The aim of this chapter is to give insight into the purpose of this study and to state clearly the problem that led to this study. The first section is the background to the study which will help create a better understanding of the variables involved in this study. The second part will identify the gaps which exist in literature that has led to this study and clearly discuss these gaps. The last sections will discuss clearly the objectives of this study and the key terms that will be used in this study will be defined.
1.1 Background of the Study
Genital mutilation has been observed to have negative health effects on females especially in developing countries such as a Nigeria where circumcision is commonly practiced (Rigmor, Vigdis, Jan, Atle, and Gunn, 2012). Women and girls living with FGM have experienced a harmful practice. Experience of Female Genital Mutilation increases the short and long term health risks to women and girls and is unacceptable from a human rights and health perspective (Adinma, 2007). While in general there is an increased risk of adverse health outcomes with increased severity of Female Genital Mutilation (FGM), WHO is opposed to all forms of FGM and is emphatically against the practice being carried out by health care providers (medicalization). Female genital mutilation (FGM) comprises all procedures involving partial or total removal of the female external genitalia or other injury to the female genital organs for non-medical reasons as defined by the World Health Organisation (WHO, 2015).
The centuries-old practice of female genital mutilation/cutting (FGM/C), also known as female circumcision, is a culturally sanctioned practice that consists of “all procedures involving partial or total removal of the female external genitalia or other injury to the female genital organs for non-medical reasons”. According to the WHO typology, there are four main types: type I (clitoridectomy), type II (excision), type III (infibulation or pharaonic circumcision), and type IV, which is used to describe all other harmful procedures to the female genitalia in the absence of medical necessity (Balk, 2000). The nomenclature for the practice varies across regions, ideological perspectives and research frames, and one could use the expression preferred by UNICEF and UNFPA, two central policymakers in the global effort to end the practice, ‘female genital mutilation/cutting’ (FGM/C). Wade (2015) explains that Western efforts to end FGM/C since the early 1970s has relied primarily on two frames that have influenced the discourse of FGM/C and, in turn, the ideological contestation over the practice. In addition to the women's right frame, a dominant frame has been that the practice involves physical and mental harm.
Obermeyer (1999) observed that, despite the vast volume of publications, relatively few correspondences on female genital mutilation were of reasonably good quality. He indicated that serious problems such as haemorrhage, shock or septicemia occurred in 0-3% of cases that infections and urinary symptoms ranged from 0-15%, and various scars and cysts ranged from 0-12%. Concerning reproductive health problems, such as those connected with labour and delivery, infertility, and sexual function, there was much less evidence, reported frequencies ranged more widely, and it was difficult to gain a good understanding of the effect of the operations on reproductive health (BonessioL. Bartucca, Berelli, Morini, Aleandri and Spina, 2001). Current practice shows a degree of diversity, reflecting the debates that have been ongoing for decades. Obermeyer (1999) reported that circumcision of female has a negative health effect on their sex organ. He appears to equate the operations performed on women with those performed on men, which are in fact considerably less extensive; and mutilation because it imputes to parents and practitioners motivations to inflict harm. Since that time, the expression female genital cutting has come into use, because it seems to provide a less specific and more neutral way of talking about the operation; it remains however awkward when talking about "cut" women (BonessioL, et al., 2001).
Indeed, for close to a century, observational studies, supported by biological theories, have suggested a negative association between FGM/C and various health outcomes. Until recently, the effects of female circumcision on health and sexuality were poorly documented, and the bulk of the literature consisted of general articles decrying the practice, discussions of policies, programmes and activities, and reports of personal experience (Carr, 2007). In the past few years, however, there has been an increase in research on the health effects of female circumcision, and an expansion of the scope of studies beyond strictly defined health complications, to include sexual effects. This is an opportune time to take stock of the available evidence as this present study will focus on the health effects of female genital mutilation.
1.2 Statement of the Problem
In Nigeria, especially in Ethiope East L.G.A of Delta State, female genital mutilation has been perpetuated over generations by social dynamics that make it very difficult for individual families as well as individual girls and women to abandon the practice. Even when families are aware of the harm female genital mutilation can bring such as severe pain, excessive bleeding, infections, Human Immunodeficiency Virus (HIV), urination problem, Psychological consequences, shock, menstrual pain, obstetric fistula, death, etc. They continue to have their daughters, circumcised because it is deemed necessary by their community for bringing up a girl correctly, protecting their honour and maintaining the status of the entire family (WHO, 2008).
Acknowledging that the tradition brings shame and stigmatization upon the entire family and prevent girls from becoming full and recognized members of their community if not practiced, people out of ignorance tend to fall prey this weak traditional practice. These among others have brought serious problems to females in Ethiope East L.G.A of Delta State especially those in rural areas.
From the aforementioned problems, it could be observed that female genital mutilation brings with it its attendant health problem as well as negative effects on the female gender. This study will address the above mentioned problems and recommend appropriate measures to control its practice in the study area.
1.3 Aim and Objectives of the Study
The aim of this research work is to examine the health effects of female genital mutilation in Ethiope East Local Government Area of Delta State.
In order to achieve the above stated aim, the following objectives were designed to guide this study;
- To examine the diseases associated with female genital mutilation in Ethiope East L.G.A of Delta State;
- To examine the major reasons behind the practice of female circumcision in Ethiope East L.G.A of Delta State; and
- To discuss possible ways to address the problems associated with the effects of female genital mutilation in the study area.
1.4 Research Hypothesis
The following stated null hypothesis will be tested in this study;
- Female genital mutilation has no significant effect on the health of female inhabitants of Ethiope East L.G.A of Delta State.
- The practice of female genital mutilation is not significantly dependent on religion, preserving the women virginity, etc.
1.5 Significance of the Study
This study is significant to the inhabitants, research institutions, the government and other policy makers. The study will go a long way in helping government at local, state and federal levels and other policy makers in indentifying the problems, causes, effects and solution to female genital mutilation and its adverse effect on human health.
The study is also significant because it makes for awareness of the facts that man is the architect of his own fortune. The work will discuss the need for greater care of the female gender towards preventing them from having grievous health effects as a result of female genital mutilation. It will serve the needs of many readerships, which is not only limited to Ethiope East L.G.A indigenes but to geographers, and the entire society of academia.
1.6 Study Area
The study area, Ethiope East Local Government Area is located in Delta State and in the Niger Delta (South-south geopolitical zone) region of Nigeria. The description of the study area: Abraka will be done in the following sub-headings:
1.6.1 Location and Size
The study area, Ethiope East is located in Delta State, Nigeria. It is situated in the Southern part of Nigeria which has abundant rainforest vegetation and it’s characterized by evergreen deciduous forest vegetation (Efe, 2006). The region lies approximately on latitudes 050 451N of the equator and longitudes 060 001E of the Greenwich meridian (Alaskis, 2000). Ethiope East L.G.A covers a total land area of about 239.53 square kilometers (92.5 square mile) (Alaskis, 2000).
Ethiope East L.G.A is bounded by Orhionwon Local Government Area of Edo State in the north, bounded on the east and south by Ukwani and Ughelli North Local Government Areas of Delta state respectively and lastly it is bounded on the west by Ika Local Government Area of Delta State (Akinbode and Ugbomeh, 2006).
Ethiope East L.G.A of Delta State consists of ten (10) regions which includes Abraka, Agbon, Isiokolo, Samagidi, Kokori, Oviere, Okpara-Inland, Okpara-Waterside, Eku, and Ewu. These communities have common relationship and different kingship institutions and kingdom (Aweto, 2005).