Should war on FGM be intensified in the urban areas?

Last Friday, I posted the following on my Facebook timeline:

Every February 6th is the International Day of Zero Tolerance to Female Genital Mutilation. In Kenya, this year’s national celebrations will be held in Sankuri location, Garissa County.
The theme of the celebrations is “Working Together to End FGM by 2030”.
Ending FGM, My Responsibility.

fgm-photo

 

As I was preparing to go home having finished the day’s work, a male colleague came to my desk and we somehow found ourselves taking about the International Day of Zero Tolerance for FGM as I had posted. Being aware of the fact that he comes from a community that largely practices FGM, I asked him if he thinks it is possible to stop the menace- his answer left me with a toothache.

‘This thing will not end soon Lourdes. People are coming up with creative ways of doing FGM every other day. For example doing it at a younger age to reduce public scrutiny while taking advantage of the child’s inability to resist and because there must be a form of celebration, it is done in the disguise of a birthday party and only very close family members are aware of the real celebration’

I looked him straight in the eye and asked, ‘would you allow your daughter to undergo the cut?’

 
His answer left me with a bitter taste in the mouth.

‘We are not talking about me here but again, what would I do? Remember she has a mother and even if I resist, her mother will report me to our family members thus turn me against them. I will look like the bad one here- if she insists, I will just have to corporate for peace sake’

This clearly explained why urban women are more likely to be circumcised at the youngest age range of 5-9 years than rural women.

 
According to UNICEF, 9.3 million women and girls, or 27 per cent of all women and girls in Kenya, have undergone genital mutilation, placing Kenya 17th among the 29 countries in Africa that carry out the practice.

fgm
As the world marks the International Day of Zero Tolerance for FGM, statistics reveal the war against the practice is far from over, with a trend over time to circumcise girls at increasingly younger ages. In some parts of the country, infant FGM is being practiced on days-old girls. This is because they want to keep it a secret and therefore do it fast enough before the law catches up with them.

 
FGM causes significant health risks including bleeding, infections, and fistula, complications during sexual intercourse and childbirth, and even death.

 
To preserve our next generation, this should be the rallying call: ‘Ending FGM, My Responsibility’

fgm-by-numbersStatistics courtesy of The Daily Nation

The encouraging state of maternal health in Rwanda

Every day, 800 women around the world die for reasons related to pregnancy or childbirth. And some 5.7 million women annually suffer severe disabilities following childbirth.

But there’s another positive side to this story. Maternal mortality has generally decreased by half since 1990 and this includes even in places that are extremely poor. New technologies and health care approaches, better infrastructure, and creative government policies are changing the odds for pregnant women and their families.

Someone dear to me will be traveling to Rwanda soon and that, together with my passion for Maternal, Newborn and Children health ignited me to acquaint myself with the state of maternal and children health in this country of a thousand hills, which my French brothers will call “Pays des Mille Collines”.

I was pleased with the facts  that I got. I know you have an idea of this country, Rwanda, but allow me to refresh your mind a little. Between April and June 1994, an estimated 1 million Rwandans were killed, 2 million displace and health systems destroyed in the space of 100 days.

map-of-rwanda
Despite that, Rwanda’s maternal mortality ratio decreased by 77 percent between 2000 and 2013 and currently stands at 320 deaths per 100,000 live births. Under-5 child mortality also reduced by more than 70 percent making it one of the few African countries to meet goal 4 and 5 of the Millennium Development Goals in 2015.

rwanda-matertal-mortality-ratio

Many factors created this success story:

  • Rwandan government subsidizes a national health insurance scheme, which has led to increased use of family planning, prenatal care and health facilities.
  • Midwives and other clinical officers are trained in emergency obstetric care.
  • Women are fined for giving birth at home, and doctors are financially rewarded for high quality obstetric care.
  • Rwandan clinics have focused on improving their quality. Many strive to keep regular clinic hours, well-staffed and supplied clinics, good hygiene practices and respectful staff.
  • By 2012, there was one doctor per 16,000 people and one nurse per 1,300 people. Before 1997, Rwanda had no trained midwives, but now there are around 1,000. Rwanda established new standards for quality of care, and in 2010, delivery by a skilled provider was at 69 percent, as was delivery in a health facility
  • Rwanda’s government is committed to providing universal health care as part of its Vision 2020 Strategy.

In 1995, most development agencies were ready to give up on Rwanda, then one of the poorest and most vulnerable countries in the world. But now, Rwanda is one of the few countries on track as far as maternal, newborn and children health is concern. Mine is to say kudos Rwanda. Kenya is behind, but i am positive we will get there too…someday!

kenya-maternal-mortality-ratio

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