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 GLOBAL QUEST TO END FGM 

One day, Adama Susso and her twin sister set off from home in the company of their grandmother for a routine trip to the market. Or so they thought.

The young pair, aged nine at the time, did not know that their grandmother was instead taking them to undergo female genital mutilation (FGM), a harmful practice that involves the altering or injuring of female genitalia for no medical reason.

Susso, a Gambian FGM survivor and youth advocate today, still has a vivid recollection of what happened that fateful day.

Instead of a familiar trip to the market, she and her sister would later find themselves inside a room in an alien location — their backs on the ground and hands held down, under instructions to remain still, apparently so as not to get hurt during the procedure.

But unable to bear the pain, the helpless little girls screamed and cried throughout their horrifying ordeal.

"It was one of the most horrendous activities ever performed on me and, I think, for the rest of my life," Susso told a webinar organized by the UNFPA-UNICEF Joint Programme on the Elimination of FGM on Tuesday.

The virtual meeting was held in commemoration of the International Day of Zero Tolerance for FGM, observed every February 6.

'I will take you to Police, mum'

"Until today, if I think about what happened, it always gives me the chills," said Susso.

It only dawned on her later while in school that what she and her sister had undergone "was really wrong and it should not have happened".

From that time on, the young advocate vowed to work to ensure that the same never happens again. "Not to my friends, not to my siblings, not to my agemates, not to anyone I know and, most especially, not to my children."

And her resolve is not sparing anyone's blushes.

"From that day on, I keep telling my mum all the time: 'If I ever see you helping anyone taking their children to get them circumcised, you are going to be following me to the police station'."

▪️ Focus turns to action after 2nd FGM conference in Tanzania

International Day against FGM in Madrid on February 6, 2016

'It is not sick'

The last thing Susso wants to see is another young girl endure the scarring effects that she has had to deal with to this day as a result of undergoing FGM.

For instance, her menstrual cycle became irregular because of — as later trips to the gynaecologist revealed — infections picked up when she underwent the procedure.

Ever since then, she has been struggling with infections and diseases.

"No human being has the right to get something from somebody without their permission. And most especially a part of my body that I wouldn't want cut, because it is not infected. It is not sick," said Susso.

'Progress must be quickened tenfold'

But much as the young Gambian FGM survivor desires that no other girl or young woman undergoes this terrifying experience, official data projects a much harsher reality.

This year (2024), nearly 4.4 million girls — or more than 12,000 each day — are at risk of FGM around the world, according to the United Nations (UN). 

If the world sits back, this unwanted statistic will pile onto the over 200 million girls and women alive today who are survivors of FGM. Worse still, it would also drag the globe further adrift of its ambitious target of ending FGM by the year 2030.

Good enough, the world is collectively trying to do something about it.

The fact that today a girl is about one third less likely to be subjected to FGM than she was three decades ago, according to UN data, provides an encouraging snapshot of the dividends of concerted global efforts trained on ending the practice.

Yet, it is not enough.

With only six years left of this decade, campaigners argue that progress needs to be at least 10 times faster to meet the much-desired 2030 target of eliminating FGM (SDG 5.3).

Acceleration of collective anti-FGM efforts means more money must be injected into the global campaign. In fact, the UN says $2.75 billion (sh10.5 trillion — or nearly a fifth of Uganda's annual national budget) is needed to eliminate FGM by 2030 in 31 priority countries. 

The much-needed funding would enable investment in, among other things, FGM survivor-led movements, the latest area of focus in the campaign to end the practice.

Campaigners believe that FGM survivors, such as Susso of Gambia, hold an important key to the elimination of the harmful practice and as such, their voices should be amplified in local, regional and global dialogues, efforts and decision-making.

It is hoped that allowing survivors to tell their stories and experiences will not only raise awareness about FGM, but also inspire collective action.

And that is what inspired the theme of this year's International Day of Zero Tolerance for FGM: Her voice. Her future. Investing in survivor-led movements to end FGM.

"It is important to put to focus the voices of survivors to let them tell their stories rather than talk about them," said Dr Bärbel Kofler, the Parliamentary State Secretary to Germany's Federal Minister for Economic Co-operation and Development.

"Surviving women and girls need prospects for the future without stigmatization and exclusion."

