Warning: Dis tori get graphic details wey fit disturb some pipo.
“I bin fear di idea say dem go cut me again, even though dis time na wit my permission. But I bin need to do am for my mental health.”
Shamsa Sharaawe dey tok about her decision to do reconstructive surgery afta dem cut her clitoris and vulva troway 25 years ago wen she be only six years old.
Na her family members and one traditional midwife do di female genital mutilation (FGM) for Somalia for house.
E pass 230 million girls and women wey don face FGM all ova di world, dis na according to one recent Unicef report.
For Africa alone, di report say e don happun to ova 140 million women and girls.
For Somalia, Guinea and Djibouti, most girls dey go through FGM, like 90% of di population. Di belief for dis kontris be sa FGM go make sure say di girl remain a virgin, something wey dey important well-well locally.
Many pipo for di Somali community believe say virginity of women and di family honor dey connected. Dem believe say di family honor go dey intact if dem make sure say di girls go through cutting.
Plenti pipo for Somalia dey see women wey no do FGM as pipo wey get loose morals or high sex drive wey dem believe say go scata di reputation of di whole family.
Wen she dey grow, Shamsa say she bin face ogbonge pain wen she dey on her period.
She say, “I no ever wan feel pain again.”
For late 2023, wen she be 30, Shamsa decide say she go find out if she fit get reconstructive surgery to end di pain.
By now, she don dey live for UK and don turn loud social media activist speaking out against genital cutting.
To sabi say many women wey don go through wetin she face no know weda dem fit do anything to improve dia quality of life make am ginger to share awareness about di surgery.
Shamsa say, “not enough informate dey outside about di surgery gan-gan. Na why I dey tok about am.”
Clitoral reconstructive surgery na procedure wey dem dey do to improve function, no be so e go fine. How dem dey do am na to reconstruct di clitoris, labia and comot cysts and scar tissue so pain go reduce and to restore di woman sex life.
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Afta plenti research, Shamsa find out say di only possible option for her own surgery na for Germany.
She start to fundraise from one online platform and raise $31,000 (£25,000).
But even wit di generosity of her supporters, some of dem wey neva even hear of FGM bifor, she find out say she still no gada enough money to cover di surgery and her costs join.
For di end, Shamsa spend ova $37,000 (£30,000) to arrange for who go take care of her pikin, her trip go Germany and to do di surgery.
E put am for debt and she still get gbese of 3800 Euros (£3,280, $4045) to pay di hospital.
“I neva fit go back for my aftercare consultation bicos I no fit afford am”, na so Shamsa tok as she neva see any doctor afta di surgery.
“Paying for damage wey be say no be you choose am or no be you do am to yourself dey very unfair.”
Surgical remedy?
Dem be four different types of FGM wey get different levels of seriousness. Type one na di removal of part or all of di clitoris. Type two na di removal of part or all of di clitoris and di inner labia (wey be di inner lips wey dey around di vagina), wit possibility say dem go comot di labia majora (di outer thick folds of skin).
Type three na to reduce di vaginal open by creating a seal wit di labia wey dem cut. Type four, di most drastic na to remove di clitoris, vulva and everytin else comot come sew di remaining tissue join togeda.
Ova di past 20 years, plastic surgeons don develop specific medical techniques to try repair di damage wey FGM cause.
Na for 2004, French urologist, Dr. Pierre Foldès develop di first FGM reconstruction surgery. Since den, oda surgeons start to develop oda kain restoration techniques.
But for Africa, wia di demand dey pass, access to di surgery no too dey like dat. E currently dey only available for Kenya wia patients go pay from dia own pockets or for Egypt wia na NGO’s dey cover cost for some survivors.
For Europe, some kontris dey offer di surgery for low price. Clitoral reconstruction dey covered by public health insurance for Belgium, Germany, France, Sweden, Finland and Switzerland.
According to one FGM specialist doctor for Kenya, reconstructive surgery don turn growing speciality for some western kontris.
Dr Adan Abdullahi wey be surgeon for Nairobi say, “some European and American surgeons dey wey dey do am for diaspora communities. But no be everi surgeon fit do dis surgery. E dey complicated and every patient dey different.”
Dr Abdullahi say women wit all di kain FGM wey dey go benefit from di operation, but di women wey dey get di most relief na di ones wey dey seriously affected di most.
E say, “e get positive effect for childbirth, especially for type three wey get narrowing of di vagina.”
E say di surgery fit improve or cure oda issues like pain during sex, e add say im patients dey often get improved self esteem “and sense of completeness”.
‘Tough on your body’
Haja Bilkisu, a German citizen from Sierra Leone, don do several FGM reconstruction surgeries. She tell oda survivors make dem study wella wetin di surgery fit do bifor dem chook head.
She say, “reconstruction no be just to rebuild di clitoris, plenti women wey dem cut get scars, dem get ogbonge scar tissue. You go need discuss am wit your doctor. How you fit comot di scars? Wetin you fit do to make di vulva to dey more elastic?”
She explain say e no only dey important for sex but also for childbirth.
Each of di surgeries wey Haja do take six hours.
She say, “e dey hard on di bodi for sure. Dem go put you under anaesthesia. You get to take medicine afta. I no fit waka for three weeks total.”
Bicos of wetin operation fit do for pesin bodi, some doctors dey ginger to push non surgical procedures.
Dr Reham Awwad na di co-founder of one clinic for Egypt wey dem dey call Restore, wey dem arrange for 2020 to offer treatments to FGM survivors.
Dr Awwad say wetin inspire am to start her health centre na di case of FGM wey she see wen she be medical intern. E make am do specialist surgical training for treatment of survivors.
She say even though operation fit bring relief, di cutting wey dem dey do fit bad sotay even wit di most ogbonge surgical methods, e no fit do much to bring back function.
She say, “I definitely no tink say surgery na di ansa for everibodi. We don actually reduce di number of surgeries wey dem go need do.”
Dr Awwad say about half di cases wey her clinic dey treat na wit non-surgical treatments wey go increase blood flow to di area. Dis na plus psychological therapies for women wey face genital cutting wen dem bin dey old enough to remember am.
She explain say di few methods wey dey non surgical wey dem fit try na platelet-rich plasma, wey be process wey dem dey use for different fields for medicine.
She say, “di plasma fit cause regeneration and stimulation of increase blood flow and reduce inflammation for di place wey you inject am put,” dis na as she add say di treatment cost well-well and e mean say many of di pipo wey need am no fit access am.
New body
For di pipo wey pick reconstructive surgery, di results fit dey emotional.
For Haja from Sierra Leone, e bin take am time to dey used to her new bodi.
She say “di first time, wey I actually take eye see my clitoris, I shock bicos for me, e no be like e be my own”.
“Dem cut me wen I be eight, I no dey look dat bodi part”.
Now for recovery, Shamsa say even wit all her gbese, she dey happy say she carry money do di surgery.
She say, “Wen I recover, I need to learn how to live wit my new clitoris and vulva.
“But now I sabi how e feel like to be a full woman”.
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