Unlike other harmful practices that have been abolished overtime due to civilization, it is surprising that in Africa, Female Genital Mutilation (FGM) is being practiced among certain communities in 29 countries, with Nigeria, Sudan, Mali and Ghana, labelled as practicing the worst type of FGM. ODIRI UCHENUNU-IBEH writes. Female Genital Mutilation (FGM) otherwise known as female circumcision, which is the partial or complete removal of the external part of the female genitalia for non-medical reasons, is a tradition whose origins could be difficult to trace as it is practiced all over the African continent. According to the United Nation Population Fund, (UNPF), an estimated 200 million girls and women alive today are believed to have been subjected to FGM and those who have experienced FGM live predominately in sub-Saharan Africa and the Arab States. In Africa, FGM is practiced among certain communities in 29 countries namely Benin, Burkina Faso, Cameroon, Central African Republic, Chad, Cote d’Ivoire, Democratic Republic of Congo, Djibouti, Egypt, Eritrea, Ethiopia, Gambia, Ghana, Guinea, Guinea-Bissau, Kenya, Liberia, Mali, Mauritania, Niger, Nigeria, Senegal, Sierra Leone, Somalia, Sudan, Tanzania, Togo, Uganda and Zambia. While there have been widespread interventions aimed at reducing and changing the perception of the world about FGM, yet, the practice still lingers. According to a United Nations International Children’s Fund (UNICEF) report, in the sub Saharan Africa, Nigeria, Sudan, Mali and Ghana have been labelled as practicing the worst type of FGM and the reasons given by those who practice it ranging from culture, religion to superstition. In Nigeria, latest public opinion poll results released by the Ngozi Okonjo-Iweala Polls (NOIPolls), have revealed that although 87 percent of Nigerians expressed knowledge of FGM, 64 percent of this proportion confirmed that FGM is not prevalent in their locality while 36 percent disclosed that there are various degrees of prevalence within their communities; with high level of prevalence across Ondo, Kwara, Enugu, Delta, Adamawa, Ebonyi, Cross-River, Anambra and Niger states. Some of the local Government areas where this practice is particularly prevalent are; Moro, Ilorin-south, Ilorin-north in Kwara state and Akure-north and Akure-south in Ondo state. Others are Ika-south, Ughelli, Warri-south, Sapele and Aniocha-south all in Delta state. The poll also evaluated the support of Nigerians for Female Circumcision and the results show that most of the respondents surveyed (88 percent) say they are not in support of the practice in the country; and this also cuts across gender, geo-political zones and age-group. However, 12 percent expressed their firm support for the practice of FGM, particularly amongst respondents in some South-West (19 percent) and South-East (15 percent) states; as well as senior citizens aged 60 and above (19 percent). The views of Nigerians regarding legislation against the practice of FGM were assessed; and an overwhelming majority (90 percent) indicated their absolute support for legislation to abolish the practice in the country. On the contrary, 10 percent of the respondents declared firmly that they would not support any legislation to end the practice of female circumcision, saying that they identify with the practice from a socio-cultural perspective and it would amount to them going against their ancestral beliefs if the practice was to be abolished. With the negative effect of FGM, stakeholders however, are calling on medical practitioners, state and local government officials, federal and state ministries of health, traditional rulers, indigenous healthcare attendants, Non-Governmental Organisation (NGOs), Community Based Organisations (CBOs), Faith Based Organization's (FBOs) and the general public to address the issue in a cross-cutting manner, by funding and implementing sensitization campaigns to get the message, especially to the grassroots, where the practice is mostly prevalent. Commissioner for health, Lagos state, Dr. Jide Idris said improved guidelines, trainings and policies to ensure health professionals can provide counseling to young girls and women is a major solution to the challenge of FGM in Nigeria. The commissioner, while speaking on the negative effect of the practice on women disclosed that FGM is a socio-cultural practice that is hazardous and mostly done by traditional circumcisers, adding that the act is usually very harmful to the health of women since it can lead to urinary tract problems, tetanus infection, severe bleeding, cysts, genital swelling, complications during child births and increased risk of neonatal death. According to Idris, FGM or intentional alteration of the genital for non-medical reasons does not have any health benefit as wrongly believed by the proponents, it does not reduce libido in women nor contribute to chastity as erroneously claimed. He noted that, on the other hand, FGM can have long term consequences such as pain in intercourse, decreased sexual satisfaction, problem with menstruation as well as the need for later surgeries. Idris also addressed the assumption that the procedure is safer when done by health or medical personnel demanding that no health workers should support such gross infringement on the well-being of women. While advising health workers to desist from performing FGM, he also expressed concern about psychological problems such as depression, anxiety, post-traumatic stress disorder that accompany such procedures. According to the Commissioner, FGM is an unnecessary pain inflicted on women by people they know and respect, usually family members and leaders of the community, hence, it can be a precursor of mental and psychological problems for the affected women. Speaking on the panacea for this situation, Idris pointed out that in addition to government policy, there is need for the development of a robust advocacy to educate, enlighten community and religious leaders on the harms of the practice and engage them on the need to abandon it. He further added that there is also the need for training and orientation of health and social workers to manage and counsel victims of this barbaric act as it will help in no more small measure to alleviate their sufferings and reduce the burden of psychological trauma being experienced. Idris disclosed that the Ministry has an Adolescent/Youth Sexual Reproductive Health unit to cater for the youths of Lagos state especially with regards to Counseling, Reproductive health clinic, and Provision of Preventive and Clinical services. He added that the centre is expected to bridge the gap by providing a "safe and confidential centre for young people”. The Director, Family Planning and Nutrition, Ministry of Health, Lagos state, Dr. Folashade Oludara, has employed all Nigerians to be an advocate of prevention of FGM, adding that it is not enough for government to make law as FGM is a cultural inherited belief, hence the need to embark on focus group discussion. Oludara said in a bid to prevent more women and girls from undergoing FGM, the Lagos state government is calling on stakeholders to collaborate with the state to end the practice. She said, "The Lagos state government believes so much in collaborative efforts. The state government is ready to collaborate with any agency in the fight against FGM." The executive director, Child Health Advocacy Initiative (CHAI), Mrs Lola Alonge, said recent statistics from the UNICEF shows that more than 200 million women and girls have undergone FGM globally with 10 percent of them living in Nigeria. Alonge said the states with highest prevalence of FGM are Osun with 77 percent, Ebony with 74 percent, Ekiti, 72 percent, Imo, 68 percent and Lagos state with 45 percent. "In some societies, FGM is considered a rite of passage; in others, it is seen as a pre-requisite for marriage or attributed to religious beliefs. The practice is considered a means of maintaining chastity and preventing promiscuity or infidelity," she added. The executive director said FGM is globally recognized as an extreme violation of the rights of women and girls as it violates human rights principles and standards including the principles of equality and non-discrimination on the basis of sex, the right to the highest attainable standard of health, the rights of the child and the right to physical and mental integrity and even the right to life.She however called on stakeholders, including faith leaders and traditional rulers to act as change agents, challenge misconceptions that FGM is a religious and cultural requirement and be proactive in ending FGM.