▪️  Drawing men and boys into quest to end FGM

'Resilience and power'

Also speaking at the virtual event on Tuesday, Swede Elizabeth Harleman — head of regional development co-operation of sexual and reproductive health and rights in Africa, based at the Swedish Embassy in Pretoria, South Africa — shared similar sentiments about the power of survivor-led programming.

"When survivors are at the centre of our efforts, we foster a generation of empowered change makers who will drive the momentum to eradicate FGM and create a future where every girl is free from harm," she said.

As a donor-partner of the Joint Programme since 2018, Sweden has contributed $56 million (sh214 billion) to the programme, according to Harleman.

To keep the global anti-FGM campaign going, the financial taps will have to somehow keep flowing in the coming years.

The donors, partners, governments and other stakeholders represented in Tuesday's online engagement were paying close attention.

Positively, there emerged a general appreciation of the urgent need to invest in survivor-led movements, which, according to event moderator Dr Leyla Sirad Hussein Gikandi OBE, are "fueled by the courage and determination of individuals who have transformed their pain into purpose".

"Today, we celebrate the resilience and power of those who have survived FGM," said Hussein (pictured below), a Somali-born British psychotherapist who was subjected to FGM at the age of seven.

She is currently specializing in supporting survivors of sexual abuse.

'We will end FGM'

In Hussein's country of birth (Somalia) is one inspiring pioneer woman who has spent most of her long life advocating for the end of FGM: Edna Adan Ismail.

"I would like to remind the world that we have been trying to eradicate this very harmful practice for many, many years," said the octogenarian in her recorded message to the world.

"I had the honour to launch and pioneer the very first public discussions in Somalia at that time, before Somaliland separated from Somalia, and to speak about the fact that FGM is not an Islamic requirement but a traditional practice that is harmful to the health and wellbeing of little girls.

"It is my very sincere hope that inspite of all the resolutions that have been taken and because FGM is still being undertaken, we will combine our efforts to do all that we can to protect little girls from this very harmful practice that is carried out on them and that also interferes with their future and reproductive life," said Ismail.

The founder of the Edna Adan University and Edna Adan Hospital, Ismail started working as a nurse and midwife in 1960s Somalia.

She will have been emboldened by the tone of optimism struck on the day by Dr Natalia Kanem (pictured below), the executive director of UNFPA, the UN's sexual and reproductive health agency.

"UNFPA is united with you in our collective commitment. We will end FGM. And we are united in our support for the 200 millon FGM survivors worldwide," said Kanem in her message.

She said the burden of addressing FGM is a responsibility that belongs to everyone — not the survivors.

"It is up to all of us to stop this human rights violation in every community where it persists and to help survivors heal and take control of their lives."

Anti-FGM campaigners march to end FGM in Sierra Leone on International Women’s Day in Freetown on March 8, 2022

'Indomitable spirit of survivors'

The UNFPA chief said investing in survivor-led movements will help accelerate efforts to end FGM by the end of this decade.

"Survivors understand the obstacles to eliminating FGM. They are leading the way to overcoming those obstacles, one family, one community, one person at a time."

Kanema said UNFPA is committed to centering the voices of FGM survivors as "invaluable partners" of the Global Joint Programme.

"Since its inception in 2008, the programme has supported over 11,000 organizations. Many of them are grassroots and survivor-led.

"Of course much more work will need to be done to address the scale of the problem. By the time we all go to sleep tonight, 12,000 more girls will have undergone FGM. 

"So, today, I ask everyone to think about what you can personally do to help turn the tide to help make FGM history.

"And as we go forward, let us be inspired by the resilience, courage and determination of survivors. Let our movement to end FGM gain strength from the indomitable spirit of survivors and let us join them in becoming fearless champions of change," said Kanema.

'Catalyst for change'

A plenary session during the 2nd International Conference on FGM in Tanzania in October 2023

Speaking of fearless champions of change, Kenyan Anna Qabale Duba, an FGM survivor who is currently a human rights and anti-FGM champion, stands out.

The mother of two, who is expecting her third child, underwent FGM at the age of 12 and narrowly escaped forced early marriage two years later in the village of Tuba in Kenya's northern pastoralist county of Marsabit.

Against all odds, Duba feels lucky to have became the only educated girl in a family of 19 children and the first female graduate from "my small village".

"So I decided to go back [to her village] and be the voice of change for my people and for the other girls and women who deserve their voice to be heard," she said.

