Immediately an old woman entered the room and got a razor out of her bag. My mother held my arms very tight so that I could not move. The woman used her razor to circumcise me. I cried loudly but nobody listened, the pain was unbearable. After all was done, my mom paid her some money and she left. A few hours later, I started to bleed."

In countries such as Djibouti, Sierra Leone, Mali, Somalia and Guinea the practice is so rife that almost nine out of 10 girls undergo genital mutilation.

Dreading the day

Eleven-year-old Mariama is dreading the day she will have to go through her excision ritual. Her family fled the violence in northern Mali and moved to the capital Bamako a few months ago.

As if the stress of displacement is not enough, Mariama says she is consumed by thoughts of the pain that awaits her. "My friend's sister from our neighbourhood died after her excision. I am very worried what will happen to me," she says.

Religious leaders take varying positions on the issue, with some promoting it and others supporting its elimination.

El Sheikh Saad is the sheikh of his village mosque in Egypt's Assiut province. A father of a seven-year-old girl, Sheikh Saad was not initially against female genital mutilation until he became informed about its health dangers, and after consulting religious scholars.

"I was not convinced about the harms of this tradition," he says. "I brought the matter up before the local religious committee and they told me clearly that there was no religious basis of the practice."

"Girls and boys are not only rights holders themselves, but also future parents who will play a crucial role in ending this generational scourge." - Madina Bocoum Daff, FGM survivor



In many instances, female circumcision is performed on extremely young girls. In rural areas in Mali, for example, it is being done to girls under five. In some urban areas, the surgery is even conducted on new-born girls before they are 40 days old.

The practice violates a number of fundamental rights outlined under international protocols. But despite that, only 19 of the 28 countries that practice FGM in Africa have national laws prohibiting it. And even where laws exist, prosecutions are rare.

Despite many African countries signing up to international legal frameworks to protect children, traditional laws governing customary practices often override such treaties.

After suffering through female genital mutilation herself, Madina now works with Plan International to eliminate it from her country, Mali. She says progress is being made.

"Through community awareness and education, 44 villages in areas where we work have declared themselves FGM-free," Madina says.

"Besides parents and elders, engaging with children and young people is a key part of our approach. Girls and boys are not only rights holders themselves, but also future parents who will play a crucial role in ending this generational scourge."