A recent study highlights the ongoing public health crisis of female genital mutilation (FGM) in Sierra Leone. Despite increased awareness and legal efforts, the practice continues to affect over 80% of Sierra Leonean women and girls. The research, published in Women, calls for a community-driven approach to end FGM, focusing on cultural sensitivity and local leadership.
FGM is not just a physical issue but a cultural one deeply rooted in Sierra Leone’s traditions. The study examines data from 2012 to 2025 and underscores that entrenched social norms, weak legal enforcement, and limited healthcare access have all contributed to the persistence of the practice. This marks a significant challenge for global and national health and human rights advocates.
Why Does FGM Continue in Sierra Leone?
The study identifies cultural entrenchment as the main reason FGM persists. In Sierra Leone, the practice is closely tied to the Bondo society, a women-led secret group. FGM is seen as an essential rite of passage, symbolizing maturity and eligibility for marriage. For many women, belonging to the Bondo society is crucial for social integration, reinforcing the widespread adherence to the practice.
Even though Sierra Leone has ratified international human rights agreements, local laws against FGM remain weak. Existing laws are often poorly enforced, and traditional leaders resist changes they see as foreign impositions. Women themselves, raised to believe in the importance of FGM, play a central role in its continuation, making it one of the few gender-based violence practices that is both inflicted and perpetuated by women within their communities.
Socioeconomic factors, such as poverty, low literacy rates, and limited healthcare, also reinforce the practice. In rural areas, where FGM is most common, health education is scarce, and public health messages have struggled to challenge deeply ingrained beliefs.
The Health and Social Consequences of FGM
The study reveals the severe health risks tied to FGM, including excessive bleeding, infections, and obstructed menstruation. Long-term complications include infertility and difficult childbirth. However, many women avoid professional healthcare due to mistrust or lack of access, often seeking treatment from traditional healers. This reliance on informal care highlights the systemic inequalities that prevent effective intervention.
Another concerning finding is the connection between early-age circumcision and increased vulnerability to intimate partner violence (IPV). Women who undergo FGM between the ages of 10 and 14 are more likely to experience IPV, especially if they marry early. The study suggests that FGM not only causes physical harm but also perpetuates cycles of gendered violence and subjugation.
The study also addresses the issue of medicalization, where some FGM procedures are performed by health professionals. While intended to reduce harm, this trend could inadvertently legitimize the practice, potentially entrenching FGM under the guise of clinical safety.
The Role of Education and Empowerment in FGM Eradication
Education is often seen as a key factor in opposing FGM. The study finds that while higher education correlates with resistance to FGM, economic empowerment does not always lead to rejection of the practice. In some cases, even women with access to education and employment were still willing to circumcise their daughters. This highlights the need for structural change alongside education to challenge the cultural norms that sustain FGM.
What Can Be Done to End FGM?
The study argues that top-down approaches, often led by international organizations, have had limited success in Sierra Leone. The key to eradicating FGM, according to the researchers, lies in grassroots engagement and cultural sensitivity. Community-driven efforts that include local leaders, healthcare providers, and survivors have proven more effective in changing attitudes.
The study points to successful models, such as those in Senegal, where health education and gender rights were integrated into community development programs. These programs promoted participatory learning and local dialogue, which helped change cultural attitudes while respecting traditions.
The Empowerment Theory and the Intervention Based on Competences (IBC) model are recommended as frameworks to support women’s autonomy and resistance to harmful practices. These approaches encourage critical reflection and the development of skills that allow women to challenge the norms that view FGM as necessary for social acceptance.
Additionally, the study advocates for the creation of alternative rites of passage that maintain cultural values without causing harm. Working with cultural insiders, these alternatives offer a path to social integration while eliminating the dangers of FGM.
In conclusion, the study emphasizes that eradicating FGM requires more than legal action—it demands long-term, culturally respectful engagement. Only by bridging the gap between legal frameworks and local cultural legitimacy can Sierra Leone hope to eliminate this harmful practice and protect the health and rights of its women and girls.
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