Duba, a nurse and Miss Tourism Kenya 2013 winner, agrees that investment in survivor-led movements is a crucial and effective approach in combating FGM.

Featuring on the cast of speakers of Tuesday's virtual event, she said such movements empower women and girls who have experienced FGM to become advocates and leaders in the fight against it. "These are the people who give you their real life experiences."

She then went on to make a case for investment in survivor-led efforts, as follows:

▪️ Authentic voice. Survivors of FGM have firsthand experience of the physical, emotional and pyschological consequences of the practice. Their voices carry authenticity and credibility, making them powerful advocates for change.

▪️ Community trust and engagement. Survivors are usually deeply embroiled in their communities and they possess cultural knowledge and senstivity. They can engage with communities in ways that outsiders cannot.

▪️ We are the catalyst for change. Survivor-led movements can catalyze a broader social change by raising awareness and influencing public opinion and mobilizing communities to take action against FGM.

▪️ Survivor stories have the power to inspire empathy and solidarity.

▪️ Survivors can advocate for policy changes at all levels: local, national and international.

In all this, Duba said supporting survivor-led movements helps to strengthen their capacity to lead initiatives.

▪️  Ending FGM 'needs all hands on deck'

An ex-FGM cutter of the Pokoto tribe Chepureto Lobul (2ndF) reacts during a meeting with journalists in Katabok village, northeastern Uganda on January 30, 2018

'Nobody could hear me'

According to UN data, one in four survivors underwent FGM by a health worker. It may, therefore, be unsurprising that some health professionals are survivors themselves.

But some of them, like Kenyan nurse Catherine Chacha Menganyi, are working to help others not to experience what they went through.

Also a gender activist, she embodies the power of health professionals in the fight against FGM, having dedicated her life to ending FGM and breaking the cycle. 

Hers is a powerful testament to the sacrifice individuals make.

Menganyi is currently coordinating the gender-based violence prevention and response in Migori county under the health department in Kenya.

She underwent FGM at the age of 12 and blames it on "the beliefs and culture in my community about FGM".

She struggles to shake off the memories.

"This is an experience that I have never forgotten. It is still very fresh in my memory: I always see this health care provider in a white coat, wearing gloves and holding a blade. I am put on the ground. Everybody is trying to make me not to scream and she [medical worker] has to perform the [procedure].

"I screamed, but nobody could hear me, because we had women who were holding my mouth and trying to make me not to speak out."

Menganyi believes that as health care professionals, they have a role to play in the fight against FGM.

"We need to have the voice of healthcare providers in ending FGM. The World Health Organization (WHO) has developed a new approach of person-centred communication in the prevention of FGM, which starts with the personal reflections of the individuals."

In retrospect, Menganyi feels she could have done much more in the past to reduce the prevalence of FGM in Migori.

"The number of women I have encountered for the last 18 years, if I had had the conversation of ending FGM [with them] then, I would have reached a bigger population and reduced the physical and pyschological trauma."

She has done what she can within her power. Her face lights up when she reveals that her two daughters, aged 14 and 16, have not experienced FGM.

"And I have been able to save more than 200 girls from FGM through the conversation of how to break the cycle."

'People will start to listen'

Meanwhile, the UN warns that with no further action, 68 million girls will be subjected to FGM by 2030.

To avoid this happening, governments must be committed and communities engaged. 

Campaigners will have been encouraged to see young people like Susso from Gambia taking centrestage in building movements against FGM.

She has already confronted her grandmother over subjecting her and her twin sister to FGM when they were younger.

"When I went home, I told my grandma: 'What you did to me still affects me today and it might affect me when I get married. I am so scared sometimes that I was sealed and when I go to my husband's house, they will have to reopen me and I will have to go through that pain again'."

Despite her traumatic experience, Susso remains resolute in her anti-FGM advocacy.

"I do know one thing for sure: that if we keep on speaking — and because it is a survivor-led movement and they are not reading it from social media or Google — I feel like people will start to listen, because I have seen people start to listen."

Students of Kalas Girl's primary school who escaped from FGM or child marriage walk to the church, next to the school, in Amudat town, northeast Uganda, on January 31, 2018

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💬    WHAT THEY SAID 

'Survivors are powerful agents of change'

Dr Wisal Ahmed, global co-ordinator of the UNFPA-UNICEF Joint Programme on the Elimination of FGM:

❝ We bring attention to the 200 million girls and women who have undergone FGM. They are not to be forgotten. They are important stakeholders.

