Health complications of female genital mutilation in Sierra Leone

Abstract

Sierra Leone has one of the highest rates of female genital mutilation (FGM) in the world, and yet little is known about the health consequences of the practice.PurposeTo explore whether and what kind of FGM-related health complications girls and women in Sierra Leone experience, and to elucidate their health care-seeking behaviors.Patients and methodsA feasibility study was conducted to test and refine questionnaires and methods used for this study. Thereafter, a cross-section of girls and women (n = 258) attending antenatal care and Well Women Clinics in Bo Town, Bo District, in the southern region and in Makeni Town, Bombali District, in the northern region of Sierra Leone were randomly selected. Participants answered interview-administrated pretested structured questionnaires with open- ended-questions, administrated by trained female personnel.ResultsAll respondents had undergone FGM, most between 10 and 14 years of age. Complications were reported by 218 respondents (84.5%), the most common ones being excessive bleeding, delay in or incomplete healing, and tenderness. Fever was significantly more often reported by girls who had undergone FGM before 10 years of age compared with those who had undergone the procedure later. Out of those who reported complications, 187 (85.8%) sought treatment, with 89 of them visiting a traditional healer, 75 a Sowei (traditional circumciser), and 16 a health professional.ConclusionThe high prevalence rate of FGM and the proportion of medical complications show that FGM is a matter for public health concern in Sierra Leone. Girls who undergo FGM before 10 years of age seem to be more vulnerable to serious complications than those who are older at the time of FGM. It is important that health care personnel are aware of, and look for possible complications from FGM, and encourage girls and women to seek medical care for their problems.

Female Genital Mutilation in Sierra Leone: Forms, Reliability of Reported Status, and Accuracy of Related Demographic and Health Survey Questions

“…In the short term, these can include excessive bleeding, local infections, shock, and delay in or incomplete healing [13–15]. …”

Impacto de la mutilación genital femenina en los objetivos del milenio

“…Hemorrhage, a consequence of cutting an artery or a secondary effect of a blood clot breaking off (6,13,15) , hypovolemic hemorrhagic shock, as well as distribute, septic, and neurogenic shock (14,18) , hepatitis B and C infections, tetanus and HIV/AIDS (18) , and an increase in the number of newborns that require reanimation right after birth (2,16) , with this type I and II FGM being linked to 22% of perinatal deaths (2) . These consequences of FGM entails a limitation for the achievement of MDG.4 (Table 3).…”

“…Immediate consequences of FGM Hemorrhage (6,13,15) Acute posthemorrhagic anemia (7) Shock (14) Infections (15) Increase in number of newborns who require reanimation after labor (2,16) Death as a result of complications in previous cases (14) …”

Female Genital Mutilation: A Violation of the Human Rights of Girls and Women a Call for Concrete Policies and Renewed Actions

“…Since in most cases the procedure is carried out without anaesthesia, the resulting pain and trauma can produce a state of clinical shock [6]. Immediate complications include delayed or incomplete healing, and infections [1,17].…”