In countries where FGM is prevalent, daughters of mothers who have undergone FGM are at significantly higher risk to undergo FGM. 

But, FGM survivors are not victims. They are resilient and powerful agents of change to end and abandon FGM.

Let us celebrate FGM survivors' resilience and activism and call for global and local actions to invest more into this untapped resource.❞
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'Survivors bring authenticity'

Catherine Russell, executive director of UNICEF:

❝UNICEF is calling on the global community to continue to strengthen the commitment to ending this harmful practice [FGM].

Estimates show that over 200 million girls and women alive today have undergone FGM. The situation demands urgent action and we can all play a part.

The private sector, for example, can play an important role by increasing investments for survivor-led movements, especially movement of young people. 

Survivors of FGM play an especially powerful role in eliminating the practice.

Survivors know their communities well. They bring authenticity, the ability to dispel myths and misconceptions and they are powerful advocates to empower lives, including through education.

Lasting change is more likely when initiated and championed by the communities themselves and with effective advocacy for policy changes and legal frameworks that protect girls from FGM.

Survivor-led movements also create a global network of solidarity, uniting individuals and organizations committed to ending FGM.

Working together and focusing our collective efforts on investing in FGM survivor-led movements can go a long way to help eliminate FGM once and for all.❞
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'Health workers have important role'

Dr Tedros Adhanom Ghebreyesus, WHO director-general:

❝The World Health Organization (WHO) is committed to helping countries build capacity to provide healthcare and support the survivors of FGM and work with communities to prevent it.

Four million girls are at risk of this harmful practice each year. It harms the health and wellbeing of women and girls. It is a violation of their human rights.

WHO supports countries in training health workers to treat the complications of FGM in primary care settings. 

Health workers have an important role to play in community outreach  and in communicating with women and families during routine care to prevent FGM.

In fact, health workers in countries where this practice occurs may be survivors themselves.  They know the trauma and pain it causes. Many have turned that pain into advocacy and are speaking out against FGM.

Today, on the International Day of Zero Tolerance for FGM, we stand with survivors to hear their voice, to ensure they have the care that they need and to support their efforts to stop FGM.❞
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'Culture is not immutable'

Dr Geeta Rao Gupta, US Ambassador-at-Large for Global Women's Issues:

(The US has been a partner of the Global Joint Programme since 2017 and was a donor in 2023)

❝One recent study showed that FGM was the leading cause of death for women and girls in African countries, with over 44,000 women and girls dying each year because of the practice.

No matter the type or motivation for performing it, FGM is a human rights abuse and a form of gender-based violence (GBV).

In December, the US government launched an update to the US strategy to prevent and respond to gender-based violence globally. Notably, this update places a strong emphasis on addressing the unique needs and vulnerabilities of girls and young women to GBV, and the importance of collective action, working with girls and communities to shift norms and to create lasting change.

Because this issue has no borders, the US also recognizes the importance of ending FGM domestically here in the US.

In addition to the US federal law criminalizing the performance of FGM on girls, which has been in place since 1996, the STOP FGM Act of 2021 expanded the scope of those who can be prosecuted under the law and double the maximum penalty.

Forty-one (41) states in the US also have their own laws criminalizing FGM.

While policy and legislative frameworks are obviously necessary to accelerating progress and creating this change, we know that FGM is rooted in long-standing traditional and cultural norms. 

But it is important to remember that culture is not immutable. We have evidence that norms can and do change over time.

In the last two decades, the proportion of girls and women in high prevalance countries who want the practice to stop have doubled. In other words, the women and girls who undergo FGM want it to sttop and are increasingly vocalizing that.

The areas where FGM is concentrated are in fact shrinking, though we still have a long road ahead.

On this journey to end FGM, girls' voices and leadership must be central and elevated: grandparents, parents, teachers, religious leaders and other community members also have critical roles to play in creating an environment where girls are safe and empowered.

As we work collectively to achieve the Sustainable Development Goals (SDGs), it is imperative to note that without significant and accelerated action, the world will not achieve the outcome of FGM elimination that we strive for.

In fact, SDG 5 is among the farthest behind, which should serve as a warning all for us.

UNICEF has predicted  that progress must take place and at least 10 times faster to meet the global target of eliminating FGM by 200. This means we must work 10 times harder to forge new partnerships to secure additional resources and to build the capacity of local organizations, groups and networks.

The US is committed to working with our partners, survivors, locally-led women's organizations and youth-led groups and networks and everyone else to ending all forms of GBV and uplifting the priorities and voices of girls and young women around the world.❞

Year of these statistics: 2018

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'Eliminating FGM benefits everyone'

Peter MacDougall, Canada's Assistant Deputy Minister for Global Issues and Development:

❝This year's theme reminds us not only that we must not continue to invest in ending this harmful practice but also the importance of prioritizing support to women and girl survivors, their organizations and movements.

Because when we support survivor-led movements, we support women's and girls' meaningful participation in decisions that affect their bodies and their lives.

They thrive as a result and we multiply the impact of our investments.

We know that gender-based violence and the denial that women and girls bodily autonomy, including through the practice of FGM, are major barriers to gender equality and their empowerment.

We need to listen to affected communities, to women, and girl leaders and survivors and to support their efforts for change.

Through its Feminist International Assistance Policy, Canada is contributing to these efforts. We recognize the central role gender equality and the elimination of all forms of sexual and gender-based violence play in achieving the SDGs. 

We have taken concrete action to increase funding for programming to address harmful practices such as FGM. 

As part of our global committment to global health and rights, we invest $700 million (sh2.69 trillion) annually to advance sexual and reproductive health rights, including addressing sexual and gender-based violence.

This funding includes support to various partners, including women's rights organizations, who are at the forefront of advocacy and action against sexual and gender-based violence — from the grassroots to the national and global levels.

Canada is committed to continuing its work with UN agencies and other states  and support organizations that address FGM.

We are proud to support the Joint Programme and we believe this global initiave is key to protecting girls at risk and ensuring that future generations can lead fulfilling lives free from harm.

Eliminating FGM benefits everyone. Let's keep working together to end this practice.❞
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'Patience and perseverance'

Dr Bärbel Kofler, Parliamentary State Secretary to Germany's Federal Minister for Economic Co-operation and Development:

❝Germany is home to about 67,000 women who have undergone FGM. About one in 10 women and girls dies during the procedure. Many more die from its long-term consequences.That is intolerable.

Ending gender-based violence is an intergral part of Germany's development policy.

Together with our partners, we want to strenghten the rights, resources and representation of women and girls.

It is important to put to focus the voices of survivors to let them tell their stories rather than talk about them. Surviving women and girls need prospects for the future without stigmatizaion and exclusion.

It will take patience and perseverance to end FGM, but change is possible. This is evident from the progress made from our Joint Porgramme with partners such as UNFPA and UNICEF.

For instance, it was also thanks to our programme that in 2022, 500 religious and community leaders publicly condemned this harmful practice.

Experience shows that there is a need for exchange with local communities, a need for continuous dialogue among all generations and most imprtantly,  a need for close co-operation with surviving women and girls.❞
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'Change is possible'

Elizabeth Harleman, head of regional development co-operation of sexual and reproductive health and rights in Africa, based at the Swedish Embassy in Pretoria:

❝Ending FGM will require efforts and engagement at all levels by multiple actors and within many sectors.

It is about having legal environments that prohibit these practices. It is about poverty and families not being able to feed enough children and it is about traditions, norms and values that favour such practices.

It is important to remind ourselves about progress that has been made and that change is possible.

In the last two decades, FGM prevalence rates have dropped by a quarter and the proportion of girls and women in high prevalence countries who oppose the practice has doubled.

However, in some countries, FGM remains near-universal or is as common today as it was even 30 years ago.

For the global community to meet SDG target 5.3 by 20230, progress will need to be at least 10 times faster than it has been over the past 15 years.

We know what needs to be done to end FGM, but progress is too slow.

We know that education plays an important role in keeping young girls and women safe. The longer a girl stays in school, the less likely she is to be married before the age of 18 and have children during her teenage years.

We also know that survivor-led programming is key to ending FGM by empowering girls and women, amplifying their voice and nurturing their agency.

When survivors are at the centre of our efforts, we foster a generation of empowered change makers who will drive the momentum to eradicate FGM and create a future where every girl is free from harm.

Women and girls' bodily autonomy, including the elimination of harmful practices, is a top priority for Sweden.

Let us all take on the responsibility to make sure that we put an end to FGM.❞